Many school-based dental sealant programs have opted to use disposable instruments (e.g., evacuator and syringe tips, mirrors, cotton roll holders, bite blocks). Use of disposables eliminates the need to purchase an autoclave and ultrasonic cleaner, which reduces up-front equipment costs, sterilization and testing supplies (sterilizer bags, weekly spore testing) costs, and time spent on testing and maintenance.
The supplies a school-based dental sealant program needs depend upon the method of dental sealant application selected, the decision to use disposable or reusable instruments, and program administrators’ and staff preferences. The table below provides a list of supply categories to consider when making purchases.
Table 4.1: School-Based Dental Sealant Program Supplies
Staff and Student Protection
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Student Treatment
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Sterilization and Disinfection
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Additional Supplies
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| * Available as a disposable ** Not required if disposables are used |
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The cost of purchasing durable equipment (e.g., mouth mirrors, cotton roll holders, trash cans, dishpans, extension cords, tray tables) should be estimated for budget purposes. Programs need to make allowances for replacement in the event of breakages. The annual cost of disposable single-use infection-control materials and supplies should also be estimated.
Many manufacturers produce a variety of dental sealant materials. The material chosen should appear on the American Dental Association’s Seal of Acceptance Program list. This program approves sealant materials based on information about material working time, setting and curing time, depth of cured and uncured thickness, and biocompatibility with the oral environment.
When selecting the dental sealant material for use in a school-based dental sealant program, program administrators should look for cost-effective materials that have prolonged retention properties, self-adjust through normal occlusion, have low solubility in the oral environment, and are simple to apply. Administrators should also carefully select sealants, bonding agents, conditioners, and enamel etchants.
There are four general classifications of dental sealant materials that can be used in school-based dental sealant programs. All are effective at arresting and preventing pit-and-fissure occlusal caries and minimizing the progression of non-cavitated occlusal caries that received a sealant. No sealant material is more effective than the others.1
The four classifications of dental sealant materials include
In terms of retention and effectiveness, no resin type is superior to the others.
School-based dental sealant programs commonly use unfilled resin-based dental sealants. These sealants have low viscosity, which allows for easy flow into pits and fissures. Occlusal adjustments are not required after placement, as any high points in occlusion will abrade with normal chewing.
Dental sealant materials are also available that are partially filled (less than 10 percent). Like their unfilled counterpart, partially filled sealants do not require occlusal adjustments after placement. They have low viscosity, which allows for easy flow into pits and fissures, and they release fluoride that may aid in delaying or preventing the caries process.
Filled dental sealant resins are more viscous than unfilled sealants and offer greater bonding strength and resistance to wear and abrasion. Because they do not abrade rapidly, adjustments to the occlusion may be needed after they are placed.1 Under most state practice acts, a dentist is the only oral health professional allowed to perform this procedure. Occlusal adjustments also require the use of a handpiece and add time to the procedure. These requirements decrease efficiency and increase the school-based program’s equipment and operating costs.
The effectiveness of resin-based dental sealants is technique dependent. To adhere to the tooth, resins require an isolated, clear, dry enamel surface. This can be difficult to achieve if teeth are partially erupted or if the student is uncooperative.
BPA is a component of some dental sealants. There are concerns about systemic absorption of unpolymerized BPA. To date, exposure to BPA as a result of sealant application has proven to be negligible.2 Sealants should remain a part of routine preventive oral health care.
Once a decision is made to purchase a specific dental sealant material, it is important to follow the manufacturer’s application instructions carefully. Placement techniques can vary from one sealant type and one brand to another.
Research on the placement of bonding agents or primers before dental sealant placement has shown improved retention rates, particularly in the buccal pits and lingual grooves.4 The use of a bonding agent, however, adds a step to the application process. This involves applying a bonding agent layer to the tooth surface and then air thinning this layer before the sealant can be placed.
The acid typically used for enamel etching is 37 percent phosphoric acid. Acceptable bonding is obtained if the etchant is in contact with clean enamel for 15 to 20 seconds. Topical fluoride treatments can be applied before dental sealants are placed without impairing the sealant’s retention.5
Other factors to consider when selecting dental sealant materials include
Since school-based dental sealant programs cannot carry large volumes of supplies from school to school, a central storage location is needed. Supplies are sent to the program from central storage, as needed. For programs located in rural areas, supplies can be shipped directly to the home of a staff member. Stored supplies should be kept off the floor on palettes or shelves.
Climate should also be considered, particularly in areas of the country with extreme temperatures (hot and cold). Some equipment and supplies should not be stored in vehicles during the day or overnight. Be sure to carefully follow all storage instructions for each set of supplies and equipment.
Supply costs vary among school-based dental sealant programs because each program operates differently, selects different supplies, and uses different purchasing processes. When planning a program, however, an estimate of supply costs is helpful.
