How many sealants have you placed in your career? Chances are you’re busy drying, etching, and curing sealants every week in addition to educating your patients even more frequently than that. But should you still recommend sealants? And if so, how do you choose which type to use?
The good news is the application of pit-and-fissure sealants is still an effective way to create a physical barrier to pathogen colonization, thus reducing potential for cavities. Studies show sealant retention of 61% five years post-application, with operative factors such as moisture control, tooth surface preparation, and the application of dental adhesives affecting retention rates.1 The latest research shows that the caries disease process is multifactorial and, as such, providing a customized comprehensive caries management program that includes healthy dietary habits, fluoride intake, and sealants is an effective method for achieving oral health.
The history of dental sealants dates back to the 1970s when they were first introduced as a preventive measure against tooth decay. In 2016, the American Dental Association and the American Academy of Pediatric Dentistry (AAPD) developed clinical practice guidelines based on a systemic review of the use of pit-and-fissure sealants on both permanent and primary molars. Results concluded that sealants are indeed effective compared to the non-use of sealants or use of fluoride varnishes and that sealants can minimize the progression of non-cavitated occlusal caries lesions.2
Today, sealants are classified based on their primary composition material and often fall into two categories: resin-based or glass ionomer-based sealants. However, recent innovation and research has shown self-bonding polymer as an additional category and a next generation sealant material, changing how we apply and think about sealants.
Resin-based dental sealants are most commonly used and are made of an organic resin-based oligomer matrix as well as Bis-GMA. This type is typically applied using 37% phosphoric acid etch and achieves polymerization through light-curing. Resin sealants can also be classified as filled or unfilled. Filled sealants contain various shapes of glass particles, helping create a more wear-resistant surface. However, the drawback of filled resin materials is that the sealant liquid is more viscous and thus has a difficult time reaching into the pits and fissures.1
Glass ionomer sealants consist of a combination of glass and acrylic resin and are quickly gaining in popularity because of their ability to slow-release fluoride ions to promote remineralization. Glass ionomer sealants need to be mixed at time of placement and typically rely on a strong acid-base reaction to adhere to the tooth surface. The exception to this are resin-modified glass ionomers and polyacid-modified resins, which set by a combination of acid-base reaction and polymerization. Recent studies from 2012-2022 show a lower retention rate (40%) in glass ionomer sealants after two years when compared to resin sealants (80%).1
The latest innovation in sealant material utilizes a self-bonding polymer gel technology and is applied without mixing or the need for etch or curing light – you simply dry the surface, paint the material on, and buff the excess with a 2×2 gauze. Consisting of Poly Dimethyl Siloxane and invented by a dentist in the 1980s, this completely translucent material automatically chemically bonds to hard surfaces at 1 micron thick (1/70th the diameter of a human hair). As a bonus, it instantly reduces sensitivity when applied to root surfaces, and is hydrophobic in nature, preventing biofilm, calculus, and stain buildup.3
Since the 1970s, dental sealants have been an effective method at reducing cavities and inhibiting the caries disease process. However, retention rates vary greatly based on operative factors such as moisture control and the application process. However, the latest next generation sealant technology includes a self-bonding polymer, allowing an easier application process and biofilm control applications.
References:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149715/
- https://www.ada.org/en/resources/research/science-and-research-institute/oral-health-topics/dental-sealants
- https://dentakote.com/wp-content/uploads/2022/09/SDS-Sheet-DentaKote-Final.pdf
About the Author
Melissa K. Turner, is a fresh force of change and is on a powerful mission to transform the future of dentistry for both patient and practitioner. An award-winning speaker, key opinion influencer, and hygienist, Melissa represents a new generation in dentistry through a focus on inclusion, practitioner well-being, and innovative technology. She is a 2022 recipient of the Sunstar Award of Distinction, the dental hygiene industry’s highest honor, and is a top dental content creator nationwide. She leads the Cellerant Best of Class Hygiene Awards as their Chief Hygiene Officer and Director of Social Strategy. Learn more and contact her at www.melissakturner.com
