One of the most common preventative dental treatments available to growing kids and teens is dental sealants. Between 10% and 50% of all students will have at least one sealant at any given grade school in the United States. While many parents are well educated on the benefits of sealants, the whole picture is slightly less clear. What are they made out of? What exactly are they “sealing?” Are they designed to last forever? In this blog post, we will shed some light on commonly asked questions on dental sealants and how they can be excellent preventative tools in young teeth.
Deep enamel pockets in the biting surfaces of molars can create difficult-to-clean teeth.
The principle behind dental sealants (also known as pit and fissure sealants) is very simple. In young children and teens, tooth anatomy can be deep and varied. In the molars, these “pits” (natural dips in the teeth) and “fissures” (natural troughs in the teeth) are prone to collect bacteria and acidic food particles. Unfortunately, these groves are often too big for toothbrush bristles to invade and clean. The result is a perfect pocket of food and bacteria that can sit unharmed even after a perfect brushing session.
Sealants come into play by making these ridges and pockets shallower by using a specialized filling material. We typically place sealants on adult teeth once they are fully erupted and show signs of deep tooth anatomy. Baby teeth are usually shallow enough that sealing them is an unnecessary measure. The necessity and appropriateness of sealants are typically determined at a regular cleaning/exam appointment.
In placing a sealant, we first use air abrasion technology to gently roughen the tooth surface around the pits and fissures. This process is extremely gentle; your normal saliva flow has strong enough remineralization powers to reverse the effects of air abrasion. After the tooth is prepared, we place a hard material called glass ionomer into the pits and grooves. We love glass ionomer because it is engineered to provide prolonged fluoride release, making it perfect for this application. Once the material is hardened and set, we perform a final adjustment to make sure the sealant isn’t interfering with normal biting and chewing. The entire appointment takes about 30 minutes for one tooth, with 15 extra minutes for each additional tooth.
A typical before (left) and after (right) of dental sealants.
Since we are only placing material in near-microscopic grooves (thinner than a toothbrush bristle!), the resulting “filling” is incredibly shallow and thin. Likewise, sealants can fall out or break after a number of years. This is a completely natural and expected part of the sealant life cycle. However, many of our patients have their sealants last for near lifetimes. When a sealant does fall out, we note it during a regular exam and consider the options. We can replace a sealant at any age, but changes in tooth structure often make this step unnecessary.
For most people, extreme molar anatomy is exclusively a childhood problem. Children's teeth grow in at different paces and will often be in a position where they have nothing to hit against while chewing. This lack of constant contact makes these pockets of bacteria and food even harder to displace. However, we can and will place sealants in adults, if necessary.
Please note that sealants are not the same as fillings on the biting (“occlusal”) surfaces of your back teeth. If there is active decay in the pits and fissures, we must place a filling to reverse it’s progress. However, deep anatomy can usually be caught and adressed before actual decay sets in. If you have any further questions about dental sealants, how they work or why we place them, please feel free to call our office. We want all of our patients to be well educated on the best preventative services available to them and their children.