4.2 The Dental-Sealant-Application Process

Step 3: Acid Etching

  • Etch the tooth surface with phosphoric acid. Either liquid or gel etchant is acceptable; the choice is at the discretion of individual OOH-funded school-based dental sealant program.
  • Products vary based on delivery method (e.g., syringes with disposable applicator tips, brushes, cotton pellets).
  • Apply etchant at least 2 mm up the cuspal inclines beyond the anticipated sealant margins, including buccal pits and lingual fissures, if free of gingival contact. Leave in contact with each tooth for at least 15 to 20 seconds.
  • Avoid contact of etchant with skin or soft tissue. If contact inadvertently occurs, rinse the skin or tissue immediately with water. (For more information, see "Injury Prevention.")
  • If a tooth is partially erupted with grooves that are not accessible because they are partially covered with tissue, the operator may temporarily seal the tooth with a glass ionomer sealant, which would ideally be replaced by a resin-based dental sealant when the child presents for follow-up the next year. Taking this approach, however, requires that the dental sealant program stock additional supplies. Alternatively, the operator can carefully tease the resin material as close to the gingival margin as possible and add additional material to these sub-gingival grooves during subsequent visits, when the tooth has erupted further.

Step 4: Rinsing and Drying

  • Thoroughly rinse all etchant from tooth surfaces for at least 10 to 15 seconds, using the high-volume oral-evacuation system to help keep teeth free from saliva.
  • Dry teeth until etched enamel appears frosty or chalky. If teeth do not take on a frosty or chalky appearance or are contaminated with saliva at any time, re-etch for 15 to 20 seconds, rinse, and dry.