Module 6

Question 1

what is the ideal isolation method for placing a fissure sealant

Answer 1

• rubber dam

- it is the ‘gold standard’

Question 2

what are alternative methods for isolating the tooth other than rubber dam

Answer 2

• cotton wool rolls
• saliva ejector
• parotid shield

Question 3

how is the tooth cleaned

Answer 3

• clean occlusal surface with pumice and water slurry = slow speed, rubber cup, brush
• rinse with 3-in-1 water spray

Question 4

what etch is used for fissure sealants

Answer 4

• 35% ortho-phophoric acid on occlusal surface

Question 5

how long is etch left on for

Answer 5

• 20 seconds

Question 6

how is the etch removed -

Answer 6

• wash off with 3-in-1 water spray

- dry tooth with 3-in-1 air spray

Question 7

what should the tooth surface look like after being etched

Answer 7

• frosted

- chalky white appearance

Question 8

what is the sealant applied with

Answer 8

• micro-brush
• brush
• probe
• small excavator

Question 9

what is the usual time for light curing the sealant

Answer 9

• 40 seconds

- but go off manufactures instructions

Question 10

what do you check sealant for after

Answer 10

• air bubbles
• excess sealant
• if it can be dislodged

Question 11

what od you do if there are air bubbles in the sealant

Answer 11

• remove part of sealant and replace

Question 12

what is the term for extra sealant and how do you remove it

Answer 12

• ‘flash’
• common at distal interproximal
• remove with a probe of dental floss

Question 13

how do you determine if the sealant can be picked off or not

Answer 13

• try to dislodge with a probe
• pick at the edges
• if it dislodges, repeat the procedure

Question 14

how often should sealants be reviewed

Answer 14

• every 6 months

Question 15

how often should a high risk child be reviewed radiographically

Answer 15

• every 6 months

Question 16

how often should a moderate risk child be reviewed radiographically

Answer 16

• every 12 months

Question 17

how often should a low risk child be reviewed radiographically

Answer 17

• every 24 months

Question 18

when should fissure sealants be placed

Answer 18

• on permanent molars as early as possible after eruption

- as soon as you can gain appropriate moisture control

Question 19

what are the two types of sealants

Answer 19

• resin based sealants

- glass ionomer sealants

Question 20

which type of sealant has better retention

Answer 20

• resin

Question 21

what is the standard prevention advice for fissure sealants for all children

Answer 21

• place in all pits ad fissures of permanent molars as soon as possible
• ensure buccal pits of lower first molars and palatal fissures of upper first molars
• check sealants at every recall visit for wear and tear
• top-up damaged sealant

Question 22

when would you use GI sealants

Answer 22

• on fully erupted teeth where child is uncooperative and ensure flouride varnish application is optimal

Question 23

what is the standard prevention advice for fissure sealants for high risk children

Answer 23

• provide standard prevention
• consider using GI on partially erupted 1st and 2nd molars until tooth is fully erupted and can give resin
• fissure seal palatal pits on upper lateral incisors, occlusal and palatal surfaces of D’s and E’s and 1st and 2nd molars

Question 24

what are the options for cleaning the tooth

Answer 24

• wipe tooth with cotton wool pledget, clean with toothbrush but no paste, using a bristle brush with a prophy paste or gently pulling a probe through he fissures to remove debris
• use of 3-in-1 alone is not good enough

Question 25

how do you check the airline is free from water

Answer 25

- blow air onto the mirror surface to reveal any water contamination

Question 26

how far up the cusp of the tooth should be sealed with resin

Answer 26

- a third of the incline of the cusp

Question 27

why must you not let resin to overflow into gingival sulcus

Answer 27

- could compromise the seal

Question 28

why must you wipe the air-inhibited layer from the surface of the sealant

Answer 28

- children find the taste distressing

Question 29

how can you tell if a clear sealant is leaking

Answer 29

- if there is opalescence visible at the sealant/tooth interface that usually indicates leakage and demineralisation

Question 30

when can a resin sealant be difficult to place

Answer 30

- on a partially erupted tooth, or with a child who cooperation is limited

Question 31

what is the main disadvantage of GI sealant

Answer 31

- retention rates are poor long-term

Question 32

when should you consider using GI sealant

Answer 32

- when child is pre-coperative - when resin sealant is indicated bu there are concerns about moisture control - on a partially erupted tooth

Question 33

what technique is used for GI sealants

Answer 33

- press finger technique

Question 34

how are GI sealants placed

Answer 34

- place a small amount of GI on finger tip and petroleum jelly on the adjacent - wipe tooth surface with a cotton wool roll - firmly apply the finger tip with GI to tooth surface - keep finger in place for 2 minutes - place second finger in the mouth and rapidly switch fingers to allow coverage of GI with petroleum jelly before moisture contamination

Question 35

what are fissure sealants

Answer 35

- plastic coating that are painted on to the grooves of the back teeth

Question 36

what does fissure sealant do

Answer 36

- forms a protective layer that keeps food and bacteria from getting stuck in the tiny grooves in the teeth and causing decay

Question 37

how long do sealants last

Answer 37

- usually last many years but need to be checked regularly to make sure the seal is intact