Dental sealants provide a different form of preventive care.  Composed of a plastic material, they are applied to pits and fissures of occlusal and buccal/lingual surfaces of teeth to act as a shield to prevent food from becoming trapped and to arrest demineralization.  With proper application, and provided that the sealant stays in tact, it can protect teeth from decay for years.

The success of this treatment hinges on the correct identification of at-risk teeth as well as achieving long-term retention.  Although occlusal surfaces typically retain the properly selected and applied sealant, achieving retention on buccal and lingual pits and fissures of molars is generally more problematic.  In addition, challenges are posed by how to handle teeth on which it is difficult to achieve good sealant retention, including partially erupted permanent first molars, second molars and partially erupted premolars.

To determine which teeth are appropriate for sealant application, the practitioner should examine the thoroughly dried occlusal surface of permanent molars and premolars using a dental mirror and explorer to confirm the presence of deep occlusal pits and fissures.

Note that although it is possible to unknowingly seal over active or incipient carious lesions on the occlusal surface, there is no evidence to show that this negatively impacts caries progression.



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