A Pit and Fissure sealant ( Dental sealant ) is an adhesive material applied to the occlusal pits Fissures of a Caries producing bacteria. Resin- based sealants and Glass lonomer Sealants are the most commonly used sealing materials.
PROCEDURE
Cleaning the pit and fissure surfaces of the tooth:
The surface of the tooth should be thoroughly cleaned prior to the placement of a dental sealant . Historically, it has been advocated to clean the occlusal surface of a tooth with a Bristle Brush pumice. Use of Prophy paste, especially one that contains Fluoride is discouraged because it may make the enamel surface less reactive to the Etchant, which in turn,will reduce the bond strength. Air Abrasion has also been suggested for the preparation of the occlusal surface before the placement of a dental sealant.
Isolate the tooth:
Adequate isolation is the most critical aspect of the process of sealant Application.Salivary contamination of the surface during or after Acid Etching will have a deleterious effect on the ultimate bonding of sealant to the tooth. A Rubber Dam, when properly placed, helps provide the best, and most controlled isolation. how ever, cotton Roll isolation (CRL) has also been used for sealant Placement.
Etching the tooth:
The most critical step in the procedure for sealant Application is Acid Conditioning or Acid Etching procedure. Acid Etching helps enhance a tooth receptivity to bonding with a Dental sealant. During this critical step, meticulous maintenance of a dry tooth surface is vital to making the bond successful.
Thoroughly rinsing and drying the tooth:
Manufactures of Dental sealants recommend rinsing a tooth for 20-30 seconds to remove the Etchant. A Dental Practitioner should ensure that the rinsing process is long or thorough enough to completely remove the Etchant from the tooth surface. The tooth is that is completely dried will exhibit a chalky, frosted appearance.
Applying the dental sealant:
During sealant Application, all the Caries susceptible Pits and Fissures, Including Buccal pits of the Maxillary molars and Lingual Grooves of the maximum Caries Protection.
A dental sealant can be applied to the occlusal surface of a tooth in a number of ways , with the help of a small Ball Burnisher or an Applicator Tip. Many sealant Kits are available with their own Dispensers; some are preloaded and hence, sealants can be directly applied to the tooth surface.
After the application of the sealant, If you find that there are small bubbles, they should be teased out with a Brush before its Polymerization. Certain sealants have a low viscosity that makes them prone to pooling in the distal pit area of the maxillary molars of a patient. This can be rectified by either applying a sealant judiciously or removing the excess amount with brush.
Evaluation:
The Sealant should be visually and actually inspected to ensure that the Pit and Fissures of the tooth are completely sealed and that there are no voids or bubbles. Attempts should be made to dislodge the sealant with a Dental Explorer. If the sealant is dislodged, the tooth should be carefully inspected to see that no debris has been left in the pits and Fissures, as it might have interfered with the bonding. Small voids in the Dental Sealant can be repaired by adding the material again to the voids.
During a recall examination, it is necessary to reevaluate a sealed tooth surface both visually and actually to see that there is no loss of sealant, voids in the material, and caries development. The need for reapplication of Dental Sealant is usually the highest during the first six months after its placement.
Conclusion:
Dental caries can affect people of all ages. ideally, high-risk patient should take steps to place a sealant on all the posterior permanent teeth upon eruption Proximal Caries or self- cleansing pits and Fissures are contraindications for a Dental Sealant.
It is necessary for a Dental Practitioner to be familiar with the various types of Dental Sealants and the specific method of their application so as ensure optimal treatment outcomes. With proper placement and maintenance, a Dental Sealant can last for years.