Fissure Sealants

Fissure Sealants are a protective layer placed on the Occlusal biting surface of Molar teeth. The Occlusal surface is a natural stagnation area where cavities can occur.    These sealants are placed to protect the fissures from decay.

Decay will occur due to poor diet and brushing due to bacteria that exists within plaque.  If the sticky film of plaque is not thoroughly removed, cavities will begin to form.

Children’s’ 1st molars erupt at approx 6 years of age – 6s at 6, and as young children have not developed a good brushing technique, therefore cannot remove debris from within the fissures of the molars. They are also susceptible to caries, especially between the ages of 6 -17.  It is very common to place sealants on these newly erupted teeth before cavities can be allowed to form.  Placing the sealants essentially makes a smoother surface which in turn means that plaque cannot gather deep in the fissures and makes tooth brushing easier.  The 2nd molars generally erupt around the age of 12, and as these are susceptible to caries, these too are generally fissure sealed.
Adults too can benefit from fissure sealants if they are at high risk of caries.
Dentists and Dental Therapists are, at present the only professionals who can place fissure sealants.
Fissure sealants are a relatively quick and easy procedure.  In the past, the tooth was undercut and amalgam was placed but the disadvantage of this was that you were essentially cutting into sound enamel.  The introduction of Glass Ionomer and Composite has changed how this procedure is carried out today.

Generally, the patient does not require an anaesthetic.  Firstly, the dentist will clean the tooth area with a slow hand piece and a dab of prophylaxis paste.  As Composite is not an adherent material, the dentist will acid etch the tooth surface to make it retentive.  Cotton wool rolls are placed to retract the tongue and cheek if needed, as the acid etch as a very bitter taste, this can upset the younger patients and make them gag, which can make the child nervous and in turn un-cooperative. This is left on for around 20-30 seconds. Good, thorough aspiration is required when rinsing off the acid etch as to avoid the patient swallowing it.  As the surface needs to be completely dry, the dentist will then completely dry the tooth and again place cotton rolls to tongue and cheek area.  The dentist may require you to use the slow saliva ejector as part of keeping the mouth dry.  The dentist will then apply the fissure sealant material – such as Helioseal to the tooth.  This material will then require to be light cured to harden on the tooth surface.  This procedure will be repeated on each tooth that is requiring a sealant.  All in all it takes around 5 minutes per tooth from start to finish.

Fissure sealants should last around 5 years, should it come away it is very easy to place back on, this is why 6 monthly check ups are important, especially in the young.

Lots of praise, big smiles and stickers at the end will put the children at ease as usually this is the very first dental procedure that the child has been through and can form an idea in their head of what dental work is about.  To make it as relaxed and as easy as possible will mean that the child will not form an irrational fear of the dentist.

Rebecca RDN

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