This is the second article in a three part series telling you of our top 3 ways to prevent decay in your child’s teeth. If you missed it, read part one on why baby teeth are important and why decay is hard to find in some kids molar teeth.
Fissure sealants are a great preventative treatment for decay
No matter how well you clean those back teeth, it is a common site for decay in children’s teeth. So a useful strategy is to seal these deep grooves to prevent decay.
If a tooth is heading down the track towards a cavity we want to get to it as early as possible.
Detecting any early damage will allows us to clean the groove out and seal it up before there’s a cavity.
Fissure sealants vs a filling
Once there is a cavity in a tooth we will have to drill right through the enamel in order to remove the decay in the tooth and place a filling. This means the tooth always ends up weaker. For the rest of your life the tooth is never going to be as strong as if it were intact and perfect.
The beauty of a fissure sealant is it allows us to clean the groove out many times without going through the enamel. The “bio-rim” of your enamel is left intact with a fissure sealant and the tooth stays strong.
What are the pro’s and cons of Fissure sealants?
The pros of fissure sealants are that they save you from getting cavities.
The cons of fissure sealants are that they cost money and time.
Do fissure sealants use the same material as fillings?
Yes. There are different types of materials and techniques that dentists use to do fissure sealants, so it is worth asking your dentist about their method.
For us our important first step is to thoroughly clean out the grooves and we use a ‘bur’ for this as it cleans everything out including the plaque. We then stain it with a dye to make sure that all the bacteria are gone and then we seal it up using an epoxy resin which is the longest lasting fissure sealant material.
Some practitioners may use a material called glass ionomer, which is a quick, ‘dirty’ and cheap solution. Some don’t even clean all the bacteria out first – the thinking is that if you seal over the top of the bacteria all will be fine. I’m not a fan of that because you just can’t be sure about what’s going on underneath the seal.
We use the epoxy resin rather than glass ionomer because it’s harder, more durable and it’s got better adhesion. In terms of how long these materials will last, we can’t be definite as there are external factors such as the patient’s bite etc that can vary the lifetime of a fissure sealant. We tell patients fissure sealants will last between 5-10 years, which is similar lifetime to a filling.
There are some special cases where we would use glass ionomer as an interim measure. This is usually only when something is happening, such as the tooth not through the gum yet. In these cases we seal it up as best we can while the tooth coming through the gum and when it’s through we would remove the temporary seal and put the proper sealant in.
Are fissure sealants common in school age children and primary school age children?
The teeth are most susceptible to deep groove cavities are the molars: the 6 year old molars and 13 year old molars. Naturally everyone is different so some kids don’t need any, some we recommend one or two and in other cases we recommend all the molars get a fissure sealant as they are all susceptible.