Clinical Tips: Perfecting your dental sealants

Sealants. Love them or hate them, they're a part of almost every dental hygienist's expected duty in the practice. Sealants prevent decay; by placing a physical barrier in the deep pits and fissures of permanent posterior teeth, pathogenic microorganisms are kept from colonizing and causing enamel demineralization.¹

Although they play an important role, sealants can present complications for a clinician as most hygienists work as solo providers and have a limited time with each patient. Therefore, it can be difficult to effectively place sealants with only two hands, especially when they are prescribed and completed in a single appointment. What are some tips for hygienists wanting to level up this preventive service?

Product selection

Not all sealant materials are the same, despite their shared purpose. Some contain various types of resin formulations, providing a high degree of strength and durability, while others contain glass ionomer compounds, which are composed of water, polymeric acid, and glass powder. While glass ionomer products may not be as strong as resin, most provide continuous fluoride release, are more tolerant of moisture during placement, and don't typically require a bite adjustment postprocedure. Additionally, sealant materials are available with or without fillers, light-cured or self-cured, and opaque or clear in color. It's important for the clinician to determine which product is best for the individual patient being treated.

Isolation

Moisture control can make or break sealant success, especially when using a hydrophobic formulation that requires an ultradry working area. To ensure a strong chemical bond between the tooth and the material, isolation of the tooth receiving treatment is imperative. Traditional options include the use of cotton rolls and dry angles, but newer solutions offer solo practitioners enhanced control and comfort. These include things like hands-free isolation devices that attach to the high-volume evacuation line, leaf-shaped suction devices with a built-in bite block, and soft absorbent angles that flex with the patient's cheek.

Application technique

We've all seen poorly placed sealants-the bulky mounds sitting on molars, filled with voids and surrounded by jagged margins. How can we avoid these monstrosities? Start by reading the user instructions for the etchant and sealant materials you plan to use. Depending on the manufacturer, the application process and exposure times can vary greatly. It's also important to remember that when it comes to applying the sealant material, less is more. The goal is to apply the least amount of product with the most coverage. Once a very small amount is dispensed onto the occlusal surface, use the tip of the syringe, a micro brush, or an explorer to spread the product and release air bubbles. Many clinicians skip or speed through this critical step, which can result in substandard sealants.

Quality assurance

Another step that is often neglected is checking the integrity of the sealant after it's been placed. Assessing the area for voids, high spots, or loose seals allows the clinician to adjust or repeat the service altogether. Simply completing the procedure is one thing; placing a strong, sound, long-lasting sealant is another. When done correctly, we hope that the patient will enjoy many years of dental health. Sending them home without making sure the sealant will last is unacceptable. Additionally, it's important to reevaluate sealants at future hygiene appointments.

Sealants can be a hassle, but with the right tools and techniques, they can be somewhat enjoyable! Remembering the value of this preventive procedure and the importance of quality care can motivate us to do these simple services with care.

Editor's note: This article appeared in the November/December 2025 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.

Reference

1. Ng TC, Chu CH, Yu OY. A concise review of dental sealants in caries management. Front Oral Health. 2023;4:1180405. Published 2023 Apr 17. doi:10.3389/froh.2023.1180405