Fissure Sealants
Fissures are the grooves that naturally occur on the biting surface of teeth. All molars and premolars have fissures to some degree. Occasionally, fissures occur on canines and incisors.
If the fissures are very deep and narrow, toothbrush bristles cannot fit inside to clean out food particles. Trapped food attracts bacteria, which multiply within the fissures and make a sticky coating called plaque. Plaque acids eat into the tooth enamel and cause decay.
Not all fissures are often prone to decay. Only the deepest and narrowest fissures are at risk. A fissure is five times more likely to develop decay than other tooth surfaces. In children and adolescents, the chewing and grinding surfaces of molars and premolars are the most vulnerable.
Fissure sealants are often plastic coatings that fill the fissures and protect teeth from dental plaque and acids. Glass ionomer cements may be used as an alternative material.
Many studies have shown that fissure sealants are effective in reducing the occurrence of tooth decay. On a tooth surface with completely sealed fissures, protection is 100 percent. As the fissure sealant wears down, protection is reduced. However, even after five years, a protected tooth has half the risk of decay compared to an unprotected tooth.
Treatment is painless and non-invasive, with a coat of the sealant applied to a cleaned tooth. The liquid sets in minutes and forms a physical barrier that stops food, bacteria and plaque acids from contacting the tooth surface. Fissures sealants may be white, clear and tinted.
Most sealants are applied to molars and premolars, but any tooth that has fissures can be treated, including incisors. Primary or “baby” molars may also be recommended for treatment. Fissure sealants gradually wear away after several years and can be reapplied if needed.
Your dentist may suggest the use of fissure sealants after an examination of your teeth or those of your child or teenager. It is common to treat only those teeth most at risk of decay. However, your dentist may recommend treatment for all premolars and molars as a safeguard.
If detected very early, tooth decay can sometimes be treated with fissure sealant instead of a filling.
APPLICATION OF FISSURE SEALANTS
Fissure sealant application is a simple process that may be performed by your dentist or by a supervised dental therapist or dental hygienist. Many different types of sealant are available, and different application techniques are used.
The general procedure
- Teeth are thoroughly cleaned and dried, because food debris and saliva can prevent the sealant from sticking correctly to the tooth. In some cases, some shallow drilling may be needed.
- The tooth surface is coated with either a weak acid gel or a chemical solution, depending on the type of sealant used. This step ensures that the sealant sticks to the tooth surface.
- An adhesive resin may be applied under the sealant.
- The liquid sealant is applied.
- Depending on the type of sealant, a white light may be used to activate bonding and hardening.
- The liquid quickly sets to form a durable plastic coating on the tooth’s surface. Some sealants release fluoride to further strengthen the tooth.
- Your bite will be checked to ensure that it is correct and comfortable. The layer of sealant should be thin enough to allow the proper occlusion of the upper and lower teeth.
While an intact issue fissure sealant offers excellent protection against decay on the treated surface, your dentist cannot guarantee that treatment will prevent decay on all tooth surfaces.
