A dental sealant, or pit-and-fissure sealant, is a protective plastic coating applied on the chewing surface of teeth to help prevent tooth decay. Dental sealants, alongside the discovery of fluoride, are widely seen as two of the greatest advances in preventative dentistry. Preventative dentistry is the field of dentistry that tries to prevent decay from occurring, as opposed to simply treating already decayed teeth.

Tooth Decay

Through regular use, our teeth get covered with a sticky film of bacteria called plaque. The bacteria found in plaque is harmless to our teeth, but combined with sugar or starch-containing foods which we regularly consume, they cause decay. The bacteria in plaque convert the sugar and starch into acids that can attack tooth enamel - termed "acid attacks". For some people, repeated acid attacks may eventually result in decay.

Regular brushing and cleaning between teeth with floss helps remove food particles and plaque that forms on the surface of tooth enamel. Another way to prevent decay would be to consume less sugar, so the bacteria in plaque have nothing to convert into harmful acid.

How do sealants protect from decay?

The top picture is of an isolated tooth that has been cleaned, but does not have sealant applied. The bottom picture is of the same tooth but with dental sealant applied. While it appears "wet", the material is actually hard and sealing the pits and fissures.

Certain parts of teeth are more susceptible to decay than other parts. For children and teenagers, the most common place that tooth decay develops is on the chewing surface of the back teeth (molars and premolars) - where dental sealants are most useful.

When you run your tongue along the chewing surfaces of these teeth, you can feel depression and grooves called "pits and fissures", respectively. Regular brushing and flossing helps clean most of the tooth surface, but pits and fissures are often difficult to access and keep clean. Tooth brush bristles cannot reach into the microscopic grooves to remove plaque bacteria that accumulate there.

A dental sealant is a plastic material applied to these surfaces that act as a barrier, protecting the enamel from plaque and acid. They are safe, and have been effectively used for decades. Dental sealants are not noticeable, bring no discomfort to the patient, but wear down with time, so they need to be re-applied with time.

Who are dental sealants for?

Since the likelihood of developing tooth decay on the chewing surfaces begins early in life, children and teenagers are the best candidates for receiving dental sealants. Adults can benefit from sealants as well, but for them, decay tends to occur on the sides of teeth, so flossing plays a more significant role in preventing decay. Adults who are susceptible to tooth decay though are often great candidates for dental sealants as well. They include those with poor oral health, deeply pitted or fissured teeth, or highly cariogenic diets.

Dental Procedure

As discussed, the procedure is most often performed on baby teeth soon after they have erupted, since these teeth are highly susceptible to decay. The procedure needs to be repeated yearly though, as the sealant gets worn off with regular chewing.

To begin, your dentist first cleans the teeth surface using pumice and a small rubber cup attached to the dental drill. They are dried, and a weakly acidic solution is applied to the surface. The acid helps etch the surface of the teeth lightly so that the plastic can hold onto something and be retained longer. Then, each tooth is "painted" with a very thin layer of the sealant coating.

Your dentist will then shine a high-density curing light on the surface of the teeth that sets off a chemical reaction within the sealant coating. The coating hardens and goes from being liquid, to a solid plastic coating. The coating is clear, or slightly white, and blends easily with the natural color of teeth. It is not visible to others, does not affect your bite or occlusion and is painless to apply. With regular fluoride use, dental sealants are a great way to protect the teeth of children and adults who are susceptible to decay.

Cost

Dental sealants can range from roughly $20 to $50 per tooth. The ability of sealants to protect teeth from decay make them a very popular choice among dentists and patients alike, since they save a great deal of hardship and cost down-the-line. Dental insurance will often cover the cost of dental sealants; however, this is dependent on the level of insurance you have. See your dentist about the advantages of sealants for your particular situation.