Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents

Children who have their molar teeth covered by a sealant are less likely to have dental decay in their molar teeth than children without sealant.
Sealants are coatings applied by the dentist or by another person in dental care on the grooves of mainly molar teeth. These coatings are intended to prevent the growth of bacteria that promote decay in grooves of molar teeth. The review shows that after 4.5 years the sealed permanent molar teeth of children aged 5 to 10 had over 50% reduction in decay on biting surfaces compared to teeth without sealants. One study with longer follow up showed that after 9 years only 27% of sealed tooth surfaces were decayed compared to 77% of tooth surfaces without sealant.

Pit and fissure sealants

What are sealants?

Sealants are a safe and painless way or protecting your teeth from decay. A sealant is a protective plastic coating, which is applied to the biting surfaces of the back teeth. The sealant forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the teeth and causing decay.

Which teeth should be sealed?

Sealants are only applied to the back teeth – the molars and premolars. These are the teeth that have pits and fissures on their biting surfaces. Your dentist will tell you which teeth should be sealed after they have examined them, and checked whether the fissures are deep enough for sealing to help. Some teeth naturally form with deep grooves which will need to be sealed, others with shallow ones which will not need sealing.

What is involved?

The process is usually quick and straightforward taking only a few minutes per tooth. The tooth is thoroughly cleaned, prepared with a special solution, and dried. The liquid sealant is then applied and allowed to set hard – usually by shining a bright light onto it.

Will I feel it?

No, it is totally pain free, and the teeth do not feel any different afterwards.

How long do pit and fissure sealants last?

Sealants usually last for many years, but your dentist will want to check them regularly to make sure that the seal is still intact. They can wear over time, and sometimes the dentist needs to add or replace some sealant to be sure that no decay can start underneath them.

How do pit and fissures work?

The sealant forms a smooth, protective barrier, by covering all the little grooves and dips in the surface of the tooth. Dental decay easily starts in these grooves.

When should this be done?

Sealants are often applied as soon as the permanent teeth start to come through. This is usually between 6 and 7 years of age. The rest are usually sealed as soon as they appear which can be any time between 11 and 14 years of age.

Do I still have to clean my teeth?

Yes. It is still vital that they do this. The smooth, sealed surface is now much easier to keep clean and healthy with normal toothbrushing. Using a fluoride toothpaste will also help to protect your teeth. Pit and fissure sealing reduces tooth decay and the number of fillings you might need.

Whom do I ask about the treatment?

If you would like to know more about the treatment, ask your dentist They will tell you if fissure sealing will help your teeth, and if it is the right time to do it.
Pedodontics, or pediatric dentistry, deals specifically with the oral care of children. A Pedodontist, or pediatric dentist, receives training in child psychology, growth and development. They are an ideal choice for children with fears or behavioural problems that make visits to the regular dentist unproductive.

Babies are born with their primary teeth formed underneath the gums, but they don’t start appearing until many months later, usually between six to seven months after birth; however, there is considerable variation in the timing.

Children’s teeth begin forming before they are even born. The first primary, or baby teeth, to erupt through the gums are the lower central incisors. These are followed closely by the upper central incisors which come through around four months after birth. Although all twenty primary teeth have usually appeared by the time the child reaches three years old, the pace and order of eruption varies from child to child.

Oral care should begin soon after birth. Gums should be cleaned after each feeding. You should begin brushing your child’s teeth as soon as they appear.

Permanent teeth start to come through around the age of six. This begins with the first molars and lower central incisors. This process continues until approximately age twenty-one.

Adults have twenty-eight permanent teeth, or up to thirty-two including the third molars (wisdom teeth).


Primary teeth are also called baby teeth, milk teeth, or first teeth. Baby teeth are very important as place holds for permanent teeth. There a couple of simple rules that usually applies to the eruption of baby teeth:

  • lower teeth usually erupt before upper teeth
  • girls teeth usually erupt before boys teeth of the same age
  • teeth usually erupt in pairs

Your child’s first baby tooth is another milestone in the growth of a child. Parents love to celebrate the tiny, yet momentous steps that pave a child’s healthy development. Keeping your child free of tooth decay is the goal. A little effort may reveal the secrets how dentists keep their own children cavity free. Pedodontics focuses heavily on preventative oral care to reduce the risk of future complications like thumbsucking in the children, thus possibly reducing the risk of overbite. A Pedodontist may also start interceptive orthodontic treatment to prepare a child’s mouth for future orthodontic work.

By the child is nearly 18 months old, start keeping him from bottles by this age. Doing so will help prevent Baby Bottle Tooth Decay. By the time children are three years old, they usually have a full set of 20 primary teeth. Faulty brushing habits coupled with the consumption of sticky substances are generally responsible for triggering dental decay or dental caries in milk teeth.

Permanent teeth usually start to erupt about first grade. A special note here is that often the first molar, or six-year molar, erupts before the front tooth. Additionally, the first molar erupts behind the last baby tooth and does not replace a baby tooth as occurs for front teeth. Often lower front teeth come in behind, on the tongue side, and give the appearance for a while as if there are two rows of teeth.

If baby teeth are lost too early, the other teeth can drift out of their position and invade the empty space. This might cause permanent teeth to come in crooked or unable to erupt into the gum, which leads to malocclusion.

Children suck on things because sucking is one of a baby’s natural reflexes and as infants get older it serves many purposes. Since thumbsucking is relaxing, it may help induce sleep. After the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and alignment of the teeth. It can also cause changes in the roof of the mouth. Some aggressive thumbsucking may cause problems with the baby (primary) teeth. It can also cause changes in the roof of the mouth.

Pacifiers can affect the teeth essentially the same ways as sucking fingers and thumbs. However, it is often an easier habit to break.

Praise children for not sucking, instead of scolding them when they are.

  • Children often suck their thumbs when feeling insecure or needing comfort. Focus on correcting the cause of the anxiety and provide comfort to your child.
  • For an older child, involve him or her in choosing the method of stopping.
  • Your dentist can offer encouragement to a child and explain what could happen to their teeth if they do not stop sucking.
  • If the above tips don’t work, remind the child of their habit by bandaging the thumb or putting a sock on the hand at night. Your dentist or pediatrician may prescribe a bitter medication to coat the thumb or the use of a mouth appliance.

    Preventive Dentistry
    Preventive dentistry is perhaps the singularly most important role the pediatric dentist can play in your child’s life. Beginning dental visits early is the key to success, as it helps and assists us in recognizing and warding off potential problems before they become serious. Child should be thoroughly examined to detect any potential problem areas, diet counseling, and if necessary, fluoride recommendations by the dentist.

    Dental care – common conditions – 0 to 5 years
    Mouth ulcers affect 20 per cent of the population. The natural healing takes one or two weeks. In the event these are painful and accompanied by fever, consult the dentist/doctor. Meanwhile, citrus in all forms should be avoided; take less salty foods; and apply topical anaesthetic.

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