Prevention of dental disease is a core part of Dr Teo’s practice, which means she takes a proactive approach when it comes to decay. She prefers to work with her patients to actively prevent the development of a cavity, rather than waiting for one to develop and hence needing to be filled.
The placement of Fissure Sealants in teeth at risk of developing cavities is an important preventive service available at our practice.
What Is A Fissure?
Dentists use many terms to describe the naturally occurring grooves in tooth enamel. Pits, fissures, grooves, crevices, valleys, “nooks and crannies” and similar terms are all used to describe the same phenomenon.
A pit or fissure is simply a groove that forms within the tooth. Pits and fissures most commonly occur on the chewing surfaces of molar and premolar teeth. They can be relatively shallow or very deep and are usually irregularly-shaped. Often, they are deep enough to trap plaque (bacteria), but too narrow, deep and convoluted for toothbrush bristles to access. This means colonies of bacteria can remain completely undisturbed and protected inside a pit/fissure.
How Does Decay Begin in a Fissure?
Bacteria consume dietary sugars and produce acids, and this can lead to the development of decay inside the pit/fissure. Unfortunately, decay often begins at the base of a deep pit/fissure, which means the cavity can grow quite large before it can be detected clinically (by probing) or on x-rays.
What Is A Fissure Sealant?
A Fissure Sealant is a protective coating that is placed within a pit and fissures that are deep enough to harbour decay-causing bacteria. The objective of placing a sealant is to seal the pits/fissures up in order to prevent plaque bacteria from getting a foothold, thereby preventing decay from developing.
When Should Fissure Sealants Be Placed?
Fissure sealants are most often recommended for susceptible teeth in children and are placed within 6-12 months of the tooth emerging into the mouth. Children might expect to have their first sealants placed at around the age of 6-8 years old, which is the time that their first adult molars erupt.
However, fissure sealants can be placed in a susceptible tooth at any age as part of a long-term preventative regime.
Do All Teeth Need To Be Sealed?
Teeth that have deep pits and fissures are most susceptible to decay and hence benefit most from sealants. Deciduous (baby) teeth generally have very shallow fissures and usually don’t require sealants.
Similarly, if adult teeth have shallow fissures they are unlikely to ever get decay, and so a Fissure Sealant is not necessary.
Can Teeth With Fissure Sealants Get Decay?
It’s important to keep in mind that, while the sealed up pits and fissures are very unlikely to decay, other tooth surfaces may still be susceptible. In particular, the sides of the teeth that touch together are at risk of developing decay if the spaces between the teeth aren’t kept clean. That’s why Dr Teo recommends daily use of floss or interproximal cleaners.
All teeth should be checked regularly for signs of developing dental disease, including teeth which have sealed fissures.
How Are Fissure Sealants Placed?
The placement of sealants is a fairly straightforward procedure. There is no need for a local anaesthetic because the sealant is placed in enamel, a substance that has no nerve endings in it.
It’s important for teeth to be kept dry while being sealed so that the sealant material can adhere soundly to the teeth. Dr Teo uses soft cotton rolls and gentle aspiration (suction) to keep teeth dry during the procedure.
Dr Teo will first clean the fissures to remove plaque and food debris; this step is called a “fissurotomy”. It allows Dr Teo to inspect the pits/fissures to ensure that there is no decay present. The cleaned pits/fissures are then washed and dried, and the sealant is placed. Dr Teo will check the bite and make sure that the sealant is smooth and easy to clean.
Dr Teo prefers to use tooth-coloured sealants, so they blend in beautifully with your natural tooth colour.
What If Decay Is Already Present Inside The Fissure?
If decay is present, it needs to be removed before the sealant is placed. This may require a local anaesthetic, especially if the cavity extends deep into the dentine (which is the sensitive, softer layer of tooth beneath the enamel).
Once the decay has been removed, a tooth-coloured filling is placed to fill the cavity. Then the rest of the fissures are sealed to prevent decay from occurring elsewhere in the tooth. This treatment is both minimally-invasive and preventative.
If you would like to know more about Fissure Sealants, please feel free to contact us for more information.