Fissure Sealants

Question 1

Describe the clinical technique for fissure sealant placement.

Answer 1

• tooth is non-carious
• isolate tooth with rubberdam (gold standard), cotton wool rolls, saliva ejector and/or parotid shield
• clean tooth with pumice annd water slurry
• rinse with 3-in-1 water spray
• etch tooth with 35% orthophosphoric acid for 20secs
• wash off with 3-in-1 water spray
• dry tooth with 3-in-1 water spray and look for chalky-white appearance of enamel
• apply fissure sealant resin to fissure pattern using micro-brush, brush, probe or small excavator
• light cure ~40secs
• do post-op checks (air bubbles, excess/flash, pick edges)

Question 2

When should fissure sealants be reviewed?

Answer 2

review every 6 months

review radiographically as per caries risk assessment:
* high risk 6 months
* moderate risk 12 months
* low risk 24 months

Question 3

What is the SDCEP guidance for fissure sealant placement?

caries prevention

Answer 3

standard prevention:
* pits and fissures of all 6s
* resin-based FS is first choice
* if uncooperative, GIC + Fl varnish

increased risk prevention:
* palatal pits of upper 2s
* O+P+F of all Ds, Es, 6s and 7s