As most dental professionals know, the use of preventive measures on teeth, such as a dental sealant application, can help patients avoid big-time renovation down the road. In fact, the Centers for Disease Control and Prevention (CDC) reports that sealants can reduce the incidence of caries by as much as 80% for up to 2 years, and by 50% for up to 4 years.1Centers for Disease Control and Prevention. Dental Sealants Prevent Cavities. Available at: https://www.cdc.gov/vitalsigns/dental-sealants/index.html. Accessed August 15, 2018.
Dental sealants are like a dose of strong medicine in preventing the ravages of caries, especially in young children. According to the CDC, 1 children ages 6 to 11, who have not received sealant treatment, have nearly three times more first molar caries than their dental sealant-protected counterparts.
Dental Sealant Application
The American Dental Association (ADA) likens sealants to “raincoats for your teeth.” Painted into the pits and fissures on the occlusal surfaces of posterior teeth, they form a protective barrier, shielding teeth from cariogenic bacteria. Dental sealants can even stop the progression of early decay.2Mouth Healthy. Sealants. Available at: https://www.mouthhealthy.org/en/az-topics/s/sealants. Accessed August 15, 2018.
A dental sealant application is usually preceded by a thorough cleaning and etching, and followed by light curing. Some self-etching formulations are now available. But for cases in which the etchant is a separate component, the sealant is typically painted onto tooth surfaces following etching of the enamel for 15 to 20 seconds and rinsing. Some clinicians feel that this technique offers the best results.3Spear Education. Five Key Criteria for Sealant Success. Available at: http://www.speareducation.com/spear-review/2014/03/five-key-criteria-for-sealant-success. Accessed August 15, 2018.
Selecting Dental Sealants
Most of today’s sealants are resin-modified glass ionomer (RMGI) or glass ionomer (GI)-based. GI materials are noted for their ability to release fluoride and for their hydrophilicity, which can come in handy in pediatric patients. But GI-based dental sealants reportedly don’t have as long a retention rate as resin-based formulation.4Olmsted JL. Strategies to improve sealant retention. Dimensions of Dental Hygiene. 2017;15(6):14–16.
Most traditional resin sealants, which contain urethane dimethacrylate or bisphenol A-glycidyl methacrylate monomers, must be applied to a meticulously dry field.5Olmsted JL. Strategies to improve sealant retention. Dimensions of Dental Hygiene. 2017;15(6):14–16.
Striving for Success
According to the ADA, sealants, applied properly, can last for several years before reapplication is needed. For the best shot at effective sealant retention, besides thorough coverage, isolation of the field and constant evacuation are indicated. After all, the number one reason for dental sealant application failure is said to be moisture contamination — and failure can be catastrophic. For this reason, four-handed dentistry, involving an assistant with a high-volume evacuator suction tip makes perfect sense. In addition, employing devices such as dental dams or other kinds of isolation systems, such as the Isolite 3, can help create the right conditions for the sealant to take hold, helping to improve bond strength, which can enhance longevity and help prevent marginal leakage.6Olmsted JL. Strategies to improve sealant retention. Dimensions of Dental Hygiene. 2017;15(6):14–16.
In fact, a Temple University Hospital Pediatric Dentistry Residence Program study7Henig M, McGrath E. White paper. Sealant Placement Efficiency: A Comparison of Isolite to Cotton Rolls. found that the Isolite 3, a self-contained system that provides isolation, suction, retraction, bite block, and illumination in one device, reduced sealant placement time by as much as 25% when compared to a traditional isolation technique, involving cotton rolls, a mouthprop, dry angles and high-and low-speed suction. This time savings can be a lifesaver, especially for clinicians working in pediatric dentistry.
A dental sealant application is like a prescription for good preventive medicine. Because caries can interfere with a child’s speech, eating, sleeping, and learning,8NC Child. School-Based Sealant Programs: An Innovative Approach to Improve Children’s Oral Health. Available at: http://www.ncchild.org/wp-content/uploads/2018/03/FINAL-Oral-Health-Report.pdf. Accessed August 15, 2018. the proper selection and application of dental sealants are imperative to improving the overall quality of life for young patients.