Fissure sealants: when to do them and how much they cost

Chewing teeth have grooves where food gets stuck. A brush cannot reach the bottom of such grooves. A sealant closes them and prevents caries from starting. We explain when the procedure is appropriate and how much it costs.

What fissures are

Fissures are natural grooves and pits on the chewing surface of a tooth. They can be deep and narrow.

Plaque accumulates in such grooves. The enamel there is thinner, so caries starts exactly in the fissures.

In children the fissures are deeper and hygiene is not yet established. So the risk is higher.

Fissures come in different shapes. Narrow and deep ones are harder to clean than wide ones.

The doctor assesses each tooth separately. Sometimes a sealant is needed on one tooth and not on the neighbouring one.

Parents often confuse fissures with caries. A spot in a groove can be pigment or an initial lesion.

So an examination is needed before sealing. The doctor decides whether the groove can be sealed.

Why sealing is done

A sealant is a filling material that closes the groove. The surface becomes smooth.

• blocks the path of plaque to the bottom of the fissure
• makes cleaning easier
• reduces the risk of caries
• does not need drilling
• preserves the enamel

Sealing does not treat caries. It works as prevention.

The sealant is applied to the chewing surface. It does not change the colour of the tooth and is not noticeable in the mouth.

The effect depends on hygiene. If a child brushes irregularly, the sealant will not save the neighbouring surfaces.

The procedure does not replace visits to the doctor. Check-ups remain essential.

Sealing is also done on teeth that already have a filling nearby. The doctor assesses the edge and how tightly it fits.

Age and which teeth

Permanent molars erupt at about 6-7 years. That is the time to seal them, while the enamel is not damaged.

Premolars appear later, at 10-12 years. They are also sealed when indicated.

Baby teeth are sealed less often. The decision depends on the depth of the fissures and the risk of caries.

If a tooth has only partly erupted, the sealant may not hold. The doctor may advise waiting.

The risk period lasts the first years after eruption. That is when the enamel has not finished maturing.

Sealing is sometimes done for adults too. The indication is deep fissures without caries.

The decision is based on the depth of the groove and the risk of caries. Age is not the main criterion.

Stages of the procedure

The doctor examines the tooth and checks for caries. An X-ray is taken if needed.

The surface is cleaned and isolated from saliva. Dryness is important for good bonding.

The sealant is applied to a dry surface. That is why the doctor isolates the tooth from saliva.

Then the material is applied and cured with a lamp. The sealant sets.

The material can be clear or white. The colour does not affect protection.

At the end the doctor checks the bite and polishes the surface. Excess material is removed.

The procedure is short and often takes one visit.

After the procedure the child can eat right away. There are almost no restrictions.

Sealing can be combined with a routine check-up. Then the child gets used to the clinic without a separate visit.

Without drilling

If there is no caries, no drilling is needed. The enamel stays intact.

Children's fear is often linked to the drill. That is why sealing is calmer than treatment.

If the doctor sees caries in the fissure, a sealant is not placed. Treatment is needed first.

If the sealant has worn partly, it is renewed without drilling.

Service life and monitoring

A sealant lasts several years. It wears under chewing and can partly come away.

The doctor checks it at every examination, usually every 6 months. The damaged area is renewed.

If the sealant is lost, the risk of caries returns. So monitoring matters.

How the child chews also affects durability. The habit of biting pencils or nails quickly damages the material.

The sealant is checked visually and with a probe. Sometimes an X-ray is needed to rule out caries underneath.

The child gets used to the smooth surface within a few days. There are almost no food restrictions.

Parents should check whether the material has come away. It shows as a light band or a hollow on the surface.

Ask the doctor to show what the sealant looks like. That makes it easier for parents to check it at home.

Do not try to remove the sealant yourself. It damages the enamel.

If the child complains of a sharp edge, book an examination. The doctor will polish the surface.

When sealing is not suitable

• there is already caries in the fissure
• the tooth has not fully erupted
• the child does not allow the tooth to be isolated from saliva
• there is an allergy to the material
• hygiene is very poor and there is no control

In such cases the doctor offers another plan. Sometimes it is enough to teach the child to brush their teeth.

Sealing is not done on a tooth that has not fully erupted. The gum edge prevents isolation from saliva.

Sealing is not done if the gums are inflamed. The tissues are treated first.

Sometimes the doctor offers fluoridation instead of sealing. It strengthens the enamel but does not close the groove.

Does it replace cleaning

No. The sealant closes the groove but does not remove plaque from other surfaces.

Tooth brushing and professional hygiene remain essential. Sealing only complements care.

Sealing does not remove plaque from smooth surfaces. The brush does that.

Caries prevention includes more than sealing. Brushing, fluoride and control of sweets matter.

Prices in Irpin

The full price list is on the prices page. The doctor gives the exact amount after the examination.

About the first visit read in the article a child's first visit. About caries treatment - in the material caries treatment: from signs to a filling.

The procedure is described on the fissure sealing page. All children's services are in the pediatric dentistry section, and treatment - on the children's fillings page.