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95 comments:
you still have to RDI if you want to do PRR and sealants ideally.
Catherine Do #122
Rubber dam is almost always a must to keep moisture out. Many times it is a clinical judgement whether we go into dentin for PRR. Less than 20% dentists place sealants even it is in the market for 30 years.
Eric Cheung #110
Ideally, the best time to apply sealants is 6-12 months after the tooth has erupted because that's when it is most susceptible to caries.
Sanam Soroudi #180
It is important that the sealant material we use is opaque, so we are able, clinically and radiographically,to differenciate between the material and future decay underneath the sealant( if any, hopefully no).
Heidi Gonzalez #526
Indications for doing occlusal sealants:
-Following eruption of permanent molar (within 6-12mo after eruption)
-Tooth was no radiographic or clinical evidence of caries
-The tooth can be isolated properly since sealants are very technique sensitive
Amy Dixon #120
Sealants are usually placed on permanent teeth, which have deep pits and fissures. Even though primary teeth have more coalesced enamel and shallower anatomy than permanent teeth, sealants can be placed on primary teeth.
Sealants are placed on permanent teeth soon after eruption (within 6-12 mo.). If more than 12 months have passed since the tooth has erupted, it is still a good idea to seal its pits and fissures.
Raquel Ulma #188
I learned that there is still a lot of controversy over putting sealants over active decay or under no decay at all.
-Carol Kim (138)
To prevent the onset of caries, you can apply a thin coat of sealant material on caries-prone locations such as pits and fissures. If there are signs of shallow lesions, one can perform a PRR...anything deeper would need a Class I prep.
I also learned the proper way to apply sealants
Jun Flores #130
Sealant + PRR = Microrestorative procedures
Only 10-20% of dentists apply sealants to their pt.
Sealant Indications are: 1)Recently Erupted teeth 2)Good isolation 3) Virgin teeth free of decay
Xiang Li #146
Follow-up is an important factor in considering whether we should tx plan sealants.
Tina Duong #125
Sealants are placed on permanent teeth after eruption. Even when teeth already present in mouth for a period of time, we can applyselant on it. And rubber dam is necessary to keep moisture-free.
Tiffany Hsu #529
Sealants & PRRs are technique sensitive, require excellent moisture control, fail over time, and require periodic monitoring & maintenance to prevent caries.
Austin Tung 187
In some cases, glass ionomer may be appropriate to use as a sealant. It is less technique sensitive and useful in teeth that are difficult to isolate. Also useful in patients with high caries rate.
Emmy Le
#142
When a preventive resin restoration “A” is done it may not be necessary to use anesthetic while using a slow speed round bur in the enamel. The thing that may become challenging is placing the rubber dam if the patient is not numb. Definitely, if the PRR ends up as the “B” form into the dentin anesthesia is necessary.
Also if an existing sealant needs touch up work, that can be done by acid etching the margins of the old sealant and placing new sealant right on top of it.
Dave Tajima #181
Things I learned in this lecture are:
1/ You need to put a rubber dam on a patient when you do sealant even if occlusal surface is the working surface because there is a great change of moisture and other contamination w/o a rubber dam.
2/ Teeth that are just erupted have a greater chance of having caries because their enamel has not reached maturation.
Naomi Nguyen, #158
There is often no clear cut line between a preventive resin restoration (PRR) and a conventional posterior composite restoration.
-Apply dental sealants shortly after eruption - for maximum benefit.
-Less is better during sealant aplication (should be a thin layer just to cover the fissures).
-Sealants are opaque clinically and radiographically to distinguish from caries.
Dilshad Abtin #524
A few factoids about sealants seemed to be the most magical to me: 1) only 10-20% of dentists apply sealants regularly, 2) it is critical to monitor sealants over time, 3) isolation is key & 4 hands are better than 2 hands, 4) sealing over caries can sometimes stop the caries process.
Sean Young #192
If a sealant is placed on a surface with active decay, it may change the dinamics of the caries.
Sealants should be applied in a thin coat, because less is better.
Claudia Rodriguez #531
I learned that when doing sealants, you should always try to place a rubber dam, and if you can't, definitely get an assistant to help with isolation. Also, after about 5 years, 70% of sealants will still be intact if they were placed correctly.
Jake Cragun #117
Sealants are THIN plastic coatings placed over pits and fissures to help prevent tooth decay. Successful retention of the sealant primarily depends on dry isolation and careful application of etchant on the occlusal surface of the tooth (avoiding the moist sulcus of the tooth). Although sealants are intended to prevent caries, interestingly, it has been shown that even teeth with intact sealants can harbor caries underneath the material.
C.Chung #112
Jonathan Do #121
There is a constant percentage of permanent molars becoming prone to caries for 4-5 yrs even after a tooth has been erupted for 1-2 years. So don’t rule out usage of sealants even though the tooth may have been mineralized.
Sealant placement can possibly stop the progression of caries by changing the microenvironment of the tooth.
Sonia Lee 145
As far as sealants are concerned, more is not necessarily better. A thin coat is desireable as it will be less likely to fracture with occlusal forces.
Farshid Siami #177
It is crucial to use a rubber dam when applying sealants. If in a situation when a rubber dam cannot be placed and there is no assistant available, or the child's behavior permits you from keeping a moisture-free environment, GI can be used instead. Although, keep in mind GI does have low compressibility and less retention.
Stacy Yu #193
There are 2 types of PRR's. Type A and B. Type A is where caries is incipient and is limited to enamel. Type B is where the caries has minimally extended into dentin.
Also, you must always use a rubber dam if possible when applying sealants.
Regina Espinoza #126
It's imporant to try and place sealants on teeth w/in 12 months of eruption to make them most beneficial. I was surprised to learn so few dentist apply sealants.
Morris Poole #169
A lingering controversy is whether there is a benefit to place sealant over enamel, in dentin, or over active caries. Some research studies report that it stops caries advancement by changing the bacterial environment. However, many practitioners are still uncomfortable with this treatment philosophy. Further evidence-based dentistry is needed in this area.
-Jeanne Wong #195
PRR's are usually placed without anesthesia and isolation is key. Several dentists today don't use sealants and PRR's.
Broc Mushet #156
When placing the etchant, it is important that it doesn't get down into the sulcus b/c it acts as a sponge to absorb moisture and therefore comprimises the sealant.
Sanaz Hamzehpour #132
Type A PRR is confined to enamel while Type B may have caries into dentin BUT NO radiographic evidence of decay. In both cases clinical judgement must be used to determine how deep the PRR needs to be and if it should be converted into a class I restoration.
Liz Miltner #150
The most interesting thing about our sealant lecture was learning about the longevity of sealants. I found it interesting to learn that most can hold up very well for 5 years. The importance of using a rubber dam, when placing sealants, will also forever be engrained in my memory.
Ryan Plewe
#168
I was very surprised to learn that only about 10% of dentists actively place sealants in their patients. It seems that since sealants can reduce caries dramatically on posterior teeth, sealants should be more of a priority.
Michelle Duong #123
Sealants are placed after permanent teeth have erupted and requires adequate moisture control such as a rubber dam in order to properly place the sealant.
A sealant is a thin plastic coating. When placing a sealant, less is better because if it is too thick, it can be subjected to too much occlusal force, causing it to to fail. A sealant may also be used for "micro-restorative" needs.
Joanne Kim, #140
I learned that you can place sealants as soon as 1 year after a tooth is erupted. Also that there is much controversy over exactly when to place a sealant or PRR, or when to leave it alone.
Shannon Lazarian #133
I learned that the majority of dentists do not normally place sealants and that sealants must be placed correctly in order to work effectively and ideally placed 6-12 months after tooth eruption.
Shelby Padua #166
It is really important to keep in mind when placing sealants that more is not better. It is best to have a nice thin layer so there is less chance of fracturing the sealant and you do not introduce interferences in the child's occlusion.
#154
I learned that the success rate of placing sealants with an assistant is much higher that of placing them alone. Also I learned that glass ionomers may be used as sealants in some cases.
Cynthia Morford #153
Moisture control is critical in placing sealants. Properly placed sealants can last for a long time.
Varo Boyajyan #106
I thought that the most important thing about lecture was the fact that rubber dams are REQUIRED for each sealant. One question I had regarding this was if we also needed to give anesthesia when doing each sealant then? Kinda sounds excessive to me... Sean Nguyen #160
I didn't realize that there are 2 types of prr. Having a sealant that is radiopaque is good becaus sometimes the margins will look good when there are problems below. Some clinicians are ok with sealing over caries that are into enamel, but you have to be sure it's not badly into dentin.
That last one was me.
Chris Claus
113
Natalie Nguyen #159:
Sealants ideally placed right after tooth eruption, but data indicate that they can still be placed years later since caries increase with years. ALWAYS USE RUBBER DAM for PRR and Sealants!
Good technique is important in placing sealants as the failure rate is around 30% within 5 years.
Kim Pham #167
Indications for sealants include: a recently erupted tooth, a tooth that can be isolated, no visible evidence of dentinal caries, and no evidence of radiographic caries. Isolation is very important, as there is a predicted 30% failure rate in 5 years due to moisture contamination.
Kevin Omoto #163
Sealant placement is very technique sensetive and critically dependent upon adequate isolation. If you can’t keep it dry or keep it dry and isolated long enough, it won’t work.
Soheil Yashari #191
You can add more sealant to rough margins of teeth sealed years ago. Only 10-20% of dentists today place sealants.
Orly Hendizadeh, #134
When placing etchant on a tooth, make sure that the etchant stays on the occlusal surface of the tooth. Don’t let the etchant runs down the side of the tooth to the gingival sulcus area because the etched side tends to draw fluid to the occlusal surface contaminating the it.
Hoang #135
Sealents need periodic maintenance because of marginal integrity and wear, in addition to the predicted 30 percent failure rates in 5 years because of poor moisture control.
Matthew Moadel, Student #151
Some things to consider when evaluating the quality of the sealant we just placed are: the marginal integrity, are there Pits or voids in sealant?, Are there Overhangs?, and is there Heavy occlusion upon funtion?. Focusing on the presence or absence of these criteria can determine whether or not a placed sealant will remain protective in the child's mouth for the maximum possible duration of time.
Jeff Flores #129
best time to apply sealants is 6-12 months after the tooth has erupted in the oral cavity.
Poonam Rai #530
The best time to place a sealant is 6-12 months after the tooth has erupted. If the sealant fails the most likely reason is because of poor isolation.
The best time to place a sealant is 6-12 months after the tooth has erupted. If the sealant fails the most likely reason is because of poor isolation.
Joshua Cardwell #108
Sealants should ideally be only a thin layer of material so as to not interfere with occlusion. The place we are going for, the fissure, isn't in occlusion anyway.
William Traynor #186
Sealants could potentially trap decay. More research is needed on determining the what the effects are, in containing this decay with a Sealant (stop the caries or allow it to fluorish).
E. Lai #141
In this lecture, I learned that we don't have to use bur in every stained pits and fissures to place PRR. rita 109
Use of a rubber dam is important in placement of sealants in order to prevent contamination and eventual loss.
-Shelton Chow #111
One of the controversies regarding the placement of sealants is whether or not to place them over active caries. Some believe that doing so could help arrest caries.
Rick Shamo #176
While etching the tooth it is important not to etch the tooth too cervically as that may cause moisture to be brought into the area to be sealed, and defeat the perpose of the rubber dam.
The thing that surprised me the most was Dr. Crall's statistic of how few dentists actually place dental sealants.
Thomas #182
The most important things fo me:
1. Using rubber dam is the best way to avoid saliva contamination
2. Using an opaque sealer helps to differentiate between sealer and decay.
Cornel Crasnean #525
Rubber dam is crucial when applying sealants as good moisture control is key to success.Glass ionomers can be used as sealants on teeth that are difficult to isolate.They are less technique sensitive and can be advantageous on individuals with high caries rate.
Amandeep Iqbal
#527.
Prior to this lecture I did not know that it is sometimes possible to seal teeth that show some evidence of caries, instead of doing a traditional restoration. Changing the environment in such a way can stop the decay process. Follow up exams are then necessary.
Diana Craft
115
Occasionally sealants can help prevent progression of mild carious lesions by separating bacteria from the substrate they need to survive inside the lesion.
Bozhena Fisher #128
Sealants should be applied 6-12 months after the tooth eruption.
Jan #533
Sealants are extremely technique - sensitive and require perfect tooth isolation. I learned that they should be placed as soon as the permanent teeth come out within 6-12 months after the permanent teeth come out. There is also a debate over whether sealants ahould be placed over sound tooth structure or over small starting decay or not.
Alina Tiraspolskaya #183
Sealants are a good method of preventive care for children. However, they are technique sensitive and recall exams must be done to ensure quality sealants.
Nick Quach #170
This magic moment...
I thought the most interesting thing is that although sealant placement can be important in preventing decay in caries prone pits and fissures, only 10-20% of dentists actually place them. All I know is that I will definately be in that 10-20%.
Paul Field #127
Sealants should be applied to teeth shortly after they erupt. One of the reasons is that newly erupted teeth have not undergone enamel maturation and so ions from the oral environment can still diffuse into the tooth and modify the tooth surface. Furthermore, the cariogenic challenge begins when teeth first erupt and so it is ideal to have the physical barrier provided from sealants as soon as possible.
Richard Duong #124
Sealants are commonly indicated for permanent teeth, but some times the anatomy of primary teeth is a candidate for it when the grooves are deep and unable to be cleaned by mechanical means (tooth brushing). Note: Sealants a very sensitive to moisture and require great isolation- rubber dam is the desired solution.
Paredes #164
I was surprised that less than 20% of dentists place sealants. I had assumed that it was an almost universal procedure. Indications for sealants are:
-A tooth that can be isolated
-A molar tooth soon after eruption
-A tooth with no evidence of caries (though this is a controversial statement)
Jonathan Miller #149
Glass Ionomer is succesfully placed where isolation is difficult for seallants , its hidrophillic properties and the advantage of fluoride release makes it a good alternative.
The use of 1/4 and 1/2 burs in the prep of more conservative PRR.
I learned that the thinner I apply the sealant material the better the retention and the less I will have to refine the occlusion.
Jared Lee #143
Sealants should be placed 6 to 12 months after eruption of permanent molars. Though they are a great method for preventing pits and fissure caries, they require adequate moisture control in order to be effective.
Robert Busan #107
Up to this date I had not really belived in doing prevention for extension on the occlusal of teeth without active caries. After watching the microscopic picture of the pits and fissures I am convinced that it is an effective way of controlling pathology.
Up to this date I had not yet been convinced in doing prevention for extension. After looking at the microscopic picture of pits and fissure I have realized the effectiveness of prevention of extension on occlusal pits and fissures.
pedram Sooferi
179
PRRs must be done under abselute moisture control and since they are in enamel anesthesia of the tooth can be avoided.
Azadah Ardakany
#101
Sealants are indicated for permanent molars, ideally placed within 6-12months post eruption. Follow manufacturer's recommended steps and keep the site dry.
Jing Lee#144
Less than 20% of dentists place sealants and even less use a rubber dam when doing them. The most important aspect of placing a sealant is isolation from moisture.
J. Oka #162
It is important to place the dental sealant 6-12 months after eruption. This is when the tooth is susceptible to caries, so it would be ideal to seal off the pits and fissures.
#175 Mihir Shah
It is important to use a radioopaque sealant. It is controversial whether or not it is a good idea to seal over small caries.
Trish Barsanti #105
I learned that clinicians disagree about whether to place a sealant under incipient or active decay on a tooth.
#165 NEilesh Patel
Little bit surprised to know that some research show the sealant can arrest the development of caries.
Lei Zeng, #535
The placement of sealants requires proper isolation which is best executed under the use of the rubber dam. It is advisable to place sealants within 6-12 months within tooth eruption and are typically placed on the permanent first molars.
Amy Tran #184
Only small amount of sealant should be placed inside the fissure to avoid occlusal interferences and to extend the life of the sealant.
GI is less sensitive to moisture and can be substituted for sealants in difficult situations but doesn't last as long as composite resin.
Edvin, #100
The ideal time to apply sealants to a tooth is 6-12 months after eruption because that is when a tooth is most susceptible to to caries.
Sydon Arroyo #102
It is best to apply sealants 6-12 months after the eruption of a tooth. It is during this period that there is a greater chance of dental caries; enamel has not fully matured. Also it is interesting to note that there is debate over the placement of sealants.
Niki Zarabian #194
Sealant.
• 95% intact after 1 year
• 30% after 15 years
PRR
• Type A – enamel only
• Type B – minimum dentin involvement
No solid on fissures where caries is only suspected.
Jeffrey Kim 139
Teeth that have recently erupted into the oral cavity are at high risk for caries and can benefit greatly from properly placed sealants. If proper isolation is obtained by placing a rubber dam, and utilizing an assistant, when possible, sealants have incredible success rates over several years. If a sealant becomes compromised with time, new sealant material can be placed directly over the existing remnant sealant.
Jared Martin #147
Moisture control is essential in composite restorations and PRR's.
Sealants should be placed 6-12 months after the eruption of the tooth.
Hamid Shafizadeh #174
I didn't know that sealant can be added to old sealant that has been placed years ago to help seal the margins. Also, most of the sealants I have been placed have just been isolated with drying and cotton rolls, and it never occured to me to use rubber dams to get utmost isolation.
Eric Astani #308
- Sealants should be radiopaque and clinically distinguishable from tooth structure to detect any caries around the sealant
- 10-20% of dentists place sealants (!)
- isolation is critical, so get an assistant
Dan Nelson #157
Sealants are an excellent preventive tool but require adequate moisture control to be effective.
[Colby Smith #178]
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