Fissure Sealants: Protection for Young Teeth

A “tooth” sealant (better known as a fissure sealant) is a plastic protective coating bonded onto the surfaces of some teeth. The aim of placing this coating is to cover over the areas of a tooth that are prone to becoming decayed.

The biting surfaces of a back tooth are naturally grooved.  These grooves, or fissures, can be quite deep in some teeth.  Fissures are therefore areas that are difficult to clean; plaque can readily build up here.  Fissures are wide enough for plaque and food to get into, but too narrow for toothbrush bristles to get into to clean.

Plaque build-up can then lead to tooth decay, when it is combined with the prsence of a sugary diet.

‘Pits’ can also be present on the side surfaces of back teeth, and on the back of front teeth.  Like fissures, pits are areas that are prone to plaque build-up and therefore tooth decay.

Fissure sealants are plastic coatings that are bonded to these fissures and pits.  This coating covers over these areas and results in a smooth surface that is much easier to clean. Thus that area of the tooth is less prone to dental decay.

 

Sealants: Key Facts

  • Plastic coating, used to protect certain surfaces of teeth that are naturally difficult to clean.
  • Smooth, hard protective barrier formed on the tooth.
  • Resultant reduced risk of decay at these covered sites.
  • Safe and proven very effective.
  • Painless.

 

“When Should a Fissure Sealant be Applied?”

Basically, the sooner the better, if a tooth is to be sealed. This is because the teeth are somewhat more prone to decay in the first few months after coming into the mouth and obviously the sooner they are protected the better.

 

“Why Place Them?”

As explained, some teeth have surfaces that are hard to clean. Plaque builds up in these areas. Plaque then causes tooth decay when exposed to sugary foods and drinks.

In addition, some children may find back teeth harder to clean anyway.

Sealing these surfaces will reduce the chances of decay here.

 

“Which Teeth Should get a Tooth Sealant?”

The most commonly sealed teeth are the permanent (‘adult’) molars. The first permanent molars usually come into the mouth between the ages of 6-7. The next molars come through at about age 12.

The permanent molars are most likely to have deep fissures and grooves. These are therefore most at need of protecting.

In children who have a high decay risk (e.g. lots of decay in baby teeth, siblings with lots of decay, children with special needs) every back tooth may be sealed as they come through. This will include the molars and also the smaller premolars. Children at high risk of decay, or with medical conditions where tooth extractions might be dangerous, may benefit from having their baby teeth sealed in addition to their adult teeth.

Adults can also have tooth sealants applied. This is commonly carried out on wisdom teeth when they come through into the mouth. Wisdom teeth are often hard to clean due to their location. They also often have deep fissures which render them prone to decay.

 

“Why not place them on every tooth?”

  • Some teeth will have naturally smooth surfaces, or very shallow fissures and pits. These teeth will usually not gain benefit from tooth sealants.
  • Areas where decay is present. If decay has set in, a sealant will not suffice as a treatment. Decay will require a proper filling.

 

Procedure used

The procedure is totally painless and does not require any anesthetic (‘needles’). About five minutes per tooth is required.

Fissure sealant procedure

The procedure is easy and painless for the child

  • Once selected to be sealed, a tooth will be thoroughly cleaned.
  • A solution is then applied to the tooth to make the sealant stick to the tooth.
  • The tooth is then washed and dried.
  • The tooth must be kept dry at all times. Cotton wool rolls are usually enough for achieving this.
  • The plastic sealant coating is then applied in a thin even layer.
  • A bright blue ‘curing’ light is used to set the coating and make it bond to the tooth.
  • The bite is checked and may need to be evened out a little.

The procedure is quick, easy and painless. It is readily tolerated by most children, even at a young age.

 

Who applies tooth sealants?

 

Fissure Sealants: Summary of Advantages

  • Reduced risk of decay therefore less likely to need fillings later.
  • Easy to apply.
  • Painless and readily tolerated by children.
  • Safe and proven very effective.
  • Can last for years.
  • Cost a lot less than fillings.

 

Words of Caution:

  • Sealants do not totally protect teeth from decay.
  • The teeth still need to be checked regularly by the dentist.
  • Sealants may need to be replaced every few years.
  • If applied to a decaying tooth, the decay can spread undetected under the sealant.

 

Aftercare Advice

Tooth sealants are highly effective at protecting certain surfaces of teeth. However they DO NOT totally protect a tooth from decay. Teeth will need the same care and attention whether sealed or not. If not looked after, sealed teeth can still decay around the sealant or on other surfaces of the tooth.

Normal dental advice still applies:

Tooth sealants can last a long time. They may last more than ten years. However most will not last this long, and the sealants should be reviewed at every check-up and replaced if necessary.

 

Return to the main page on dental health for kids here.

  • Renee Reinharz

    Can sealants be put on front teeth with no decay but which are naturally ridged, so as to prevent them from staining? Are sealants clear?

    • Dr Barry Hughes

      Hi Renee,

      Sealants can be placed behind front teeth, where they have natural ‘pit’s that are prone to decay.
      They are not, however, placed to prevent staining. If placed on, say, the front, ridged tooth surface – they will not stay in for long. The edges of the sealant may also tend to collect staining. So no – they are not used for this purpose. And yes sealants can be clear, or white.

      Hope this helps!

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