The Criteria for Selecting Teeth for Sealants

The criteria for selecting teeth for sealant placement include deep-occlusal fissures, fossae (Figure 21), or occlusal/lingual pits. A sealant may be contraindicated (not indicated) if:

1. a patient’s behavior does not permit the required dry-field to place sealants,

2. an open carious lesion exists,

3. caries exist on other surfaces of the same tooth and restoration will disrupt an intact sealant,

4. a large occlusal restoration is already present.

Figure 21. Deep Occlusal Fissures.

Figure 21. Deep Occlusal Fissures.

The disease susceptibility of the tooth should be considered when selecting teeth for sealants, not the age of the patient. Sealants appear to be equally retained on occlusal surfaces of both primary and permanent dentition. Sealants should be placed on the teeth of adult patients if there is evidence of existing or impending caries susceptibility, such as a chronic diet of fermentable carbohydrates or as a result of a pharmacological or radiation-induced xerostomia.