Archived Q&A and Reviews
My son is 6 years old, and I have a question about a recommendation his dentist made. His 6 year molars have come in, and his dentist is recommending that we put a sealant on each of these 4 teeth. My son has healthy teeth overall - though there was one spot where a cavity started about a year ago, but has not progressed and does not, so far, need treatment. I brush his teeth twice a day, floss once a day, and he is learning to brush his own teeth. The dentist told me that putting a sealant on the teeth would reduce risk of cavities by 80%. Are there any cons to doing this? And while I'm on the topic of dental care - does anyone have any thoughts about xrays at every 6 month visit? Thanks in advance for anything you can tell me about all of this! mixed feelings about the necessity of all of this
You don't say where you live, but I know that in my son's Berkeley school district, the schools offered FREE opportunities to put sealants on kid's teeth. It was in two different grades, I can't remember which, but you might want to check this out before paying out money. N
No, there is no necessity for sealants, but they reduce cavities, as your dentist told you. Don't you want to reduce the chance of cavities? - wish they'd had sealants when I was a kid
My dentist wants to seal the molars of my 10 and 14 year old kids. But do they really work or is this simply a revenue enhancement strategy for my dentist? The process seems counterintuitive. I read that the first step is roughening up the enamel to accept the plastic coating. Are you damaging the enamel when you do that? Also, how do you know when the coating has worn off since it is clear? Finally, it is going on the bite surface - how is it possible that it stays on through the daily grind? Disbeliever
I had sealants put on my molars when I was around your kids age - somewhere between 10-12 years old - I am now 36 and they are STILL there! They were amazing actually - I've never had a single cavity in those teeth. I'm also a stress grinder (I've had night guards over the years, but seldom actually wore them) - and the sealants held up through regularly intense grinding. To this day, whenever I see a new dentist or hygienist they will comment on the sealants and say 'wow! Whoever did your sealants did an amazing job!' also, they are nearly invisible (if you inspected my mouth with a flashlight you might notice 'something' on the top of my back molars, but they are nothing like fillings), and I certainly never actually felt them on my teeth. I have a young child, and when he gets to the appropriate age, I will certainly have sealants put on his teeth too! Sealantbeliever
Both my children (now 9 and 11) have had sealants, and neither has had any cavities, despite their addictions to candy. I don't think it is a scam and I wish I had had sealants as a kid. One thing, however, is that their dentist did not abrade the surfaces of their teeth first. He just applied the sealant with a brush. Liz O.
Sealants really worked on our son's teeth. He is 22 and has one filling which happened on a molar that came in between visits to the dentist. But I do not know about sealants for older children. Our son had it done as soon as the molars came in. Dr. Quist is a wonderful reliable dentist if you need a second opinion. tooth happy
I had sealents put on my teeth when I was very young. Maybe 8 yo. It was before they were clear or white, mine are pink. I'm now 35 and still have pink on my molars, but I have never had a cavity. I think as long as its done right it works really well. I believe!!
My dentist has been using sealants on me, and now my kids, for years. I think it helps a lot. I notice that I stopped getting cavities when he started using them (I was already an adult). I don't remember any roughing up of the surface--just a quick paint job that takes seconds. Painless and helpful. a fan
YES! They work and my daughter started getting them at 3 - on her baby teeth. NEVER a cavity or even a weakening of the enamal toward a cavity. All of her friends have had to have novacane and drilling and filling. Nothing for my daughter. When she complains about the five minutes of ''taste'' in her mouth, I hand her my cell phone and ask her to phone a friend who has had to get cavities taken care of. 13 with zero cavities - Wish sealants were around when I was a kid
I was skeptical too. I looked into sealants carefully years ago for my daughters. But it seems pretty clear they are a good investment so to speak. They only seal the grooves, which can be quite deep, found in the top of molars where it is easy for decay to begin. They do wear off partially sometimes and the doc can touch them up but since they are in the low grooves, they mostly don't wear out much. If I remember right, the roughing up is very minor and just on the surface so the sealants bond properly. Even though they are ''clear'' you can see them if you look closely and the dentist can easily see them and will typically mention that after an appointment, usually saying something like the sealants are all still in good shape.
Both of my daughters' teeth are perfect. I wish I had had sealants when I was a kid since I have many fillings. So even if the sealants had nothing to do with their dental health, I pat myself on the back and say, good father, every time I see their beautiful smiles. I set myself some goals as a father of two girls. One was to teach them to throw and catch like boys, and another was that they have healthy teeth. Check and check. A third was that they soar like flying monkeys through the rain forest tree tops. No check on that one. Perhaps I was unrealistic. Sean
The Cochrane review is a well respected and unbiased source of information about evidence of public health and medical interventions. Their recent review of dental sealants is summarized here: http://www.ncbi.nlm.nih.gov/pubmed/23543512 and if you have access to an academic library, you can get a copy of the whole thing. Their review summarizes the results of 34 studies that they determined to be of high quality and finds that ''The application of sealants is a recommended procedure to prevent or control caries. Sealing the occlusal surfaces of permanent molars in children and adolescents reduces caries up to 48 months when compared to no sealant, after longer follow-up the quantity and quality of the evidence is reduced. The review revealed that sealants are effective in high risk children but information on the magnitude of the benefit of sealing in other conditions is scarce. The relative effectiveness of different types of sealants has yet to be established.'' According to the CDC (http://www.cdc.gov/oralhealth/publications/factsheets/sealants_faq.htm) the tooth structure is not modified to apply sealants, so I'm not sure if the information you got about how they are applied is correct, or perhaps is describing a different type of procedure.
I was wondering if any of you can give your two cents about dental sealants. Yesterday my 6yo went for a routine cleaning and check-up at her dentist, a dentist we've been with since her first appointment, and that I trust. She has no decay, but they are recommening sealants for the back teeth. Maybe I am jaded, but I can't help feeling that this is an unnecessary procedure recommended in order to make a few extra $$$. Insurance covers 80%, but we would still have to pay about $90. Is it worth it? Again, she still has most of her baby teeth, and no decay to date. Plus, she brushes and flosses regularly without a struggle. Opiniones Not trying to be cheap
Dentists recommend this routinely for children these days. For some, it is probably unnecessary. But some kids will grow up like me. Although I have always brushed and flossed (even as a child), I have fillings in the tops of every single one of my back teeth. Most of them, I got as a teenager. I don't recall having trouble with my baby teeth, but have always had trouble with my permanent teeth. Once when I was about 12 I had 9 fillings put in all at the same time. My understanding now is that some tooth decay is based on lack of dental care (i.e. brushing etc.), and some is proneness based on some sort of genetic factor (I don't know if it's soft teeth, or mouth chemistry, or what). I think they do sealants on all kids as a preventative, because they can't predict which ones will be like me, and by the time the decay starts it's too late. Karen
I am with you in the belief that it's an unnecessary money maker for dentists. What really bothers me is that they seem to be ''pushing'' them these days and people aren't really researching what they're putting IN their child(ren)'s mouths. When I asked my dentist about this, he took the ADA's stance, that is that there isn't enough proof to make the claim as of yet. Well, there isn't enough proof against it for me to buy in. No sealants for us. Let's see what others say.
If they cover 80% the sealants should only be about $10-20, maybe even less (I think my 80% insurance was $6 for sealants?). W/ my 6-yr old, I did it once per year. She has great teeth, doesn't eat many sweets, and we brush well. w/o those factors I'd probably go ahead w/ the sealants on the back teeth. Having brushed & brushed the back teeth w/o dislodging food, I'd say it's worth it.
After reading all the negative info about tooth sealants already posted I figured I had to chime in about my vote for them. My 3 kids (ages 13, 11, and 7), all of whom have had their permanent molars sealed as they come in, are cavity free. I had loads of cavities as a kid, in all my molars, despite brushing, (''genetic deep fissures''), which continue to plague me today as fillings fall out and teeth parts break off. I don't know if it's the flouride or the sealants they use today, but my kids' teeth are in much better shape than mine were at their age. I am so thankful that they have been spared the torture I had to undergo in the dentist's chair getting my back teeth drilled, filled and crowned before I was a teen. Definitely worth the price in my opinion. happy to pay the dentist for sealants
Our dentist recommended that we have dental sealants put on our children's teeth (ages 6 and 8). I have heard of sealants put on permanent teeth, but never on baby teeth. Is this a common practice? How do most parents handle this? Our insurance will only pay for sealants on permanent teeth. And I'm not sure of the safety of the substances used in sealants. Thank-you. Anon
We have been considering the same issue. Our pediatric dentist has pushed sealants somewhat aggressively. After speaking with my regular dentist whom I trust and have had a very satisfactory relationship for over 10 years, I decided that for my two sons (7 & 10) we will not seal the deciduous teeth. It just doesn't make sense unlee your child has some predisposition to cavities (Some people do.).
The other consideration my dentist mentioned is that if the sealant is not done extremely well, they can actually lead to very serious cavities under the seal. These are bad because they are much harder to detect. The dentist uses touch as much as sight to detect the cavities. Our younger son has some developmental problems and has to be monitored closely to ensure that he adequately flosses and brushes. We may have his permanent teath sealed because he is at such risk for cavities. We are not going to do this for the 10 year old. Anon
I don't know all the pros and cons, but I do know that my stepdaughter had sealant applied to her teeth when she was ten, I believe. It turned out that sealant had been applied to a tooth where there was existing decay, and just as one of the other posters suggested, having the decay ''sealed on'' caused a big problem. She ended up having to have a root canal and crown at this very young age. Having seen this, I would not do sealants for my son. Fran
Can anyone give me some advice on the wisdom of getting sealants put on an 8 year old's teeth? I understand that they protect the front of the teeth only from cavities, and cavities can still develop on the sides. Our dental plan covers 75% of the cost (my dentist is $168), until the child is 9. After that it's not covered as preventive. We have an appt. this Sat to have them done, and I wanted to get some ideas from other parents. Mari
Even though my dentist said it was rather unusual for adults to do so, I had all of my virgin teeth sealed in the past few years and have felt very glad about it. From what I could understand, it is just a matter of time before the natural grooves in a tooth begin to harbor decay, no matter how good your oral hygiene is: the bottom of the groove is just too skinny for a tooth-brush bristle to fit in there. I couldn't tell you about potental health problems from leaching chemicals--your post is the first I've heard about that. So far, I'm fit as a fiddle. My dentist is big on replacing amalgam fillings to get rid of the mercury (I've declined so far bacause of what I've read about drilling out the amalgam actually exposing a person to more mercury than leaving them intact), but mentioned no qualms about toxins from the sealants. I've been looking forward to having my daughter's teeth sealed once she's old enough to keep her mouth open long enough (she just turned two). Each tooth takes about ten minutes to seal. I don't understand putting sealant on a tooth that is already decayed, though, as your post suggests--I would think that would just trap the decay under the sealant, leading to further decay and potential nerve damage. I have a couple of white I guess resin fillings, as well as a number of old amalgam ones. Supposedly the white fillings don't last as long, but mine are holding up very well--seven years and counting. I have a porcelain semi-crown. It was quite a lot of hoopla getting it made and installed (required an impression and sending it off to a lab and a couple of return visits to get it fitted in there right, and then it didn't feel right for another six months)--I don't picture that for a three-year-old, and I sure can't imagine an insurance company paying for it--porcelean costs the same as gold--about $1,000 per tooth (I don't picture spending that for a deciduous tooth). Hope this helps.
I just wanted to mention a bad experience I had when I asked a dentist to apply sealants to my teeth. The reason I wanted to get sealants was so that my teeth wouldn't get any more spots where the enamel is worn off (high risk for cavities) than they already had. Unfortunately my dentist, without telling me what he was doing, started drilling my teeth -- to make grooves in the enamel so that the sealant would stick better to my teeth! New grooves in the teeth were exactly what I wanted to prevent, and here he was creating them. I didn't particularly care if the sealant would have fallen off sooner than it would have without the grooves; I just wanted to delay the onset of grooves in the first place. The thing is, sealant always wears off after a few years anyway, maybe 5 years if they add the grooves, maybe a year if they don't add them (I don't know the exact figures). So now that I do have grooves in my teeth, I am stuck with either replacing the sealants for the rest of my life, to protect these drilled out grooves from turning into cavities when the sealant wears off, or letting them be exposed and turning into cavities. So I guess the moral is: If you get sealants, make sure you find out from your dentist, beforehand, what their policy is on drilling new grooves into your teeth.
To the person who wanted advice on Tooth Sealants... I had tooth sealants put in well over 20 years ago (I'm 31 now) on my back teeth, the biting surface. I don't recall the process or the type of sealant used back then, and don't know the dangers, but you might like to know I only have one cavity (which on the biting surface, so it wasn't covered by the sealant anyway.) Whenever I go to my dentist every six months, he tells me the sealants are still doing fine, after 20 years. Again, I'm not sure if my Tooth Sealants from 20 years ago are the same as today's, but mine are holding up fine.
My dentist in Canada swore by them, and applied them to my teeth after I developed my first cavity at age 28, to protect the rest of my teeth. Several years later, I haven't developed any other cavities. However, that may be due more to good luck than the sealants (I take good but not great care of my teeth, so it probably is genetic!). Barbara
Just to let folks know, the plastic used in tooth sealants MAY be an endocrine disruptor--the kind of thing that's leading to weird crocodiles and decreased sperm counts. Pregnant women should probably not have their teeth sealed, since in utero exposure appears to be the problem. We're trying to decide whether to have it done for our son, weighing the possible risks of the sealants against the risk of cavities... Deborah
A few days ago, someone posted some information about the effects of tooth sealants on teh endocrine system (abnormalities in alligators and low sperm count). Unfortunately, I deleted the bulletin in was listed in so I don't have the name of the person who posted it. I'd like to know the source of this information. I've searched the internet and have been unsuccessful. I would appreciate it if the person who posted the message could let me know! Bonnie
I'm the person who posted the message about tooth sealants, and I have some more information. Bisphenol A is the endocrine disruptor in tooth sealants, but I think there may be some sealants w/o it (trying to find out). Two useful websites: www.wwfcanada.org/reducerisk World Wildlife Fund Canada's how to reduce your risk from endocrine disruptors www.tmc.tulane.edu/ecme/eehome General info on environmental estrogens, but I didn't see anything there about tooth sealants Deborah
I recently read an article about tooth sealants on Mothers and Others web page. If anyone is interested in reading it here is the link: http://www.mothers.org/mothers/greenguide/features.html My oldest daughter does have tooth sealants and I do personally regret it. I had no knowledge of any reasons not to do it and went with the dentists recommendations without doing any research. My daughter is one of those children who started puberty premutarely (at 8 years old!) and it is and has been very difficult for her, since she really is still a child. We have made an effort to limit her exposure to hormones and hormone like chemicals since then but unfortunately we can't undo the changes her body has already gone through and while I am sure there were numerous other exposures besides the sealants I feel badly about my decision to add on one more. Carolyn
I'm concerned that I may have made people overly worried about tooth sealants, for example the mom who was worried that her daughter's tooth sealants might have contributed to early puberty. So I checked with my mom, Shanna Swan, an epidemiologist who does research on endocrine disruptors (though not tooth sealants in particular). And she had this to say.
The evidence we have indicates that endocrine disruption occurs primarily in utero. For example, studies that looked at the effect of PCB exposure (primarily from fish in the Great Lakes) find extent of developmental delay correlated with levels of PCBs in the mother's blood when she is pregnant but not in her breast milk.(and quite a few studies have looked at these two routes of exposure). On the other hand, no one has studied tooth sealants and premature puberty, so of course we can't rule it out. Let's say I would consider it very unlikely.
Also, the exposure to the bad chemicals in the sealants is highest at the time they're applied and presumably also if they were to be removed). Once they're in there, very low levels would leak into the body. Based on the limited reading I've done, I think people who have them should not have them removed, pregnant women should definitely not have them applied or removed, and I'm still not sure about having my son get them. Probably he's getting lots more exposure from other sources!
Hope this clarifies. Deborah
Our dentist (whom I'm not thrilled with) has suggested after the last cleaning of my 4 year old son's teeth, that they should put on sealants to prevent cavities. Is there any collective experience on this? How necessary is it? Maybe it is commonplace, but I just don't know. Martha
Regarding sealants for 4 year olds, we were advised by our dentist to have them put on my son's molars at about 5-6 years of age because he has very deep recesses in his molars. We did, and he has only had one cavity (he's 9 now). The same dentist has not recommended them for my daughter, who is now six, because her molars aren't as deep and cavity prone. We like and trust our dentist, and think that the sealants help. It does require the child to sit still for some amount of time, and it wasn't easy for my son, but he got through it and it doesn't hurt. And its much better than filling a cavity! Helen
re: sealents on teeth...My kids who are now in their 20's had sealents. Later we learned that some people worry that the plastic used off-gasses things that are bad. I can't remember details at my advanced age but urge any parents who are considering this to find out. Margy
My understanding of sealants on teeth is it means virtually no cavities for the child. I've had two children go through the sealant process and, while not 100% effective (it can and does wear off and needs to be re-applied periodically), it certainly seems to have helped. Becky
I asked my father, a general dentist for 40+ years, about the use of sealants in a 4 year old. He said that sealants are very effective but should not be put in until the child's 6 year molars come in. Prior to that, tooth decay can be combatted with diligent dental hygiene. This is more than just handing your child a toothbrush and letting them brush their own teeth. He recommends that the parent brush and floss the child's teeth because children at that age do not yet have the dexterity to properly brush their back molars. As children, my siblings and I had our teeth brushed every night by one of my parents until we reached the age of 10. The result has been that none of us has had a single cavity, and we are all over 30. Sharon
Our dentist put sealant plastic on our kids permanent molars. The biting surface is all that gets covered. The idea is to fill in the crevaces where no toothbrush is sharp enough to reach. This is extremely effective at preventing cavities in these locations. Our dentist sees no reason to do this for baby teeth,( perhaps because getting a cavity drilled is such a strong lesson in the need for good oral hygene.) Roger