Sealants

Sealants have been available for almost thirty years, yet, the idea is still new to many and the need is not well understood. Tooth decay should already be a problem of the past but, unfortunately, it is not. Why? Because, only 11% of the children in the United States have had one or more sealants. Without a sealant more that half of the molar teeth will eventually decay. 

Start of Decay

Tooth decay starts in childhood because children are especially vulnerable to it. They do not have their resistance built up, and most of the new permanent molar teeth have tiny open holes in the enamel surface. This is a huge invitation for bacteria to eat away the softer inner dentin. Enamel is like skin, it is suppose to protect the underlying dentin from bacteria and wear. Unfortunately, the groves in the center of many teeth have flaws which allows the decay to easily penetrate the tooth's protective layer. Once inside the hard enamel, decay will mushroom out into the dentin and destroy large amounts of tooth in just a few months. 

Painless Repair

Children today do not have to be afraid of the dentist. In fact, they should look forward to their visits since they will be the focus of attention and receive vast amounts of information and preventive care.

The best thing to do is repair the tiny flaws in the groves in the center of many teeth with a bonded sealant before decay starts. Once the tooth surface is properly cleaned a thin sealer is applied which flows into the porosity of the enamel and seals out the decay germs. This painless procedure does not require any shots or drilling. (It is so easy that in California, and many other states, auxiliaries may legally apply the sealants). 

The sealings a tremendous cost savings to the consumer. As long as the tooth is sealed, there is 100% protection from decay on the biting surface. Sealants wear out and should be replaced as needed until about age 25. By that time, the cavity prone years are over and there is no further benefit from sealants with the possible exception of the wisdom teeth (18 year molars). 

Sealant Actually Stops Decay

80% of the decay in children's permanent teeth is located in the vulnerable groves. New permanent molars come in at ages 6, 12, and 18. These years are the critical ones since the sealants should be applied before decay begins. However, research has shown that if a tiny amount of decay has already begun, the sealant will actually stop it. 

Decay must have contact with the oral cavity otherwise it cannot proceed. Apparently, if a few decay germs are left under the sealant they are entombed until the sealant is lost. If, on the other hand, a substantial amount of decay has already begun then a combination sealant restoration is indicated. 

No Need To Drill Away Good Teeth

In the past when a pin head size cavity was found dentists were taught to place a large pea sized lump of mercury/silver in an oversized preparation. In order to do that, they drilled away about 1/3 of the middle of the tooth. This excess drilling weakens the tooth 75% and often leads to broken and dead teeth (root canals and crowns) later in life. 

With the sealant/filling there is no need to drill away any good tooth. If a pin head size cavity has already begun, then a pin head size filling should be placed in the area of decay and a sealant applied to the rest of the surface of the tooth.