Pearson’s Supplemental Materials to Address New Scope of Practice under the New Legislation from the Dental Board of California for Dental Assistants and Registered Dental Assistants



Download 79.89 Kb.
Date conversion30.11.2016
Size79.89 Kb.
Pearson’s Supplemental Materials to Address New Scope of Practice under the New Legislation from the Dental Board of California for Dental Assistants and Registered Dental Assistants
The following are procedures that dental assistants and registered dental assistants can now perform in the state of California.
Procedure I: Intraoral Photography Using Digital Camera

Procedure II: Extraoral Photography

Procedure III: Intraoral Impressions for Nonprosthodontic Appliances

Procedure IV: Facebow Transfer and Bite Registration

Procedure V: Place and Remove Isolation Devices

Procedure VI: Monitoring Patient Sedation


The following are procedures that registered dental assistants can now perform in the state of California. These procedures are not in the scope of practice for dental assistants.
Procedure VII: Use of Automated Caries Detection Devices and Materials to Gather Information for Diagnosis by the Dentist

Procedure VIII: Obtain Intraoral Images for Computer-Aided Design (CAD), Milled Restorations

Procedure IX: Placing Bonding Agents

Procedure X: Chemically Preparing Teeth for Provisional Restorations

Procedure XI: Place, Adjust, and Finish Direct Provisional Restorations

Procedure XII: Fabricate, Adjust, Cement, and Remove Indirect Provisional Restorations

Procedure XIII: Remove Excess Cement from Surfaces of Teeth with a Hand Instrument

Procedure XIV: Adjust Dentures Extraorally



Procedure XV: Application of Sealants
The information in this supplement package provides details needed to teach the procedures listed above. In addition to using some information found in Pearson’s Comprehensive Dental Assisting textbook, the supplement provides further details as necessary to ensure proper teaching of each procedure. When appropriate, references to materials found in Pearson’s Comprehensive Dental Assisting are indicated.

Procedure I: Intraoral Photography Using Digital Camera

Introduction: Intraoral photography with the assistance of a digital or nondigital camera is part of a patient’s record. The photographs are part of a patient’s diagnosis record and must be treated as such. It is extremely important that these images are accurate and of high quality. Some insurance companies will accept digital camera images along with radiographs as part of dental documentation.

Equipment and Supplies [Figure 1-1]


  • Basic setup:

    • Mouth mirror

    • Explorer

    • Cotton pliers

  • Personal protective equipment such as gloves and mask; eyewear for patient

  • Moisture control: Saliva ejector, high-speed evacuator (HVE), air/water syringe tip

  • Isolation materials: Cotton rolls, cotton gauze

  • Lip lubricant agent

  • Patient napkin with napkin clips (if needed)

  • Cheek retractors

  • Dental photography mirrors

  • Digital camera and/or intraoral camera (follow manufacturer’s instructions)

Procedure Steps

  1. Position the patient.

  2. Make all headrest adjustments for best support.

  3. Adjust overhead light (if being used).

  4. Lubricate patient’s lips (to avoid cracking lips).

  5. Retract cheeks using cheek retractors.

  6. Position photography mirror for best photo result. [Figure 1-2: Dental photography mirror in place while retractors secure lips/cheeks away from target]

  7. Turn on camera. [Figure 1-3a: An intraoral camera is used for computer viewing of the patient’s oral cavity and documenting.]


  8. Focus camera over subject for best photo results.

  9. Position camera lens for best results with minimal movement.

  10. Have patient breathe through his or her nose.

  11. Take intraoral photograph using digital camera. [Figure 1-3b: A digital camera is used for documenting the patient’s oral cavity.]


  12. Review image for doctor’s specifications.

  13. Continue taking all necessary photos.

  14. Remove retractors.

  15. Rinse patient’s mouth and suction as necessary using saliva ejector.


Procedure II: Extraoral Photography

Introduction: Much information regarding extraoral photography is provided in Chapter 50 of Pearson’s Comprehensive Dental Assisting. The following information provides more details necessary for dental assistants (DA) and registered dental assistants (RDA) to perform extraoral photography in the state of California. Intraoral and extraoral photography are part of a patient’s record (digital and nondigital). These images provide information needed for insurance billing, office referrals, and or specialty referrals. It is extremely important that these images be of high quality and handled with care.

Equipment and Supplies [Figure 2-1: Basic photography set up including camera kit (digital).]


  • Basic setup:

    • Mouth mirror

    • Explorer

    • Cotton pliers

  • Moisture control: Saliva ejector, high-speed evacuator (HVE), air/water syringe tip

  • Isolation materials: Cotton rolls, cotton gauze

  • Lip lubricant agent

  • Patient napkin with napkin clips (if needed)

  • Cheek retractors

  • Dental photography mirrors

  • Digital camera and/or intraoral camera (follow manufacturer’s instructions)

Procedure Steps

  1. Position the patient.

  2. Make all head adjustments.

  3. Turn on camera (follow manufacturer’s instructions).

  4. Focus camera over subject for best photo results.

  5. Position camera lens for best results with minimal movement.

  6. Snap photo.

  7. Review image to ensure that the image meets doctor’s satisfaction.

  8. Continue taking all necessary photos. Examples of extraoral photos are provided in the following figures: [Figure 2-2 a, b, c: Standard extraoral photos: a) frontal view with lips in relaxed position, b) frontal view with lips in a smile, and c) profile view of the patient’s right side with lips relaxed.]

    [Figure 2-3: Frontal view of an anterior bite]





Procedure III: Intraoral Impressions for Nonprosthodontic Appliances

Introduction: Intraoral impressions are made for diagnostic reasons and to construct various types of nonprosthodontic appliances such as crowns, bridges, veneers, athletic mouth guards, and bleaching trays, to name a few. These types of impressions fall into two categories: preliminary impressions and final impressions. Impression materials used for this procedure depend on the doctor’s preference. Final impressions must be precise because they are a reproduction of the patient’s oral cavity.

Equipment and Supplies

  • Stint

  • Spatula

  • Delivery gun with material cartridge and tip

  • Mixing pad

  • Tubes of temporary cement [Figure 3-1: Provisional tray setup.]


Procedure Steps

  1. Fill stint with provisional material. [Figure 3-2: Filling the stint with provisional material.]


  2. Place stint over prepared tooth or teeth. [Figure 3-3: Fitting the stint in the mouth.]


  3. Allow material to cure per manufacturer recommendations. [Figure 3-4: The proper bite alignment.]


  4. Trim, finish, and polish the stint so no rough edges are felt.

  5. Mix temporary cement and fill the provisional.

  6. Seat provisional onto prepared tooth. Allow cement to cure.

  7. Remove excess cured cement from around the tooth or teeth. [Figure 3-5: Final provisional cemented on the prepared tooth.]


Procedure IV: Facebow Transfer and Bite Registration

Introduction: The facebow requires three points of reference, which vary with the type of facebow used. Frequently, an earpiece facebow is used for two points of orientation. The facebow rests on the patient’s face (most commonly over the bridge of the nose), and the occlusal relationship is recorded by inserting wax, vinyl polysiloxane, or another material into the oral cavity with the use of the bitefork (part of the facebow kit). This records the patient’s accurate horizontal bite relationship as well as the centric or eccentric relationship of the patient’s jaw. This procedure can be used for diagnosis, treatment planning, and patient treatment.

Equipment and Supplies

  • Basic tray setup:

    • Mouth mirror

    • Explorer

    • Cotton pliers

    • Air/water syringe

    • Spatula

    • Other instruments required by the dentist

    • Saliva ejector

    • High-speed evacuator (HVE)

    • Air/water syringe tip

    • Cotton rolls

    • Cotton gauze

  • Lip lubricant agent

  • Patient napkin with napkin clips (if needed)

  • Facebow kit:

    • Bow

    • Anterior pointer

    • Shaft assembly (includes clamps #1 & #2)

    • Reference plane locator (measuring gauge)

    • Bitefork

  • Wax or vinyl polysiloxane

  • Mixing bowl (with warm water)

  • Red colored marker (sharp point)

Procedure Steps

  1. Adjust patient's headrest for best support and alignment.

  2. Assemble facebow:

    1. Align anterior pointer over bow.

    2. Secure shaft assembly to bottom side of facebow (follow manufacturer’s instructions). [Figure 4-1: Shaft assembly secured onto facebow.]


    3. Numbers (1 & 2) on assembly should be visible to operator and properly aligned. [Figure 4-2: Numbers on assembly should be facing operator.]


  1. Using marker and measuring gauge, plot the point of reference on patient’s face (as indicated by manufacturer). The point of reference is the third point of interest and is 43 mm up from the incisal edge of the right central or lateral incisor.

  2. Prepare bitefork by covering horseshoe-shaped frame with wax or vinyl polysiloxane; avoid blocking notch (midline indicator). If wax is used, soften slightly by dipping prepared bitefork into warm water for half a minute.







  1. Align bitefork’s notch with maxillary midline in patient’s mouth. [Figure 4-3: Align fork’s notch with patient’s midline.]


  2. Once aligned, have patient bite down.

  3. Slide the shaft of the bitefork through clamp and slightly tighten.

  4. Gently place the bow in the external meatus of both ears. [Figure 4-4: Bow placed in the external meatus of both ears.]


  5. Position the anterior pointer with the third point of reference (previously marked).

  6. Confirm reference points are aligned.

    1. View point through notch on top of bow [Figure 4-5: View point through notch on top of bow.]


  7. Tighten clamp #1.

  8. Tighten clamp #2.

  9. Remove facebow.

    1. Loosen the notch on top of facebow.

    2. Carefully spread earpieces from patient’s ears and remove facebow.

  10. Evaluate that the bite registration was evenly recorded.

  11. Optional: Record any measurements (as indicated by dentist) in the patient’s chart.

  12. Remove bitefork shaft assembly from bow.

  13. The final step is mounting the models on an articulator using the bite taken during the facebow procedure. However, this procedure can be done either inhouse or by a lab technician away from office, depending on dentist’s preference/specifications.
    [Figure 4-6: Bite being used in articulating transfer.]



Procedure V: Place and Remove Isolation Devices

The topics of placement and removal of isolation devices are well covered in Chapter 26 of Pearson’s Comprehensive Dental Assisting. In addition to the information presented in the text, it should be explained that a light-reflective resin barrier such as isolite is applied to the junction of the teeth with the gingiva to prevent materials being used from touching the soft tissue to avoid possible irritation or even burns.



Procedure VI: Monitoring Patient Sedation

Introduction: The dental assistant may place patient monitoring sensors and “monitor patient sedation, limited to reading and transmitting information from the monitor display during the intraoperative phase of surgery for electrocardiogram waveform, carbon dioxide and end tidal carbon dioxide concentrations, respiratory cycle data, continuous noninvasive blood pressure data, or pulse arterial oxygen saturation measurements, for the purpose of interpretation and evaluation by supervising licensed dentist who shall be at the patient’s chairside during this procedure” (retrieved from:CADAT Dental Assisting Alliance; Synopsis of AB2637, italics added).

Electrocardiogram waveforms are recorded using an EKG unit. [Figure 6-1: EKG machine.]


This unit measures all of the heart’s activity. Although there are a variety of units, the dental assistant should at minimum be able to monitor a 3-lead EKG/ECG machine, always following the operating manual for specific instructions. There are different types of leads, such as disposable, reusable, ones with gel and without gel, and saline–based leads. The leads are placed in a manner in which a triangle is formed. For instance, the negative lead (white) is placed on patient’s right side of chest directly above nipple and just below collar bone. (Placement of the negative lead on the right shoulder would also be correct). Theground lead (black) is placed on the patient’s left side of chest directly above nipple and just below collar bone (or again the lead can be placed on the left shoulder). The positive lead (red) is placed on the left side of the chest. Be aware that there can be a discrepancy with the ground lead and the positive lead, meaning they are interchangeable, depending on the unit and manufacturer.

The dental assistant should be able to identify the different wave patterns being displayed on the monitor in order to properly monitor, but not to diagnose. Parts of the EKG wave include: the P wave, which is the atrial depolarization (contraction of the right and left atria); the QRS complex, which represents ventricular depolarization (contraction of the right and leftventricles); and the T wave, which is ventricular repolarization. [Figure 6-2: Parts of the EKG wave.]


A normal rhythm (normal EKG reading pattern) must have uniform upright P waves and identical QRS complexes that maintain uniform widths. Normal heart rate (HR) is 60 to 100 bpm (beats per minute). [Figure 6-3: Normal sinus rhythm]

The following are examples of abnormal EKGs. These all require immediate attention to prevent the patient from falling into asystole (cardiac failure).

Bradycardia – rate is <60 bpm but usually >40 bpm. [Figure 6-4: Sinus bradycardia rhythm]

Tachycardia – rate is >100 bpm but usually <170 bpm.


[Figure 6-5: Sinus tachycardia rhythm]

Ventricular Arrhythmia – premature ventricular contractions. [Figure 6-6: Premature ventricular contractions]


Ventricular Tachycardia – rapid rate 140–300 bpm. [Figure 6-7: Ventricular tachycardia]


Ventricular Fibrillation – cardiac failure. [Figure 6-8: Ventricular fibrillation]


Asystole – cardiac failure. [Figure 6-9: Asystole]


When monitoring a patient it is important to note not only the heart rate but also the respiratory cycle. This cycle involves inhaling and exhaling. This is recorded by observing the patient’s rise and fall of the chest and abdomen. Normal respiratory rate is 12–18 breaths per minute.

Blood pressure should be monitored with the use of a sphygmomanometer and stethoscope. Normal ranges for blood pressure are: Systolic (top number) 95–139, Diastolic (bottom number) 60–89. See Procedure 23-2 on how to measure blood pressure as provided in Chapter 23 of Pearson’s Comprehensive Dental Assisting.

Oxygen saturation (SpO2) is measured with a pulse oximeter which is attached to the patient’s finger, toe, or earlobe. [Figure 6-10: Pulse oximeter]


A normal SpO2 is 95–100%. SpO2 below 92% will normally require the administration of oxygen. Signs and symptoms of hypoxemia (low O2) include:

Tachypnea (elevated respiratory rate)

Shortness of breath

Tachycardia (elevated heart rate)

Hypertension (high blood pressure)

Headache

Restlessness

Confusion and disorientation

Accuracy of pulse oximetry can be affected by movement, sensor misalignment, dysfunctional hemoglobin, ambient light, nail polish, or skin pigmentation and/or thickness. Normal pulse measurement is 60–100 bpm (beats per minute).



The following are new procedures that registered dental assistants can now perform in the state of California. These procedures are not in the scope of practice for dental assistants.

Procedure VII: Use of Automated Caries Detection Devices and Materials to Gather Information for Diagnosis by the Dentist

Introduction: In addition to the materials related to caries detection devices in Chapter 13 of Pearson’s Comprehensive Dental Assisting, in the section titled Laser Caries Detector, the following information is important to review.

Avoid placing the caries detector over metal restorations to avoid faulty readings. Place the tip over the natural tooth structure for a more accurate reading. Depending on the model or make of the caries detector, the detector can identify decay by visual/light or sound/signal. Some units require calibration before each use; follow manufacturer’s recommendations.


[Figures 7-1 through 7-3: Placing tip over facial of a natural tooth structure to obtain initial density reading.]

Procedure VIII: Obtain Intraoral Images for Computer-Aided Design (CAD), Milled Restorations.

Introduction: CEREC (ceramic reconstruction) refers to the fabrication of an anterior or posterior milled restoration using a precision-cut, high-strength piece of ceramic. This system using CAD/CAM is a computerized method of creating restorations, thus eliminating the need for impressions and wearing temporary restorations, unless long-term treatment calls for the need for temporaries, which the CEREC also fabricates. This procedure has several advantages: not only is the entire procedure (preparation to cementation) done in a single session, minimizing the need for anesthetic, but treatment is less invasive, saving more tooth structure. There is also more patient comfort and convenience. CAD/CAM milling machines are mainly used to fabricate crowns and bridges.

Equipment and Supplies

  • Crown and bridge tray setup [Figure 8-1: Crown and bridge set up]


  • Acquisition unit (computer unit)

  • Milling unit [Figure 8-2: Milling unit]


  • Camera with wand [Figure 8-3: Camera with wand]


  • CAD/CAM software

Procedure Steps

  1. Make all necessary preparations to the camera prior to taking any photo (always follow manufacturer’s instructions).

  2. Hold camera with steady pen grasp or use finger rest for maximum control. Avoid any movement. [Fig. 8-4: Holding camera with steady pen grasp.]


  3. Avoid foreign and/or unnecessary items in the oral cavity while capturing the picture such as fingers, cotton roll, saliva ejector, wedges, isolation device, etc. In order to facilitate a precise optical impression, avoid overspraying prepped tooth/teeth with the contrast medium powder. If too much medium powder covers the prepared surface, it will distort the image, resulting in a faulty product. Avoid scratching the lens with anatomy of neighboring teeth or any other objects. Keep lens away from the surface of the tooth to avoid scratching the lens. [Fig. 8-5: Avoid scratching lense]


  4. Use the camera stabilizer. Stabilizer devices are used to make contact with an adjacent nonprepped tooth.

  5. Begin taking images (follow manufacturer’s specifications).

  6. Take three optical images for each preparation. (Important since this will take the place of the impression, and contacts must be established.)

    1. First of prepared tooth

    2. Second of distal tooth (unprepared tooth)

    3. Third of mesial tooth (unprepared tooth)

[Figure 8-6: Prepped tooth with overlapping view of, unprepared, adjacent teeth]

Reference Tip: Camera images are equivalent to optical impressions and should be treated with the same importance and care.


Procedure IX: Placing Bonding Agents

The topic of placing bonding agents is well covered in Chapters 33 and 34 of Pearson’s Comprehensive Dental Assisting.


Procedure X: Chemically Preparing Teeth for Bonding

The topic of chemically preparing teeth for bonding is well covered in Chapter 33 of Pearson’s Comprehensive Dental Assisting.



Procedure XI: Place, Adjust, and Finish Direct Provisional Restorations

Introduction: Adjusting and finishing direct provisional restorations are covered in Chapter 41 of Pearson’s Comprehensive Dental Assisting. The following procedure provides additional detailed information on the placement of direct provisional restorations.

Equipment and Supplies

  • Restorative kit including:

    • Mouth mirror

    • Explorer

    • Cotton pliers

    • Air/water syringe

    • Spoon excavator

    • Scissors

    • Hemostat

    • Backhaus towel forceps

    • Spatula

    • Other instruments required by the dentist

  • Cast or milled restoration

  • Bonding setup and/or cementation setup (per dentist’s preference)

  • High-speed and low-speed rotary handpieces

  • High-volume evacuator (HVE) and saliva ejector

  • Articulating paper and holder

  • Cotton products (pellets, rolls, 2 x 2 gauze, dry angles)

  • Scaler to remove excess cement

  • Restoration delivered from the laboratory

  • Dental floss

Procedure Steps

  1. Verify that final fixed prosthesis is ready (delivered from lab and/or milled).

  2. Isolate area using cotton rolls and/or dry angles.

  3. Using a curved hemostat, firmly secure and remove provisional restoration, avoiding teeth on opposing arch. A scaler or other hand instrument that would fit below the margin of the provisional may also be used, being careful to keep provisional away from patient’s throat. [Figure 11-1: Secure provisional using a rocking motion.]


  4. Remove all remaining cement (supragingivally) from the prepared tooth surface with a hand instrument (scaler and/or explorer). [Figure 11-2: Remove all supragingival cement.]


  5. Rinse and evacuate all cement particles.

  6. Dry, using cotton products or an air/water syringe (avoid pushing cement particles subgingivally with stream of air).

  7. Isolate area (change cotton products as necessary).

  8. Use moisture control evacuation (per dentist preference).

  9. Prepare to try in final fixed prosthesis.



Procedure XII: Fabricate, Adjust, Cement, and Remove Indirect Provisional Restorations, including Stainless Steel Crowns When Used as a Provisional Restoration

Information for this procedure is well covered in Chapter 41 of Pearson’s Comprehensive Dental Assisting.



Procedure XIII: Remove Excess Cement from Surfaces of Teeth with a Hand Instrument

Introduction: After cement has been placed in a cast restoration (fixed prosthesis), the excess cement is removed. The timing of removing the excess cement is determined by the type of material. For this procedure we are using an explorer. To remove permanent excess cement from supragingival surfaces, RDAs can use an ultrasonic scaler lic.

Equipment and Supplies

  • Mirror

  • Explorer

  • Dental floss

Procedure Steps

  1. Use the explorer to remove cement and to ensure the cement has properly set.

  2. Carefully run the edge of the explorer in a horizontal direction just under the cement’s edge, pulling the excessive material away from the tooth and casting.

  3. Tie a knot in the middle of the dental floss, and floss the contacts by passing the knot through both the mesial and distal contacts. This helps remove excess cement from the interproximal area. [Figure 13-1: Flossing the contacts]


  4. Hand instruments can also be useful in the removal of cement. [Figure 13-2: Hand instrument used to remove supragingival cement away from tooth surface.]


  5. Clean and disinfect all equipment.



Procedure XIV: Adjust Dentures Extraorally

Introduction: Adjustments to a denture may be necessary as part of the delivery or denture reline appointment. Supporting the denture is the alveolar bone and oral mucosa which can be permanently damaged with an ill-fitting denture. Minor adjustments can be performed with the aid of pressure-indicating paste, a low-speed handpiece with an acrylic bur, and articulating paper.

Equipment and Supplies

[Figure 14-1]




  • Basic tray setup including spatula

  • Pressure-indicating paste with stiff application brush

  • Paper mixing pad

  • Articulating paper and holder

  • High-speed handpiece

  • Diamond and finishing burs (HS grip)

  • Low-speed handpiece

  • Assorted acrylic burs and discs (SS grip)

Procedure Steps

  1. Denture fit is evaluated in patient’s mouth.

    1. Adjust one arch at a time (maxillary then mandibular denture).

  2. Place small amount of pressure-indicating paste on mixing pad.

  3. Remove denture from patient’s mouth and dry denture.

  4. Brush on a thin, even coat of paste over tissue surface of denture.

  5. Using air/water syringe gently spray surface of coated denture.

  6. Carefully seat denture in patient’s mouth.

  7. Remove the denture from the patient’s mouth. Identify the type of contact marks on the inside of the denture plate—excessive pressure, normal contact, or no contact.

  8. Adjust using a low-speed handpiece and acrylic burs.

    1. Look for pressure spots on the base of the denture and peripheries.

    2. Adjust frenum as needed.

  9. Repeat procedure for the second arch (if applicable).

  10. Remove all paste from denture.

  11. Evaluate occlusion using articulating paper.

  12. Adjustments are done (if needed) using:

    1. high-speed handpiece.

    2. diamond burs and polishing discs.

  13. Most dentures need to be polished after adjustments are done. Never polish the inside (the part that goes on the patient’s gum) of the denture.

  1. Polishing is done in the laboratory using buffing rag wheel and compound.
    [Figure 14-2: Buffing ragwheel]


  1. Provide followup care instructions per office policy.

  2. Dismiss patient.



Procedure XV: Application of Sealants

Introduction: Sealants are used as a coating over deep pits and grooves. A dental sealant is a hard clear, opaque, or tinted resin that is placed on the pits and fissures of the occlusal surfaces of a caries-free tooth. The sealant helps make the tooth smooth and easier to keep clean and helps reduce tooth decay. Sealant materials are composed of dental composites or glass ionomers. Composites are preferred because they do not chip and wear away as fast as glass ionomers.

Equipment and Supplies

  • Mirror, explorer, cotton pliers

  • Saliva ejector

  • High-volume evacuator tip

  • Air/water tip

  • Slow-speed handpiece

  • Light-curing unit

  • White Arkansas stone (finishing bur)

  • Pumice

  • Dappen dish

  • Prophy angle (disposable or sterile)

  • Cotton rolls and/or dry angles

  • Etchant

  • Sealant material

  • Articulating paper

  • Fluoride gel or foam [Figure 15-1: Sealant equipment and supplies]


Procedure Steps

  1. Review the patient’s medical and dental history.

  2. Greet and seat the patient. Place a napkin and eyewear on the patient and tell him or her about the procedure. Instruct the patient on the importance of keeping the mouth open during the procedure to maintain a dry field (or place a dental dam). [Figure 15-2: Placement of a dental dam]


  3. The dentist checks the tooth to ensure no decay is present.

  4. Moisten pumice with water to create a slurry consistency. Always make sure that the cleaning agent does not have any fluoride in it, because that would not allow the sealant to bond completely to the enamel rods.

  5. Clean the occlusal surface with pumice and rinse thoroughly.

  6. Place a cotton roll on the lingual and buccal surfaces. Dry the tooth completely with the air tip. Prior to using the air tip, be sure to clean out the air line by testing it on the patient’s napkin or on your gloved hand.

  7. Place acid etchant into the pits and grooves of the occlusal surface. Leave on for 30 to 45 seconds or according to the manufacturer’s instructions. [Figure 15-3: Etch application]

  8. Completely rinse the tooth for a full 60 seconds.

  9. Carefully replace cotton rolls as needed to ensure that no moisture gets on the etched surface.

  10. Ensure teeth are completely dry, then dab the sealant on the occlusal surface covering all pits and fissures. Make sure the sealant is evenly placed across the surface. Light-cure for 60 seconds. [Figure 15-4: Sealant application]

    [Figure 15-5: Sealant material being light cured.]


  11. Check the sealant surface with the explorer for hardness. [Figure 15-6: Placed sealant]


  12. Remove cotton rolls.

  13. Check the occlusion with the articulating paper.

  14. The dentist will make adjustments if necessary.

  15. Fluoride may be applied to remineralize the enamel.

  16. Freshen the patient’s mouth.

  17. Give the patient postoperative instructions.


The database is protected by copyright ©dentisty.org 2016
send message

    Main page