sealant technology. We are possibly at another time of change with the development
of non-rinse bonding. There is evidence that the use of bonding agents during sealant
placement helps reduce the effect on retention of slight salivary contamination. There
is also one small trial showing that sealants placed with non-rinse bonding are as
retentive as those placed following traditional acid etching. Further larger trials are
required to confirm this but the advantages in ease of placement are obvious if this
proves to be the case (258HFig. 6.18).
259H
Fig. 6.18 Fissure sealant placement on a
first permanent molar tooth. (a) Etching
gel applied with a brush; (b) fissure
sealant application after washing and
drying.6.5 TREATMENT PLANNING FOR CARIES PREVENTION
The above summaries of the various methods of preventing dental caries have
highlighted the advantages and disadvantages of the four practical methods of caries
prevention: diet, fluoride, fissure sealing, and plaque control. Each is capable of
preventing caries, but achieving changes in diet and toothbrushing, undertaking
fissure sealing, and applying fluoride in the dental chair are all time-consuming. It is
unrealistic to attempt to use each method to its maximum potential and it is necessary
to agree an overall philosophy. Everyone should receive some advice in caries
prevention and those perceived to be at greater risk of and from dental caries should
receive a more thorough investigation and preventive treatment plan.
Four clear preventive messages are promoted by the Health Education Authority
(HEA) in England (260HTable 6.9). This is the minimum advice. Parents of infants and
young children should be advised on sensible eating habits; the abuse of sugar-
containing fruit-flavoured drinks and the need for meals which will reduce the
demand for snacks. Toothbrushing should be observed in the surgery giving an