What is a Fissure Sealant?
A dental sealant (or fissure sealant) is a preventative treatment that seals the patterns on the tops of your back teeth to help protect them.
A special dental paint is used to paint the chewing (occlusal) surface of your tooth. This flows into all the nooks and crannies to seal them, making the tooth easier to keep clean and less likely to decay.
A completely sealed tooth offers near to 100 percent protection. The material used for a dental sealant is a flowing composite (composite filling material that contains little or no filler). Sometimes GIC is also used.
Why Would you Need a Fissure Sealant?
The biting surfaces of your back teeth contain a complex pattern of pits and fissures.
Pits are deep indentations in your tooth and fissures are grooves or valleys hence the term ‘fissure sealant’.
If the pattern is quite simple and shallow and you are able to keep it clean easily with your toothbrush, then a sealant is not generally needed.
If the fissures are deep and narrow, they can provide a sheltered place for bacteria to grow. The bristles of your toothbrush may not be able to reach the plaque and food debris that gets stuck in there and over time this can lead to decay. A fissure is 5 times more likely to develop decay than other tooth surfaces.
Not every child needs fissure sealants.
However, They are indicated in the following:
- Decay and fillings in their baby teeth
- Deep and difficult fissures for cleaning
- Poor hygiene
- Special Needs- anyone medically compromised, physically or mentally disabled or with learning difficulties.
Which Teeth Should be Fissure Sealed?
Fissure sealants are generally placed on the molar teeth- most commonly your first permanent molar, but they can also be placed on the second permanent molar if necessary.
If you have decay in one of your first permanent molars, all of them (the remaining three) should be sealed and if you have decay in more than one, it might be a good idea to seal all the second permanent molars too.
Unless the child is a special needs child or has a very unfavorable tooth form, premolars are generally not sealed.<
When Should you have a Fissure Sealant, if one is Required?
They are generally placed in children and teenagers, not on baby teeth and rarely in adults.
The best time to place the fissure sealant is when the adult tooth has just erupted and certainly within two years. For the first permanent molar, this would be around the age of 6 years old and for the second permanent molar, the age of 12.
The reason it is best to do this as soon as possible after the tooth has come through, is because this is when the enamel of the tooth is at its weakest. Dentists would refer to the enamel as being ‘immature’ meaning it hasn’t been exposed to the mouth and fluoride for long enough to toughen up.
Having said that, you can get decay in the patterns of your teeth (pit and fissure caries) at any age- you are just more vulnerable and likely to have problems shortly after the tooth has come through.
In adults, sometimes we do something called a PRR- a ‘Preventative Resin Restoration’ . This a combination of a small white filling– aka a ‘resin restoration’, in the top of your tooth (where decay has occurred) and a ‘preventative’ fissure sealant (to protect the remaining pattern from future decay).