Resin Based Sealants – The Cons
Glass Ionomer Sealants – Revolutionized Sealants
Michelle Strange: A Tale of Two Hygienists presents this week’s TIPisode: Quick and easy tips to keep you up to date and presented by the experts in the profession. Now, get ready for your unofficial TIPisode, this week brought to you by GC America.
Dr. Jeannette MacLean: Hi. This is pediatric dentist Dr. Jeannette MacLean here with today’s TIPisode on sealants, more specifically glass ionomer sealants with GC America’s Fuji TRIAGE sealant material. This is a product that has revolutionized the way that I do sealants in my practice. I have been placing sealants for more than a decade, and back when I used to use resin-based sealant materials, there were a lot of issues and headaches with that type of material.
I’m going to vent. Perhaps you can relate to these issues. Often, it was difficult if not impossible to achieve the ideal isolation necessary for a resin-based sealant. It has to be perfectly dry, right? Well, a lot of little kids or patients with a heavy gag reflex or special needs patients couldn’t tolerate the isolation necessary to put resin-based sealants. So, a lot of patients who would really benefit from sealants, we couldn’t even get them done, right? Or at least not do quality sealants.
Placing resin-based sealants was time consuming. Often, we couldn’t get it done right then and there at the exam. They’d have to come back for a separate 30- or 45-minute appointment in one of our work rooms versus in the open bay. So there were a lot of sealants that never got done because the parents never bothered to schedule, or they would make the appointment and then no-show or cancel. You know, talk about a waste of time.
Now, on the patients that we could and did do sealants on, sometimes there were issues within or after the appointment. For example, you have to use 37% phosphoric acid etch, which comes in a syringe. We’ve had kids all isolated, ready to go, we bring out the etch syringe, assistant passes it to me, and the kid freaks out. They think they’re getting a shot [laughing], and the whole appointment just goes down the tubes.
We’ve had where, accidently — even though we’re being so, so careful, everything’s isolated, handing everything right — where etch has accidentally gotten on the patient’s lip or face, and then they caused a chemical burn. You feel terrible, right? Has that ever happened to you?
You cannot and should not place resin-sealants on a partially erupted molar. You will not have the proper isolation, there will be saliva contamination, and that sealant is going to fail.
My private practice has been around more than four decades, and a lot of our patients stay with us from the time that they’re toddlers until they go off to college. Well, what I had started to notice over time in my teenage and college-age patients is that often under their resin-based sealants as they, let’s say, chewed ice or hard candies and inevitably that resin material starts to leak or even chip, there was either decalcification or frank cavitation under the resin.
You know, resin is tatted as being so strong and wear resistant, but I finally had an epiphany about five years ago when I realized that resin is basically just plastic. There’s no other redeeming quality to the material other than providing a physical barrier. But the problem is, as it inevitably leaks over time, you can get caries and decalcification underneath.
And then I started looking at the meta-analyses and systematic reviews seeing that glass ionomer sealants were equivalent at preventing caries when compared to resin-based sealants. However, a key difference is that retention of the glass ionomer sealant is not necessary for caries prevention, and that basically blew my mind [laughing]. And, looking into it further, it’s because the material actually acts as a fluoride reservoir and releases and recharges with fluoride.
So, even as the material — the low-viscosity glass ionomer cement material wears in time, it’s still down in the pits and fissures of the tooth acting as a fluoride reservoir and helping to prevent caries. It’s making it more acid resistant and less likely to get decay.
So my practice made the switch to glass-ionomer-based sealants, and we exclusively use GC America’s Fuji TRIAGE sealant, and we’ve never looked back. It’s really revolutionized the way that we do sealants.
The procedure is so simple. The material is hydrophilic, so it actually needs moisture to set. It’s well tolerated by a wide range of patients. We can get them on basically anyone. Kids that we would have never imagined being able to get sealants on before when we used resin, we can easily get the TRIAGE sealants on. The material is biocompatible. It’s the most tooth-like material we have in restorative dentistry. You can place Fuji TRIAGE sealants on partially erupted molars, and the low-viscosity glass beautifully and easily flows into the pits and fissures. And, remember, it acts as a fluoride reservoir.
The procedure is so quick and simple. We typically do it right then and there at the exam. They don’t have to schedule a separate appointment. We don’t have to spend all this extra time. As an example, we can usually get all four first permanent molars done with one capsule of Fuji TRIAGE in under five minutes. It’s awesome.
You know, the kids are happy because it’s quick and simple. The parents are ecstatic because you’re getting it done right then and there. They don’t have to come back. They don’t have to make an extra appointment. The teeth are protected, you’ve saved char time, reduced your supplies and overhead expenses, and increased your production. Literally, everybody wins.
So, if you’re not using glass ionomer sealants yet, now’s the time to make the switch. You won’t regret it.
For more clinical tips on TRIAGE sealants, you can check out some videos on my YouTube channel, which is Affiliated Children’s Dental Specialists. Check out GC America’s website. There’s lots of great information on TRIAGE sealants there. There’s downloads, links to the scientific articles, more videos. Reach out to your local GC America rep. Have them come visit your office and do a lunch and learn. Have them bring you capsules of TRIAGE and let you play with the material. Have them show you the new Fuji TRIAGE EP that’s coming out next month. Lots of great options to help get you started.
Thanks so much for listening.
Michelle Strange: Thanks for listening to another TIPisode, and thank you to GC America for sponsoring this week’s episode. You can find more about their great products at gcamerica.com. And don’t forget to hit the “subscribe” button in your podcast app, follow us on Facebook or Instagram, and head over to our website, ataleoftwohygienists.com, to sign up for our newsletter. We always appreciate ratings and reviews. Thanks again for listening to your unofficial dental hygiene podcast.