Sealants protect the chewing surfaces of the back teeth, but they don’t take the place of brushing and other tips to prevent decay. Help your child brush and floss daily, get regular fluoride treatments, and see your dentist regularly.
A sealant is a clear or white, acrylic-like material that bonds with the tooth to help a shield out decay-causing bacteria from the chewing surfacing of the back teeth. They form a protective barrier covering the pits and fissures (depressions and grooves) to prevent cavities in hard to clean back teeth.
Sealants are a safe, painless, and low-cost way to protect patients’ teeth - particularly children. Sealants have been used on children’s teeth for more than 30 years to keep food and bacteria from getting into the tiny grooves of their developing teeth. Children’s cavities occur most often in these areas because the bristles of a toothbrush are often too wide to enter the area, even with vigorous brushing.
To complicate matters, tooth enamel is thinner in pits and fissures than in other areas of the tooth, so they are particularly vulnerable to decay. Decay occurs as bacteria acts on food to form acids that weaken and destroy tooth enamel. After decay starts and a cavity is formed, it must be repaired by a dentist to save the tooth. Although fluoride use has reduced the incidence of tooth decay, it is of limited use in protecting pits and fissures. This is why sealants are an invaluable form of protection, since they provide a true shield from decay causing agents.
Children are often better candidates than adults for this treatment because sealants can only be applied if teeth are free of decay and fillings, which is the case with new teeth in children.
Sealants should be applied as soon as the first permanent molars (6-year molars) come in, between 5 and 7 years of age. The second molars (12-year molars) and the premolars should be sealed as soon as they come in, between 11 and 14 years of age. That’s because the greatest chance of decay occurs during the first three years after the teeth come in. However, it’s never too late to apply sealants, as long as the teeth are free of decay and fillings.
The baby molars often don’t need to be sealed. However, your dentist may recommend sealing the baby molars if there is a high risk of decay. Since baby teeth are “space holders,” losing baby molars from decay can cause crowding when the permanent teeth come in.
Sealants are usually long-lasting if the seal remains intact. Regular checkups are necessary to make sure the sealant has not been dislodged and to reapply if needed. Some hard foods, such as candy, ice, or sticky foods, may dislodge sealants and should be avoided.
If the decay process has already started, it is too late to apply sealants as a preventative measure. Decay will not start under a fissure sealant because the decay-causing organisms are deprived of food and oxygen that is required for them to flourish. Therefore, some teeth may not be good candidates for sealing while others may be fine. Only your dentist can make that decision.
Sealants can be applied by any member of your dental team. There is no discomfort associated with sealant application, so numbing is not necessary. The treatment is done in three quick, easy steps.
To begin, the teeth are cleaned, dried, and etched so the sealant will adhere. Any plaque (a bacterial film) is first removed from the teeth. Cotton rolls are placed around the teeth to keep them dry. Then each tooth is treated with a mild etching solution to kill any bacteria and make the surface slightly rough. A rough surface helps the sealant adhere better.
Second, the sealant is painted on and hardened. The chewing surface of each tooth is painted with liquid sealant, using a small brush or applicator. Spaces between the teeth are not painted, so your child can still floss between each tooth. The sealant is then hardened, usually with a special light.
Finally, the sealant is carefully checked. Each tooth is examined to be sure that the grooves are fully covered and that the sealant won’t interfere with chewing. The sealant bonds to the tooth as it hardens so your child can eat normally right away.
Sealant material is quite durable, but it is a good idea to occasionally check to make sure it is still in place (chewing on ice cubes, hard candy or sticky foods should be avoided). Here are some great snack alternatives that combined with sealants and fluoride, reduce your chances of tooth decay:
The use of sealants substantially reduces the risk of tooth decay by keeping food and bacteria out of cavity prone areas. Some people mistakenly believe that once the teeth are sealed, that is all that is necessary.
However, sealants are but one of the group of measures needed for good care of your teeth. In combination with careful brushing, flossing and fluoride, sealants are an effective step towards a lifetime of excellent dental health.
If you have any further questions about sealants, please ask your dentist.
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