Thursday, February 11, 2010

What are dental sealants and are they safe?

Dental sealants protect the grooved and pitted areas of the teeth against tooth decay.  They’re thin plastic coatings that bond to the teeth to prevent plaque and bacteria from getting into areas that are difficult to brush.  Depending on an individual's tooth anatomy these crevices may be more or less difficult to clean.  In some cases, even the best brushers won't be able to clean these areas as the toothbrush bristles may be wider than the crevices.  Typically, we seal the first permanent molars that grow into the mouth at around age 6 and also the second permanent molars that grow at around age 12.
Placing sealants requires no drilling of the teeth.  The procedure involves cleaning the tooth, applying a conditioning gel or "etch", placing the sealant which has a syrupy consistency, and curing it in place (or hardening it) with a light.  While the procedure is painless, we have to keep the tooth dry with cotton rolls, and some kids don’t like the feeling of the cotton in the mouth.  Afterwards the sealants often have a sticky or tacky feeling.  Again, some children get concerned about this, but it goes away after a day or two.
The sealants we use are tooth colored or a bit lighter than the tooth.  They can be sometimes be seen in an illuminated mirror, but not from a social distance when talking or eating.  Sealants can last 5 to 10 years, though I think 3 years is more the average.  In our office we check the sealants at every cleaning visit.  If they need replacement within the first year we do so at no cost to the patient.
While sealants are an excellent tool for cavity prevention, they don’t replace the need for a healthy diet and proper oral hygiene.  In fact, sealants can’t prevent cavities in the front teeth or in between the back teeth.  Sometimes we may recommend sealing baby teeth.  This isn’t done routinely, but only when we see a baby tooth that looks like it’s developing the beginnings of a cavity.  This would only be done if the tooth wasn’t going to be falling out soon and we wanted to avoid doing a full filling.  In this case we may remove a very superficial layer of the affected tooth enamel.  This sensation involves lots of vibration, but it doesn’t hurt.
Being a recent father, I’m always paying close attention to what my baby is exposed to.  One of the most prevalent, and highly publicized, chemicals that I try to avoid is bisphenol-A or BPA.  BPA is found in many plastic products, including a few brands of sealant.  In our office, we use a brand of sealant (Ultraseal, by Ultradent) that doesn’t contain BPA.  Instead it uses a much more stable Bis-GMA (see referenced link below for more info).  That being said, no sealant (or any other dental restoration for that matter) is “natural”.  They best way to maintain a healthy, chemical free mouth is still by eating well and having excellent oral hygiene.  This is also why, in our office, we don’t seal teeth in every patient.  We do so on a case by case basis only after a thorough examination and consultation.
For more information on the sealant we use see this link:
The American Academy of Pediatric Dentistry has this to say:
And the CDC:

As always, I’m happy to answer any questions here or you can reach me below at: