The tooth surface must be thoroughly cleaned prior to the placement of the sealant. Cleaning can be accomplished using hydrogen peroxide, a toothbrush, a prophy cup or brush, or a prophy jet. Products containing fluoride and/or glycerin are contraindicated and should not be used to clean the tooth.
Isolation is the most critical issue in the proper placement of sealants. If the surface of the etched tooth is contaminated by saliva, the resin material will not adhere because the remineralization process begins as soon as saliva touches the etched surface. Sealant loss and immediate failure of retention are most often linked to moisture or salivary contamination. Rubber dam is the ideal method for tooth isolation for sealants, but it is not always possible or appropriate for young children. Cotton rolls, dry field pads, dry field kits, and single tooth isolation are all used with success
Etching the surface of the tooth, also called conditioning, is accomplished by using 38% orthophosphoric acid. The acid use in etching the tooth has the additional benefit of killing the bacteria in the pit and fissures.
After etching for 20 seconds, the surface needs to be rinsed with water to remove the acid. Suction and air should be used to thoroughly dry the etched tooth surface. Again, it is extremely important to avoid salivary contamination.
The sealant material should be placed only in the pits and fissures. Too much material can result in occlusal interference. Although occlusal interference is not a concern, the amount of material should also be limited when sealing pits and fissures on lingual and buccal surfaces.
After the light cured sealant material is applied and the operator is satisfied that all surfaces are coated using the correct amount, the sealant should remain undisturbed for 20 seconds before applying the curing light.
Immediately after the material has cured the sealant should be evaluated for retention, flaws, and occlusion. Use an explorer to check for retention and flaws.
Our priority is to provide our patients with a full dental care service at the highest level.