A barrier to providing sealants is concern about inadvertently sealing over caries. The objective of this meta-analysis was to examine whether sealants are effective in preventing caries progression. Methods: Our search of electronic databases for comparative studies examining caries progression in sealed permanent teeth located 1905 unique records. We ordered 311 articles that met the inclusion criteria. We used a random-effects model to estimate percentage reduction in caries progression in sealed carious teeth compared to not-sealed carious teeth. Findings: Six studies including 4 randomized-controlled trials (RCT) were used in the analysis (1090 surfaces, 840 teeth, and 384 persons). The median annual percentage of non-cavitated lesions progressing was 2.6% for sealed and 12.6% for unsealed carious teeth. The summary prevented fraction for RCT was 71.3% (95%CI: 52.8%-82.5%; no observed heterogeneity). Conclusions: Sealing non-cavitated caries in permanent teeth reduces caries progression by over 70% up to 5 years after placement
