Resin-based pit and fissure sealants are established tools for prevention of dental caries. Conversely, the role of sealants for management of existing early dental caries lesions has been disputed despite the recommendation from the American Dental Association Council on Scientific Affairs. The development of more sensitive caries detection technologies has revealed that many sealants have likely been placed over incipient lesions inadvertently over the years. However, the issue remains whether sealing overt incipient occlusal caries lesions leads to a worse outcome versus restoring the surface. Certainly, there are diverse opinions regarding this topic. But what does the science say? This Critical Appraisal presents evidence from several clinical trials for sealing incipient occlusal caries lesions.