ALL ABOUT DENTAL SEALANTS

Humans have four types of teeth. Starting from the midline, the first two are incisors, followed by one canine, two premolars and lastly 3 molars. Incisors being the most front teeth are used for biting purposes whereas canine is involved in wear and tear. Back teeth, premolars and molars, have large chewing surfaces therefore involved in breaking down food into smaller particles before it can be swallowed.

Chewing surfaces of premolars and molars have various pits and fissures which are highly susceptible to food accumulation. If food is allowed to accumulate for prolong periods of time this leads to the onset of decaying process and eventually tooth destruction.

Dental sealants or more specifically Pits and Fissure Sealants are included in preventive dentistry. They are generally placed in children and teenagers but adults may also benefit from this. They are applied as a thin layer most commonly on the chewing surfaces of premolars and molars to prevent ingress of bacteria into the grooves. Also, if the decaying process is initiated but a cavity is indiscernible in this case dental sealants are used to arrest the process from further progression. Once there is a cavitated lesion, filling becomes the most appropriate treatment of choice.

Dental sealants are most frequently used for children that are at high risk for developing caries. High risk patients include those with increase intake of sugary foods and drinks, inadequate brushing due to physical or mental disability, decrease fluoride availability. Cancer patients undergoing chemotherapy or radiotherapy are also at a higher risk of developing caries due to decreased salivary flow rate.

Dental sealants are of the following types — Resin based sealants, Glass ionomer cements/sealants, resin modified glass ionomer sealants and polyacid-modified resin sealants. The latter two are combination of the former two. Advantages of glass ionomer sealants is that it releases fluoride which helps in remineralization of tooth making it resistant to destruction.

Dental sealants once applied create a smooth surface which is effortlessly cleaned. It forms a physical barrier on the tooth surface thus preventing it from bacterial attack. It is a minimal invasive technique that involves removal of bacteria from the tooth followed by placement of sealants adequately. It is less time consuming and usually painless although a minor discomfort can be felt by the patient. However, they do wear naturally and may become damaged overtime therefore needs to be replaced.

Dental sealants have no specific contraindications. However, moisture control during placement is imperative for their success. In case where moisture control cannot be established easily, glass ionomer sealants can be used. When moisture control is adequate, resin based sealants are applied.

The final word

Dental sealants effectively curtail the chances of caries but this alone is not sufficient for caries progression. Patients including parents in case of children, need to be counselled regarding their diet to limit sugar intake. Parents should supervise their children’s brushing until the age of 10 years making certain that every aspect of tooth is being thoroughly cleaned. Brushing twice daily especially at night time is of utmost importance.