Fissure Sealant Notes Template for UK Dentists

Sealing over active caries without radiographic exclusion is a key risk with fissure sealants — and undocumented isolation is another. Below is a template for UK clinicians to paste into their PMS for every sealant.

Why this fissure sealant template wins

• Caries status pre-sealant explicitly assessed — defends against "sealed caries that progressed".
• Radiograph review (or documented exclusion of need) — IR(ME)R + SDCEP audit defence.
• Isolation method recorded — wet sealants fail; dry isolation defends against early failure claims.
• Sealant lot number — MDR + traceability.
• Sealant quality check (coverage, voids, margins) — proves the application was assessed before discharge.

The template (paste into your PMS notes field)

Paste the fissure sealant template below into your PMS notes field. Patient demographics are left out because your PMS already holds them.

INDICATION: [Increased caries risk + sound deep fissures / early non-cavitated caries (sealed, not restored)]

CARIES RISK (SDCEP): [Increased — basis]

TOOTH/TEETH: [FDI — UR6 / UL6 / LR6 / LL6 / UR7 / UL7 / LR7 / LL7 / premolars if at risk]
ERUPTION: [Fully erupted with clinically dry fissure / partially erupted — sealant deferred]

PRE-SEALANT ASSESSMENT:
- Caries status: [No clinically detectable caries / ICDAS 1-2 (non-cavitated — sealing acceptable) / radiograph reviewed for proximal/occlusal caries]
- Radiograph: [BW reviewed for fissure caries Y/N / not indicated if non-cavitated and patient asymptomatic]

ISOLATION:
- Method: [Rubber dam / Dri-Angle + cotton rolls + suction]
- Effectiveness: [Excellent dry field maintained throughout / good]

PROTOCOL:
- Tooth cleaned: [Pumice + slow-speed cup / oil-free prophy paste / air abrasion / fissurotomy bur if deep]
- Acid etch: 37% phosphoric — applied to enamel — [time] seconds, rinsed thoroughly, dried
- Sealant material: [Brand — colour: clear / opaque / tinted — light-cured Y/N]
- Sealant lot number: [Recorded]
- Light cure time: [Seconds per surface]

SEALANT QUALITY CHECK:
- Complete coverage of fissures: [Confirmed visually]
- No voids: [Confirmed]
- Margins smooth: [Confirmed]

OCCLUSAL CHECK: [Articulating paper — no high spots / adjusted minimally if needed]

POST-OP: No specific aftercare. Sealant material is durable — usual diet. Recall to monitor.

RECALL: [Sealant integrity check at 6 months / next routine exam]

Try the fissure sealant note in the live demo → No account needed.

What good looks like — a worked example

The same fissure sealant template, completed for a realistic case.

INDICATION: Increased caries risk — sound deep fissures on newly erupted permanent first molars

CARIES RISK (SDCEP): INCREASED — based on caries history (ULD lesion treated 2 months ago with Hall crown), sugar frequency partially reduced but ongoing risk.

TOOTH/TEETH: UR6, UL6, LR6, LL6
ERUPTION: All four permanent first molars fully erupted with clinically dry fissures.

PRE-SEALANT ASSESSMENT:
- Caries status: No clinically detectable caries on any of the four first molars. Fissures deep but no ICDAS score >1 (no white-spot lesions, no cavitation).
- Radiograph: BW R+L taken last visit (2 weeks ago) — no fissure caries detected on any first molar.

ISOLATION:
- Method: Dri-Angle (right cheek) + cotton rolls + saliva ejector. Single-tooth isolation each in turn.
- Effectiveness: Excellent dry field maintained throughout each application.

PROTOCOL:
- Tooth cleaned: Oil-free prophy paste + slow-speed cup. Rinsed thoroughly.
- Acid etch: 37% phosphoric acid (Total Etch Kerr) applied to occlusal enamel — 20 seconds per tooth, rinsed thoroughly with water spray for 10 seconds, dried with oil-free air to chalky white appearance.
- Sealant material: 3M Clinpro Sealant (clear, light-cured)
- Sealant lot number: [CP-2026-04-1023]
- Light cure time: 20 seconds per tooth

SEALANT QUALITY CHECK:
- Complete coverage of fissures: Confirmed visually on all four teeth — sealant extends to perimeter of fissures
- No voids: Confirmed — material flowed into all anatomic grooves
- Margins smooth: Confirmed with explorer

OCCLUSAL CHECK: Articulating paper — no high spots on any sealant. Patient bit normally.

POST-OP: No specific aftercare needed. Sealant durable. Normal diet.

RECALL: Sealant integrity check at 6 months (per SDCEP). Will assess at routine recall in 3 months (caries risk increased, frequent recall ongoing).

Compliance: the medico-legal angle

• SDCEP Prevention and Management of Dental Caries in Children (3rd ed, 2025) — fissure sealant protocol and indications.
• NICE CG19 (recall) — preventive interventions for increased-risk patients.
• MDR 2017 — sealant material is a regulated medical device; lot traceability required.
• GDC Principle 4 — preventive interventions documented sufficiently for monitoring effectiveness.

Common documentation mistakes

• Sealing over active caries without radiographic exclusion — caries progresses under sealant; child needs endo at age 14.
• Isolation inadequate — wet sealant fails early; child re-presents with caries within months.
• No lot number recorded — MDR breach.
• Routine sealing for low-risk children — not SDCEP-supported; sealant indicated for increased-risk dentition.
• No 6-month integrity check at recall — sealants fail and need replacement; absent monitoring is a missed prevention opportunity.

Sources

• GDC Standards for the Dental Team, Principle 4: Maintain and protect patients’ information (accessed 18 October 2026)
• The Ionising Radiation (Medical Exposure) Regulations 2017 (SI 2017/1322) (accessed 18 October 2026)
• NICE CG19: Dental checks: intervals between oral health reviews (October 2004) (accessed 18 October 2026)
• SDCEP: Prevention and Management of Dental Caries in Children (3rd edition, February 2025) (accessed 18 October 2026)

Frequently asked questions

Guides that cover this

• Dental Therapist New Graduate UK Guide

Patient leaflets for this treatment

• Your Guide to Fissure Sealants

Related dental note templates

Browse the full set of free dental notes templates.