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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 determined 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 benefitted 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 National Institute
of Dental Research;
Leslie V. Margens, DDS, MPH, Professor and Chair of the Department
of Health Ecology, School of 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 of Maryland
at Baltimore.
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