Brushing as good as handpiece prophylaxis before placing sealants

Area of Science:

• Dental materials science
• Preventive dentistry
• Clinical trial methodology

Background:

• Sealant manufacturers' instructions for use (IFU) generally recommend tooth cleaning before acid etching.
• While not always explicit, some IFU imply the necessity of handpiece prophylaxis for cleaning.
• No IFU recommend surface-altering procedures for caries-free teeth.

Discussion:

• Direct evidence from two clinical trials found no significant difference in complete sealant retention between mechanical cleaning (pumice/paste) and air-water syringe or dry toothbrushing.
• Indirect evidence from ten studies indicated that sealant retention rates over time were equivalent or superior with toothbrush prophylaxis compared to handpiece prophylaxis.

Key Insights:

• Supervised toothbrush cleaning by patients achieves sealant retention rates at least as high as traditional handpiece prophylaxis.
• Mechanical cleaning methods using pumice or prophylaxis paste showed no advantage over simpler methods like air-water syringe or dry toothbrushing for sealant retention.
• The findings challenge the necessity of handpiece use for routine sealant preparation.

Outlook:

• Potential for reduced costs in dental materials, equipment, and personnel by adopting simpler cleaning protocols.
• Further research could explore patient-administered cleaning efficacy in diverse clinical settings.
• This could lead to more accessible and cost-effective preventive dental care strategies.