Primary Preventive Dentistry by Aggarwal Neha G

Author:Aggarwal, Neha G. [Aggarwal, Neha G.]
Language: eng
Format: azw3
Publisher: Medtech Publisher
Published: 2019-02-17T16:00:00+00:00

INTRODUCTION Fluorides are highly effective in reducing the number of carious lesions that occur on the smooth surfaces of enamel and cementum. Unfortunately, fluorides are not equally effective in protecting the occlusal pits and fissures, where the majority of carious lesions occur. The placement of sealants is a highly effective means of preventing carious lesions in the pits and fissures in both primary and permanent teeth. A Cochrane systematic review examined the effectiveness of second-generation resins compared with no treatment; the resin-based seal- ants were highly effective in preventing caries in permanent first molars in individuals under 20 years of age, and in chil- dren 5 to 10 years of age. Another systematic review examined the efficacy of professional measures for caries prevention in high-risk individuals; sealants presented an 88% reduction in caries in that population. Sealants present great preventive value when placed correctly and monitored regularly. A sealant is indicated if an occlusal fissure, fossa, or incisal lingual pit is present. When in doubt, seal and monitor is the preferred course of action.

A liquid resin, more commonly called a dental sealant, is placed over the occlusal surface of the tooth where it penetrates the deep fissures to fill areas that cannot be cleaned with the toothbrush (Figure 13-1). The resin then solidifies and, subsequently, the hardened sealant presents a barrier be- tween the tooth and the hostile oral environment. Concurrently, there is a significant reduction of Streptococcus mutans on the treated tooth surface.Pits and fissures serve as reservoirs for mutans streptococci; therefore, sealing the niche reduces their oral count.

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