4.2 The Dental-Sealant-Application Process

Step 2: Tooth Isolation

Meticulous isolation of tooth surfaces to avoid saliva contamination is the most crucial step in the sealant-application process. Any salivary contamination following acid etching will result in a weakened bond between the dental sealant and enamel and in poorer chances of retention. Sealant teams that effectively isolate half of a mouth at one time increase efficiency by reducing the sealant-application time.

Follow these steps to achieve proper isolation:

  • Position the child’s head with the chin elevated, tilted away from the teeth to be sealed.
  • Place cotton rolls buccally and lingually to the mandibular teeth to be sealed. Cotton roll holders can help the sealant team isolate half of a mouth rather than a quadrant.
  • Place a buccal dry angle-type shield covering the parotid duct openings opposite the upper first permanent molars.
  • Bend a dry angle-type shield at a right angle, place the shield between the tongue and the lingual cotton roll, and gently hold it in place to isolate the child’s tongue.
  • If saturation of barriers occurs, exchange wet barriers with dry ones in a manner that does not contaminate etched surfaces with saliva, or place dry barriers over moist ones that may be suctioned to remove excess saliva.