Sealants & Icon Treatment
We’ve talked about restoring teeth, but would you like to sit through a procedure to prevent a cavity from forming in the first place? Would it help you decide if you were told that there is no need for anesthetic (a shot) to do it? Welcome to sealants.
Sealants were developed in the 1950s and first became available commercially in the early 1970s. The first sealant was accepted by the American Dental Association Council on Dental Therapeutics in 1972. Sealants work by filling in the pits and fissures on the chewing surfaces of the teeth; all those grooves formed in the valleys of the pointed cusps. This keeps out food particles and bacteria that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years. In fact, research has shown that sealants actually stop cavities when placed on top of a slightly decayed tooth by sealing off the supply of nutrients to the bacteria that causes a cavity.
Sealants are best suited for permanent first molars, which erupt around the age of 6, and second molars, which erupt around the age of 12, though they can also be placed on primary molars (baby teeth) and permanent premolars (bicuspids) as well.
Sealants are most effective when applied as soon as the tooth has fully come in. Because of this, children derive the greatest benefit from sealants because of the newness of their teeth. Research has shown that more than 65% of all cavities occur in the narrow pits and grooves of a child’s newly erupted teeth because of trapped food particles and bacteria. These areas are too fine for a toothbrush to effectively clean out.
Sounds great right, how is it done? Sealant application involves cleaning the surface of the tooth and rinsing the surface to remove all traces of the cleaning agent. An etching solution or gel is applied to the chewing surface of the tooth for 15 seconds and then thoroughly rinsed away with water. After the site is dried, the liquid sealant material is applied and worked into the pits and fissures with a fine brush and then hardened by using a special curing light. The etching and curing is the same process used when placing tooth colored composite restorations.
Sealants should last at least 3 years, in fact in our office we guarantee it. If a tooth that has been sealed gets a cavity in the chewing surface within 3 years of placement, any fee paid by you or an insurance company will be applied toward the cost of any necessary restoration. We’ve seen sealants last 10 years and more. Everyone’s teeth are different, some develop with almost unnoticeable pits and fissures, other’s look like the Grand Canyon. The more accentuated the grooves are the better the sealant will be retained. Conditions under which the sealant was placed can also impact how long they last, saliva for instance contaminates the surface and the bond is adversely affected. Sealants should always be examined at the child’s recare appointment. Most insurance covers sealants, often without a deductible or co-pay, but usually only on permanent molars and often only to a certain age.
There is also another treatment than can be offered that does not require anesthesia and is useful under two circumstances. The first is after braces. Many people develop “white spot lesions” on their front teeth around where they had brackets. These areas are often times semi-circles and are the result of less than ideal home care while in braces. The accumulated plaque led to the early stages of a cavity, demineralization of the enamel and show as a white spot. Through a very technique sensitive process, the enamel can be etched sufficiently deep and a liquid then placed on it that penetrates and fills in all of the demineralized areas resulting in a masking of the white spots. No shots, no drilling involved and no filling to potentially stain or fall out in the future. The down side is the expense; due to material cost and time in the chair, it is nearly the same price as a filling and insurance likely won’t cover it. The second circumstance where this product can be used is when early stage cavities are noted to be forming interproximally (in between teeth). When x-rays show a darkening in the outer part of the enamel, but no penetration through the enamel and into the dentin (inner hard part of tooth) three choices are available: drill it out now and restore, watch and wait for it to enlarge or avoid the drilling with the same process mentioned for white spots after braces. Again, the expense is likely to be yours, but you avoid the shots and removing of otherwise sound tooth to access the problem area.