The use of fissure sealants in children

PresidentMike

Hi,
My youngest went to her first public dental appointment.
Doctor said she needs to get fissure sealants to prevent problems.
Her teeth are in excellent condition and there is not even the smallest evidence of cavity problems.
I am wondering if the sealant is really needed...
I came across the Irish Oral Health Services Guideline Initiative and I understand there are advantages in this measure.
But the guideline also mentions the following:

Who Should Get Sealants?

• Children and adolescents who are assessed as being at high caries risk should have resin-based fissure sealant applied

I have spent many many hours in a dentist chair (my parents were way too relaxed in relation to my dental hygiene!:() and I am well aware and familiar with teeth problems. For this reason, I am very strict with my daughter and I am sure she doesn't qualify as having "high caries risk". So, why make the treatment?
What are the main disadvantages with this type of prevention?
I would appreciate your opinion!

georgieporgy

Sealents are useful if placed on perfect teeth. It's like rust proofing your car before it leaves the factory. When decay is already present it is too late to fissure seal.
There are no side effects.

brusher

In order for the sealant to be effective 2 things will need to happen, it must be possible to isolate the tooth and keep it perfectly dry during placement ( not always easy on a young child ) and more importantly the sealant must be monitored and maintained. The latter is the real problem as if this treatment is being carried out by the PDS then the chances are your child may not be seen again for a long time or at all. A poorly placed or poorly maintained sealant can do more harm than good.

PresidentMike

brusher wrote: »

The latter is the real problem as if this treatment is being carried out by the PDS then the chances are your child may not be seen again for a long time or at all. A poorly placed or poorly maintained sealant can do more harm than good.

Interesting.

How can we ensure they are properly maintained (at home)? I'm guessing keeping teeth clean...

Do you know when should the sealants be checked after they are applied? We can always go to the private dentist if it's needed.

brusher

PresidentMike wrote: »

brusher wrote: »

The latter is the real problem as if this treatment is being carried out by the PDS then the chances are your child may not be seen again for a long time or at all. A poorly placed or poorly maintained sealant can do more harm than good.

Interesting.

How can we ensure they are properly maintained (at home)? I'm guessing keeping teeth clean...

Do you know when should the sealants be checked after they are applied? We can always go to the private dentist if it's needed.

A regular check up, and re application or repair of the sealant as needed

Cathyht

My children are both late teenagers, have both had fissures sealant work. Neither have ever had a cavity. I would absolutely recommend fissure seals. It also gets a child used to the whole procedure of sitting in the chair and the exercise of letting the dentist work at their teeth. They don't have the dentist fear, for example. My children have both had braces, so they are very relaxed, visiting the dentist every few weeks is a part of life. It is wonderful not to suffer from the Fear of the Dentist.

btkm8unsl0w5r4

Fissure sealants are a good strategy for kids for several reasons.
1. Its gets them used to dental treatment and shows its painless and simple.
2. It can prevent decay especially decay related to high refined carbohydrate consumption.
3. Its puts the emphasis on prevention rather than disease control.

The confusion comes as you read a guideline made by a health service with limited resources. They have to allocate funds to provide treatment for those who need it most. In the case of fissure sealants that's those with a high decay risk. Personally I think they are of benefit to most kids and protect the first molar (very important and at risk tooth) during a dangerous time in the child life for the development of dental problems.

There are some provisos
1. The sealant must be well bonded to the tooth (read moisture control etc above)
2. The sealant needs monitoring.

A poor sealant or half broken sealant is worse than no sealant at all. Sealants are one of the first things a dentist learns to do, every dentist is expert at applying them.

Cathyht

My children's back teeth were very large and had deep recesses, I suppose that increases decay risk too. As they are older now, I think their teeth have worn more evenly and the recesses aren't as deep.

Regular checkups, or mentioning it to the dentist to check during brace tightening, (if your child has braces) will ensure the seals are fine.

I think it's an amazing thing to see a mouthful of gorgeous teeth, and not one filling. Well worth the investment. My offspring ate their share of sweets when they were kids. Once or twice a seal broke, but my daughter heard the 'click' and we had it redone. The seals are almost invisible, just like clear silicone over the top of the tooth.

ash23

My daughter was at the dentist in school who recommended she have sealants as she has very deep crevices in her teeth. They actually sealed her primary molars and so far, so good. They're in there a couple of years and no cavities.
Her permanent molars will be coming up in the next 2 or 3 years and I will be getting them all sealed.

bscm

I had sealants when I was in primary school (I don't remember which teeth, only that the sealants were aqua blue )

Only had one small filling since (done last month), and my only recent dental issues have been wisdom teeth movement and some small movement with my front teeth (as expected in late teens-early 20's).

From what I remember, most of my class had them done. My younger sister did not, as at the time, she was in the process of having several teeth removed (she wasn't the most thorough brusher), and she's had 3-4 fillings since.

I don't see a huge issue with them, they don't hurt the child. All I remember was the dentist spraying the blue spray in my mouth and then rinsing it out.