Sealants are a plastic barrier to protect the chewing surfaces of the eight permanent molars from decay. The six-year molars usually erupt (come in) between five and seven years of age and the twelve-year molars erupt around 11 to 14 years of age. More than 90% of decay occurs in the deep grooves of the chewing surfaces of these molars. When teeth first erupt, the enamel is not completely calcified (hardened), and the teeth are very susceptible to decay. Sealants should be applied as soon as the molars are in far enough to see the entire chewing surface. If a primary (baby) molar has early decay on a chewing surface, and the child is cooperative, a sealant may be recommended. Once decay has penetrated the second layer of tooth structure, a restoration (filling) must be placed.
The application of a sealant is painless, but does require cooperation. A very high flow of saliva, a strong gag reflex, or an inability to open the mouth wide enough for access to the molars, will make the procedure difficult. Your dentist will use various methods to manage these circumstances. The most important requirement for a quality sealant is your child's cooperation.
In order to see how the sealant is performed, you and your child could ask if
you may watch the procedure being performed on another child or your dentist may have a videotape or DVD that you may view. There are four six-year molars and four twelve-year molars. Because the teeth do not always come in at the same time, all four permanent molars may not be sealed during one visit.
First, the tooth must be isolated from saliva. Remember, the tooth must be
dry for the sealant to bond tightly to the tooth surface. A gel will be applied for 15 seconds. After this is rinsed away with water, the sealant is applied (usually with a tiny brush). A bright light is used to harden the sealant. There is no heat or sensation from the light. The procedure takes only minutes for each tooth. Your child may eat right away.
Sealants do wear out. Retention rates are about 85% over three years. Grinding teeth and chewing ice, popcorn kernels, or hard candy can crack sealants. How well the child's enamel bonds with the sealant will often determine how long a sealant will last. If a sealant is lost, the tooth is still more protected from decay than if the tooth had never been sealed. Decay will probably not occur if the sealant is replaced during the next six-month dental check-up. If your child has had a problem with cavities and his or her oral hygiene is very poor, decay can still occur.
Sealants are one of the very best things dentistry has to offer. Seal out your child's decay!
by Jane A. Soxman, DDS
