More than 90% of all decay occurs in the deep grooves and fissures of the six-year molars and the twelve-year molars. Sealants are a plastic covering to protect the chewing surfaces of these permanent molars. These surfaces are highly susceptible to decay when they first erupt because the enamel is not fully calcified. Once decay has penetrated into the second layer of tooth structure, the dentin, a restoration (filling) must be performed. Sealants offer no protection for decay in between the teeth.
Sealants should be applied as soon as the molars have erupted enough to see the entire occlusal (chewing) surface. The application of a sealant takes only minutes and is painless, but it does require a cooperative patient. A very high flow of saliva, a strong gag reflex or inability to open the mouth wide enough to access the molars will make the procedure very difficult. A DVD may be viewed in the office to preview sealant placement. Isolation of the tooth from saliva is critical to retention of a sealant. A gel is applied for 15 seconds and rinsed off with water. A tiny brush is used to apply the liquid sealant and a bright heatless light is placed over the tooth for 15 seconds. The child may eat immediately.
Sealants are a form of a plastic and do wear out. Retention rates average 85% over three years. Grinding teeth, chewing ice, popcorn kernels or hard candy will fracture sealants. Some enamel bonds better than other enamel and this can also increase or decrease the retention time of a sealant. Although no one can promise that a sealed molar will never experience decay, the chance of decay is significantly reduced. If the oral hygiene is poor, decay can occur around the edges of a sealant. Checking sealants is an important part of the six-month periodic examination. If a sealant is lost, it can usually be replaced before any decay occurs.
Sealants are one of the very best things dentistry has to offer! Seal out your child’s decay!
Sealants
Dr. Jane A. Soxman
Pediatric Dentistry