Exam 2: Sealants!! Flashcards
Sealants are thin _____ coatings bonded to enamel to act as a physical barrier to bacteria.
resin
What is the most popular type of unfilled resin used in sealants?
Bis-GMA (BISphenol A - Glycidyl MethAcrylate)
If a sealant does have a filler, what is the typical range of % filler in the sealant?
6-50%
What are the two ways to cure a sealant?
1.Chemical 2. Light
When light curing a sealant, it takes ___ seconds, uses visible ____ light, and you hold it __ mm from the tooth.
20 seconds, blue, 1mm
Review: Caries Epidemiology–___% of children 6-19 years had dental caries in their permanent teeth. AND A small group (20%) of kids had ___% of the caries – these are kids in high risk groups
42%…80%
Sealants can reduce caries by ___% at 4 years after placement.
75%!!!
Sealants can ______ the progression of incipient caries up to 70%.
ARREST
When the tooth is partially erupted (and we can’t maintain moisture control), what do we use instead of a sealant?
A Glass Ionomer
ADA Guidelines: The use of _______ is not necessary for the detection of early lesions.
explorers
ADA Guidelines: The clinician should use recent ________, if available, in the decision-making process but should not obtain radiographs for the sole purpose of placing sealants.
radiographs
ADA Guidelines: There are many technologies that detect caries. Recent reviews suggest that these devices should be used only as _______ devices.
adjunctive
ADA Guidelines: These devices should serve primarily as a support tool for making preventive treatment plan decisions in conjunction with ________.
CAMBRA
Risk Factors to determine Sealant Use: Age—Newly erupted enamel needs to undergo a _______ process. Daily acid attacks & surface ion exchange gradually replaces the _______ inclusions with F & more insoluble mineral complexes.
maturation….carbonate
Risk Factors to determine Sealant Use: What are the 2 most caries susceptible teeth?
- Lower molars (50%) 2.Upper Molars (35-40%)….THE REST-it goes highest risk in posterior and lowest risk in anterior.
Risk Factors to determine Sealant Use: Fissures with ______ DO NOT SEAL.
OBVIOUS CARIES
When doing a sealant, these two burs are handy in case of a FISSUREOTOMY!!!
1/4 round bur AND 132F diamond
OWN THIS: WHAT ARE THE 8 STEPS TO APPLY A SEALANT?!?!
- Isolate with rubber dam 2. Cleanse with pumice and brush 3. Rinse and dry thoroughly 4. Apply acid for 20 seconds 5. Rinse and dry completely. If contaminated, re-etch 15 sec. 6. Apply sealant with brush or syringe 7. Cure 20 sec. each area 8. Check retention, occlusion, and contacts
OWN THIS: WHAT ARE THE 8 STEPS TO APPLY A SEALANT?!?!…#1-Isolate with a _______.
Rubber Dam
OWN THIS: WHAT ARE THE 8 STEPS TO APPLY A SEALANT?!?! #2-Cleans with ______ and a brush.
pumice
OWN THIS: WHAT ARE THE 8 STEPS TO APPLY A SEALANT?!?! #3-Rinse and ____ thoroughly.
DRY
OWN THIS: WHAT ARE THE 8 STEPS TO APPLY A SEALANT?!?! #4-Apply acid for ___ seconds.
20 seconds
OWN THIS: WHAT ARE THE 8 STEPS TO APPLY A SEALANT?!?! #5 Rinse and _____ completely. IF CONTAMINATED, re-ETCH for ___ seconds.
DRY!!!…..15 seconds
OWN THIS: WHAT ARE THE 8 STEPS TO APPLY A SEALANT?!?! #6- Apply the ______ with a brush or syringe.
sealant
OWN THIS: WHAT ARE THE 8 STEPS TO APPLY A SEALANT?!?! #7–CURE for ___ seconds in EACH area.
20 seconds
OWN THIS: WHAT ARE THE 8 STEPS TO APPLY A SEALANT?!?! #8-Check retention, ______, and contacts.
occlusion
When placing sealants, working with an _______ will IMPROVE the overall retention rate!
assistant (they help keep it DRY!)
When giving patient instructions: give them a great _____ line and always use ______ encouragement and dialogue, its ESSENTIAL!!!
story line…positive
To isolate the teeth, which method is the best? Cotton rolls? Dri-Angles? Rubber Dam?
Rubber Dam!
When placing a Dri-Angle, the cotton side faces the patient’s ______.
cheek
When pumicing the tooth first, do not use ______ polishing pastes.
flavored
What are the 2 approaches to placing a sealant? (which one is most commonly used?)
1.non-invasive= routine-90%….2.invasive-fissurotomy
The normal % _______ acid in etch is 35-50%.
Phosphoric Acid
Deciduous teeth are etched ___ longer.
2x
Etching makes ______ tags, which will create ________ retention.
resin…micromechanical
If you are going to go the extra mile and use a bond, make sure you use one WITHOUT ______.
Self-etch
When applying the sealant, place it in the groove/pit with the _____ elevation and let ______ flow it evenly.
highest…gravity!
After placing the sealant remove bubbles/voids with ______.
an explorer
Cure the sealant for a minimum of ___ seconds, but Dr. H prefers to cure for _______.
20 seconds…1 minute
WHAT IS THE FIRST THING YOU DO AFTER CURING THE SEALANT???? What are the 3 reasons for doing this?
Rinse the teeth or wipe with gauze!!! 1. Removes Oxygen Inhibited Layer 2. Removes bad taste 3. Reduces BPA exposure (xenon-estrogen)
What are the two burs we use to adjust occlusion after placing a sealant????
1.Ultrafine football diamond 2. #7404 (multi fluted carbide)
Lastly after getting occlusion correct, _____ to check the contacts and give _______ to child AND parent.
floss….home care instructions
How long does the patient have to wait to eat after a sealant?
They don’t! As long as they are not numb…TRY to stay away from hard foods though for a day.
When I enter the sealant procedure into the patient’s chart, I add: the ____, the ____ and surfaces sealed, the ______ and rationale for Tx, how I ______ from saliva and the ______ I used to seal, and that I gave ______ to kid and parent.
date, tooth, diagnosis, isolated, materials, post-op instructions
What is the most common failure of sealants related to? What are some other reasons?
moisture! not enough isolation…then oil from paste or air/water syringe.. not enough etch, and occlusion
Most sealant failures will show up within the first ___-___ months. Where all or part of the sealant will come off.
3-6 months
When checking previous sealants, check for discolorations around the ______ of the sealant and _____ the sealant.
margins….underneath
If a sealant is partially lost: reduce & _______ remaining sealant. Pumice tooth, _____ & reapply sealant. Or remove ____ of remaining material and reapply following the initial procedure.
roughen…etch…ALL
What is a major benefit of the temporary GI for hard to control moisture situations?
Fluoride Release!!
In a GI situation, full eruption of molars can take ___-___ months.
6-12 months.
