What are they?
Fissure sealants are most commonly used in children who have decay in some of their adult molars. They are a painless and safe way to seal over the fissures (grooves) of the teeth which bacteria may accumulate in and lead to decay. They can be clear or opaque.
Fissures are on the biting surfaces of the back teeth whereas pits are the little hollows also on the surfaces of teeth. In some patients these are very deep which can be problematic as it makes cleaning more difficult. This can ultimately lead to more and more bacterial build up and cavity formation. Fissure sealants are a way to prevent bacteria being trapped in the fissure system, before it gets to the point that a filling is needed.
They use a runny plastic material to cover the pit and fissure system of the tooth which is set hard by using a light. The light activates a component of the material to allow it to change from a liquid to a solid to form the protective barrier.
When are they used?
The main indicators for using fissure sealants are in children who have decay in one of their permanent molars, if an individual is deemed moderate to high risk for decay or if someone has very deep pits and fissures as cleaning can be more difficult. They can’t be used if the decay has already progressed beyond a certain stage but are very useful in the very early stages.
What is the process?
Initially X-rays will need to be taken in order to assess the amount of decay of the tooth. If it is only superficial and limited fissure sealants may be considered. Usually bite wings radiographs are taken which show the crowns of the teeth in both the upper and lower jaws. After it has been decided by your dentist that fissure sealants are the appropriate option, the treatment may begin.
The biting surface of the teeth must be thoroughly cleaned to get rid of any left over bacteria and staining from the fissure system. This will give the material a much better surface to attach to and likely have a much longer lasting restoration than if they were applied straight onto the tooth without cleaning. The cleaning should be done carefully using a brush on the end of a drill to sweep any debris off. The dentist will probably use air to check to see if any debris has been left.
Once everything is nice and clean, some material called etch will be placed on the surface to help roughen up the surface of the enamel and also help make a better bond to the tooth. This is washed off before a glue like material (bond) is used to allow the sealant to stick to the tooth.
Sealants are applied, but only once everything is really dry. They are spread over all the pits and fissures of the back teeth to create the protective barrier and then set with the light again. You can get different brands of sealants which mean the material can be white or see through. This is up to your dentist which they want to use.
They don’t normally need adjusting afterwards, but in some cases might need some smoothing. They will then be monitored by your dentist at each of your check ups to make sure the seal is still tight and protecting the tooth from decay.
How long should they last?
Sealants normally last for a few years but depend on how well they were put in by the dentist. It also depends on how clean you keep your teeth. They can become damaged if you clench or grind your teeth as this can cause the surface to fracture. It is really important that you clean your teeth normally because even though the sealant is protective it won’t prevent other teeth or other areas of the back teeth from decay as bacteria can still settle there.
How much do the cost?
The price of fissure sealants varies from around £25-£35 privately and on the NHS they can be in band 1 or band 2 depending on the extent of sealant required. If they are being applied to under 18s it is free on the NHS.