7 FAQs About Pit and Fissure Sealing

1. What is pit and fissure closure?

The chewing surface of your teeth is also known as the occlusal surface. Your premolars and molars - the back teeth - have uneven grooves and small holes. These are called pits and fissures. While everyone has these, some people have deeper grooves than others, which can easily trap food, especially sticky foods that children are fond of. (Like candy!) Some grooves are so deep that even if you have the best oral hygiene, you will not be able to clean them thoroughly. That makes pits and fissures very susceptible to dental caries (decay).

Pit and fissure sealants are commonly placed to prevent decay, typically just referred to as sealants. Sealants are applied to the occlusal surface using a layer of protective material called composite, much like a tooth-colored filling. However, sealants are non-invasive and pain-free. Patients do not even need a local anesthetic to place the sealants.

2. Why do deciduous teeth also need pit and fissure sealing?

· Every child has eight deciduous (or primary) molars - two in each quadrant of the mouth. (The upper left, upper right, lower left, and lower right.) These molars erupt when the child is between two and three years old and remain in place until age 12. They help children eat and establish a healthy occlusal relationship until the permanent teeth erupt. These primary molars have especially deep fissures, making them more prone to decay.
· It's common for children to enjoy eating sweets and typically not have the best oral hygiene habits. These two facts combined are why children usually have higher decay rates.
· Food that resides in the pits and fissures for extended periods of time becomes fermented with bacteria and turns to acid, which causes corrosion that leads to decay. Once decay has started, sealants are no longer an option, and the tooth will require a filling, at the minimum. If the decay is advanced, it could require much more extensive treatment. Young children are often not cooperative during complex treatment, and exposing them to this at young ages may result in fear of the dentist as they get older. However, not having treatment can permanently impact the health of the permanent teeth that will erupt later.

3. Do all deciduous teeth need to be sealed?

Only the posterior deciduous teeth require pit and fissure sealants. A dentist will examine the teeth and determine if sealants are necessary. If the teeth have deep grooves and no decay, it is very likely the dentist will recommend sealants for caries prevention. However, if the grooves are shallow and the child has been able to keep them clean, they may not require sealants.

4. How are sealants placed?

Placing sealants is a very quick procedure and is often completed in just a few minutes. Materials include an adhesive bonding agent and composite resin such as those used for fillings. However, the sealants can become dislodged, so they may need to be replaced over time. The dentist will check to ensure they are in place at every routine visit, which typically occurs every six months.

5. Can I do pit and fissure sealing if there are cavities in deciduous teeth?

If there is decay present in a fissure, you cannot have sealants placed. Instead, you will need to remove the decay and place a filling. If the decay is more extensive and has reached the tooth's pulp (the nerve), it may even need endodontic (root canal) treatment. In extreme cases, the tooth might need to be extracted.

6. Will pit and fissure sealing of deciduous teeth affect tooth replacement?

Sealants will not affect the replacement of teeth. They are only used to protect the deciduous teeth and help them transition into permanent tooth replacement. When the primary tooth falls out, the sealant will fall out with it.

7. When can a pit and fissure seal be done?

The best time to seal the pit and fissure is when the teeth have fully erupted.
Primary molars: 3 - 4 years old
First permanent molars: 6 - 7 years old
Second permanent molars: 11 - 12 years old

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