Pits and Fissures sealants

PIT & FISSURE SEALANTS

PIT & FISSURE

Pits and fissures are actually naturally occurring enamel faults/ narrow shafts of some length on the occlusal/top surface of teeth whose blind ends are directed inwards.

Caries/tooth decay potential is directly related to the shape and depth of pit  and fissures dues to the:

• Morphology of fissures
• Niche for microorganism
• Inaccessible ( brush & saliva)
• Thickness of enamel
• Less effectiveness of fluoride
• Salivary pellicle (newly erupted teeth)
• More porous enamel (newly erupted teeth)

In order to prevent tooth decay on these surfaces, Sealants were developed in the 1970s and 1980s. Pit and fissure sealing plays a fundamental role in preventing occlusal caries. Cariostatic properties of sealants are actually by physical obstruction of pits and fissures. It is defined as:

“An adhesive material that is applied to pits and fissures of n teeth in order to isolate from the rest of the oral cavity.”

Following are the Age ranges of sealant application

Why would I need pit and fissure sealants?

Pit and fissure sealants form a protective finish over the chewing surface of molars, sealing off bacteria.

Preventive dental care can help people of all ages avoid unnecessary treatment, expense, and discomfort. Over 90% of adults have a history of dental caries¹, but early intervention can decrease the number of decayed, missing, or filled teeth. Pit and fissure sealants offer a proactive way to protect teeth against damage from tooth decay.

The occlusal surface of young patients has high caries susceptibility due to the presence of pronounced cusps and Grooves, pits, and fissures. Fluoride which is said to prevent dental caries is usually ineffective in the occlusal surfaces, it is very effective on smooth surfaces of the tooth like Buccal, Lingual and interdental surfaces.

When bacteria colonize these Pits and fissures, it is impossible with normal brushing to clean or remove the bacteria and food debris as the bristles do not reach the pits. So it is best to close or block these pits and Fissures with sealants to block the entry of debris.

What Are Pits and Fissures / FACT

• Pits are small hollows on the biting surfaces of permanent teeth, and fissures are grooves on the outside of the tooth’s surface. While pits and fissures on the surfaces of teeth occur naturally, they can deepen over time, which may lead to tooth decay. Regular oral hygiene is not always sufficient in removing bacteria that can build up in these crevices. If left sitting, the bacteria interacts with the starches in food, producing acids that can eat tooth enamel, which can eventually result in pain and damage.
• A Dental Sealant is a material usually restorative which is placed and bonded into the pits and fissures on the occlusal or chewing surface of the teeth. In some cases, the Sealants are also placed in Pits on the Buccal or Lingual surface of the teeth (Buccal Pits in lower molars).
• The Sealants are basically placed inside the Pits fissures to prevent any food accumulation and thus prevent the onset of Dental Caries. As the Pits are Fissures are a magnet to food debris which lead to bacterial colonization and thus leads to caries. As these grooves are blocked with a Sealant they prevent debris accumulation and thus decrease the risk of cavity formation.
• The occlusal surface of young patients has high caries susceptibility due to the presence of pronounced cusps and Grooves, pits, and fissures. Fluoride which is said to prevent dental caries is usually ineffective on the occlusal surfaces, it is very effective on smooth surfaces of the tooth like Buccal, Lingual and interdental surfaces.
• When bacteria colonize these Pits and fissures, it is impossible with normal brushing to clean or remove the bacteria and food debris as the bristles do not reach the pits. So it is best to close or block these pits and Fissures with sealants to block the entry of debris.
• The sealant forms a protective layer that keeps food and bacteria from getting stuck in the tiny grooves in the teeth and causing decay.
• Resin-based fissure sealants should be applied to the permanent molars of all children as early after eruption as possible.

What’s involved?

• The process is usually quick and easy taking only a few minutes per tooth.
• The tooth is thoroughly cleaned, prepared with a special solution, and dried. The sealant is then applied and allowed to set hard – usually by shining a blue light onto it.

How long does fissure sealant last?

• Sealant usually lasts for many years but needs to be checked regularly to make sure that the seal is intact.
• It can wear over time, and sometimes needs to be added to or replaced to be sure that no decay can start underneath

What to Expect During a Dental Sealant Procedure?

Placing Dental Sealants is usually painless and does not require drilling or numbing medications.

1. Tooth preparation – first, the dentist will polish the surface of the tooth to remove plaque and food debris from the pit and fissure surfaces. Next, the dentist will isolate and dry the tooth. Then the hygienist will etch the surface of the tooth, rinse off the etching material and dry the tooth.
2. Sealant application – the dentist will apply the dental sealant material to the surface of the tooth with a brush; a self-curing light will be used for about 30 seconds to bond the sealant to the tooth surface.
3. Evaluation – the dentist will evaluate the dental sealant and check its occlusion.

What are the Indications of Dental Sealants?

Dental Sealants are indicated in patients or teeth that are at high risk of Dental Caries.

This includes patients with:

1. Enamel defects, such as enamel hypoplasia
2. Orthodontics appliances
3. History of Dental Caries
4. Deep pits & fissures
5. Early signs of Dental Caries
6. Poor plaque control

What Are The Contraindications of Dental Sealants?

Dental Sealants are contraindicated in patients or teeth that are at low risk of Dental Caries:

This includes patients with:

1. Teeth with shallow, self-cleansing pits & fissures
2. Teeth that partially erupted without adequate moisture control
3. Teeth with previously restored pits & fissures.
4. A balanced diet low in sugars or carbohydrates
5. Good oral hygiene

A note from Dr. Mansour Majed

Pits and Fissures sealants

What are Pits and fissures?

First thing first let’s explain what is pits and fissures, and how they can make teeth more prone to decay.

Pits and fissures are deep grooves that is normally found on the surfaces of your back teeth (molars & premolars), they are more common in children and teenagers, and they are often the main cause of teeth cavities.

 So, what is the Sealant?

Sealants are considered as the primary line of prevention of teeth caries, they are a plastic protective coating that covers the pits and fissures of your teeth, and produces a smooth protective barrier against any food impaction that can lead to dental cavities.

 All teeth should be sealed.

No, our dentist will examine your back teeth (molars & premolars) and seal only the deep narrow grooves that are hard to be cleaned with toothbrushes. 

What is involved?

The procedure is fast, easy, and straightforward. In a few minutes tooth is cleaned and sealed with a liquid sealant. This liquid sealant is then hardened by shining a bright light on it.   

Will it feel?

It’s totally pain-free. We don’t need any anesthetic agent during the treatment. 

When should this be done?

Sealants are often applied as soon as the first permanent teeth start to come through. This is usually between 6 and 7 years of age. The rest are usually sealed as soon as they appear which can be any time between 11 and 14 years of age.

How long does it last, and do I still have to clean my teeth?

Usually, they last for many years, but our dental team will check them regularly to make sure that the seal is intact, as they can wear over time.

And for sure yes, you have to clean your teeth regularly. The smooth, sealed surface is now much easier to keep clean and healthy with normal brushing. Using fluoride toothpaste, the last thing at night and at least one other time during the day will help to protect your teeth. Pit and fissure sealing reduces tooth decay and the number of fillings you might need.

Is it effective?

Its effectiveness has been greatly contributed by its longevity of clinical survival. Clinical trials reported more than 80% complete retention of sealant after 2 years and 70% after 3 years in permanent molars.

So, can we do it for adults?

We only recommend a fissure sealant for adults who are at a high risk of developing cavities as a result of tooth fissures.

 Dr. Mansour Majed

https://ydmcdxb.net/