What are dental sealants, and should my kids have them?

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Today, let’s talk about dental sealants for kids! 

You might hear conflicting opinions about the benefits and risks of dental sealants, and we want to help you understand why we often recommend dental sealants at our office. Simply put – dental sealants are a safe and easy way to protect teeth from cavities.

Want to know more about what a sealant is, what they’re used for, how long they last, and if they work to prevent cavities? Let’s explore.

VIDEO: What is a Sealant?

What is a dental sealant? 

As a tooth grows, it grows in lobes. Ideally, as those developmental centers come together, they coalesce and make tight seams. But most of the time, there’s a tiny gap where these developmental lobes meet. Typically, that space is too small for a toothbrush bristle to reach. Some people have deeper grooves than others, and you get a lot more staining and cavities for those people.

So, what is a dental sealant? A dental sealant – or sealant – is a thin plastic coating that flows into and over the grooves of the pits and fissures on the tooth’s biting surface. 

What’s the difference between a dental sealant and a filling?

When I was in dental school, the general rule was that if there were any chance that a cavity was starting, only a filling would be appropriate. For a filling, we remove a portion of the tooth and, ideally, all the bacteria in the groove of the tooth, then we replace it with a strong plastic material. So, a filling is a more invasive procedure compared to a sealant. 

We now know that sealants have been inadvertently placed over microscopic cavities for a long time, and cavities did not form under those sealants. When we can ensure that the sealant is placed properly, it prevents food from reaching any remaining bacteria that are under the sealant. The sealant starves the bacteria and they cannot continue producing acid and breaking down the tooth. 

Of course, we prefer to place a sealant on a recently erupted tooth because we can catch it before it even starts to form a cavity, but even if a small cavity is starting to form, we are often able to prevent progression with a sealant. Sealants are about 80% effective, which is pretty amazing! 

What’s the difference between a dental sealant and fluoride?

Fluoride works well on smooth surfaces, but it doesn’t work well on grooves of the teeth. That’s why sealants and fluoride work so well together! While fluoride helps to protect those smooth surfaces sealants help to protect the groovy surfaces. Both sealants and fluoride are part of a successful cavity prevention plan.

Here’s what we do when applying a dental sealant for kids

When we apply a dental sealant, first, the tooth is cleaned. Then, the thin plastic material flows down into those grooves. While it is still in a fluid state, we can adjust it to make sure it goes right where we want it. After that, we use a UV light to start a polymerization reaction that cures it from a fluid to a solid state. This hard coating prevents food and bacteria from accumulating in the groves and prevents cavities from forming.

When explaining sealants to kids, we often place the material on their fingernail to show them what we’ll be doing and then we shine the UV light to make it hard. Not only is it interesting for them to see, it also helps them be more comfortable with the steps of the procedure. It’s pretty cool and actually kind of similar to having gel nails placed! But, of course, we’re using medical-grade plastic and not nail polish!

You might also wonder – can you eat after sealants? Once a sealant is placed and cured, it is as hard as it ever will be. That means you can eat and drink normally following sealants.

The great thing about a preventative procedure like sealants is that your child won’t need to be numb, and the procedure is less invasive than a filling. So you can definitely make a sealant appointment that is right before lunch.

How long do dental sealants last?

Another question parents ask a lot is: how long do dental sealants last? A sealant can last a really long time, but I always have a hard time answering this question because there are a lot of factors that go into it.

If a kid is chewing on hard sticky candies like a Jolly Rancher or hard, cold items like ice, a sealant can’t be expected to last as long. A sealant can come off fairly quickly or it could last for 50 years. Believe it or not, my mom still has her sealants on after all these years! 

We check how the sealants are looking at each appointment and we can recommend replacing or touching up sealants if we see they have been lost. Thankfully, with the right care and monitoring, sealants can last a very long time.

What are the risks of placing a dental sealant? 

Sealants are a preventative procedure, but of course, every procedure has some risk. The risks of sealants have been well researched, and minimized, and can be broken down into 3 categories: cavities forming under sealants, sealants fracturing, and BPA release. 

When sealants were first introduced, there were many concerns about the safety and dangers of sealants. Thankfully we now have many decades of research to support their benefits and safety. Let’s dive into some of the specific concerns dentists and patients have had about sealants.

  • Cavities can form under sealants, but only if the mechanical binding between the tooth and product is insufficient. When food, even microscopic particles, can get under the sealant, any bacteria that remain can produce acid and form a cavity. The frustrating part about cavities forming under a sealant is that they may be larger before they are discovered since the sealant can obscure the area at regular examinations. For kids who struggle at dental visits, sealants may not be an option since a bad sealant is worse than no sealant. So to minimize this risk, in addition to carefully following the evidence-based steps to placing a sealant, we also will not place a sealant if we cannot meet the standards. 
  • Sealant fracture used to be a big concern for dentists. The theory was that if a sealant broke and a rough margin remained, bacteria would accumulate along this rough area. In addition to providing a surface for bacteria to latch onto, dentists thought that it would be especially hard to keep the area clean, and then cavities would likely form along the broken sealant. The good news is that many replicated studies show that even a fractured sealant provides some prevention and protection from cavities and does not increase the risk of cavities. 
  • BPA or bisphenol A is a plastic ingredient that can act like estrogen in the body, and long-term, high-dose exposure can cause a variety of health disorders. Trace amounts of BPA may be released when dental sealant and filling materials are cured. These trace amounts of BPA may be further reduced by fully curing the material and wiping or rinsing the surface after placement. So while there may be a transient increase in BPA in the body, it would not be a concentration or duration that would result in health conditions. 

Looking for your pediatric dentist in Bellevue?

Expedition Pediatric Dentistry is a pediatric dentist in Bellevue, WA, providing dental care for infants, children, and adolescents in Bellevue, WA. We also accommodate special needs! If you’re local, book an appointment, and we can figure out the best treatment plan for your child from our office!

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