Fissure sealants

This is a learning resource about placement of fissure sealants (dental sealants). See also Wikipedia article on dental sealants.

After the placement of rubber dam around the tooth being treated to ensure moisture control, the operator first cleans and dries the biting surface of the tooth. Then a slightly acidic solution is applied on the tooth to create a rough surface that increases the surface area for better retention of the sealant. Finally, a thin layer of liquid plastic material is painted into the pits and fissures of the tooth. After application of the plastic liquid, blue spectrum natural light is shone on the applied material for a few seconds to cure (set) the plastic. Alternatively, a self-cure glass ionomer cement can be used which is cured via a chemical process, rather than the use of a light. After curing, the plastic becomes a hard, thin layer covering the treated portions of the tooth, which makes these surfaces easier to clean.

Although sealants do wear naturally and may become damaged over time, they have the potential to remain effective for five years or longer, despite the heavy pressures endured by teeth during chewing each day. Longevity of the dental sealants is also dependent on the type of material used for the fissure sealant, which is discussed below. It is believed that bacteria and food particles may eventually become entrapped under the dental sealants, and can thus cause decay in the very teeth intended to be protected.

Fissure sealants should be reviewed annually to ensure that they are retained in the fissures of the teeth. One of the major causes to the loss of sealants in the first year is salivary contamination, therefore it is important to have adequate isolation during the placement of sealants.