Background and Aim: Although there have been several epidemiologic studies on first permanent molar caries in Iranian students, the need for endodontic therapy has not been investigated so far.
The purpose of this study was to assess the need for first molar root canal therapy in 7- to 11-year-old schoolchildren and its association with age, gender, and parent education level.

Materials and Methods: We selected 885 students (572 girls and 313 boys) from 12 elementary schools, using a random cluster sampling method. We recorded the subjects' identities and examined their maxillary and mandibular first molars with a mirror and an explorer. In case of any doubts about the need for endodontic therapy, we performed vitality tests and/or obtained periapical radiography. Chi-square and Mann-Whitney tests were used for statistical analysis.

Results: In 26 students (3%) there was an indication for endodontic treatment of the first molars. Of these, 18 teeth were in mandible and 8 in the maxilla. The need for endodontic therapy was significantly related to the subjects' age and the parents' education level. We did not detect a significant association between gender and the need for endodontic therapy.

Conclusion: We recommend pit and fissure sealant plus fluoride therapy, beginning with the eruption of the first permanent molars- especially in the mandible.