The role of fissure sealants in children’s teeth

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Oral Hygiene and Dental Therapy
BOH (LaTrobe)

childrens_dentistryAs the saying goes, prevention is better than the cure. And if you have ever been faced with tooth ache or the prospect of dental fillings, root canal treatment or even tooth extraction, I’m sure you would agree – even with the help of a caring and experienced dental professional.

Fissure sealants are hard protective coatings that are applied in order to cover and protect the deep grooves (fissures) in our teeth and prevent dental decay. These fissures are most commonly located at the chewing surfaces on back teeth (molars and premolars). The grooves are at high risk for decay as they can be deep and narrow and collect plaque bacteria and food that cannot be accessed by toothbrush bristles. The plaque bacteria trapped in the fissures produce acids that can go on to cause decay at these prime sites. When these grooves are sealed, the risk for dental decay can be markedly decreased, especially in children’s teeth.

According to the Australian Dental Association, a fissure is five times more likely to develop decay than any other tooth surface. Also, on a tooth surface with completely sealed fissures, protection is 100%. With wear over time, even after five years, a sealed tooth still has half the risk of an unsealed tooth. It is common to treat only those teeth that are identified to have a high risk for decay, but your dentist might recommend that you have all premolar and molar teeth sealed as a precaution.

The first permanent molar teeth erupt into the mouth when a child is around 6 years old. The permanent teeth are important as they have a role to play throughout adult life. The best time to apply fissure sealants is immediately after the permanent teeth appear, as this is when they are most susceptible to decay – and children do not develop the manual dexterity to brush their own teeth effectively until they are of 8 to10 years old. Further permanent teeth continue to erupt right up until the age of 11 to 14.

Hence, fissure sealants are a good preventative measure to lower the risk for dental decay in children’s teeth. Many studies have shown that fissure sealants are an effective way to lower risks for dental decay if combined with regular dental checkups and a good oral hygiene routine and diet.

What is involved?

The treatment is conservative, painless and non-invasive. No injections or drilling are involved. The materials used to seal the fissures are safe and may be a very strong plastic or a material called a glass ionomer. The colour may be white or clear.

First the tooth is thoroughly cleaned and the area is kept dry. The tooth is prepared with a weak acid or conditioning agent to ensure the sealants bond well to the tooth. Then the sealant is applied in liquid form. A UV light may be used to set the material hard. The tooth is then checked and may be smoothed if necessary. The patient can eat and drink as normal immediately after the procedure.

As fissure sealants are most commonly placed in high-stress areas such as the chewing surfaces, they are subject to wear and may intermittently require reapplying.

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