EFDA - Expanded Function Dental Auxiliary Sealant Application and Polishing Questions and Answers — Questions and Answers
Question 1: An EFDA is applying a sealant to a newly erupted permanent molar on a 7-year-old patient. After etching and rinsing the tooth, the EFDA notices the etched surface does not have a distinct, frosty-white appearance. What is the most appropriate next step?
- Proceed with applying the sealant material as planned.
- Dry the tooth for an additional 30 seconds and then apply the sealant.
- Re-etch the tooth surface according to the manufacturer's instructions. (Correct answer)
- Polish the tooth with pumice and then re-start the etching process.
Correct answer: Re-etch the tooth surface according to the manufacturer's instructions.
A frosty-white appearance after etching and drying is critical because it indicates that the enamel surface has been properly prepared for micromechanical bonding. If this appearance is not achieved, the sealant will not adhere properly. The correct procedure is to re-etch the tooth to create the necessary surface microporosities for a strong bond.
Question 2: Which of the following is the primary reason for sealant failure, especially in the short term?
- Using an unfilled sealant material.
- Saliva contamination of the tooth surface during application. (Correct answer)
- Curing the sealant for too long.
- The patient chewing hard foods immediately after the procedure.
Correct answer: Saliva contamination of the tooth surface during application.
The success of a sealant is highly technique-sensitive, and the most common reason for failure is moisture contamination, particularly from saliva. If the etched enamel becomes contaminated with saliva, the sealant will not bond correctly to the tooth, leading to partial or complete loss of the sealant.
Question 3: After placing and curing a sealant on tooth #30, an EFDA uses articulating paper to check the patient's occlusion. A heavy blue mark is visible on the sealant material. What should the EFDA do next?
- Dismiss the patient, as the mark will wear down naturally.
- Use a slow-speed handpiece with a finishing bur to carefully reduce the high spot. (Correct answer)
- Attempt to remove the entire sealant and re-apply it.
- Apply a top coat of bonding agent over the existing sealant.
Correct answer: Use a slow-speed handpiece with a finishing bur to carefully reduce the high spot.
A heavy mark from articulating paper indicates a high spot on the sealant, which can interfere with the patient's bite and potentially cause discomfort or fracture the sealant. The standard procedure is to use a slow-speed handpiece with a finishing bur to carefully adjust the occlusion by removing the excess material until the bite is no longer high.
Question 4: When preparing a tooth for sealant application, which of the following is an essential step to be completed *before* applying the acid etchant?
- Flossing the interproximal contacts.
- Applying a fluoride varnish.
- Thoroughly cleaning the pits and fissures with a slurry of pumice. (Correct answer)
- Checking the occlusion with articulating paper.
Correct answer: Thoroughly cleaning the pits and fissures with a slurry of pumice.
The pits and fissures of the tooth must be free of plaque and debris to allow the etchant and sealant to penetrate effectively. Cleaning the surface with a prophy brush and a slurry of pumice is a standard and effective method to prepare the tooth for etching. Using a prophy paste with fluoride before etching is contraindicated as it can interfere with the etch.
Question 5: A patient presents with deep, stained pits and fissures on their permanent first molars but no clinical or radiographic evidence of decay. According to ADA and AAPD guidelines, what is the appropriate action?
- Place a preventive resin restoration.
- Monitor the teeth and re-evaluate in six months.
- Apply a fluoride varnish to the occlusal surfaces only.
- Place pit and fissure sealants. (Correct answer)
Correct answer: Place pit and fissure sealants.
Evidence-based guidelines from the American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD) recommend the placement of sealants to prevent caries in teeth with deep pits and fissures, and also to arrest the progression of non-cavitated carious lesions. Since there is no evidence of decay, sealing the susceptible surfaces is the standard of care for prevention.
Question 6: While polishing a patient's teeth, an EFDA is about to polish a tooth with a porcelain crown. Which of the following materials is the most appropriate choice for polishing the crown?
- Coarse pumice to remove all stains.
- A bristle brush with standard prophy paste.
- A rubber cup with a low-abrasion polishing paste or cleaning agent. (Correct answer)
- An air-polishing device with sodium bicarbonate.
Correct answer: A rubber cup with a low-abrasion polishing paste or cleaning agent.
Restorative materials like porcelain can be scratched or damaged by abrasive agents. It is essential to use a non-abrasive or low-abrasion cleaning agent or polishing paste specifically designed for restorations to avoid roughening the surface, which could lead to increased plaque and stain accumulation. A rubber cup with light pressure is the appropriate delivery method.
EFDA - Expanded Function Dental Auxiliary Sealant Application and Polishing Questions and Answers
An EFDA is applying a sealant to a newly erupted permanent molar on a 7-year-old patient.
After etching and rinsing the tooth, the EFDA notices the etched surface does not have a distinct, frosty-white appearance.
What is the most appropriate next step?