What is the procedure for a fissure sealant?

The procedure for a fissure sealant is very simple and only takes a couple of minutes. It varies slightly depending on the type of sealant and manufacturer being used but will be similar to that described below.

Your dentist, therapist or hygienist can perform it.

No anaesthetic is required and it is totally painless. It just takes being open for a couple of minutes and and the dentist being able to keep the teeth really dry whilst placing the fissure sealant.

• The child lies back in the chair and the tooth being sealed is padded out with cotton wool rolls, absorbent pads, a salivary ejector or rubber dam- whatever is necessary to keep it dry and isolated from saliva.

• The tooth is cleaned with a brush or cup (sometimes using pumice) to remove any plaque and food debris.

• A special blue gel is placed on the tooth. This is a mild dental acid that etches the tooth.

• This is then washed off thoroughly with water. The nurse will use suction to remove the water and re- isolate the tooth. The tooth will have a frosty appearance so you know that it has been etched properly.

• The fissure sealant then flows like paint into every part of the pattern of the tooth (all the pits and grooves).

• The material is then set hard (or ‘cured’ as the dentist would say) by the nurse with a special blue dental light and the bite will be adjusted if it is too high. Generally the tooth will feel a little spongy to bite on, but it will wear and feel normal again within a couple of days.

The above procedure will often be repeated for the remaining three first molar teeth until all four have been protected.

How do I look after my sealed teeth?

Is there anything I can’t or need to do afterwards?

No- the good news is that once the sealant is set hard- that’s it! You can eat and drink as normal. It is important that you continue to care for teeth well; brushing, flossing and keeping a good diet.

DO NOT assume that sealants mean you don’t have to brush!

The dentist will simply review your sealants when you come in for your check up every 6 months- to check that they are still there and doing their job. If any sealant has been lost, or partly come away, it may need to be replaced.

What problems can you get with sealants?

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.