Dental Sealants

Chelsea Huntington, RDH, BS

University of Bridgeport, MSDH Student Intern

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Definition

• Sealant- A pit and fissure sealant is an organic polymer (resin) that flows into the pit or fissure and bonds to the enamel surface mainly by mechanical retention when the acid etch process precedes the application of the sealant material.

Purpose of the Sealant

• Provide a physical barrier to seal off the pit or fissure.

• Prevent oral bacteria and their nutrients from collecting within the pit and fissure to create acid and dental caries.

• To fill pit and fissure as deep as possible, providing tight and smooth margins with the enamel.

Purpose of the Acid Etch

• To produce surface irregularities or micropores in the enamel rods.

• To allow liquid resin to penetrate into the micropores and create a retention bond or mechanical locking.

Indications for Sealant Placement

1. PATIENTS AT HIGH RISK FOR DENTAL CARIES (ANY AGE)

a) Xerestomiab) Patient undergoing Orthoc) Patient with Incipient caries (with no

radiographic evidence of caries on adjacent proximal surface) (Dentist will determine)

Indications cont…

2. TEETHa) Newly erupted: place sealant as soon

after eruption as possible.b) Occlusal Contour: when pit and

fissures of posterior teeth are deep and irregular.

c) Mainly posterior teeth, commonly 6 and 12 yr molars and sometimes premolars.

d) Caries History: many other teeth with carious lesions or restorations.

Contraindications

• Radiographic evidence of proximal dental caries.

• Carious lesions that are no longer incipient.

• Low caries risk patients, pit and fissures are well coalesced and easily self-cleansing.

Evaluate Pit and Fissure Sealants

Sealant Application and Procedure

• General Rules:• Treat each quadrant separately.• Use 4- handed dentistry when available.• Success of treatment depends on

precision in each step of application.• Retention of sealant depends on

maintaining a dry field during etching and sealant placement.

Sealant Application

• Tooth Preparation• Remove all debris, deposits and stains.• Cleanse the tooth with either

toothbrush and water, polishing cup with pumice, or air abrasion polisher.

• Rinse thoroughly .

Sealant ApplicationEnsure Proper

Isolation

• Rubber Dam• Dry Angles• Cotton Roll Isolation• Saliva Ejector

• Prepare tooth for etch, by drying for 10 seconds.

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Sealant Application

• Acid Etch• Apply etch only to pits and fissures.

Leave for 15-60 seconds (varies depending on manufacture instructions)

• Rinse thoroughly and suction all remaining etch.

• Dry and examine etched surface for chalky white appearance. ( Repeat etch process if not)

• Dry for 15-20 seconds and maintain isolation.

Sealant Application

• Applying the sealant• Cover all pits and fissures• Do not overfill, spread evenly• Try to break or reduce air bubbles• Light cure for 20-30 seconds• Check for voids • Vigorously use explorer to check retention of

sealant.• Use articulating paper to check for occlusion,

adjust with slow speed hand piece if necessary.

Retention

• Reexamination• Sealants can be retained for many

years, in some patients up to 10 yrs.• Always check sealants at maintenance

visits.• Reseal when necessary (sometimes

removal of existing sealed areas is necessary. Repeat all original sealant application steps).

References

• Esther Wilkins, 2009. Clinical Practice of the Dental Hygienist 10th Edition. © 2009, Lippincott Williams & Wilkins.