Preparation Several methods have been advocated for treating a tooth’s occlusal surface preparatory to placing a P/F sealant. Least aggressive, but still effective, is using pumice with a prophy brush to clean the surface and into pits and fissures. The pumice is rinsed away before proceeding. Note that neither a prophy brush, nor use of prophy paste work as well as a brush and pumice: neither do as good a job of cleaning into deep pits and fissures.
Alternatively, micro-etching with an air abrasion unit will clean even more deeply into pits and fissures as well as removing superficially demineralized enamel. This also requires rinsing after use. Further than that, some advocate preparing the pits and fissures with small burs to expose solid enamel and reduce the amount of plaque retained in the surface. Pacific no longer recommends this for P/F sealants.
Regardless of how the occlusal surface is treated, that surface must be isolated to prevent contamination during the placing of a P/F sealant. Rubber dam isolation is best. Single tooth isolation is adequate; clamps can usually be placed without anesthesia. Suction/bite block devices such as Isolite and Isodry are a good second best.
Cotton roll isolation may be adequate but usually requires the help of an assistant to work well.
Clean pits and fissures with a prophy brush and pumice.
Thoroughly rinse off pumice.
Isolate individual tooth with rubber dam or Isolite.
Apply phosphoric acid gel to P/Fs for 20 seconds.
Trace P/Fs with an explorer to ensure etching into depths.