What are fissure sealants, and why are they placed?
Dentistry has changed in many ways. We are now becoming more preventive based and therefore decreasing the amount of dental disease in younger people.
Nevertheless, decays that occur on fissured surfaces, account for 80% of decays on recently erupted permanent teeth. Often the grooves (fissures) in the teeth are deep, meaning that the bristles of the toothbrush do not access these deep grooves, and fluoride cannot penetrate deep into these areas of enamel. Because of this, bacteria and food can stay in the grooves – forming acid, which can cause decay.
Fissure sealants are usually a tooth-coloured material that is set hard within the grooves of the back molars to make the grooves smoother and easier to clean. Fissure sealants do not require the tooth to be cut prior to placement, and are a non-invasive way of preventing decay. They are a preventive measure to reduce the incidence of decay in back teeth. Sealants are placed in molars of young children and adolescents.
How do I know my child needs fissure sealants?
A number of studies have shown that the first molars (erupting around 6-7 years of age) and the second molars (erupting around 11-13 years of age) are the highest risk teeth of developing decay. Evidence suggests that just as we use vaccinations to protect against other diseases (such as chicken pox and polio) we should be protecting these at risk teeth. The majority of disease in teeth occurs in these molars, so to lower the risk of complications throughout our lifetime, placement of sealants at the earliest time possible is of great benefit.
Reference: ‘Grouping of tooth surfaces by susceptibility to Caries: A study in 5-16 year old children’, Batchelor PA, Sheiham A, BMC Oral Health, 2004;4(1):2.
Reference: ‘Permanent dentition caries through the first half of life’, Broadbent JMI, Foster Page LA, Thomson WM, Poulton R, Br Dent J. 2013 Oct;215(7):E12
How are fissure sealants placed?
Teeth tend to have grooves that can retain food, bacteria and debris. Therefore it is essential that the grooves are thoroughly cleaned and dried.
Firstly, micro air abrasion of the tooth surface to clean away debris is done. Then followed by application of a conditioning liquid for 20 seconds, which is then washed off and thoroughly dried. This provides a clean surface for the material to bond to. It is essential that no contamination occurs at this point.
Then the sealant material is processed and applied immediately to the tooth surface to fill in all grooves, fissures and defects. A blue light is then applied for 30 seconds to help with setting, followed by polishing and checking of the bite. The whole procedure takes less than 8 minutes per tooth.
Before: the grooves of the teeth are deep and can decay.
After: the grooves of the teeth are fissure sealed, so that they are smoother and easily cleaned
How long do they last?
Fissure sealants have a failure rate of 5-10% each year.
As they are a thin layer of material placed in the grooves on chewing surfaces of the teeth – they can chip and wear over time. The best way to keep fissure sealants for as long as possible is to maintain good oral hygiene, use fluoride toothpaste and have a healthy diet.
Poor oral hygiene and poor dental health can weaken the enamel of the tooth surrounding the fissure sealant. When this occurs, the enamel of the tooth will not be able to retain the fissure sealant as well as strong enamel. As fissure sealants can chip and wear over time, it is important that you attend for regular dental appointments to review the fissure sealants to make sure that they are still protecting your teeth, and if they are chipped – repairs are made as soon as possible with ease.
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