4.3 Dental Sealants

Some children with special health care needs may be at increased risk for dental caries because they take medications high in sugar, have special dietary requirements (e.g., they need to bottle feed or snack frequently), or have salivary dysfunction. For some children, anatomical abnormalities affecting the teeth can also increase risk. These children may benefit even more than other children from the application of dental sealants. Children are likely to cooperate with dental sealant application, since applying dental sealants does not require an injection or the placement of a rubber dam.

Children who severely brux their teeth (e.g., because of cognitive disabilities, cerebral palsy, or autism) may not be candidates for dental sealants because of the flattened occlusal surfaces.

Wet-bond dental sealants have eliminated the need to maintain a dry field during the application process. However, isolating the working field may be difficult with some children who have oral motor dysfunction. Efficient and effective suctioning is essential for successful application of dental sealants. The air syringe should be used cautiously, as it may trigger a startle reflex.