Sealants Exam Questions And Answers Graded A+!!!

Pit and Fissure Anatomy - ANS Ideal place for the accumulation of acid- producing bacteria Saliva cannot clean deep pits and fissures on the molar The pits and fissures on the teeth are so small that even a single tooth brush bristle is too large to enter and clean them Barrier to Caries Development - ANS To provide a physical barrier to "seal off" the pit or fissure To prevent oral bacteria and their nutrients from collecting within the pit or fissure To fill the pit or fissure as deep as possible Indications for Sealants - ANS Patients at risk for dental caries Xerostomia - from medications or other reasons Patients undergoing orthodontics Incipient caries - when the caries is limited to the enamel Teeth Newly erupted - as soon after eruption as possible (ideally less than 4 years) Occlusal contour - when pit and fissure is deep and irregular Caries history - other teeth restored or have carious lesions Dietary patterns Current and past fluoride exposure Ability of patient to cooperate during sealant placement Contraindications for Sealants - ANS Obvious dental caries Any proximal dental caries Insufficiently erupted teeth Primary teeth expected to be lost soon Poor patient cooperation in dental chair Pit and fissures are shallow and self- cleansing Steps to Sealant Placement - ANS Assess/Plan/Prioritize Clean Isolate & dry Apply etch Rinse, dry, evaluate Apply sealant Cure* Evaluate Record Purpose of Isolation - ANS to keep the tooth clean and dry for optimal action and bonding of the sealant to eliminate possible contamination by saliva and moisture from the breath to keep the materials from contacting the oral tissues, being swallowed accidentally, or being unpleasant to the patient because of the flavour Dental Dam - ANS Is the method of choice because the most complete isolation is achieved Is essential when profuse saliva flow and overactive tongue and oral muscles present Combined treatment should be planned Use anesthesia when the application of the clamp cannot be tolerated by the patient Dental dam may not be possible when the tooth that is essential for holding the dam is not fully erupted Cotton-Roll Isolation - ANS Patient position: tilt head to allow saliva to pool in the opposite side of the mouth Place cotton roll holder (Garmer/conduit holder or isolator for mandibular arch) Place saliva ejector Apply triangular saliva absorber over the opening of the parotid duct in the cheeks Take great care to prevent contamination from entering the area to be etched Changing Isolation Materials - ANS Ensure the contaminated cotton rolls do not contact the etched tooth surface and contaminate the area Ensure etched tooth does not come in contact with oral mucosa, the tongue, or saliva The Importance of Adequate Isolation - ANS Moisture contamination is the primary cause for failure of sealant retention! Purpose of Etching - ANS to create irregularities or micropores in the enamel ◼ increases surface area and provide retention for the sealant ◼ allows the sealant material to penetrate into the micropores and create a bond or mechanical locking to remove contamination from enamel surface to provide antibacterial action Types of etching - ANS Phosphoric acid: 15% to 50% (depends on product and manufacturer) Liquid: low viscosity allows good flow into pit or fissure, but may be difficult to control Gel: Tinted gel with thick consistency allows increased visibility and control, but may be difficult to rinse off the tooth surface Semi-gel: tinted with viscosity between the gel form and the liquid allows good visibility, control, and rinsing ease Methods of Acid Etch Application - ANS Liquid etch: ◼ Use a small brush, sponge, or cotton pellet ◼ Apply continuously throughout the etch time to keep the surface moist