Definition and Overview
Dental fissure sealant, also known as pit and fissure sealant, is a type of dental treatment prescribed for the prevention of tooth decay.
These sealants are applied to the biting surface of the teeth, especially on the grooves or fissures of the back teeth (which are wider and have more roots) and the cingulum pits of the front teeth, which are especially vulnerable to tooth decay because food debris easily gets stuck in these parts. Cleaning dental fissures and pits with just regular brushing is also more difficult particularly for young children.
Tooth decay, also known as dental caries or cavities, is the progressive breakdown of the human teeth. This condition is often caused by bacterial activity inside the patient’s mouth. Upon visual inspection, teeth affected by tooth decay might exhibit colours of yellow to black, depending on the severity of the condition. Patients might experience extreme tooth pain, which can lead to difficulties in eating as well as observe pain and swelling of the tissue surrounding the tooth, eventual tooth loss, serious infection (characterised by fever and other symptoms), and the formation of abscess in the gums.
Bacteria can break down the hard tissues of the teeth known as the enamel, dentin, and cementum—whenever these tissues are weakened by acid coming from sugar and food debris. Caries-causing bacteria use the simple sugars found in food as an energy source, which means that a high sugar diet increases an individual’s risk of developing tooth decay. Individuals with diabetes Mellitus and Sjogren’s syndrome, or taking certain medication (such as antihistamine or antidepressants) are also at a higher risk of developing dental caries.
Who Should Undergo and Expected Results
Dentists typically prescribe dental fissure sealants to children, who are at a higher risk of tooth decay. Younger patients usually have these sealants placed as soon as their permanent (or adult) molar teeth have broken through. Due to the anatomy of the chewing surfaces of the molar teeth, they are not properly protected by the caries-preventing compounds of the saliva or fluoride in toothpaste and drinking water.
The sealant is made of a clear, plastic-like material that protects the teeth from tooth decay. This is considered to be more effective in preventing the development of caries in younger individuals, compared to dietary restrictions. It forms a hard shield that prevents food debris and bacteria from being stuck in the grooves of the teeth. In younger patients, most cases of tooth decay occur in the back teeth, where food debris and bacteria are harder to remove by normal brushing.
Dental fissure sealants are effective in preventing caries in children as long as the material remains adhered to the patient’s tooth. Typically, sealants are effective for five years or more, despite the high chewing pressure they undergo every day. With some younger patients, the fissure sealant remains in place even through adulthood.
However, if the sealant is improperly applied, it can break down faster due to contamination of the patient’s saliva.
How is the Procedure Performed?
The procedure to coat the teeth with dental fissure sealant is relatively straightforward. The patient will have to go in to the dentist’s office to have this done, and because the procedure is very simple, the patient typically does not need to make an advance appointment or other preparations.
If the patient is a child, the dentist might take some time to explain to him or her what will happen during the procedure.
A dental hygienist will then clean the patient’s teeth properly (removing all traces of plaque and food debris) before calling in the dentist for a quick visual inspection. The dentist will then coat the tooth with a special solution, and wait for a couple of minutes to wait for this solution to dry. Typically, the special prep solution does not require special equipment for drying—the patient’s mouth will just be kept open for a while.
A liquid, plastic-like material will then be applied to the tooth, which will then be set by a curing light. There are several types of resin-based dental fissure sealants that can be used on young patients, including those that require UV curing light for setting, an autopolymerised material, a type that only requires visible (ambient) light for curing, and a fluoride-fortified sealant to boost tooth protection.
Recently, more and more dentists are using glass ionomer sealants, which contain fluoride and are generally less sensitive to moisture. This type of fissure sealant also prevents tooth decay in the long run—even after the sealant has fallen out—because of their fluoride-releasing ability.
Possible Risks and Complications
Dental fissure sealants are generally safe and should not cause risks and complications in patients.
- American Dental Association