Dental sealants represent a cost-effective and invaluable preventive intervention, with particular importance in the context of children’s oral health.1 These thin, protective coatings are strategically applied to the occlusal surfaces of molars and premolars, and their importance stems from multifaceted considerations.
First, dental sealants act as a strong barrier against one of the most common dental problems among children: tooth decay. Deep grooves and fissures in the back teeth often provide a favorable environment for food particles, plaque and bacteria to accumulate, making these areas susceptible to tooth decay. Sealants effectively seal these areas, preventing tooth decay.2 It is a non-invasive, painless procedure, making them accessible and comfortable for children.3 The app means minimal sitting time, which reduces worry for young patients and their parents or guardians.
Over time, dental sealants play a key role in mitigating costly and invasive restorative procedures such as composite fillings, root canal therapy, and dental crowns. This proactive measure not only contributes to significant savings for patients, but also aligns with our commitment to maintaining the oral health and well-being of patients. By preventing dental problems at an early stage, sealants serve as a wise and insightful investment, offering patients a future free of complicated and costly dental procedures.
As dental hygienists, we commonly come across materials promoting various dental sealant products. Here is a comprehensive exploration of dental sealant options, supported by an assessment of their individual advantages and disadvantages. There are four main classes of sealants in wide use.
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Resin-based sealants
Resin-based sealants are most often used for children. They can be further categorized into resin-filled sealants that contain fillers such as silica, which increases their strength and wear resistance and are suitable for sealing molars and premolars in pediatric patients, and unfilled resin sealants, which they are less viscous, flow more easily into deep fissures and pits, and are suitable for shallow or narrow fissures in primary and permanent teeth.
The main disadvantage of resin-based sealants is the requirement for careful moisture control. This depends on factors such as patient behavior, dental anatomical features, maintenance of an adequately open oral cavity, and the presence of a posterior. Maintaining a moisture-free environment around the tooth during the application process can present challenges.
Glass ionomer sealants
These have gained distinction due to their release of fluoride, making them an advantageous choice for safeguarding the oral health of pediatric patients. They provide additional protection against caries. In addition, they adhere effectively to both enamel and dentin, enhancing their utility for sealing various tooth surfaces.
However, the disadvantage associated with glass ionomer sealants is related to their preservation. Studies have shown that these sealants exhibit a retention rate that is significantly lower compared to their resin-based counterparts. The average retention rate for glass ionomer sealants is approximately 8%, in stark contrast to the strong 76% retention rate seen with resin-based sealants.4 This highlights the need for careful monitoring and possible reapplication in clinical practice.
Resin-modified glass ionomer sealants
These sealants fuse the properties of both glass ionomer and resin-based materials, presenting an amalgam of improved tensile strength and superior adhesion compared to conventional glass ionomers.4 Potential disadvantages are limitations in long-term durability, susceptibility to moisture-induced complications during placement, and relatively reduced wear resistance.
Resin sealants modified with polyacids (compomers)
These release fluoride and exhibit good adhesion properties. They are used in pediatric dentistry to protect against caries while benefiting from the release of fluoride. This particular sealant exhibits a comparatively modest fluoride release capacity compared to other options.4 This type of sealant is inherently hydrophobic, requiring careful moisture control at the point of application to ensure optimal adhesion and performance.4
Choosing an optimal dental sealant for pediatric patients depends on the evaluation of many factors—the child’s age, dental anatomy, caries risk profile, and clinician preference. In this process, experienced pediatric dentists and dental hygienists play a key role. They evaluate these considerations to discern and ultimately prescribe the most prudent type of sealant. In doing so, they ensure not only effective tooth decay prevention, but also strong oral health and overall well-being for their pediatric patients.
bibliographical references
1. Amilani U, Carter HE, Senanayake S, Hettiarachchi RM, McPhail SM, Kularatna S. A scoping review of cost-effectiveness analyzes of school-based caries interventions. Comm Dent Oral Epidemiol. 2020;48(5):357-363. doi.10.1111/cdoe.12553
2. Paglia L, Ferrazzano G, Beretta M. The role of filling holes and fissures in caries prevention. Pit crack sealants. 2018? 2: (53-68). doi.10.1007/978-3-319-71979-5_4
3. Desai H, Stewart C, Finer Y. Minimally invasive therapies for the management of dental caries—a literature review. Dent J. 2021; 9(12):147. doi.10.3390/dj9120147
4. Colombo S, Beretta M. Dental sealants part 3: Which material? Efficiency and effectiveness. Eur J Ped Dent. 2018;(19):247. doi.10.23804/ejpd.2018.19.03.15
Samantha Farrar, DHS, MPH, BSDH, RDH, is a qualified hygienist with a PhD who excels as a clinician, educator and examiner. With a particular passion for pediatric dentistry and research, she brings 18 years of invaluable experience to her practices. As an adjunct faculty member at the College of DuPage, she is dedicated to shaping the next generation of dental professionals. Driven by her commitment to the advancement of oral health, she continually strives to improve dental care for patients of all ages.
Editor’s Note: This article appeared in the January-February 2024 print edition of RDH Magazine. Dental hygienists in North America are eligible for a free print subscription. Register here.
