Dental sealants can come off (and often do) or wear away over time. The main reason for failure is not being able to keep the tooth dry whilst placing the fissure sealant.
For a sealant to be successful, it is crucial the tooth is totally isolated from saliva and in a child’s mouth this can be easier said than done- with their limited attention span, small mouths and gallons of saliva.
If the sealant comes off, the tooth is simply back to where it started and can be replaced.
As a guide, 50% of sealants will last over 5 years.
One danger of sealants is that part of the sealant comes away and part stays bonded to the tooth, or the sealant doesn’t effectively seal the tooth. If this happens, then decay
can occur underneath out of site needing a large filling
later on when it is detected. Screening X rays
are useful in monitoring this and should be taken at appropriate times.
In my opinion unless a good job can be done of placing the sealant, it is better to wait until the tooth is a little further through and the child can open wider to allow easier access.
In the mean time, a high fluoride varnish
can be painted on the pattern (E.g. Duraphat) every 6 months to help reduce the chances of getting any problems. This has proven to be an effective alternative to fissure sealing.