Dental Sealants: The procedure.

- The individual steps of the tooth sealing process. / What type of material is placed? / Kids, use our inter-active graphic to see how much you've learned.

The steps of the tooth sealing procedure.

All of the individual steps of dental sealant placement.

There are few dental procedures that are as easy, quick and painless as having sealants placed.

And considering that they help to prevent the need for a filling, anyone and everyone should be eager to have this procedure performed. It makes an especially good introductory dental procedure for children.


Step 1 - Cleaning the tooth.

The dentist must first clean the surface of the tooth, otherwise the sealant will not bond to it properly.

The dentist will place a small brush in their dental drill. As the drill spins the brush, they'll use it to scrub the tooth's surface and clean out its grooves.

Variations: After using a brush, if the grooves of the tooth still seem to harbor debris, the dentist may take extra steps.

  • They may use a mini sand blaster. - This is called air-abrasion technique. These units do make some "blowing" noise, and they can be a little messy, but using one on your tooth is painless.
  • The dentist may use their dental drill and buff off the debris. - This is trimming at its very slightest. No anesthetic is required.


The tooth's surface is etched with a mild acid.

Etching gel is applied to the tooth's surface.

Step 2 (frame B) - Conditioning the tooth's surface.

After cleaning the tooth, the dentist will spread "etching" gel over that area where the dental sealant will be placed.

Once they get it positioned properly, they'll allow the gel to sit for somewhere between 20 and 60 seconds and then wash it off.

What does this step do?

The etchant prepares the tooth's surface so the sealant will be able to bond to it (see below).

FYI:

  • Tooth etchants are acidic. If you were to get some on your tongue, it wouldn't hurt but it would taste bitter or sour.
  • The acidic nature of the etchant has the added benefit of killing bacteria that lie at the bottom of the tooth grooves being sealed.
 

An etched tooth surface ready to receive a dental sealant.

Etched tooth enamel has a frosty appearance.

Step 3 (frame C) - Evaluation of the etching step.

After washing the etching gel off, and using their air gun to blow the tooth dry, the dentist will evaluate their work.

The part of the tooth that has been treated should look frosty and dull, similar to the way etched glass looks.

A simple warning.

Once your tooth's surface has been conditioned, it must remain dry for the remainder of the process. If saliva contamination occurs, the tooth must be re-etched. (So keep your mouth wide open.)

What the etching step has accomplished.

The tooth's frosty look holds the key to the whole dental-sealant bonding process.

At a microscopic level, the acidic etchant has dissolved some of the mineral content from the tooth's enamel surface. That means the tooth is now rough rather than smooth (hence the change in its appearance).

The dental sealant is able to stay in place because it can grasp onto (bond to) this roughened surface.

 

Application of liquid dental sealant.

The sealant (a liquid) is dabbed into the tooth's grooves.

Step 4 (frame D) - Applying the sealant.

While the tooth is still dry, the dentist will apply the sealant (a liquid plastic) into the grooves of the tooth.

They might do this using a small brush or squirt it out of a mini syringe.

The liquid nature of the sealant allows it to flow into each groove's nooks and crannies. The sealant isn't necessarily used to fill in the whole tooth surface but instead just those pits and fissures that have the potential to trap and retain debris.

 

The dental sealant is cured.

The sealant is set using a curing light.

Step 5 (frame E) - Curing the sealant.

Once the dentist has the liquid sealant positioned properly, they'll set it using a "curing" light. This is a kind of dental flashlight that outputs blue light.

The color of the light is important because sealing products are formulated with a catalyst that's activated by light having this specific hue.

That means the sealant will stay in liquid form for as long as the dentist needs it to. But once it's been positioned properly, it can be set instantly (in about 60 seconds or so) simply by shining a curing light on it.

 


A completed dental sealant.

The sealant is finished and ready to go.

Step 6 (frame F) - Evaluating the sealant.

Once the dentist has finished curing the sealant, it's fully hardened and ready to be used.

Of course, the dentist will want to evaluate their work. For example, they'll check to see that all of the grooves have been filled in sufficiently.

Two teeth having dental sealants.

Checking the bite.

They'll also need to check the way other teeth bite against the tooth. The dentist doesn't want the sealant's thickness to interfere with the way things normally close together.

If it does, the dentist will buff the sealant for a split second or two with their dental drill, so to thin it out.

Step 7 - The sealing process is now finished.

After it's passed its evaluation, the new sealant is ready to be used. Eating and drinking, even immediately, should pose no problem.

 

OK, time to see how
much you've learned!

How long does the whole process take?

Assuming that the patient is cooperative and the dentist has easy access and good visibility, the process of actually sealing any one tooth might take as little as 5 or 6 minutes, start to finish.

Is that really all there is to it?

Yes that's it, with the exception that your dentist needs to monitor the condition of your sealants at your dental checkups.

 

Tooth isolation during your procedure.

2 teeth isolated by a rubber dam ready for dental sealant placement.

These teeth have been isolated using a rubber dam and are ready to be sealed.

During the sealing process, it's important for the dentist to keep the tooth they are working on dry (this is termed tooth "isolation"). A failure to do so will interfere with the bonding process, and typically results in sealant loss (partial or whole).

The dentist may choose to isolate the tooth by way of packing cotton rolls or gauze around it. Or, as shown in our picture, by placing a "rubber dam" around the tooth, or teeth, being treated.

Rubber dams.

A rubber dam is a sheet of latex. The dentist punches holes in it (one for each tooth) and then fits it over the teeth receiving treatment. Because it separates the portion of the teeth that the dentist is working on from the rest of the mouth, it is easy for the dentist to keep them dry.


What type of sealant material is placed?

  • The most common type of material used as dental sealant is dimethacrylate monomer (BIS-GMA) diluted with a co-monomer. That's a plastic or "resin." It's similar in nature to the materials a dentist uses to create white fillings.

    There are a number of commercially available brands of this type of material that a dentist has to choose from, with no single one (or its proprietary formulation) having been proven to be vastly superior in terms of retention over the others.

  • Other types of materials can be used instead, including glass-ionomer dental cement. But it seems BIS-GMA plastic remains the material of choice.

(Haisch 2013)

Options and variations.

Sealant can be white, clear or colored. White or colored plastics are generally easier to see and therefore monitor. But using clear resin makes it possible for the dentist to visualize what's going on underneath. Some sealant formulations contain fluoride, which is suggested to help protect the teeth on which it's placed.


How much did you learn?

Try to remember what the dentist does at each step of the sealing process. Click the number of each step to see if you're right!

1

2

3

4

5

6

 

Send this test as an eCard.


Talk things up with your child.

Children who have never had a filling placed will have little concept of the type of difficulties the simple task of placing a sealant can prevent. And because of this, they may be unmotivated to offer much cooperation.

If that's the case, what is normally a very simple procedure may become a struggle. Or their lack of cooperation may affect the quality of the dentist's work.

As a parent, you should take efforts (before their appointment) to communicate with your child about the importance of giving the dentist their utmost cooperation. Doing so will improve their experience, and possibly the level of protection their sealant will be able to provide.

 

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