Which of the following are contraindications for placing dental sealants?

• A. Lack of pits and fissures
• B. Apparent occlusal decay
• C. Interproximal decay
• D. All of the above

Answer: (D)

Sealants are used to protect chewing surfaces by sealing deep pits and fissures so they’re easier to clean and less prone to trap plaque. For a sealant to be effective, there must be pits/fissures to seal and no active decay that would be hidden or trapped under the seal.

If there are no pits and fissures, there’s nothing to seal, so applying a sealant isn’t indicated. If there is apparent occlusal decay, sealing would lock in bacteria and caries beneath the material, which is not appropriate; the tooth needs to be treated/restored before considering sealants. If there is interproximal decay, sealing the occlusal surface won’t address decay on the sides between teeth and can allow progression under a sealed area, so that situation is also a contraindication.

Since each of these conditions would make sealants inappropriate, all of the above describes contraindications for placing dental sealants.