Better Understanding the Role of Dental Sealants

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To better understand why dental sealants are an effective treatment in the prevention of cavities, it is important to begin with a brief explanation regarding the causes of cavities (dental caries and tooth decay are other commonly used terms). The process of cavity formation can be broken into the following simple steps:

1) Bacteria in the mouth adhere to the surfaces of teeth
2) Bacteria begin to break down sugars residing on the surface of teeth as a metabolic fuel source
3) Those sugars are converted into energy (used by the bacteria, not you) and acidic byproducts (metabolic waste)
4) The acidic byproducts, when left to accumulate over time, dissolve away tooth structure which creates holes, or cavities, on the surfaces of teeth.
5) If continually unaddressed over time, these cavities will eventually wear entirely through the solid tooth structure, accessing the underlying pulp tissue.

Brushing is effective in cavity prevention because it removes the sugars and bacteria that stick to the surfaces of teeth which eventually lead to decay. Because toothbrushes can’t reach the areas between teeth or underneath the gums, we also floss to further remove those harder to reach areas. But sometimes, even kids who regularly brush and floss, can still get cavities. How can this be?

The reasons why most kids who regularly brush and floss may still get cavities include:

1) Ineffective brushing and flossing techniques

Regularly brushing and flossing is a good thing. But if the underlying technique is incorrect, even regular brushing and flossing may leave behind plenty of the sugar and bacteria responsible for tooth decay. For a review of correct brushing and flossing techniques, click here.

2) Deep Pits and Fissures

Oftentimes, children with regularly brush and floss and utilize correct techniques may still be prone to dental decay! The major reason for this can be understood by taking a deeper look at the anatomy of teeth.

Pits and fissures are formed between the cusps of molar teeth, similar to the way valleys form between mountains. And just as valleys may collect water and runoff, the fissures and pits of teeth may also collect food particles (i.e., sugars). But sometimes, these pits and fissures can be so deep that they cannot be readily cleaned using everyday brushing techniques. This is the major reason why dental sealants are used to prevent cavities.

How Dental Sealants Work

Dental sealants help block out the hard to brush pits and fissures that trap the sugars and bacteria that ultimately lead to cavity formation. The materials used in dental sealants often include either glass ionomer or resin. In both cases, the pits and sealants of the tooth in which the sealant material will be placed are first cleaned and prepared by the dentist. Next, the sealant material is flowed into the pits and fissures and cured to reach a hardened state in which the material becomes firmly bonded to the tooth.

Firmly bonded to the tooth, the sealant can now effectively minimize the hazardous areas in which tooth decay commonly occurs. This does not mean, of course, that brushing and flossing of those areas is any less important than before sealant placement. Moreover, the sealants should be regularly monitored to ensure their stability over time.

The Importance of Monitoring Dental Sealants Through Regular Dental Checkups

While there is a great deal of scientific evidence that supports the placement of dental sealants as a means of cavity prevention, it is also well understood that the placement of dental sealants requires new responsibilities for the dentist and patient.

To explain why regular checkups are so important in maintaining the effectiveness of dental sealant placement, it is helpful to make an analogy between dental sealants and wood sealants. Though these products differ in several ways, the basic concept remains the same. Wood sealants, such as varnish, work by placing a protective coating (sometimes several) over the wood that helps block out the effects of moisture that can eventually lead to wood rot or warping. When exposed to the outdoors (as is the case with decks or porches here in Tampa), even the best varnishes eventually crack and wear down.

Similarly, dental sealants are not perfect and simply do not last forever. Even more than wooden decks, dental sealants are exposed to a variety of daily stresses including strong forces incurred through chewing, acidic liquids, and continual moisture. Due to these variables, the longevity of a well-placed dental sealant is also variable because it is dependent on the unique conditions within each patient’s mouth. Any small crack in the sealant material may be an entryway for sugars and bacteria. Oftentimes, decay can then spread from underneath the sealant.

It is for this reason that sealant placement cannot be undertaken without also assuming responsibility for the continual monitoring of that sealant’s integrity. With regular checkups, small cracks that eventually occur in dental sealants can be visualized by the dentist. The dentist will then replace these old sealants to ensure they provide the level of protection intended.

If your child has not yet had dental sealants placed, or has not seen a dentist for evaluation of their existing sealants in the last 6 months, it is strongly recommended that you schedule an appointment with your dentist. If you have any further questions for Dr. Mike regarding dental sealants, feel free to pose your questions here or at the time of your next dental appointment.

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