Permanent molars usually have very deep pits, grooves, and fissures on the biting surface. These holes can be very difficult to keep clean so they are the most common place to get cavities.
In the 1970’s dentists started cleaning out these pits and fissures then squirting runny plastic into the cleaned out grooves to keep bacteria from growing there. This procedure is called a dental pit and fissure sealant.
Over the last 35 years this procedure of placing dental sealants has saved millions of dollars in dental fillings that were prevented.
Sealants almost always have to be placed onto dry teeth. This can be a challenge for some younger children to hold still and keep their tongue away while the sealant is placed.
The original sealants were made to harden by themselves so they took a little longer than the newer, light-activated ones. This makes it much easier for seven year olds to tolerate.
Some parents have asked me to place sealants on baby molars. I am happy to do so, if the child is able to hold still. However, I believe that it is better to wait and not place a sealant on a squirmy child than to put one on that got wet and will not stick well. This is because a bad sealant is worse than no sealant. Bad sealants allow water and bacteria to seep underneath and start decay but cannot be brushed clean.
As good as dental sealants are, they are not 100% cavity proof. Teeth can still get cavities on the other sides that are not sealed (and cannot be sealed because they are smooth).
Sealants can also be chipped be chewing ice or other hard food. If the sealant gets chipped, then that part is no longer protecting the tooth and a cavity can develop.
With these limitations, dental molar sealants are about 75% effective at preventing cavities if regular dental checkups occur to catch any chipped or lost pit and fissure sealants.
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