Dental Sealants
What is a sealant?A dental sealant is a thin plastic film painted on the chewing surfaces of molars and premolars (the teeth directly in front of the molars). Sealants have been shown to be highly effective in the prevention of cavities. They were developed through dental research 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.
How effective are sealants?
Scientific studies have proven that properly applied sealants are 100 percent effective in
protecting the tooth surfaces from caries. Because sealants act as a physical barrier to decay,
protection is determined by the sealants' ability to adhere to the tooth. As long as the sealant
remains intact, small food particles and bacteria that cause cavities cannot penetrate through or
around a sealant. 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.
Sealant protection is reduced or lost when part or all of the bond between the tooth and sealant is broken. However, clinical studies have shown that teeth that have lost sealants are no more susceptible to tooth decay than teeth that were never sealed.
How are sealants applied?
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 enamel surface of the
tooth, including the pits and grooves. After 15 seconds, the solution is thoroughly rinsed away
with water. After the site is dried, the sealant material is applied and allowed to harden by using
a special curing light. Other sealants are applied and allowed to harden much the same way nail
polish is applied to fingernails.
Sealant treatment is painless and could take anywhere from five to 45 minutes to apply, depending on how many teeth need to be sealed. Sealants must be applied properly for good retention.
How long will a sealant last?
Sealants should last five years, but can last as long as 10 years. One study reported that seven
years after application, an impressive 49 percent of treated teeth were still completely covered.
Sealants should not be considered permanent. Regular dental check-ups are necessary to monitor
the sealants' bond to the tooth.
Who should receive sealant treatment?
Children, because they have newly erupted, permanent teeth, receive the greatest benefit from
sealants. The chewing surfaces of a child's teeth are most susceptible to cavities and the least
benefitted by fluoride. Surveys show that approximately two-thirds of all cavities occur in the
narrow pits and grooves of a child's newly erupted teeth because food particles and bacteria
cannot be cleaned out.
Other patients also can benefit from sealant placement, such as those who have existing pits and grooves susceptible to decay. Research has shown that almost everybody has a 95 percent chance of eventually experiencing cavities in the pits and grooves of their teeth.
Are sealants covered by insurance?
Although insurance benefits for sealant procedures have increased considerably, coverage is still
minimal. The trend is toward expanded coverage of this benefit, especially as companies start to
realize that sealants are a proven preventive technique. This preventive measure can help reduce
future dental expenses and protect the teeth from more aggressive forms of treatment.
SOURCES:
American Dental Association;
The National Institute of Dental Research;
Leslie V. Margens, DDS, MPH, Professor and Chair of the Department of Health Ecology, School of Dentistry, University of Minnesota, Minneapolis;
Leonard Cohen, DDS, MpH, MS, Associate Professor and Chair of the Department of Education and Instructional Resources, Baltimore College of Dental Surgery, University of Maryland at Baltimore.
