sealants Flashcards
CARIES PROCESS
- ________
- bacteria metabolize ______ _________ producing _____ resulting in localized destruction of _____ dental tissues
- microbiological shifts within the oral biofilm upset the balance of the ______ remineralization/demineralization process
- affected by ________ and composition, ________ exposure, consumption of ________, and preventive behavior such as ___________
- whether dental caries progresses, is halted, or reverses depends on a balance between _______ and _________ factors
- MULTIFACTORIAL
- bacteria metabolize FERMENTABLE CARBOHYDRATES producing ACIDS resulting in localized destruction of HARD dental tissues
- microbiological shifts within the oral biofilm upset the balance of the TOOTH ENAMEL remineralization/demineralization process
- affected by SALIVARY FLOW and composition, FLUORIDE exposure, consumption of DIETARY SUGARS, and preventive behavior such as BRUSHING YOUR TEETH
- whether dental caries progresses, is halted, or reverses depends on a balance between PROTECTIVE and PATHOGENIC factors
what is a sealant
- thin resinous coating
- physical barrier to bacteria and carbohydrates
what are the requirements for a sealant placement
- occlusal surfaces only (molars)
- no restorations
- no clinically detectable carious lesions (primary prevention)
- non-cavitated lesions confined within the enamel (secondary prevention)
*HOWEVER AT ODU WE DO NOT SEAL INCIPIENT CARIES
what is the biggest indication for sealants
any patient at risk for dental caries (any age)
what risk factors increase your risk for caries (indicating your need for a sealant)
- xerostomia
- orthodontic treatment
- incipient pit and fissure caries with no radiographic evidence of caries on an adjacent proximal surface
- low socioeconomic status
- high sugar diet
- inadequate daily care
selection of teeth for sealants
- newly erupted teeth; place sealant as soon as tooth is FULLY ERUPTED
- deep pits and fissures
- history of caries/has other restored teeth/other carious lesions
Sealants are more effective in reducing the incidence of _______ caries in primary and permanent _______ of children and adolescents when compared to ___________
Sealants are more effective at reducing ______ compared to no sealant placement
Sealants minimize the progression of _________ occlusal caries lesions (also called ______ or _______ lesions) of the tooth that receives a sealant
Sealants are more effective in reducing the incidence of OCCLUSAL caries in primary and permanent MOLARS of children and adolescents when compared to FLUORIDE VARNISH
Sealants are more effective at reducing CARIES incidence compared to no sealant placement
Sealants minimize the progression of NONCAVITATED occlusal caries lesions (also called INCIPIENT or INITIAL lesions) of the tooth that receives a sealant
if 100 children do NOT receive sealants, how many get caries?
if 100 children DO receive sealants, how many get caries?
what is the reduction rate?
no sealants: 50% do, 50% don’t
sealants: 12% do, 88% don’t!
reduces chances by 76%^
why might BPA be found in dental composites?
- a by-product generated if the sealant/restoration is breaking down in the mouth over time
- trace contaminate from materials used when manufacturing sealants/composites
is BPA used as a formula ingredient in dental materials?
no, ADA research confirmed by direct communications from dental material manufacturers show that BPA is NOT a formula ingredient
do sealants contain BPA? should it be a concern
Sealants can contribute to very low-level bisphenol A (BPA) exposure for a few hours after placement; however, based on current evidence, there is no health concern relative to BPA exposure from any dental material
breathing air exposes people to _______ times more BPA than dental sealants
100
how can dental providers help minimize BPA exposure after sealant placement (6)
Be sure that your curing light is functioning properly
Read and follow manufacturers’ instructions & curing instructions
Use a mild abrasive, or pumice on a cotton applicator or a prophylaxis bristle brush to reduce the possibility of unpolymerized BPA remaining on the surface
Wash the surface of the sealant for 30 seconds with an air-water syringe with suction to remove fluids and debris from a child’s mouth
Have older children and adults rinse with water after curing is complete
list the contraindications for sealant placement
- radiographic evidence of interproximal caries on the tooth needing a sealant
- allergic to the sealant ingredients or resins
- pits and fissures are well coalesced (shallow) and self-cleansing (low caries risk)
- The tooth is not fully erupted
- primary tooth that is about to be shed
- how would you explain the reason/need for sealant placement?
- How would you explain the process to patient/patient’s parent?
- How would you answer the question “How long do sealants last?”
- We will place the sealant in order to prevent cavities from. It’s very important that the sealant stay dry, do not lick it or close your mouth.
- We are going to place a sealant which is a coating that will cover the deep grooves and prevent sugar from getting in there.
- They are not permanent but they can last a while, we will check each appointment. If it needs to be replaced we can do so.
pre existing sealants should be _______
charted
if someone wants a sealant ODU clinic requires:
(4)
- Pt needs BWX with 1 year
- Planned in axiUm and approved by faculty
- Informed consent obtained
- Fee of $8/tooth must be collected prior to placement
what armamentarium is needed for sealant
Curing light
Amber protective eyewear (X3) –one for patient, clinician, and faculty
Mirror and explorer
Dri-aids
Cotton rolls
Bonding agent (L-Pop)
Sealant syringe and tip
Articulating paper
Disposable brush
Handpiece for biofilm removal
Pumice and dappen dish
what is the procedure for sealants (8)
- Remove cap on syringe, twist on tip applicator. Save the cap.
- Perform a prophylaxis with one of the following: Air polisher, Handpiece with a non-fluoride oil free prophy paste or pumice, or a Wet toothbrush
- Rinse well with water
- isolate the tooth with cotton rolls and dri aids; dry the tooth
- Apply universal bonding agent for 15 seconds.
- Dry tooth for 5 seconds.
- Dispense sealant using syringe to cover pits and fissures. (Only a little bit!)
- Light cure for 20 seconds.
in the ODU clinic, after scaling, you will be completing __________ with prophy paste
should you prophy the teeth you plan on sealing?
in the ODU clinic, after scaling, you will be completing SELECTIVE POLISHING with prophy paste
NOOOOOOOOOOOO (prophy paste contains fluoride, can’t mix those, we use a special paste to polish prior to sealants)
after placement of the sealant, what do you do? (7)
- Remove the dispensing tip from the syringe and replace it with the original cap. Place the dispensing tip in the sharp’s container.
- Check occlusion with articulating paper to ensure it is not overfilled
- Tell the patient normal chewing forces will adjust the sealant after 24 hours
- Floss mesial and distal surfaces of the tooth to ensure contacts are open
- Check sealant with explorer to ensure it cannot be removed
- Record in services rendered the teeth numbers where sealants were placed and record on dental chart
- Disinfect curing light, sealant syringe, and amber eyewear and return to proper storage
what is the number one reason for a failed sealant?
saliva contamination, NOT MAINTAINING A DRY FIELD
(maintaining the dry field is the most important thing for a successful procedure)
