More than one patient has sighed and asked why our teeth aren’t made of something like Kevlar. That
LIMITS TO PREVENTION
Ideally, we’d all follow a perfect routine of dental hygiene. We’d eat and drink tooth-friendly selections. Promptly brush and floss after eating and drinking. We’d be properly fluoridated. Regular dental checkups and cleanings would come like the seasons. All these things unquestionably help. And yet, about 1 in 4 American adults has untreated tooth decay.
Genes certainly account for some of this rampant decay. Some people are born with a built-in tendency to tooth decay. That can’t be changed, although it can be managed, to be sure.
The big, bad reason for the tooth decay plague, however, is behavior. Many people find it difficult or impossible to meet the basic standard of brushing for two minutes twice daily and flossing at least once. Not surprisingly research has found that about 25% of us fib to our dentists about our self-care habits. Falling short in oral hygiene practices promotes tooth decay, and gum disease, too. So why don’t we take better care of ourselves? Well, whatever the reasons, the fact is we don’t. Dentists are not here to judge patients’ character, dentists are here to promote oral health. It’s obviously important to keep up our efforts to educate patients and encourage better self-care. When the results are not satisfactory, though, it may be time to discuss dental sealants with your Lake Worth Dentist.
True, dental sealants are not the fantasy Kevlar teeth we opened with. The concept, however, is similar. Sealants are a decay-proof barrier that coats natural teeth and protects them. Body armor for teeth! Sealants have been around for over 50 years now. Like everything else, the materials, equipment, and procedures have improved steadily.
There are two types of sealants in use nowadays. Most dentists prefer resin sealants. After painting a tooth with a resin, it won’t harden until the dentist shines a curing lamp onto it. Hence, there’s no rush, no pressure. The dentist has all the time needed to coat the tooth perfectly. Autopolymerizing sealants, in contrast, put the dentist on a tight schedule. These sealants have two ingredients. The dentist mixes them together right before applying. Once mixed, this type of sealant cures itself automatically. The dentist, therefore, is on a timetable and must finish painting teeth before it’s too hard to work with. Of course, there’s also an upside. The procedure for applying these self–curing sealants requires less equipment. The two types of sealant are equally effective in preventing tooth decay.
WHICH TEETH TO SEAL?
The tooth surfaces where decay is most likely are priority candidates for dental sealants. These would be the chewing surfaces of our grinding teeth, the molars and nearby premolars. It’s easy to see why these are most at risk for decay. The chewing surfaces are full of fissures, or fine grooves. This is what makes them especially effective at grinding food. The problem is that the fissures get packed with food particles. The average adult can grind those teeth together with a force of 170 lbs! That’s why it’s so hard to clean those surfaces with a toothbrush. The trapped food particles, alas, linger and promote decay.
It’s ideal to apply sealants to a tooth before there’s been any decay or fillings. As has been noted, this pristine condition becomes rarer as the years go by. Once a tooth has a filling, it’s not a great candidate. Where decay is in a very early stage, however, a sealant can halt the decay before it develops into a cavity (carie).
SEALANT PROCEDURE – CLEANING
Sealant treatments are a piece of cake for dentists and patients both. Easy, painless, and quick. The first step is giving the tooth a thorough cleaning. A small rotary brush is the basic tool. The dentist or hygienist pays special attention to the chewing surfaces, to those grooves and fissures. If need be, air abrasion follows after the rotary brush. This device is a kind of micro-sandblaster. It jets a stream of tiny silica or baking soda particles under high pressure. It’s a little messy, but really shakes food residue from the fissures. It doesn’t hurt. If need be, a third option called enameloplasty can be deployed. This is with the drill, yes, but it’s very gentle. No actual drilling or grinding, just nudging any stubborn shmutz. No pain, at any rate. After cleaning, the dentist or hygienist rinses and dries the tooth. It’s now perfectly clean.
SEALANT PROCEDURE – CONDITIONING
It’s easy to understand that a sticky sealant gets a better grip on a rough surface than on a smooth one. Hence, the next step is roughing up the target tooth’s surfaces. To this end, the dentist uses a mild phosphoric acid solution, called etching gel, to condition enamel. It’s more of a liquid than a gel, in fact, so it flows easily into the tiniest of fissures. As a bonus, the gel also kills bacteria. This step is entirely painless. Moreover, the gel won’t injure gums or other soft tissues like the tongue or cheeks. After a thorough rinse, the dentist dries the tooth with an air gun.
SEALANT PROCEDURE – APPLICATION
From here on the tooth has got to stay totally dry until the dentist finishes applying sealant. Even the tiniest drop of saliva will mess up the bonding of sealant to a tooth. In that case, the dentist may have to u-turn and repeat from the etching step. Dentists have ways to keep that target tooth bone dry. One is building barricades from cotton and gauze. Dental dams are another. Patient cooperation is important.
Now, the magic moment. The dentist paints on the sealant with a brush or a little syringe. The liquid fills in every nook, cranny, and fissure. No spot is left unsealed. This is particularly critical. The bacteria that cause decay are relentless. They will exploit any opening they find, no matter how small.
If the dentist has chosen a resin sealant, he or she now uses a special curing lamp to harden it. The self-curing sealants harden quickly by themselves. Voila! Body armor for the tooth. The sealant layer is very thin, but the dentist checks the patient’s bite anyway. If the sealant’s a little too thick in spots, the dentist thins it with gentle strokes of a drill. The tooth is then good to go. The whole procedure took 5-10 minutes for one tooth.
ARE SEALANTS RIGHT FOR YOU?
Sealant treatment averages $50 per tooth. That ’s a lot less than it would cost to get a cavity filled. Inasmuch as sealants are about 80% effective in preventing decay in molars, it’s a winning investment. That 80% number, by the same token, means sealants are not a substitute for proper brushing and flossing. It does mean, though, that inevitable lapses in oral hygiene are a lot less likely to promote decay.
Dental sealants are not permanent. They will need replacing, usually after around 5-10 years. This increases the lifetime cost of this solution. However, it still beats the expenses of filling cavities.
Dental sealants are an option which can greatly benefit some individuals. Our Royal Palm Beach dental office practitioners are happy to discuss it and can answer any questions or concerns.