Paeds Moisture Control and Fl- Varnish Flashcards
What is the golden standard for moisture control?
Dental dam
Why is dental dam generally not used very much in paediatrics?
- Patient may find distressing
- Can be harder to keep it in if there is spacing
- Patient compliance may make it difficult to use clamp
If you were to use dental dam on a paediatric patient, what would be a better tolerated technique of putting it on?
-Split dam technique
What are fissure sealants?
Materials used to obliterate the fissures and remove the sheltered environment in which caries can thrive
Where would you position yourself for fissure sealants in each quadrant?
Upper right - behind
Upper left - behind
Lower left - in-front
Lower right - behind
What can be used to achieve adequate moisture control for fissure sealants?
- dry guards
- saliva ejector
- cotton wool rolls
- suction
Why do we need good moisture control for fissure sealants?
To allow the material to bond to the tooth properly
If there is not adequate moisture control (and therefore the material hasn’t adhered properly) the sealant can become a food/plaque trap and you may end up with caries under or around the border of the fissure sealant
On what surfaces do you place a fissure sealants on:
a) upper 6’s
b) lower 6’s
upper 6’s = occlusal surface, palatal fissure and cusp of Carabelli
lower 6’s = occlusal surface and buccal fissure
When might you use a GIC fissure sealant over a resin fissure sealant and why?
If factors like eruption status and co-operation make moisture control and/or effective placement difficult
Describe the technique for placing a resin fissure sealant.
The tooth surface should be cleaned and debris/plaque removed
Tooth should be isolated (either dental dam or cotton wool rolls)
Surface etched for 20-30secs with 37% phosphoric acid
Surface washed and dried (will need to replace cotton wool at this point)
Resin light cured
Fissure sealant inspected
Describe the technique for placing a GIC fissure sealant.
Can use 20% polyacrylic acid to etc but not required
Tooth isolated
GIC is run into the fissures
Unfilled resin, petroleum jelly or fluoride varnish can be placed to protect the material
How do you assess a fissure sealant?
check sealant is firmly adhered by trying to dislodge
check there isnt any airblows
check no material interproximal
What is the BSPD selection criteria for placement of fissure sealants?
Children with special needs
Children from a disadvantaged social background
Children with extensive caries in their primary dentition should have all permanent molars sealed soon after eruption
If one PFM develops occlusal caries, the rest should be sealed as well as the second primary molars
Children with a caries free primary dentition do not usually require their permanent molars to be sealed
In high risk individuals, what teeth can be sealed?
First permanent molars
Second permanent molars
All premolars
The palatal pit on the upper lateral incisors
