- Where potential risk factors, such as dietary factors or oral hygiene factors, indicate
a high risk of caries, then all sites at risk should be sealed. - Where there is a doubt about the caries status of a fissure or it is known to have
caries confined to the enamel, fissure sealants may be used therapeutically. After
application, it is essential to monitor the surface both clinically and radiologically.
Sealant use must be based on personal, tooth, and surface risk, and the clinician must
assess these risks since it might change at any time in the life of the patient. So
whereas it was traditionally stated that dentists should complete sealant application up
to a year or two after eruption, he or she should assess the potential risk factors
regularly, and place the sealant, when indicated irrespective of age. Failure rates are
higher when sealants are placed on newly erupted teeth and in mouths with higher
previous caries experience. Monitoring the integrity of sealant is vital in those
circumstances and any deficiencies in a sealant should be corrected (419HFigs. 9.6 and
420H9.7).
421H
Fig. 9.6 This tooth which is too early to seal with resin, should be painted with
fluoride varnish or if the caries risk is very high should be sealed with glass ionomer
until further eruption has taken place.