Tooth decay has been a common oral problem affecting both children and adults. Children are more susceptible to the problem because their teeth have multiple bumps and grooves on the chewing surface. Food debris becomes trapped in the grooves, increasing the risk of tooth decay. In adults, the molars have multiple pits and fissures, which increase the risk of tooth decay, especially where poor oral hygiene is involved. Fortunately, at The Encino Dentist, we will use dental sealants as a preventive measure to protect teeth prone to decay. If you are considering dental sealants, here is what you must know before seeking treatment.
Dental Sealants Overview
Dental sealants are thin, clear, or white liquid coatings painted on the chewing surface of the tooth, especially the molars and premolars. Once the liquid is hardened using a special light, it forms a plastic protective layer that shields the tooth from hazardous bacteria that cause cavities. Additionally, the coating shields the fissures from any contact with acidic bacteria that can corrode the enamel, causing cavities or holes, which later turn into tooth decay. Dentists recommend sealants as a preventative option to shield against tooth cavities and decay.
You rely on the back teeth to chew food. These are the same teeth, with multiple, deep fissures that sometimes trap food debris. When debris interacts with food particles and plaque, it forms an acidic substance that dissolves the minerals that form enamel, creating tiny holes called dental cavities. Initially, cavities develop silently, but when they extend into the dentin and pulp, you develop tooth decay, which can cause pain. This explains why decay is common in both children and adults in the back teeth.
Dental sealants partially fill the deep fissures or grooves, which reduces their depth and makes it easier to brush. With proper brushing, you remove all debris and plaque, reducing the risk of cavities and decay.
According to the American Dental Association, sealants can reduce tooth decay by 76% over 24 to 36 months. So, your dentist may recommend dental or fissure sealants because they have been tested and proven over time.
Types of Fissure Sealant Materials
Sealants are applied to the occlusal or chewing surface of the tooth to penetrate anatomic surface pits, forming a protective layer that shields the surface from harmful bacteria. The material used is determined by the reaction it produces when placed in your mouth.
One of these materials is composite resin. Resins are tooth-colored, even though they do not exactly match the color of natural teeth. However, because the material is applied to the posterior teeth, they are difficult to notice in the mouth. Manufacturers use plants or synthetics to make resin. The dentist applies composite resin sealants in the mouth, which polymerize under the special dental curing light.
The other material is glass ionomers, a combination of glass powder and a water-soluble acid. These sealers, unlike resin ones, do not require a curing light to set. They undergo an acid-base reaction during applications. Their downside is that they are less durable, according to some research.
Dental Sealants Candidacy
Toddlers and children aged 4 to 17 are most at risk of fissure-related issues, making them ideal candidates for dental sealants. However, even adults without dental fillings or tooth decay in posterior teeth can benefit greatly from fissure sealants. Generally, any party that is susceptible to tooth decay is a candidate for dental sealants.
Your dentist will examine your child’s teeth and advise whether fissure sealants are necessary. It is normal for the occlusal surfaces of the molars and premolars to be rough and filled with pits and fissures, as these help with digestion. While grooves are beneficial, they increase the risk of decay because deep ones can trap food debris and plaque, which can promote decay. As a result, you can schedule a fissure sealant application for your child when they develop their first permanent molars and premolars. That way, the protective coating can shield the child’s teeth from ages 6 to 17, when they are most at risk of decay. Normally, the first permanent molars develop at age six, and the second at age twelve.
Sometimes sealers can be used even on toddlers. For instance, your child is a good candidate for fissure sealants if their milk teeth have deep grooves that could trap debris and bacteria, leading to cavities and decay. Decay of the baby teeth poses a huge risk to your child’s future oral health, as these are the teeth that set the foundation for the permanent teeth. Early loss of baby teeth could lead to misalignment and other severe oral problems. Therefore, when your toddler develops baby molars, they can undergo a fissure sealant procedure to reduce the risk of decay and preserve the teeth for healthy permanent ones.
If you did not receive sealants during the age when the risk of tooth decay is high, you might be wondering if you are an ideal candidate as an adult, especially if you have noticed that your back teeth have deeper than usual pits and fissures where food particles get lodged.
Well, if you do not have dental fillings, suffer from tooth decay, and your occlusal surface is in good condition, you qualify for fissure sealants. If you are considering sealants as an adult, visit your dentist for an evaluation and a determination of candidacy.
Fissure Sealants Procedure
Dental sealants are placed during routine dental visits, so there is not much preparation involved in the treatment. The procedure is non-invasive and often involves applying fluoride, followed by the sealant for additional protection. The steps you should expect your dentist or dental hygienist to follow during the treatment include:
Thoroughly Cleaning the Teeth
After determining that you or your child qualifies for a fissure sealant, your dental expert will thoroughly clean the teeth to remove any plaque or food debris accumulation. Your dentist does this to remove harmful bacteria and facilitate proper bonding between the tooth and sealant material.
The cleaning performed by the dentist is professional, not the routine cleaning you do at home. The dental expert starts by attaching a small toothbrush to a dental drill. As the drill rotates, your dental expert cleans the occlusal surfaces, removing debris, plaque, and harmful bacteria from the bumps and grooves. For better cleaning, the dentist can dip the tiny brush in a mixture of ground pumice powder and water. The mixture forms a wet, thick paste that enhances the brush’s performance.
If debris is lodged in the grooves even after thorough cleaning, your dental expert can use an enameloplasty or an air-abrasion technique to remove it. Enameloplasty entails debris removal using a dental drill. Only a tiny portion of the enamel is removed, so you do not require an anesthetic for the procedure. Conversely, the air-abrasion technique uses a mini-sandblaster to remove any remaining debris and plaque from the grooves and bumps. Even though the device makes a lot of noise, the technique is painless.
Conditioning of the Tooth Surface
Once your dental expert finishes cleaning the tooth, the next step is to use a brush, sponge, or cotton pellet to apply an etching gel to the occlusal surface where the sealant material will be applied.
The dentist applies the gel to the entire occlusal surface, ensuring all tooth sections are covered to prevent bacterial recurrence.
Tooth etchant gel is acidic and contains 50% sulfuric acid, which is crucial for killing bacteria lodged at the bottom of fissures. Therefore, applying the gel is necessary, even though it causes a sour taste when it comes into contact with the tongue.
Once the etchant settles, the dentist will clean it after one minute, which is enough time for the gel to be in contact with the grooves, killing all harmful bacteria.
Drying the Tooth and Reviewing the Etching Process
After the dentist removes the etch from the tooth, they will dry it with an air nozzle to enable a proper evaluation of the treatment. The sulfuric acid in the etch gel dissolves some of the minerals that form the enamel, so your tooth might be white, dull, and frosty after the process. However, roughness is crucial for proper sealant bonding to the tooth’s occlusal surface.
The dentist should isolate the prepped tooth to keep it dry. If the tooth comes into contact with saliva, it will be re-exposed to the harmful bacteria, forcing the dentist to restart the etching procedure. The dentist uses several techniques to isolate the tooth after drying, including packing gauze or wrapping a rubber dam around the dried tooth.
A rubber or dental dam is a thin, square sheet that dentists use to isolate a dried tooth from the surrounding ones, creating a safe zone for sealant application. The dentist uses the dental dam by creating a hole in the tooth to isolate it, then places the rubber dam over the tooth.
Application of Sealant Material
While the tooth is isolated and dry, your dentist will apply the dental sealant to your pits and fissures. The application can be done using a brush or syringe applicator provided by the material manufacturer.
The sealant material is in liquid form, allowing it to flow easily into pits and fissures for partial filling. The material is used in some pits and only partially fills them. It is only applied to the deep pits that trap debris and are difficult to clean, with the intention of reducing the grooves to an acceptable depth that is easy to clean but still rough enough to enable proper chewing.
Curing the Dental Sealant
If you are having composite resin dental sealants applied, your dental expert will use a special curing light to trigger polymerization, which hardens the sealer liquid and creates a thin, plastic protective coating. The curing light produces a blue light, which activates the polymerization catalyst in the liquid. The liquid sets once the dentist shines the blue curing light on it.
On the other hand, glass ionomers set right after the acid-base reaction. Polyacid-adjusted composite resins and resin-modified glass ionomers are set through a combination of acid-base reactions and polymerization, yielding sealants with unique features that vary by material type.
Assessing the Dental Sealant
Once the sealant sets, your dental expert must evaluate it to determine that it fits perfectly. An experienced dental expert will check the new depth of the sealed grooves to ensure the depth has been reduced as desired.
Additionally, they will inspect your bite around the treated tooth to ensure that the procedure has not affected your bite. If a sealant is too thick, it may create an imbalance in the molars, overloading certain teeth during chewing. Therefore, if your dentist finds the sealants are thicker than expected, they will trim them with a dental trimmer to achieve the correct thickness and uniform occlusal surfaces. After you pass the evaluation, you can resume your eating routine, as the procedure does not impact your diet.
However, immediately after you leave your dentist’s office, your bite might feel off; this is normal, as your mouth stays open for a few minutes during the sealant application. Your mouth should feel normal after a few hours. Nevertheless, if the problem persists, your sealants might be abnormally thick, and you should see a dentist. Wait a few days before returning to the dentist for an examination, as the sealant material may wear out on its own due to its soft nature, potentially restoring your bite.
Fissure Sealants Recovery and Outlook
Dental sealants are noninvasive and have no recovery time. You can resume your life immediately after the procedure. Normal life resumption also applies to your food. You can consume the food of your choice after the treatment. However, you must be careful with hard or crunchy foods, as they could chip or erode the thin plastic coating.
Dental Sealant Lifespan and Durability
Dental sealants can last 5 to 10 years, depending on your diet, aftercare, and the material used. Also, you should visit your dental expert regularly for an examination to check if they are still functioning. If they are chipped or worn out, you risk tooth decay under the layer. The protective coating wears out over time, so dentists encourage you to replace or repair it regularly.
Similarly, the lifespan of your fissure sealants depends on your oral hygiene. The plastic coating only provides a shield from harmful bacteria on the occlusal surface. The sides of the tooth are still susceptible to harmful bacteria and plaque, and calculus buildup. Therefore, during brushing, ensure that the brush reaches all the surfaces of the tooth, even the one with the sealant. Also, you are encouraged to floss your teeth to remove any debris on the gum margins and teeth.
After brushing and flossing, you should rinse the mouth using an antiseptic mouthwash to kill harmful bacteria and remove remaining food debris from the mouth. Flossing is highly effective in removing plaque and food particles, so do not replace it with mouth rinsing.
No significant diet adjustments are required after a dental sealant treatment. However, you can extend the lifespan of your sealants by reducing your intake of hard foods, as these can chip or erode the sealant. Sticky foods are also discouraged because they could stick to the protective coating, causing it to peel.
Advantages of Dental Sealants
Fissure sealants offer several benefits. These include:
- Affordability
If your child is covered under Medicaid or CHIP, you will not pay for a dental sealant if you seek the treatment in a dental office approved by the relevant insurance program. These insurance programs in California also cover adults, so you should contact them to find out whether they will cover the full or partial cost, depending on your insurance level.
Most dental clinics charge $45 to $75 per tooth for sealants. This is a small price compared to what you must pay for invasive treatments when you develop tooth cavities and decay, when your teeth remain exposed to harmful bacteria. The cost of sealants is very affordable compared to alternatives such as root canals, dental crowns, or implants that you may need if you develop tooth decay.
- It is a Simple and Brief Procedure
Sealants are noninvasive and take only minutes to apply, so you spend less time in the dental office. The few minutes you spend visiting the dentist save you the constant worry of developing cavities.
- Improve your Oral Health
Tooth decay can lead to severe oral and health complications. Even if you remove the decay and fill the opening, the tooth’s structural integrity will be compromised. If the decay progresses to form periapical abscesses, you are at risk of severe infection if the abscesses burst and bacteria spread to the bloodstream. Dental sealants act as a protective measure, preventing tooth decay before it happens, thus preserving your overall oral health.
Other benefits include:
- High durability with proper care
- Shields the grooves from food debris
- They are not noticeable through the mouth because they are clear or white and are applied to the posterior teeth.
Disadvantages of Dental Sealants
If you are considering sealants as a preventive measure, it is worth exploring their disadvantages, as well as their advantages, so you can weigh them and decide whether to proceed with the treatment. However, in this case, the benefits of the treatment outweigh the downsides. The disadvantages of sealants include:
- They require regular replacement as they only last between five and ten years, depending on how you care for them.
- You cannot undergo the treatment if you have existing dental decay or fillings
- If the protective layer is not properly fitted, harmful bacteria can enter the fissures, leading to cavities and decay.
Discuss these disadvantages with your dentist to determine whether sealants are a good preventive option for you or your child.
Tooth Decay After a Dental Sealant Procedure
Some fissure sealants are clear, enabling your dentist to see beneath the plastic coating, ensure it is functioning properly, and identify tooth decay early before it spreads. Sometimes sealants can fail in their primary purpose, exposing the tooth to decay. For this reason, you are encouraged to visit a dentist regularly for checkups. In these meetings, the dentist can spot the decay early and replace the sealant with more advanced procedures, such as dental fillings and, in severe cases, dental crowns and implants.
When the decay is moderate, your dentist extracts the decayed material, cleans the tooth, and uses dental filling material to fill the opening.
In severe cases where the tooth structure has been compromised, the dentist removes the decayed material, fills the opening with a dental filling, and then covers the entire tooth to provide additional support. However, if the tooth cannot be salvaged, the dentist extracts the damaged one and surgically places a dental implant in the jawbone to serve as an artificial tooth root. After, they use a dental crown or other prosthetic of your choice to replace the visible section of the tooth.
The Difference Between Dental Fillings and Sealants
Dental fillings and sealants are used to protect teeth from decay. However, their application differs. Dentists use sealants to partially reduce the risk of decay in deep fissures. At the same time, a filling procedure involves removing decayed material through drilling and filling the resulting hole with a suitable filling material. Once the material is in place, the dentist hardens it with a special UV light and then checks the bite to ensure you can bite properly. The dentist can recommend either of these two depending on your age and oral needs.
Find a Competent Dental Sealant Dentist Near Me
Dental sealants are safe and an excellent preventive measure against tooth decay for toddlers, children aged 6 to 17, and even adults. They provide a protective layer that prevents the tooth from coming into contact with harmful bacteria. They are a great investment for you and your kids, even though they are not foolproof. However, before undergoing the procedure, you should be evaluated and discussed. At The Encino Dentist, we will evaluate you or your child to determine if sealants are right for you. Call us today at 818-650-0429 for a zero-obligation consultation.