Are fissure sealants worth it for children and adults?

For most children, yes. A fissure sealant is a thin coating painted into the deep grooves of the back teeth, where decay often starts, and the US Centers for Disease Control and Prevention (CDC) says sealants can prevent up to 80% of cavities in those teeth for two years. That is a lot of protection for a few minutes per tooth, with no drilling and no injection, during the years when back teeth are most at risk.

We place fissure sealants for children and adults at Durban Dental Care in Durban North.

What a sealant does

Back teeth have grooves and pits, called fissures, on their chewing surfaces. Food and bacteria collect in them easily, which is why decay so often starts there. A sealant is a thin coating of resin or glass ionomer that fills the grooves and seals them over.

Sealants go on the molars and premolars, the back teeth that do most of the chewing.

What the evidence shows

The CDC, the US national public health agency, advises placing sealants soon after the adult molars come in, and says they still protect against 50% of cavities for up to four years (CDC: about dental sealants).

Cleveland Clinic, a US hospital group, says sealants last up to five years and may then need replacing. It describes ages 6 to 14 as the cavity-prone years for the back teeth, which is why most sealants are placed in childhood.

Benefits of fissure sealants for children

• Easy for young children. Your child sits back with their mouth open, and nothing needs numbing.
• Easier cleaning. A sealed groove is smoother, so there is less for food and bacteria to cling to.
• Fewer fillings later. A healthy tooth that is sealed is less likely to need a filling down the line.

Disadvantages of fissure sealants

• Sealants wear with chewing and can chip, especially on very hard, sticky or chewy food, and part or all of a sealant can come away.
• They cover only the chewing surfaces, not the sides of the teeth or the gaps between them.
• They go only on healthy teeth: not on a tooth that is still partly under the gum, or one that already has a filling. Once a groove has decay, the tooth needs a filling instead.
• A worn sealant may need redoing later.

None of these is a reason to skip sealants on a deep-grooved new molar. They are reasons to keep up check-ups, where we catch wear early.

Who sealants are most worth it for

• Children whose first adult back teeth have just come through, at about age 6, and again when the second molars come through at about 12.
• Children and teenagers who have already had decay or a filling in other teeth.
• Adults with deep grooves on healthy back teeth, especially if decay has been a problem in other teeth.

They are less worth it on shallow grooves that clean easily, in someone who has not had decay.

Investing in your teeth

We take medical aid, card and cash, and we're on Discovery's FlexiCare dental network; whether your scheme pays for sealants depends on your plan. You can also ask us about paying in instalments, and read how sealants and check-ups help keep dental costs down.

Keep brushing as well

Sealed teeth still need brushing twice a day with fluoride toothpaste, cleaning between the teeth and regular check-ups. Keeping sugary snacks and drinks to mealtimes helps too. For how much toothpaste a child should use at each age, read your child's first dental visit.

Your questions about fissure sealants