Sealants
A correctly applied sealant 10 years after placement. Note that the sealant (the white areas) is barely visible in the tooth.
Dental sealants are resin coatings resembling white nail polish (sometimes clear, or colored) that are applied to deep, inaccessible pits and fissures in teeth so food can’t get lodged in them as easily.
If the pits or fissures in the teeth cannot be completely cleaned with a toothbrush, dental sealants may be recommended.
Figure 2: A dental sealant in this molar tooth leaked and was removed, exposing a large (brown) cavity. The presence of the sealant prevented early detection of the progressing cavity with a dental explorer or laser caries detection device. The underlying cavity was discovered via X-ray only after it had grown very large.
Sealants often need to be replaced over time.
If part of a sealant comes out of the tooth, the part that remains may leave a pit as deep or deeper than the tooth originally had. Many times it is not possible to effectively isolate the tooth from mouth fluids without using local anesthetic and a rubber dam. This is especially true if the person doing the sealant is working alone, and the tooth is not fully erupted into the mouth (which is the best time to seal the pits and fissures).
Figure 3: When the decay was completely removed, the decay under a failing molar tooth sealant had progressed to a near pulp exposure and may need root canal treatment.
Parents of children for whom sealants may be recommended sometimes assume that sealing their child’s teeth makes them unaffected by tooth decay. Even with ideally placed sealants, this is definitely not the case. Too often, parents will relax their nutrition and oral hygiene standards, believing the sealants will compensate—a big mistake.
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