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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 deter
mined 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 benefited 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
NationalInstitute 0f Dental Research; Leslie
V. Margens, DDS, MPH, professor and
chair of the Department of Health ECOlogy,
School
0f
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 0f Maryland at
Baltimore.