Dental Sealants
By Joseph Preziosi Jr., DMD
Sealants are used prophylactically to prevent caries (tooth decay) on teeth. Sealants are usually the recommended treatment for permanent posterior (back) teeth of children, but can be used on primary, or baby teeth, or on older patients who are prone to caries.
Typically sealants should be applied to the child’s permanent posterior teeth as soon after their eruptions as possible. This allows the sealants to be in place and protecting the child’s permanent posterior teeth for the greatest length of time and during the time span when the child’s oral hygiene will typically be the worst due to their young age.
The first posterior permanent teeth that lend themselves to sealants are the child’s first molars that typically erupt at the age of six years old, thus their other appellation six-year molars. Sealants can then be applied to the first premolars, or bicuspids, when the child is approximately 11 to 12 years of age, then the second molars, when the child is approximately 12 years old and the second premolars, when the child is approximately 12 to 13 years old.
Most dental insurance plans will cover the molars up to about the age of 17 or 18 and pay benefits for them to be replaced every three to four years. However, many dental insurance companies do not pay benefits on premolars. As with all benefits they are subject to the patient’s specific dental insurance policy and each policy must be referenced to determine the specific benefits it provides.
Sealants are microfilmed composites that are chemically bonded onto the surface of the teeth. To achieve the strongest possible bond and therefore the greatest possible protection for the teeth receiving the sealants the teeth need to isolated from the rest of the mouth via a rubber dam. This allows the tooth to be chemically conditioned without exposing the rest of the child’s mouth to the harsh chemicals while also keeping blood and or saliva away from the treated tooth, either of which will significantly reduce the bond strength between the tooth and the sealant. The sealant is placed over the treated tooth’s exposed surfaces and is then usually light cured, exposed to a light source that initiates the polymerization reaction that changes the sealant from a liquid to a solid. The sealant is placed over the tooth’s surfaces that have deep grooves in them that prevent easy cleaning and thus give rise to an environment that the bacteria that cause dental caries (tooth decay) can colonize and exploit. Sealants are always placed on the occlusal, or biting, surface of the teeth and can often be placed on the facial aspect, the side of the tooth that is adjacent to the lips and cheeks, and or the lingual or palatal aspects, the side of the teeth that are adjacent to the tongue and palate (roof of the mouth) respectively, depending on whether or not there are any deep developmental groves present on these surfaces.
Once a sealant is in place it is very difficult for the tooth to get caries on the surfaces that are protected by the sealants. However, it is important to realize that sealants can come off, especially if they were applied without proper isolation, such as a rubber dam, sealants will eventually wear aware and need to be replaced and sealants cannot be placed between teeth. It is this area between teeth that is the site of most dental caries on teeth that have received sealants.
As with every aspect of preventive dentistry nothing is foolproof and is a stand-alone remedy to any problem. Sealants are an integral part of preventive dentistry along with continued professional care, fluoride treatments, proper brushing and flossing and fluoride fortified dentifrices and supplements in areas that have less than optimal water fluoridation.
About the Author:
Joseph Preziosi Jr., DMD
New Jersey Cosmetic Dentist
phone. (908) 654-7100
fax 908-654-8764
email: Drpreziosi@aol.com
url: http://www.preziosidentistry.com/
