Dental Sealants: Protecting At-Risk Teeth
Has your dentist recommended that fissure sealants be used on your teeth or in your child’s mouth? Here is some information about what dental sealants are and how they can be helpful in preventing tooth decay.
Why do grooves, fissures or pits in teeth make them susceptible to decay?
Many teeth, particularly molars, have fine grooves, pits and fissures along the top of them, on the biting surface. When we eat, small particles of food and bacteria can get trapped in these fissures, and they can be particularly hard to clean, even with careful brushing. As bacteria sit in the fissures, the bacteria feed on sugars in the mouth and produce acid as part of their metabolism. The acid then accumulates in the fissure and causes demineralization of the tooth enamel, essentially breaking it down over time. Thus, fissures or pits in the teeth are sites that are particularly at risk for developing tooth decay and cavities.
What is a dental sealant?
Dental sealants consist of thin resin coatings that are applied to the grooves and pits, especially on molars, to protect the tooth from decay. By sealing the grooves in the chewing surfaces of the teeth, food and bacteria cannot accumulate in the grooves, and the tooth will be at much less risk of decay in the area of the sealant. Since it is usually the molars that have grooves and fissures, these are the teeth that are most suitable for use of sealants. The first permanent molars come in around age six, while the second permanent molars emerge around age 12. Ideally, sealants should be applied soon after the adult molar has erupted, before any decay has occurred. The sealant material is available in tooth-colored shades so it cannot be seen, except up close.
How is a sealant applied?
Sealants can be applied in a simple procedure that does not require any freezing or drilling. The teeth will be cleaned first, to remove any bacteria or food particles that may be trapped in the teeth. A special etching gel is applied to the chewing surface of the tooth, and the tooth is washed and dried. Then the sealant material is painted onto the tooth, and a light may be used to quickly harden and cure the sealant.
Are sealants effective and who can benefit?
The effectiveness of sealants has been well studied, and the evidence shows that dental sealants work well in preventing tooth decay. In one study over a 15 year period, 74% of permanent first molars that received sealants remained cavity free (1). Certainly, dental sealants are a very cost effective option for preventative care, rather than having to pay for filling the teeth after decay has occurred. Although sealants are most often used in children when they first get their adult molars, sealants can also be useful in older patients that are prone to cavities, have reduced saliva flow in the mouth or ‘dry mouth’ (also called xerostomia), or are undergoing orthodontic treatment.
(1) Simonsen (1991). Retention and effectiveness of dental sealant after 15 years. Journal of the American Dental Association. 122(1): 42-3.
(2) Lesser (2001). An overview of dental sealants. Access special supplemental issue. July; 1-8.