A Healthy Mouth
Most parents want their children to have healthy mouths and to avoid tooth decay and fillings.
If you look at your child’s back teeth, you'll see the teeth have lines and grooves on the biting surface. We call these fissures on the tooth. Like any groove, these are the hardest part to clean completely with a tooth brush, and it's the place where bacteria can hide and thrive.
No matter how well you clean those back teeth, it's a common site for decay in children’s teeth. If a tooth is heading down the track towards a cavity we want to get to it as early as possible. A useful strategy is to seal these deep grooves to prevent decay. Detecting any early damage will allow us to clean the groove and seal it up before there’s a cavity. This is why we recommend fissure sealants. Prevention is better than cure
Fissure sealants vs a Filling
Once there is a cavity in a tooth we will have to drill right through the enamel in order to remove the decay in the tooth and place a filling. This means the tooth always ends up weaker. For the rest of your child’s life the tooth is never going to be as strong as if it were intact and perfect. The beauty of a fissure sealant is it allows us to clean the groove out many times without going through the enamel. The “bio-rim” of your child’s enamel is left intact with a fissure sealant and the tooth stays strong.
What are the pro’s and cons of Fissure Sealants?
THE PROS. Fissure sealants save your child from getting cavities on the biting surface. You still need to limit your child’s intake of sugar, the number of times they have sugar, and brush twice daily with a toothpaste containing fluoride to avoid getting cavities in between the teeth. These areas are not protected by fissure sealants. Flossing is the ideal way to keep these areas clean. You may find it easier to floss your child’s teeth using a flossette which is floss on a handle.
THE CONS. Fissure sealants is a procedure that is done in the dental chair. So you need to schedule time out for an appointment to have this done. It takes 20 minutes to fissure seal two teeth. So, even if your child is a model patient, we often decide to have two appointments and do two fissure sealants at each visit. This is often adviseable rather than trying to do all four sealants in one visit and risk the child becoming impatient or not wanting to cooperate.
Here is What's Involved
We use the equivalent of an electric toothbrush to clean the surface of your child's tooth. Then we put cotton wool rolls into your child’s mouth to allow us have a dry working field. We spray your child’s teeth with air and water and then we shine a blue light on the tooth to set the fissure sealant material.
Fissure sealants are also a great way to introduce your child to treatment. So, if we find that your child needs a filling in one tooth we will often start by doing fissure sealants first. This helps to build up your child's confidence with dental work and before having a filling. Your child will realise that treatment is quite comfortable and that there is no reason to be afraid should they need a filling done at the next visit.
A fissure sealant costs €30 per tooth and provides a huge amount of benefit and prevention for your child's teeth. Compare this to paying €80 to have a tooth drilled and filled and you'll understand why it's a smart choice for most parents.
The fissure sealants usually last 5 years. We typically fissure seal the first four permanent molars when these teeth come up usually from 6 years of age. These teeth come up at a time when they're aren't any baby teeth falling out. Parents are usually busy watching the front baby teeth falling out and new front teeth coming in that they don’t realise the permanent molars have come through.
Sticky toffees and chewing gum will pull sealants out so watch what your child eats after the sealants are in place. Sealants should be checked every 6 months when your child comes in for a check up. We recommend, at this age, that they come in every 6 months for their teeth to be checked.
FAQs About Fissure Sealants
Do fissure sealants use the same material as fillings?
Yes. There are different types of materials and techniques that dentists use to do fissure sealants, so it's worth asking your dentist about their method.
For us our important first step is to thoroughly clean out the grooves. We use the equivalent of an electric ‘brush ’ for this as it cleans everything out including the plaque. Then stain it with a dye to make sure all bacteria is gone. We then seal it using an epoxy resin which is the longest lasting fissure sealant material.
Some practitioners use a material called glass ionomer which is a quick, ‘dirty’ and cheap solution. Some don’t even clean all the bacteria out first thinking is that if you seal over the top of the bacteria all will be fine. I’m not a fan of that because you just can’t be sure about what’s going on underneath the seal.
We use the epoxy resin rather than glass ionomer because it’s harder, more durable and it has better adhesion. In terms of how long these materials will last, we can’t be definite as there are external factors such as the patient’s bite etc that can vary the life of a fissure sealant. But we find that fissure sealants will last between 5-10 years, similar lifetime to a filling.
There are some special cases where we would use glass ionomer as an interim measure. This is usually only when something is happening, such as the tooth not through the gum yet, and there has been decay in the baby teeth. In these cases we seal it up as best we can while the tooth is coming through the gum. When it’s through we'd then remove the temporary seal and put the proper sealant in. We use a glass ionomer called Fugi 9 especially for this. It is pink coloured and is very easy to identify and recogonise as a temporary measure. It contains fluoride and releases this to help protect the tooth.
Are fissure sealants common in school age children and primary school age children?
Teeth that are most susceptible to deep groove cavities are the molars: the 6 year old molars and 13 year old molars, so called because generally they appear in your child’s mouth at age 6 and age 13. Naturally everyone is different so some kids don’t need fissure sealants as their fissures and grooves are shallow and are easy to clean. For some we recommend sealing the 6 year old molars, others we recommend only the 13 year old molars. In other cases we recommend all the molars get a fissure sealant as they are all at high risk to decay.
Your child's healthy Smile
So now you should understand why we recommend fissure sealants, what is involved, and why having your child's teeth sealed can help them. Your child will reward you with a great smile and a healthy and filling-free mouth! Call us at 044 9340370 for more information or book your appointment here.