What is the point of fissure sealants if they just fall out?

Your time is limited. In between sports training, tutoring and drop-offs and pick-ups there is very little time for extra activities. This especially applies to health appointments. You simply do not have time for problems such as fissure sealants that fall out. I have created this blog in response to a lot of parents asking me the same question: “what is the point of fissure sealants if they just fall out?” Read on to find out how I answer this question at my clinic Riverstone Family Dental. We see plenty of these cases and if you need a dentist great with kids, I recommend you give us a call on 8678 3538.

What are fissures?

Fissures are the grooves which naturally occur in your teeth. They are especially prevalent on the biting surfaces of your back teeth (molars and premolars). If you run your tongue over your back teeth you will find that there are high spots and low spots. The low spots are grooves which allow food to get stuck and sit there for long periods of time. To top this off, deep and narrow fissures cannot be properly cleaned with a toothbrush. This results in trapped food attracting bacteria which then leads to the formation of a cavity.

Are fissures in teeth bad?

Shallow fissures are okay. But some of us have really deep fissures in our back teeth. There are many studies looking at fissures. Most studies agree that fissures are approximately 5 times more likely to develop decay than other surfaces of a tooth. If we go back to eruption dates, we know that our adult molars come through at around 6 years of age and then another set come through at 12 years of age. If your child likes sticky and sweet foods and also has deep grooves, then they may start to develop cavities in their back teeth as early as 6 years of age. This can lead to pain, sensitivity and lots of treatment to try and fix the holes in their permanent molars. As a dentist, I try really hard to avoid these types of problems by educating my patients about diet, oral hygiene and also assessing their grooves and recommending fissure sealants where indicated.

What are fissure sealants?

Imagine you are adventurous and decide to tile your own kitchen. So you put the tiles next to one another and in between them, you need to seal the grout. The reason you need to seal the grout is to prevent staining, bacteria and mould from setting in. Fissure sealants act in the same way as grout sealer. They prevent food and bacteria from getting stuck in deep grooves. Therefore preventing cavities from developing in these surfaces. The steps your dentist will take vary depending on the type of plastic material they use. In general placing a fissure sealant will consist of three main steps:

  • Cleaning the tooth

Prophy, pumice or other agent may be used to ensure any existing plaque is removed before coating the fissures.

  • Chemical agitation

Etch, dentine conditioner or another chemical agent may be used to strengthen the bond of the plastic material used to coat the fissures.

  • Placing the sealant

The liquid sealant will be gently infused into the fissures. This is then set and hardens under a UV light. Studies have shown that it penetrates into even the deepest grooves. By doing so, the sealant can remain there and protect these deeper areas even if the superficial portion of the sealant is broken or lost. Placing fissure sealants is quick and painless. Your child may experience a slight difference in their bite. If this is an issue, it can be adjusted. For the most part, it is minor and your child will get used to it. Kids prefer sealants to fillings. This is because fillings may require numbing up, drilling then filling the cavities.

Why do some fissure sealants fall out?

In my experience, this happens in less than 5% of patients. There are many reasons why fissure sealants may fall out, here are the two main ones:

  • The material of choice may determine how likely a sealant will last. I am more likely to recommend a material which is forgiving to moisture if my patient is very young and cannot tolerate a long appointment. This material also releases fluoride over a period of time so helps to strengthen the tooth. I weigh up the pros and cons of placing such a material. If the benefits of placing this material outweigh the cons then it is better to place it, even if it is an interim treatment. This sealant may be pink in colour so that me or other dental professionals can recognise it immediately.
  • Kids that eat lots of hard, sticky foods are at high risk of decay. Therefore, a dentist is more likely to recommend fissure sealants for their molars. Fissure sealants can be at risk of breaking when the same diet is continued. Despite how strong they are, sealants can break if exposed to constant pressure from lollies like Minties, Roll-ups, Red Skins etc. I will always give diet advice along with placing sealants, both of these factors will help protect your child’s teeth.

I hope you have found this blog helpful. Fissure sealants are one of the tools your dentist may use to prevent holes in your child’s teeth. There is an enormous amount of evidence demonstrating how effective sealants can be in preventing cavities on the chewing surfaces of molars. Aside from diet and oral hygiene, sealants remain one of the best ways to prevent holes in permanent teeth. Need a caring, family dentist? Call Riverstone Family Dental today on: 8678 3538.

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