By Gordon J. Christensen, DDS, MSD, PhD
The sealant concept was introduced into the dental profession nearly 50 years ago. At that time it was assumed that when a “plug” was placed on the occlusal surface of a tooth that the underlying carious lesions were stopped, thereby eliminating further caries.
Undeniably, sealants have reduced occlusal caries in children, but they could be significantly better. The concept of sealing overt caries in teeth is now highly questioned. The following was noted in a recent ADA statement:
“The evidence supports recommendations to seal sound surfaces and noncavitated lesions ...” (JADA 2009; 140(11):1356-1365).
In our own research, overt, ongoing dental carious lesions were found under almost all previously placed sealants, with some creating near-pulp exposures.
Changes in the sealant technique are desperately needed, including better identification of the presence or lack of caries, much better removal of plaque, stain, and calculus from occlusal surfaces before sealants, and use of low-wear resins as sealants.
Our newest video, “Sealants and Preventive Resin Restorations — When and How” (Item #V5143) demonstrates how to overcome all of these sealant weaknesses.
Vol. 15, Issue 3
Dr. Christensen is a practicing prosthodontist in Provo, Utah, and a Diplomate for the American Board of Prosthodontics. He is the founder and director of Practical Clinical Courses, an international continuing education organization initiated in 1981 for dental professionals. Dr. Christensen is a cofounder (with his wife, Rella) and senior consultant of CLINICIANS REPORT (formerly Clinical Research Associates), which has conducted research in all areas of dentistry since 1976. Dr. Christensen is an adjunct professor for Brigham Young University and the University of Utah.