What are Dental Sealants?
Dental sealants are a dental treatment used to prevent dental decay (caries) or cavities especially among young kids. The decay is a result of breakdown of teeth due to activities of bacteria.
WHO document on this subject says that ‘Oral health is essential to general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.’
Children with unattended tooth decay not only bear pain and infection, but they face problems while talking, eating, learning, socializing thus affecting their overall growth and performance in the school. Worldwide almost 60–90% of school children and most adults suffer from dental cavities that often leads to pain and discomfort.
Dental sealants are the most harmless and pain-free method of guard against tooth decay and cavity formation. The biting surface of teeth is prone to damage and requires protection as they have recesses and the back teeth (molar and premolars) have fissures (grooves), these grooves help to grind food. As a molar grows, pits and grooves develop on their surfaces which are capable of trapping food particles in them thus enhancing the growth of bacteria and resulting in dental caries. Generally use of toothbrushes and flossing removes plaques and other food materials stuck on the smooth surfaces of the teeth, but they are unable to reach into these recesses, depressions and pits present on the surfaces of the teeth; thus making these areas an easy target for plaque accumulation and bacterial growth.
The sealant is basically a thin, plastic coating material, which is commonly applied to the surface of the teeth on the enamel adjoining the pits and fissures. Once applied, the fissure sealant rapidly bonds and hardens and once in place, it protects the teeth from any tooth decay.
New research has proved that dental sealants not only protect healthy teeth from dental decay, but they can also resist the decay in its initial stages by sealing off the bacteria and preventing the cavity from spreading.
Children and teenagers are the main candidates for dental sealants. Children should get their permanent molars and premolars sealed as soon as they erupt into the mouth, if required other teeth can also be sealed.
Permanent molars are most likely to gain from teeth sealants; first molars erupt when a child is 6 years old and second molars appear at about 12 years of age.
Also low- income group of children are more prone to dental decay; they have higher rates of tooth decay and are less likely to get this dental treatment on time.
Tooth decay among children can be largely prevented through school-based sealant delivery programs. These programs provide dental sealants to students either onsite in schools using transportable dental equipment or offsite in dental clinics. These programs are useful for low-income group children, having poor oral hygiene and for those with irregular dental visits. Child dental health care should begin at birth itself.
Dental sealants can only be seen when observed closely and are not visible when the child smiles or talks. Dental sealants for kids are highly recommended because they protect the teeth from acid attack from sugary foods that cause tooth decay, such as chocolates, candies, cookies, chips, biscuits, etc. Consumption of sugary beverages could be hard on your teeth and cause tooth decay.
Teenagers and young adults can get dental sealants to ensure protection to their teeth in the coming years. Dental sealants for adults can also be used if their molars or any other teeth are without any tooth decay or fillings.
Fissure sealants should be inspected or reapplied regularly because due to the chewing forces applied on them there are chances of them getting chipped off or being damaged or getting worn out.
It is important to note that these fissure sealants cannot substitute the role of fluorides. Fluorides, which are present in mouthwashes, toothpaste and community water supplies also prevent tooth decay. In fact, fissure sealants and fluorides can simultaneously help to protect the tooth from caries.
Overall fissure sealants are a successful preventive method for caries, and as long as the tooth sealant remains bonded to the tooth surface, tooth decay can be prevented.
The premolars and the molars at the back of the mouth are more vulnerable to accumulation of plaque and formation of cavities due to their position at the back and anatomical structure. The Dental sealants also known as pit and fissure sealants or fissure sealants can be used to fill these depressions in the molars and premolars, thus making the surface smooth, which are much easier to clean.
Applying fissure sealants to teeth is an easy and pain-free procedure. Only a few minutes are required for your dentist or dental hygienist to paint the sealant on each tooth.
The procedure involves the following steps:
- First your dentist will clean your teeth which have to be sealed, dry them and place cotton, any absorbent material or a rubber dam around the tooth to keep it dry.
- An acidic solution is applied to the tooth enamel to make the surfaces
rough, which facilitates the tooth sealant to bond onto the surface of the tooth.
- The tooth is then rinsed and dried to proceed further. The part of the tooth where acid was applied should look dull and frosty, similar to an etched glass.
- After this tooth enamel is painted with a thin, plastic coating of dental sealant, where it fuses with the tooth and hardens. At times, your dentist will use a special high-intensity curing light to harden the sealant. As the coating is clear and white, it merges with the natural tooth color.
- These dental sealants can stay intact for many years, but they should be examined at regular intervals for any damage or possible re-application.
The success rate of a fissure sealant is determined by the length a sealant remains intact on the tooth surface and not by the decay observed in sealed or unsealed teeth.
The reasons for fissure sealant failure are saliva contamination while placing the sealant, lack of clinical experience, uncooperative patient, and less potent tooth sealant material used.
The factors which can facilitate good retention of fissure sealants to the tooth surface are as follows:
- Correct isolation of teeth during the procedure
- Proper cleaning of the fissure to get rid of food debris and plaque
- Avoiding placing sealants on partially erupted teeth as there is gingival tissue on the crown.
Dental sealants are an essential dental treatment in preventing tooth cavities but there are some pros and cons of the procedure.
The pros are as follows:
- Can greatly reduce the risk of caries especially on the molars by filling up the pits and fissures.
- It is the easiest way to decrease the number of fissures and depressions in all the teeth and among all age groups, as it is a simple and painless dental procedure.
- It is also an easy dental treatment for the dentist or the dental hygienist to perform.
- After undergoing this dental procedure a person can be caries-free for at least 10 years.
- As fissure sealants are clear and white, they readily merge with the tooth surface, thus not affecting the aesthetic aspects of the patient.
- Fissure sealants are not very costly and can save a lot of money and extreme dental procedures in the future.
- Dental sealants do dissolve in saliva and are safe.
The cons are as follows:
- Cost could be a factor to avoid the procedure.
- Requires a second sitting after 10 years.
- They are not fool-proof and can get damaged due to the chewing forces that are constantly applied.
- Proper isolation of the tooth is required during placement of tooth sealants. Otherwise, the procedure will be a failure.
- Brush your teeth atleast twice a day
- Follow proper brushing technique
- Replace your brush with a new one after every 3-4 months
- Follow a habit of flossing your teeth
- Avoid sugary or sticky foods such as sweets, cakes, sodas, biscuits; especially between meals
- Drink plenty of fluoridated water to prevent dental caries
- Go for regular dental check-ups
- Pit and fissure sealants - (https://www.dentalhealth.org/tell-me-about/topic/childrens-teeth/pit-and-fissure-sealants)
- Sealants - (http://www.mouthhealthy.org/en/az-topics/s/sealants)
- Dental sealant - (https://en.wikipedia.org/wiki/Dental_sealant)
- About Dental Sealants - (http://www.cdc.gov/oralhealth/dental_sealant_program/)
- Tooth Decay - (http://www.nidcr.nih.gov/oralhealth/Topics/ToothDecay/SealOutToothDecay.htm#whoShouldGet)
- Oral Health Topics - (http://www.ada.org/member-center/oral-health-topics/dental-sealants)
- Know More About Dental sealants - (https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dental-sealants)
- Fillings and sealants - (https://www.dhsv.org.au/dental-health/teeth-tips-and-facts/fillings-and-sealants)
- States Stalled on Dental Sealant Programs - (http://www.pewtrusts.org/en/research-and-analysis/reports/2015/04/states-stalled-on-dental-sealant-programs)
- More on Dental Sealants - (http://jada.ada.org/article/S0002-8177(14)61447-1/fulltext)
Latest Publications and Research on Dental Sealants
- Knowledge and Management of First Permanent Molars with Enamel Hypomineralization among Dentists and Orthodontists. - Published by PubMed
- Effect of Heat and Sonic Vibration on Penetration of a Flowable Resin Composite Used as a Pit and Fissure Sealant. - Published by PubMed
- Pit and fissure sealants penetration capacity and their correlation with fissure morphology. - Published by PubMed
- Efficacy of CO lasers in preventing dental caries in partially erupted first permanent molars: a randomized 18-month clinical trial. - Published by PubMed
- Evaluation of antimicrobial properties of Solanum xanthocarpum and Pistacia lentiscus extracts on Streptococcus mutans, Lactobacillus species and Actinomyces viscosus: An in vitro study. - Published by PubMed