Sealants

Added to Handbook: Prior to June 2004
Last updated: September 2013

PURPOSE

To provide guidelines for the assessment and preparation of teeth for pit and fissure sealants by dental hygienists.

BACKGROUND

Dental sealants act as physical barriers and therefore prevent the colonization of caries-producing bacteria in the pits and fissures of teeth. The Scope of Practice Statement describes the dental hygiene scope of practice, which includes the placement of pit and fissure sealants within the implementation phase of dental hygiene care and ongoing evaluation thereafter.

In order to meet the client's oral health needs comprehensively, it is considered best practice for the dental hygienist to collaborate with the client's dentist when treatment planning pit and fissure sealants. In practical terms, a consultation between the dentist and hygienist regarding the selection of teeth for fissure sealants can occur easily in a dental office setting. In dental hygiene practices that are outside the dental office setting, however, such consultation may be more challenging.

POLICY

A dental hygienist may apply pit and fissure sealants provided that the full ADPIE process of care is followed. This would include a caries risk assessment for the client, as well as an evaluation of the continuous vs. episodic dental care accessed by the client. When possible, treatment planning for pit and fissure sealants should be done in collaboration with the dentist.

Consideration for sealant placement should be based on the best available evidence related to the effectiveness of the intervention and on the knowledge of the risk factors and patterns of caries.

There are a variety of sealant materials available and the dental hygienist should use professional judgment when determining which material to use. It is important to follow the manufacturer's instructions for optimum sealant placement and retention.

Dental hygienists may use Prophy-Jet type air abrasion systems to prepare tooth surfaces. However, air abrasion systems that use aluminum oxide may not be used. Cutting hard or soft tissues is considered a reserved act that falls outside of the dental hygiene scope of practice. Air abrasive systems that use aluminum oxide have the ability to cut hard tissue, even at low p.s.i.'s, and therefore should not be used by dental hygienists.

REFERENCES

  • Azarapazhoo A, Main PA. Pit and Fissure Sealants in the Prevention of Dental Caries in Children and Adolescents: A Systematic Review. J Can Dent Assoc. 2008 Mar;74(2):171-7.
  • Beauchamp J, Caufield PW, Crall JJ, Donly K, Feigal R, Gooch B, et al. Evidence-based Clinical Recommendations for the use of Pit-And-Fissure Sealants. J Am Dent Assoc. 2008 Mar;139(3):257-68.
  • Darby LM, Walsh MM. Dental Hygiene Theory and Practice. 3rd ed. St. Louis: Saunders Elsevier; 2010.
  • Wilkins EM. Clinical Practice of the Dental Hygienist. 11th ed. Philadelphia: Lippincott Williams & Wilkins; 2013.