4.1 Sealant Material Selection

Sealant Bonding Systems

Since the early days of bonding in dentistry, it has been apparent that bonding to enamel is more reliable than bonding to dentin. Etching for 15 to 20 seconds with 30 to 40 percent phosphoric acid is the standard for successful bonding of sealants to enamel.6

Development of newer bonding agents or adhesives accelerated in the early 1980s and has continued in the years since. These products were developed primarily for restorative dentistry applications to reliably bond to dentin. Bonding systems for restorations that involve both dentin and enamel do not result in bond strengths that consistently exceed those obtained with the traditional system for bonding sealant to enamel.

Dentin bonding systems have been marketed as both total-etch systems and self-etch systems. A total-etch bonding system uses a normal acid etch step, a primer layer, and an adhesive layer (two-bottle system); in newer products, the primer and adhesive layers have been combined (one-bottle system). Self-etch systems combine the phosphoric acid etch with the primer or with primer and the adhesive.7

Use of Newer Bonding Systems with Dental Sealants

  • A one-bottle bonding agent can be used between a previously acid-etched enamel surface and the dental sealant material if, in the opinion of the dentist or dental hygienist, the bonding agent would enhance retention. The bonding agent may enhance retention when placing sealants where moisture control is difficult.5
  • Self-etching bonding agents without a separate etching step may provide less retention than the standard acid-etching technique and are not recommended.5 OOH does not recommend the use of self-etching bonding agents without the separate etching step.
  • OOH does not require the school-based dental sealant programs it funds to use bonding agents and does not recommend using them routinely, because doing so adds time and cost to the sealant-application process. The exception is situations in which the use of bonding agents could enhance retention.