Perform a prophylaxis on the area to be sealed using a prophylaxis paste that does not contain fluoride or oil. Rinse the area thoroughly with water. Once clean, isolate the area with cotton rolls or a rubber dam (inadequate isolation and subsequent contamination is the most common reason for sealant failure). Dry teeth with moisture-free and oil-free compressed air. Apply etchant to the area for approximately 60 seconds. Rinse well and dry with moisture-free and oil-free air. The etched areas should appear dull and frosty-white; if not, re-etch them. Teeth with high fluoride content and some primary teeth may require longer etching times. Etching solutions may not penetrate deep recesses, which also may retain some debris. Therefore, it is suggested that these areas be cleaned and prepared with a bur or air abrasion to allow penetration of the sealant. Do not allow the etched surfaces to be contaminated with moisture, as this may cause the sealant to fail. Apply sealant to the occlusal surface, taking care not to create air bubbles. Cure the sealant with light, or allow it to self-cure, according to the manufacturer’s directions. Once the sealant has set, wipe the surface with cotton to remove the unpolymerized resin. Examine the condition of the sealant at six months and re-apply sealant to any exposed areas.
INDICATIONS AND PRECAUTIONS
Sealants may be indicated for children and adults who
– for a variety of reasons, may be at moderate or high risk of developing dental caries;
– have incipient caries (limited to enamel of pits and fissures);
– have existing pits and fissures that are anatomically susceptible to caries;
– have sufficiently erupted permanent teeth with susceptible pits and fissures.5
The etching solution contains phosphoric acid; therefore, contact with skin, oral mucosa, eyes and dentin should be avoided. In case of contact, the affected area should be flushed with water immediately.
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