Sealants: basic information, advanced technology

Pit and fissure sealants are an integral part of a perfect preventive program and a proven constituting of oral health care. Sealants, and other preventive measures like as limiting dietary sucrose, the use of fluorides, and the rule of dental plaque are major factors in the prevention of dental caries.

A sealant is defined as an organic polymer (resin) that roll ons into the pit or fissure, and links to the enamel surface. Its object is to provide a physical barrier to "seal off" the pit or fissure, to hinder oral bacteria and their nutrients from collecting within the pit or fissure, to create the acidic environment necessary for the initiation of dental caries, and to fill the pit or fissure as reaching far down as possible. Even when sealant material is worn or cracked away upon the surface around the pit or fissure, the sealant in the deepest aspects of the pit or fissures can remain intact and provide continued protection. The sealant management is esthetic, noninvasive, and performed without anesthetic.

This is also an extremely cost-effective way of prevention for dental patients. Sealants are a practice provided in dental offices through licensed dental professionals ... dentists, dental hygienists, and depending upon the particular state expanded function regulations, dental assistants.

In determining who should receive a dental sealant, the first pace is to assess the caries risk of the individual tooth. Caries risk factors include poor oral hygiene, a cariogenic diet, family history, depressed fluoride intake, pit and fissure anatomy, and any history of caries. Other considerations are the patient's history of preventive care, if they are publicly in the process of orthodontia, and medical issues of the like kind as xerostomia. Keep in mind that teeth should be assessed individually to determine their risk.

If teeth are determined to be caries-free, they can be sealed. Teeth with down-reaching grooves and pits will especially benefit from sealants placed as presently as possible after eruption, plenteous more so than teeth with no reaching far down grooves. Radiographs are helpful prior to sealant placement to determine if interproximal decay is at hand If interproximal decay were not absent then a sealant would be contraindicated. Although studies have shown that sealing incipient decay will arrest it, frank occlusal decay should not be sealed, nor should primary teeth that are shut to exfoliation.

There are certain situations when a sealant would not be recommended: the nearness of behavior management issues, the inability to isolate and maintain a free from moisture field, the presence of decay, pit and fissures that are well coalesced and basically self-cleansing, and any allergies to the sealant material.

Sealants are generally either resin-based or glass ionomers. Resin-based sealants, with their characteristics of pour ability and retentiveness, work exceptionally well and be under the orders of their function for many years when placed fitly Their limitation clinically is that the tooth must be fitly isolated, and contamination must be avoided from one extremity to the other of the procedure as it can spring in failure of a resin sealant.

Glass ionomers are an alternative to resin sealants, and can be considered for use in certain situations. For example, when dealing with patient management issues, glass ionomers can be used with primary molars having far down pitted or fissured surfaces that are difficult to isolate. Other situations would be permanent first or next to the first molars that are not however fully erupted, or situations where a "transitional" sealant can be considered prior to the placement of a resin sealant. In other situations beyond these special cases, resin sealants are preferr because of their demonstrated superior cord strength and retention.

The standard operation of using an explorer, visual examination, and radiographs to determine caries is greatest in quantity commonly used to determine the ne of a sealant placement upon a tooth surface. A fresh technology that is becoming popular is the DIAGNOdentAE through Kavo, which uses laser fluorescence directed to the occlusal surface to determine demineralization and caries. If the tooth is determined to be appropriate for a sealant, the decision must be made if a resin-based or glass ionomer sealant will be placed.

If using a resin-based sealant, isolation of the tooth and avoiding contamination of the surface during the manner of proceeding is extremely important. Using the traditional technique of sealant placement, the process is as follows:

* Clean, isolate, and free from moisture the selected teeth.

* engrave for 15 seconds with phosphoric acid.

* Rinse thoroughly.

* free from moisture tooth until "frosty."

* If chill appearance is not obtained, apply etchant again, rinse and dry

* Apply sealant.

* Light-cure. * Check for coverage.

* Wipe not upon air-inhibited layer.

An alternative to the traditional technique is using a self-etching adhesive instead of phosphoric acid. When considering this treatment, it is important to know the effectiveness of the adhesive ligament to uncut enamel. Adper[TM] Prompt[TM] adhesive from 3M ESPE is unique in that its acidic nature provides a high ligature to both cut and uncut enamel surfaces without having to first engrave the enamel, making it ideal for sealant placement. This alternative sealant technique, which does not require a rinsing pace is as follows: