Dental Sealants: What to Expect

Most parents have taken their children to the dentist and have been told that they should consider placing sealants on their child’s teeth, but what does that mean? Why should the sealants be done? As teeth form, they form in sections and fuse together. These areas of fusion leave pits and fissures on the biting surfaces of the newly erupted permanent teeth, which unfortunately are weak points that can form tooth decay, or cavities. Sealants are a liquid version of resin filling material that are placed into these grooves on the biting surfaces of teeth. They are meant to seal these pits and fissures shut to try to protect these weak spots. Placing this material has been proven to decrease decay in the treated teeth and has not been linked with any harmful side effects or problems. There has been some controversy about sealants containing BPA, a material found in some plastics, and its safety. The FDA has done extensive research on the materials contained in sealants and have deemed them safe. However, many sealants now have non-BPA formulations, which we at Blue Ridge Family Dentistry currently use.

When having sealants placed, you need to have realistic expectations. They will not last forever. They can last anywhere from less than a year to 10 years depending on the child.  You should anticipate that they will need to be touched up and replaced periodically in order to maintain their protection as chewing will wear them down over time. Also, particularly sticky foods can pop them out, and grinders tend to wear them out much more quickly. There are occasionally kids that really will not get as much benefit from sealants due to the way their teeth formed. These children generally received one of the best benefits of drinking fluoridated water in that their teeth formed with very shallow pits and fissures. In other words, their teeth are too flat to maintain any sealants. While water fluoridation has decreased the depth and number of pits and fissures, most kids can still benefit from sealant therapy as the pits and fissures still exist and are still weak spots for future cavities. 

Children that have had sealants may see an increase in decay as they get older if the sealants are not maintained. This happens simply because as the sealants disappear, these weak areas become exposed to the bacteria in the mouth. Therefore, regular dental care and maintenance is required to prevent future problems. Even if sealants do not last a lifetime, they were there to prevent the decay during childhood when placing fillings may be harder on both the child and the parent allowing the child to mature before many discussions of dental work have to be incurred.

Most insurances cover sealants at 100% for permanent molars. There are a few exceptions that cover them at 80% and even some plans that will cover sealants for permanent premolars as well. There can also be frequency limitations if sealants need to be replaced. You should check your policy limitations to find out the restrictions if you have any questions.  Most plans do have age limitations that do not cover sealants on adults, even though adults can benefit from placement on posterior teeth that have not already been filled. Adults can still receive dental sealants, they just may have to pay out of pocket for them.