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Dental Sealants: How Are They Applied
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Your dental professional has recommended that your child get dental sealants placed on their teeth. So what can they expect to happen? What is the process? Do they need to get a shot? All of these questions will be answered after reading how this process is done.

First, the dental professional must be sure that the tooth is cavity-free. They will do this by taking a radiograph (x-ray) and checking for any decay. They also will check the tooth with an instrument. The instrument is called an explorer and they use this instrument by pressing the tip into the grooves of the teeth. If the instrument gets stuck, then a cavity has begun to develop and a sealant will not be able to be done on that tooth.

Next the tooth will be cleaned. A small pointed brush will be used with an abrasive, unflavored paste. This brush is a rotating brush and, when placed on the tooth, quickly removes any debris that may be remaining in the grooves of the teeth. The tooth is then rinsed well.

Next the tooth needs to be isolated from the saliva in the mouth. This is done by placing cotton rolls, dry angles, or something called a rubber dam around the tooth receiving the sealant.

After isolating the tooth, the tooth is dried and an acid etch is then placed on the surface of the tooth for about 30 seconds. An acid etch creates micropores or microscopic openings in the surface of the tooth. This is what gives the sealant something to grab onto so that it can remain in place. This etch material is very bitter tasting and the dental professional will do everything possible to keep it from touching the tongue, but some of the flavor always manages to make its way there anyway. (Keep in mind that if small amounts of this material are accidentally swallowed, it will not cause any harm.)

After the 30 seconds are done, the tooth is rinsed very well and the cotton rolls or dry angles are removed. If a rubber dam is used, it will remain in place.

Fresh cotton rolls or dry angles are placed around the tooth and the tooth is dried completely using an air/water syringe. One of the causes of failure of a sealant is water contamination. If any moisture remains where the sealant is placed, it is just a matter of time before the sealant falls out. (This is why it is very important to be sure that your dental office has at least a one year warranty for replacement of a sealant.)

If the tooth has been successfully isolated with cotton and the tooth is totally dry and has a chalky look to it, then it is ready for the sealant material. A small amount of the liquid sealant is then applied to the grooves of the tooth. An instrument can be used to spread the material throughout the grooves and to make sure it is not on too thick. Once this has been done, the material needs to harden. Some sealants harden on their own over a matter of minutes and others require an ultraviolet light to be shone on them to harden.

The dental professional will then check the sealant for hardness, adherence, and occlusion. If everything is as it should be, then the sealant is complete. Sometimes the occlusion can be off. The occlusion is where the patient closes their teeth and it feels "funny" or "off". A small bur can be used to remove some of the sealant material to adjust this until it feels correct again. If the hardness isn't correct or the sealant isn't sticking to the tooth correctly, the procedure will have to be started over again.

As you can see, the application of a sealant is a painless process, but some children may have some difficulty with the process. The patient must keep their mouth open and cannot get their tongue near the tooth being sealed so there is no moisture contamination. This can be very difficult for some and not a problem at all for others. If you are concerned about how your child would do, ask the dental professional. They will be able to tell you based on how the patient does during routine visits if they will have a difficult time with the process.


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