Dental sealants are thin coatings that when painted on the chewing surfaces of the back teeth (molars) can prevent cavities (tooth decay) for many years. Sealants protect the chewing surfaces from cavities by covering them with a protective shield that blocks out germs and food. Once applied, sealants protect against 80% of cavities for 2 years and continue to protect against 50% of cavities for up to 4 years.Children aged 6 to 11 years without sealants have almost three times more first molar cavities than children with sealants.

Depending on state law and regulations, sealants can be applied by a dentist, dental hygienist, or other qualified dental professional. This can be done in dental offices or using portable dental equipment in community settings like a school.

Sealant use increased by about 75% among low-income children and remained at about 43% among higher-income children from 1999–2004 to 2011–2016. However, this effective intervention still remains underused. Less than half of children aged 6 to 11 years have dental sealants. Children from low-income families are 15% less likely to get sealants and twice as likely to have untreated cavities. Untreated cavities can cause pain, infection, and problems eating, speaking, and learning.

Overview

Dental sealants are thin plastic coatings that protect the chewing surfaces of children’s back teeth from cavities, or tooth decay. Because they have small pits and grooves, these surfaces are rough and uneven. Food and germs can get stuck in the pits and grooves and stay there for a long time because toothbrush bristles cannot brush them away. Sealants fill in the grooves and keep the food out.

Children should get sealants on their permanent molars (back teeth) as soon as they come in, before decay attacks the teeth. The first molars come into the mouth when children are about 6 years old, and the second molars appear when children are about 12 years old.

Sealants can be put on in a dental office, a community dental clinic, or in a school sealant program.

Applying sealants is simple and painless. They are painted on as a liquid and quickly harden to form a shield over the tooth.

Helpful Tips

• Ask a dentist or doctor where your child can get dental sealants. Sealants can be put on in a dentist’s office, a community health clinic, and sometimes at school.
• Make sure your children also brush with a fluoride toothpaste twice a day and see a dentist for regular check-ups.

You probably know that a dental cavity is a hole in a tooth. But did you know that a cavity is the result of the tooth decay process that happens over time? Did you know that you can interrupt and even reverse this process to avoid a cavity?

What's inside our mouths?

Our mouths are full of bacteria. Hundreds of different types live on our teeth, gums, tongue and other places in our mouths. Some bacteria are helpful. But some can be harmful such as those that play a role in the tooth decay process.

Tooth decay is the result of an infection with certain types of bacteria that use sugars in food to make acids. Over time, these acids can make a cavity in the tooth.

What goes on inside our mouths all day?

Throughout the day, a tug of war takes place inside our mouths.

On one team are dental plaque–sticky, colorless film of bacteria–plus foods and drinks that contain sugar or starch (such as milk, bread, cookies, candy, soda, juice, and many others). Whenever we eat or drink something that contains sugar or starch, the bacteria use them to produce acids. These acids begin to eat away at the tooth's hard outer surface, or enamel.

On the other team are the minerals in our saliva (such as calcium and phosphate) plus fluoride from toothpaste, water, and other sources. This team helps enamel repair itself by replacing minerals lost during an "acid attack."

Our teeth go through this natural process of losing minerals and regaining minerals all day long.

How does a cavity develop?

When a tooth is exposed to acid frequently -- for example, if you eat or drink often, especially foods or drinks containing sugar and starches -- the repeated cycles of acid attacks cause the enamel to continue to lose minerals. A white spot may appear where minerals have been lost. This is a sign of early decay.

Tooth decay can be stopped or reversed at this point. Enamel can repair itself by using minerals from saliva, and fluoride from toothpaste or other sources.

But if the tooth decay process continues, more minerals are lost. Over time, the enamel is weakened and destroyed, forming a cavity. A cavity is permanent damage that a dentist has to repair with a filling.

How can we help teeth win the tug of war and avoid a cavity?

Use fluoride

Fluoride is a mineral that can prevent tooth decay from progressing. It can even reverse, or stop, early tooth decay.

Fluoride works to protect teeth. It . . .

• prevents mineral loss in tooth enamel and replaces lost minerals
• reduces the ability of bacteria to make acid

You can get fluoride by:

• Drinking fluoridated water from a community water supply; about 74 percent of Americans served by a community water supply system receive fluoridated water.
• Brushing with a fluoride toothpaste

If the dentist thinks your child needs more fluoride, he or she may -

• Apply a fluoride gel or varnish to tooth surfaces
• Prescribe fluoride tablets
• Recommend using a fluoride mouth rinse

About bottled water

Most bottled water does not contain enough fluoride to prevent tooth decay. If your child drinks only bottled water, talk with a dentist or doctor about whether your child needs additional fluoride in the form of a tablet, varnish, or gel.

Keep an eye on how often your child eats, as well as what she eats.

Your child's diet is important in preventing a cavity. Remember . . . every time we eat or drink something that contains sugar or starches, bacteria in our mouth use the sugar and starch to produce acids. These acids begin to eat away at the tooth's enamel.

Our saliva can help fight off this acid attack. But if we eat frequently throughout the day -- especially foods and drinks containing sugar and starches -- the repeated acid attacks will win the tug of war, causing the tooth to lose minerals and eventually develop a cavity.

That's why it's important to keep an eye on how often your children eat as well as what they eat.

Tooth-friendly tips:

• Limit between-meal snacks. This reduces the number of acid attacks on teeth and gives teeth a chance to repair themselves.
• Save candy, cookies, soda, and other sugary drinks for special occasions.
• Limit fruit juice.
• Make sure your child doesn't eat or drink anything with sugar in it after bedtime tooth brushing. Saliva flow decreases during sleep. Without enough saliva, teeth are less able to repair themselves after an acid attack.

Make sure your child brushes

Brushing with fluoride toothpaste is important for preventing cavities.

Here's what you should know about brushing:

1. Have your child brush two times per day
2. Supervise young children when they brush -
   • For children aged 2 to 6, you put the toothpaste on the brush. Use only a pea-sized amount of fluoride toothpaste.
   • Encourage your child to spit out the toothpaste rather than swallow it. Children under 6 tend to swallow much of the toothpaste on their brush. If children regularly consume higher-than-recommended amounts of fluoride during the teeth-forming years (age 8 and younger), their permanent teeth may develop white lines or flecks called dental fluorosis. Fluorosis is usually mild; in many cases, only a dental professional would notice it. (In children under age 2, dental experts recommend that you do not use fluoride toothpaste unless directed by a doctor or dentist.)
   • Until they are 7 or 8 years old, you will need to help your child brush. Young children cannot get their teeth clean by themselves. Try brushing your child's teeth first, then let her finish.

Talk to a dentist about sealants

Dental sealants are another good way to help avoid a cavity. Sealants are thin, plastic coatings painted onto the chewing surfaces of the back teeth, or molars. Here's why sealants are helpful: The chewing surfaces of back teeth are rough and uneven because they have small pits and grooves. Food and bacteria can get stuck in the pits and grooves and stay there a long time because toothbrush bristles can't easily brush them away. Sealants cover these surfaces and form a barrier that protects teeth and prevents food and bacteria from getting trapped there.

Since most cavities in children and adolescents develop in the molars (the back teeth), it's best to get these teeth sealed as soon as they come in:

• The first permanent molars called - "6 year molars" - come in between the ages of 5 and 7.
• The second permanent molars - "12 year molars" - come in when a child is between 11 and 14 years old.

Take your child to the dentist for regular check-ups

Visit a dentist regularly for cleanings and an examination. During the visit the dentist or hygienist will:

• Remove dental plaque
• Check for any areas of early tooth decay
• Show you and your child how to thoroughly clean the teeth
• Apply a fluoride gel or varnish, if necessary
• Schedule your next regular check-up

What are dental sealants?

Sealants are thin, plastic coatings painted on the chewing surfaces of the back teeth.

Sealants are put on in dentists’ offices, clinics, and sometimes in schools. Getting sealants put on is simple and painless. Sealants are painted on as a liquid and quickly harden to form a shield over the tooth.

Why get sealants?

The most important reason for getting sealants is to avoid tooth decay.

• Fluoride in toothpaste and in drinking water protects the smooth surfaces of the teeth but back teeth need extra protection. Sealants cover the chewing surfaces of the back teeth and keep out germs and food.
• Having sealants put on teeth before they decay will also save time and money in the long run by avoiding fillings, crowns, or caps used to fix decayed teeth.

What causes tooth decay?

Germs in the mouth use the sugar in food and drinks to make acids. Over time, the acids can make a cavity in the tooth.

Of course a healthy tooth is the best tooth. So it is important to prevent decay. That’s why sealants are so important.

Why do back teeth decay so easily?

The chewing surfaces of back teeth are rough and uneven because they have small pits and grooves. Food and germs can get stuck in the pits and grooves and stay there a long time because toothbrush bristles cannot brush them away.

Who should get sealants?

Children should get sealants on their permanent molars as soon as the teeth come in — before decay attacks the teeth.

• The first permanent molars — called “6 year molars” — come in between the ages of 5 and 7.
• The second permanent molars — “12 year molars” — come in when a child is between 11 and 14 years old.
• Other teeth with pits and grooves also might need to be sealed.

Teenagers and young adults who are prone to decay may also need sealants.

Should sealants be put on baby teeth?

Your dentist might think it is a good idea, especially if your child’s baby teeth have deep pits and grooves.

• Baby teeth save space for permanent teeth. It is important to keep baby teeth healthy so they don’t fall out early.

Does insurance pay for sealants?

Some health insurance programs pay for sealants. Check with your state Medicaid program or your insurance company for details.

How long do sealants last?

Sealants can last up to 10 years. But they need to be checked at

regular dental check-ups to make sure they are not chipped or worn away. The dentist or dental hygienist can repair sealants by adding more sealant material.

What if a small cavity is accidentally covered by a sealant?

The decay will not spread, because it is sealed off from its food and germ supply.

Are sealants new?

No, sealants have been around since the 1960s. Studies by the National Institute of Dental and Craniofacial Research and others led to the development of dental sealants and showed that they are safe and effective.

But many people still do not know about sealants. In fact, fewer than one-third of children in the United States have sealants on their teeth.

Besides sealants, are there other ways to prevent tooth decay?

Yes. Using fluoride toothpaste and drinking fluoridated water can help protect teeth from decay.

• About two-thirds of people in the United States have fluoride in their water. If your water is not fluoridated, talk to a dentist about other kinds of fluoride that can help keep your child’s teeth healthy.
• Fluoride is the best defense against tooth decay!

Fluoride…

• makes teeth more resistant to decay
• repairs tiny areas of decay before they become big cavities
• makes germs in the mouth less able to cause decay

Fluoride helps the smooth surfaces of the teeth the most. It is less effective on the chewing surfaces of the back teeth. Regular brushing — with fluoride toothpaste — also helps prevent tooth decay.

Sealants and fluoride together can prevent almost all tooth decay.

How can I get dental sealants for my children?

Talk to your dentist, state or local dental society, or health department. Sometimes sealants are put on at school. Check with your school about whether it has a sealant program.

What are dental sealants?

Dental sealants are thin coatings that when painted on the chewing surfaces of the back teeth (molars) can prevent cavities (tooth decay) for many years. Sealants protect the chewing surfaces from cavities by covering them with a protective shield that blocks out germs and food. Once applied, sealants protect against 80% of cavities for 2 years and continue to protect against 50% of cavities for up to 4 years.

What is a cavity?

A cavity is a permanent hole in a tooth. If it is not treated, it will get bigger; it can hurt and get infected. The most common place for cavities is in the grooves of the back teeth.

Is sealing a tooth better than filling the cavity?

Sealants are a quick, easy, and painless way to prevent cavities. A tooth without a cavity is stronger and healthier than a tooth with a filling or untreated decay. Sealants are also less expensive and easier to apply than fillings.

Should I ask the dentist to put sealants on my child’s teeth?

Yes. Dental cavities are one of the most common chronic conditions among children and teens. Left untreated, cavities can cause pain and infection and problems in eating, speaking, and learning. Sealants are an extremely effective yet underutilized shield that protects children’s teeth from cavities.

When can my child get sealants?

Sealants prevent the most cavities when applied soon after permanent molars come into the mouth (around age 6 for 1^st molars and age 12 for 2^nd molars).

Will it hurt to get a sealant?

Getting a sealant is easy and does not hurt. The tooth is cleaned and a gel may be placed on the chewing surface for a few seconds. The tooth is then rinsed and dried. Next, the sealant is painted on the tooth. The dentist or dental hygienist also may shine a light on the tooth to help harden the sealant to form a protective shield.

Will sealants make teeth feel different?

Sealants are very thin and fill the pits and grooves of the teeth. Sometimes children can feel the sealant with their tongues for a short while after the sealant is placed.

What do sealants look like?

Sealants can be clear, white, or slightly tinted. Usually, you cannot see a sealant when a child talks or smiles.

How long will sealants last?

Sealants have shown to still work 9 years after placement. However, sometimes they do fall off, so they should be checked at regular dental appointments. If a tooth loses a sealant, the protective shield is gone and the tooth can get a cavity. Missing sealants are easy to replace.

If my water has fluoride, should my child still get sealants?

Yes. Sealants and fluoride both prevent tooth decay, but in different ways. Sealants keep germs and food out of the grooves in the back teeth by covering them with a safe protective shield. Fluoride in drinking water and dental products, such as toothpaste, protects against cavities by making teeth stronger.

Where can my child get sealants?

• Ask your child’s dentist to apply sealants when appropriate.
• Some schools offer sealants as part of a community public health program. Ask if your school has a sealant program. If they do, sign your child up to participate. If they don’t, ask them to start one.

If my child has dental sealants, is there anything else I need to do to protect their teeth?

Sealants are one part of a child’s total preventive dental care.