ObjectiveThis work aimed to compare the effect of retention and preventive caries of the pit and fissure sealant on primary teeth by using glass ionomer cements (GIC) with or without acid etching technique.MethodsIn this clinical trail, 100 children aged 3-4 years old with a split-mouth design were equally divided into two groups (the left second upper and lower mandibular primary molars were present in group A, and the right second upper and lower mandibular primary molars were present in group B; each group had 200 molars). All participants were placed in pit and fissure sealant with Ketac?Molar Easymix and seated with atraumatic restorative treatmen press-finger technique in the two groups. Group A was subjected to acid etching (40 s, 35% H3PO4), while group B were not subjected to acid etching. GIC preservation rate, caries rate, and decayedteeth (dt) index were observed after 12 months.ResultsAfter a 12-month follow-up period, the completely lost, partially losing, and losing rates of GIC in 86 children (172 second primary molars) were 83.14%, 9.88%, 6.98% in group A and 62.79%, 20.35%, and 16.86% in group B, respectively. The differences between the two groups were insignificant (PPConclusionUsing acid etching technology, the retention rate of the pit and fissure sealant increased, while its losing rate decreased. The retention effect of the GIC was improved, and the dental caries prevention effect was enhanced. Sealant processing was a self-curing procedure that sets without the external energy. Hence, this procedure is suitable for the preventive caries of primary teeth in children.