Applies Pit and Fissure Sealants
Block the niche
Pit and fissure sealants are resin coatings placed in susceptible occlusal pits and fissures to prevent caries. They work by physically blocking bacterial access and food retention. The exam tests patient selection, technique, and the reason each step exists.
Concepts to master
- Indications: deep, narrow, retentive pits and fissures, especially in newly erupted permanent molars and premolars, and in patients at caries risk.
- Cautions: existing caries in the fissure must be evaluated; a sealant does not replace treatment of active decay. Partially erupted teeth may be difficult to isolate.
- Technique sequence: clean the surface, isolate with a dam or other isolation, etch enamel, rinse and dry thoroughly, apply sealant, and cure. Enamel must appear frosted after etching and must stay dry.
- Retention: moisture contamination is the main cause of failure; check the sealant with an explorer and reapply if needed.
- Fluoride timing: polish before sealant placement; avoid fluoride paste immediately before etching because it can reduce etch effectiveness. Follow the product's instructions.
Traps
A frequent trap is the appearance of etched enamel: it should look chalky or frosted. Another is moisture: if contamination occurs, re-etch. Also watch for the claim that sealants are only for children; adults at risk can benefit.
Rule of thumb
Clean, isolate, etch, dry, seal, cure, check. Any step that leaves the field wet defeats the seal.