A sealant, at times called “pit and fissure sealant”, is a physical barrier that is placed over the deepest grooves and anatomical irregularities. Those are found on the chewing surface of molars and premolars. When done well, it is one of the most effective preventive measures to protect the most common site of a child’s cavity formation. When we eat, tiny particles get compressed into the fissures that are found on the chewing surface of most back teeth. Even microscopic amounts of carbohydrates (think goldfish or raisins), may be left behind to then invite the accumulation and growth of acid producing bacteria. So, it's no wonder that the groove of back teeth is the most common site for a child’s cavities on virgin teeth. In short, sealants are a most cost-effective way to prevent cavities.
So here’s how sealants are done and how they work:
First, your pediatric dentist will clean out the grooves of your child’s teeth to make sure bacteria are minimized in that area. Secondly, with good isolation (keeping all moisture and saliva away), the surface is etched, primed, and bonded. Then, a thick layer of resin (liquid plastic) is flown into the grooves. Lastly, a curing light sets the liquid to a smooth protective solid coating.
Sealants will wear down or even chip off. The most commons source of premature sealant loss is grinding (or bruxism as pediatric dentists call it). Then there is also the wear and tear from normal chewing. It’s a good idea to have your pediatric dentist check the integrity of the sealants at each routine dental check up. A well done sealant can often last 2-3 years.
Can I have sealants put over my kids cavity?
Yes. Sealants can slow down the progression of cavities that are small (which means the bacteria has not penetrated past the enamel layer). This seems to choke off the supply of nutrients to the bacteria and slow their progression so that you can delay treatment on your child’s cavity. However, sealing over small cavities can also hide the progression of a child's cavity, making it harder, if not impossible for your dentist to track if your child's cavity is getting larger. It is not recommended to place sealants over a kids cavity that has progressed beyond the enamel layer. That is because, the bacteria will have access to alternate sources of nutrients in the dentin layer.
Yes. Even if the sealant is fully intact, since it is not possible to seal smooth surfaces of teeth. In other words, where two adjacent teeth touch, plaque can accumulate. That's because your pediatric dentist can not get access to seal those areas. Conventional sealants also don’t stick well to smooth areas of enamel. There is a newer variation of resin sealant called ICON. This product is currently being used to treat small (called incipient) cavities on the smooth surface of a child’s teeth.
According to the Journal of the American Dental Association: “Sealants on permanent molars reduce the risk of cavities by 80%.” So, the sooner you can get sealants for your child the better. Your child’s first permanent molars appear around the age of 6 and their second permanent molars around the ages of 12-14. That is why, it’s important to place sealants on those teeth as soon as you can in order to prevent cavities.
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J. Shahangian
DDS, MS, CLEC, FAAPD
Dr. J is a board certified pediatric dentist and owner of Scripps Pediatric Dentistry & Brush n Brace, pediatric dental offices located in San Diego, CA. He is not only a Diplomat with the board but now also has Fellow status with the AAPD. He is a proud father of 3 beautiful girls, a San Diego native, loves soccer and is passionate about pediatric oral health. His mission is battling the number 1 disease that he has seen take over our beloved children. #AskDrJ provides answers and solutions to parents questions & concerns regarding their children's oral health. Click here for a full list of articles from #AskDrJ