Most decay in the teeth of children and teens occurs in the grooves of the back-teeth chewing surfaces. Dental sealants are coatings of a thin plastic applied to these grooves to protect these teeth from decay. The sealants prevent food particles and bacteria from burrowing into grooves where they’re hard to remove with brushing. Sealants are usually applied to first molars, which come in when kids are about six, and second molars, which appear at about age 12. The idea is to apply them as soon as possible after teeth erupt before decay can set in.
Application of the sealants is quick and painless. After the target tooth is cleaned, a gel is applied to the chewing surface and then washed and dried a few seconds later. Then the dentist paints the sealant on the tooth. It hardens in about a minute.
Typically, sealants last five to 10 years, but they should be checked at every dental appointment to make sure they’re still in place. Having sealants doesn’t mean kids get a pass on brushing and flossing their teeth, but they may get fewer cavities and, therefore, need fewer fillings.
I’m not an expert in this field so I checked with my own (holistic) dentist, Steve Swidler, for his views on sealants. He’s not a fan. He worries that undetected decay sealed into teeth can continue to move silently, so that eventually there will be deep decay or, worse, a dead tooth that will have to be extracted. Instead of sealants, Dr. Swidler recommends small, conservative fillings when decay is identified.
You should also be aware that BPA (bisphenol A), a chemical used in plastics and associated with some health and developmental problems in humans and animals, has been studied as a potential issue with dental sealants. According to research from the American Dental Association, BPA is rarely used in dental products. However, some composite resins used in dental materials might contain tiny amounts of BPA, and trace amounts of BPA used in the production of other ingredients used in dental composites and sealants could find their way into sealants. Considering the very small amounts of BPA involved, the ADA found no basis for a health concern.
Agreeing to the use of sealants on a child’s teeth is a parental judgment call. You have to weigh the very real risk of cavities (by far the most common disease among young children and teens) against the potential risks of sealants. Discussing the pros and cons with your dentist could help you with your decision.
Andrew Weil, M.D.