Dental sealant
It is these pits and fissures that are most vulnerable to tooth decay because food and bacteria stick in them and because they are hard-to-clean areas.
Dental sealants are materials placed in these pits and fissures to fill them in, creating a smooth surface which is easy to clean.
Dental sealants are mainly used in children who are at higher risk of tooth decay, and are usually placed as soon as the adult molar teeth come through.
[3] When this balance is skewed due to frequent intake of fermentable carbohydrates, poor oral hygiene, and lack of fluoride consumption, there is a continuous loss and little gain of minerals over a long period of time, which can ultimately cause what is known as tooth decay.
[4] These sealants are a plastic material placed in the pits and fissures (the recesses on the chewing surfaces) of primary (baby) or permanent (adult) molar and premolar teeth at the back of the mouth.
[4] Once the tooth is cavitated, it requires a dental restoration in order to repair the damage, which emphasizes the importance of prevention in preserving teeth for a lifetime of chewing.
Preventing tooth decay from the pits and fissures of the teeth is achieved by dental sealants providing a physical barricade to protect natural tooth surfaces and grooves, inhibiting build-up of bacteria and food trapped within such fissures and grooves.
Dental sealants also provide a smooth surface that is easily accessible for both the natural protective factor, saliva and the toothbrush bristles when cleaning the teeth.
Black, the creator of modern dentistry, informed that more than 40% of caries incidences in permanent teeth occurred in pits and fissures due to being able to retain food and plaque.
[citation needed] Miller, a pioneer of dentistry, was applying silver nitrate to surfaces of teeth, chemically treating the biofilm with its antibacterial functions against both Streptococcus mutans and Actinomyces naeslundii, which are both carious pathogens.
[8][11] This procedure involved creating Class 1 cavity preps of teeth that were considered at risk of developing occlusal caries, which included all pits and fissures.
[citation needed] Bunonocore made further advances in 1970 by developing bisphenol-a glycidyl dimethacrylate, which is a viscous resin commonly known as BIS-GMA.
[1] A transient presence of BPA in saliva has been reported immediately following placement of some resin based sealants.
The currently available evidence suggests that there is no risk of estrogen-like side effects with resin based sealants.
[nb 4] GIC materials bond both to enamel and dentine after being cleaned with polyacrylic acid conditioner.
[15] It was shown that GIC materials were more effective in prevention of development of caries despite the higher non-successful rate compared to resin based sealants.
[16] This may be accounted for due to the fluoride-releasing property of GIC which increases salivary fluoride level that may aid in preventing dental caries.
Other factors include clinician inexperience, lack of client co-operation, and less effective sealant material used.
These include: Although dental sealants do wear naturally and may become damaged over time, they usually last for around five to ten years, despite the heavy pressures endured by teeth during chewing each day.
[citation needed] It is believed that bacteria and food particles may eventually become entrapped under dental sealants, and can thus cause decay in the very teeth intended to be protected.
[22] Though GIC has poorer retention rates, the fact that they release active fluoride in the surrounding enamel is very important.
[27] Generally, each quadrant is treated separately by using four-handed technique with an assistant and to follow the manufacturer's recommendations.
A rubber dam may be used to prevent saliva from contaminating the intended site to be sealed, although often these are not used, especially for younger children.
In fact, the application procedure for glass ionomers can involve pressing a saliva-moistened finger onto the occlusal surface to push the sealant material into the pits and fissures.
[31] For partially erupted teeth which are difficult to isolate some will use GIC (doesn't need etching) as an interim option.
[33] In Portugal, a study has shown that over half (58.8%) of adolescents had a fissure sealant applied on at least one tooth.
Additionally, proper application, such as the tooth preparation, acid etch and adhesive also needs to be considered, otherwise, if they are applied incorrectly, it might resulted in unexpected and unfavorable clinical outcomes.
