Tooth sealants are thin coatings dentists apply to the chewing surfaces of the back teeth (occlusal surfaces). They can also be applied to the lingual surfaces of the front teeth (tongue side surfaces).
Sealants help keep food particles, acid, and bacteria out of tooth surfaces. The thin plastic coating forms a “protective shield” on the grooves of teeth and is an effective, safe, and painless way to prevent cavities.
Tooth sealants are typically applied to permanent teeth that do not have cavities yet. In some cases, sealants may also be applied to baby teeth, but this is less common.
In extremely rare cases, they can also be placed on teeth with minor cavities, but cavity fillings are often recommended instead to prevent further decay.
Sealants reduce the risk of decay in back teeth by up to 80 percent, especially in children and teens.
Sealants are most useful in preventing cavities in a child's newly erupted permanent teeth, including the premolars, first molars, and second molars.
The earlier sealants are placed, the better. A child’s first permanent molar (back tooth) erupts around age 6 and the second permanent molar erupts around age 12. However, teenagers (13+) are also good candidates for sealants.
Sealants can only be applied to the chewing surfaces of teeth. They cannot be applied to the smooth surfaces of teeth (in between), so cavities can still form in these areas. It is essential to floss your teeth daily and brush your teeth twice a day, even if you have sealants.
Adults may also be candidates for sealants. Some adults have deeper grooves in their back teeth, which puts them at a higher risk for tooth decay. These areas are hard to reach and clean with a traditional toothbrush. Sealants may be recommended in these cases.
According to the American Academy of Pediatric Dentistry, dentists recommend placing pit-and-fissure sealants on the biting surfaces of teeth in children because:
Children between 6 and 11 years of age who do not have tooth sealants are about 3x more likely to develop cavities.
Sealants are separated into two categories, including glass ionomers and composite resins, based on the reaction that occurs when they are applied to teeth:
Glass ionomer sealants undergo an acid-base reaction as they set on a patient’s teeth. They also release fluoride, which helps strengthen tooth enamel for many years.
Dentists typically only apply glass ionomer sealants to primary teeth.
Pros — Glass ionomer sealants release fluoride, making them very effective in reducing the chance of dental decay by up to 35 percent. Fluoride contains antibacterial properties, which helps keep the teeth strong.
Glass ionomer sealants have a chance of leakage over time. Although, the fluoride ions in glass ionomers still provide protection after leaks by mineralizing tooth enamel.
Eventually, the fluoride runs out, but the enamel’s health and strength increase. Glass ionomer materials also blend in with the color of natural teeth.
Cons — The main disadvantage of glass ionomer sealants is that they have a lower retention rate than composite resin, which means they require more upkeep. However, glass ionomer sealants provide better protection against caries than composite resin sealants.
Composite resin sealants are applied with a dental curing light. These sealants consist of a plastic compound and ceramic, which blends in with the color of your natural teeth.
Pros — Composite resin materials are strong and protect against dental caries (cavities) for a long time. They have a higher retention rate than glass ionomers and last 5 to 10 years. The material is also the same color as your natural teeth.
Cons — The main disadvantage of composite resin sealants is that they do not have acid-base bonding properties and do not release any fluoride.
When the sealant wears down over time, which is inevitable, it does not protect against cavities as well as glass ionomer sealants do.
Treatment is completed within one office visit and is relatively simple, fast, and painless. Patients can return to normal dietary and lifestyle habits within minutes after the treatment is complete.
The procedure consists of three steps:
Step 1 — Sealants are direct restorations, which means they are made inside of the mouth and not in a dental laboratory. First, the dentist cleans and dries the tooth to prepare it for treatment.
Step 2 — An acidic gel is placed into the grooves on the tooth. After 20 to 30 seconds, the etchant functions to open up tiny pores on the enamel surface that the sealant bonds to.
Step 3 — Next, the dentist rinses out the acidic gel and dries the tooth again. Then they place the sealant material into the grooves of the patient’s tooth. Lastly, they cure the sealant either chemically (glass ionomer) or with a special dental light (composite resin). Both types of sealant materials come in a liquid form.
Since dental sealants are a preventive dental treatment that protects teeth from cavities and decay, some dental insurance plans cover part or all of the cost.
The cost of glass ionomer sealants without insurance is between $30 and $75 per tooth. The cost of composite resin sealants without insurance is between $30 and $75 per tooth.
Sealants are completely safe for teeth.
Many people are worried about the toxicity of sealants because they contain compounds that turn into BPA on contact with saliva.
However, the highest level of BPA reported in saliva from tooth sealants is more than 50,000 times lower than the LD50 values reported for BPA. Toxic exposure to BPA from dental materials is low and poses no current health risks.
Dental sealants can be removed for a variety of reasons, including an improperly placed or damaged sealant. Certain foods, drinks, and everyday wear can also damage a sealant. If this occurs, you will need to get the sealant removed and replaced.
With proper care, dental sealants can last up to 10 years. Sealants protect against 80 percent of cavities for 2 years and will continue to protect against 50 percent of cavities for up to 4 years.
Children and teenagers most commonly get tooth sealants. However, adults are also candidates for sealants, especially if they are prone to cavities or have deep pits and fissures in their teeth.
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