Fissure sealing to protect teeth from caries

Fissure sealing is an important procedure in dentistry aimed at protecting against caries. It consists of creating a protective barrier on the surface of the tooth that prevents bacteria from entering the deep recesses of the enamel, called fissures. This is especially true for places where the brush cannot reach.
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Who needs sealing and for whom it is not recommended

Sealantization is a procedure that helps prevent tooth decay. It is especially important in the following cases when teeth:

  • With deep crevices that are difficult to clean with a brush
  • No caries
  • With a low level of enamel mineralization
  • Just erupted
  • If the child has already had dental caries

When permanent teeth first emerge, their enamel has not yet fully strengthened, making them more vulnerable to tooth decay. Over time, as mineralization increases, the enamel becomes more protected. For children and teenagers whose teeth are still developing, sealants are an effective way to prevent tooth decay.

However, there are cases when the fissure sealing technique is not recommended:

  • If there are wide recesses that are easy to clean
  • Already have caries
  • Gaps in teeth have not caused problems for more than five years

In these cases, either the natural protective mechanisms of the teeth are quite effective, or sealing will not help, and may even hide the problem, complicating diagnosis and treatment. In such situations, dentists choose other methods of treatment and prevention.

Who needs sealing and for whom it is not recommended

Fissure sealing techniques in dentistry

There are two main approaches to fissure sealing: non-invasive and invasive.

Non-invasive sealing does not require prior intervention in the structure. Here a sealant is used to fill the recesses. The procedure does not cause pain, which makes it suitable for a child’s first introduction to dental treatment. However, there is a risk of enclosing the initial stages of caries under the sealant. If the disease has already penetrated into deeper layers, sealing can provoke its further development under the protective layer.

The invasive technique involves removing the top layer of enamel to better fix the sealant. This approach ensures deep cleansing of fissures and increases the effectiveness of the procedure. However, it does come with certain risks: if the sealant is lost, the treated areas become more vulnerable to tooth decay and may cause increased sensitivity. This method requires specialized equipment and materials, which affects the cost of the procedure.

Both methods have their advantages and disadvantages; the choice depends on the specific situation and condition of the patient’s teeth. It is important that the decision on the sealing method is made by the doctor, taking into account all factors.

Fissure assessment

To detect the initial stages of caries in the grooves, a number of methods are used, important for preventing further tissue destruction. Visual examination is the primary and accessible diagnostic method, but its effectiveness is limited - about 25%. This is due to the fact that the instrument may not reach all the grooves, and the procedure may be unpleasant for people with sensitive teeth.

For more accurate detection of caries, the following methods are used:

  • Radiography allows you to see hidden damage that is not visible to the naked eye
  • Fissurotomy is necessary to expose and assess the depth of carious lesions in hard-to-reach places
  • Electrometry assesses the degree of tissue mineralization, which helps to identify caries in the early stages
  • The laser fluorescence method is considered one of the most effective today, as it allows you to determine the presence of caries at any stage of its development

These methods complement each other, allowing the doctor to obtain the most complete picture of the condition of the fissures and, on this basis, make an informed decision about the need to seal them. It is important to remember that only an integrated approach to diagnosis can prevent the progression of caries.

Advantages and disadvantages of fissure sealing in children

Sealing cracks in children has its pros and cons.

But sealing the tooth fissure with sealant also has disadvantages. If existing tooth decay is not noticed during the procedure, it can cause problems. Improper application of sealant can affect your bite. In adults, there are deep and stained fissures, which makes the procedure difficult to achieve. Sealing is not a substitute for regular cleanings and dental visits. Careful control, especially of the bite, is important to avoid malocclusion.

Among the advantages:

  • Prevents Cavities Sealants create a protective layer that reduces the risk of tooth decay, especially on teeth that we use to chew
  • Better hygiene Sealed cracks are easier to clean, reducing the buildup of bacteria and food debris
  • Durability The procedure helps preserve teeth, avoiding complex and expensive treatment in the future
  • Help during orthodontic treatment Sealing provides additional protection against caries during bite correction
Technique and stages of teeth sealing

Stages of teeth sealing

Sealing the fissure of a tooth in dentistry goes through several important stages. The procedure is the same for two methods - without incisor and incisor. With the incisal method there are more stages due to additional preparation.

Here are the basic steps:

  1. Cleaning from plaque and stone
  2. Opening of cracks (only with the incisive method)
  3. Isolation and thorough drying of the work area
  4. Enamel treatment to improve material adhesion
  5. Applying sealant to cracks and sealing them
  6. Using a special lamp to harden the sealant
  7. Checking how teeth meet
  8. Accurate polishing and grinding of the treated area

It is important to remember that additional problems, such as hidden caries, may be discovered during the procedure. In such cases, the doctor first treats these problems and then continues with the sealing. This provides comprehensive care and prevents future troubles.

Materials for sealing dental fissures

In dentistry, different types of sealants are used to protect against caries. They help strengthen the enamel and prevent decay. Here are some of the materials for sealing dental fissures:

  • Composite sealants made from acrylic resins. They are strong and wear-resistant
  • Compomers are a special type of composites containing acid
  • Glass ionomer cements that harden on their own without additional enamel treatment

Composite sealants are very popular. They come in different colors - transparent, milky white and even colored, which children love. But over time, transparent ones may darken. There are new types of sealants that change color when exposed to light, which is useful for detecting decay underneath.

The type of fissure sealant used depends on what needs to be treated and the physician's judgment. This procedure can be done on one tooth or on several.

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Protection of teeth grooves in children

The process of caring for children's smiles begins with baby teeth, often between the ages of two and three. This is the period when their complete release from the gums allows for a seal that reduces the likelihood of developing caries for many years, subject to proper oral care. The risk of developing caries can be reduced by up to 90%.

After analyzing the data obtained, the doctor determines the treatment approach: conservative or surgical. In case of removal, an important step is rehabilitation to prevent complications and speed up recovery.

The benefits of fissure sealing in permanent teeth in children become obvious when the child reaches the age of five and his first permanent molars begin to emerge. During this period, oral hygiene becomes more difficult due to the depressions where food debris can accumulate, contributing to the formation of caries. To maintain the health of these teeth, the following approach is recommended:

  • Regular plaque removal
  • Ensuring proper cleaning
  • Timely sealing of grooves

When a child reaches the age of seven to five years, the first permanent teeth appear in the oral cavity, which are especially vulnerable to caries. This is due to the fact that the enamel has not yet reached its final maturity and mineralization, which occurs in the next three years after eruption. Sealing during this period promotes the formation of strong enamel and prevents food particles from entering the grooves, which is a key factor in preventing tooth decay.

Choosing a sealant for children's teeth

In pediatric dentistry, special sealants are used to protect against caries. These products have a high fluidity, which allows them to penetrate into narrow grooves and recesses. An important advantage is the content of useful microelements in the composition of sealants, such as calcium, fluorine and phosphorus, which help strengthen the enamel.

Depending on their properties, sealants for children can be:

  • Transparent, which makes it easier to monitor the condition of the fissures after they are sealed. However, due to its invisibility on the tooth surface, it can be difficult to assess the integrity and wear of the coating
  • Opaque, usually milky white, easier to see and monitor

Before the procedure, the dentist discusses the choice of material with the parents. The doctor explains what sealant will be used, its composition and features. Modern specialists in the field of pediatric dentistry value openness in communication and are ready to talk in detail about the upcoming procedure, answering all questions and relieving parents’ concerns.

Choosing a sealant for children's teeth

Measures to protect baby teeth from caries

Modern pediatric dentists offer various methods of fissure sealing, both non-invasive and invasive. When choosing a specialist, you should take into account his experience, reviews and recommendations. It is best to sign up for the procedure immediately after new teeth have erupted on the chewing surface, so that the crown is visible and accessible for treatment.

To maintain the health of children’s primary teeth, in addition to fissure sealing, it is necessary to follow a number of important rules:

  • Balanced diet Including solid vegetables, fruits, dairy and fermented milk products in the diet, as well as limiting the consumption of sweets
  • Regular oral care Brushing should be done twice a day, and if using braces, after every meal
  • Frequent visits to the dentist It is recommended to visit your doctor every six months, sometimes even more often
  • Selection of brushes and toothpastes appropriate for the child’s age It is important to follow your dentist's advice when purchasing dental care products
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