203 - Variability in Dental Sealant Placement Techniques at ULSD

Abstract:

Purpose: Dental sealants are a critical preventive measure in pediatric dentistry, particularly for patients at high risk of dental caries. The efficacy of sealants can be influenced by factors such as provider knowledge, material selection, and application techniques. This study aimed to assess provider knowledge and variability in sealant placement practices at the University of Louisville School of Dentistry (ULSD) and identify potential impacts on clinical outcomes.

Methods: A cross-sectional, survey-based study was conducted involving 68 participants, including third- and fourth-year dental students, residents, dental assistants, faculty, and general dentists. A structured digital questionnaire collected data on sealant material preferences, tooth preparation methods, bonding agent use, isolation techniques, curing times, evaluation methods, and filler awareness. Descriptive statistical analyses and comparative evaluations were conducted to identify variability across provider groups.

Results: Among the 68 respondents, resin-based sealants were strongly preferred by 70%, with flowable resin (15%), glass ionomer (8%), and compomers minimally utilized. Respondents demonstrated a consistent use of acid etching (47%) and tooth cleaning via pumice prophylaxis (38%) or prophy brushes (19%). However, variability was apparent in bonding agent application; 66% consistently applied bonding agents, while 12% did so occasionally, and 22% never applied them. Isolation methods varied significantly: cotton rolls were most common (47%), followed by Isolite systems (44%), rubber dams (18%), and high-volume suction alone (12%). Curing practices primarily involved a standard range of 20–30 seconds (40% of respondents), although some participants deviated to shorter ( <15 seconds, 5%) or longer durations (>30 seconds, 20%). Evaluation of sealants predominantly included tactile exploration using an explorer (90%), supplemented by visual inspections with air drying (30%), though purely visual assessments were rare (10%). Despite routine occlusal checks and adjustments, a considerable gap was evident regarding filler content knowledge, with 80% of providers uncertain about the material properties of their sealants.

Conclusion: This study identified notable variability in sealant application techniques among providers at ULSD, highlighting gaps between evidence-based recommendations and actual clinical practices. Educational interventions aimed at standardizing sealant techniques and improving provider understanding of material properties could enhance clinical outcomes and preventive care efficacy in pediatric dentistry.