Do tooth sealings have an authorization?

I keep hearing that question. Recently, I treated a tooth where the answer to this question was very clear. That’s why I quickly took a picture of this tooth. I’ll show you that now:

This photo shows a typical sealed tooth. The fissures, i.e. the visible gaps on the tooth surface, are sealed with thin plastic. The front part of the tooth, between the two front humps, I drilled with my turbine, because the patient had toothache. In the V-shaped drilled out part you can see from the front of the tooth up to the white, superficial sealing. From the outside, the tooth looked perfectly healthy. There was no trace of brown discoloration. Under the sealant plastic you can now see a brown part of the tooth, a good two millimetres deep, which was soft and rotten and caused the patient’s toothache. I found the pathological change on the dental x-ray, a bite wing x-ray that showed an unnatural whitening in the middle of the tooth. Without the x-ray I would not have found out WHICH tooth was the cause of the patient’s discomfort. He only felt very diffuse pain without being able to tell which tooth actually hurt him. This happens quite often, and many patients do not even feel whether the pain originates from the upper or lower jaw. Some patients even feel only a diffuse headache and do not even think that a tooth could be the cause of this headache.

The word SHIELD has a very sympathetic, preserving sound in the ears of people who let their teeth stick together like this. The word suggests safety from destruction, or at least increased durability. From everyday life, we know the sealing of a wooden floor, the sealing of a letter or the sealing of a car paint. It is always a matter of protecting things that are dear and valuable to you. So how should the sealing of teeth be something inappropriate and harmful?

The insidious thing about this is that the sealed tooth gaps are no longer controllable by the dentist. We have all known since childhood that you should not only brush your teeth twice a day, but also go to the dentist twice a year. The dentist takes a close look at the teeth and can check with his dreaded probe whether the tooth surface is hard and healthy. He no longer has this control option if the endangered parts of the tooth are covered by a white plastic layer. This means that damage can often increase unnoticed for a long time until it finally becomes noticeable in pain or can be seen on an X-ray. But then it is very late and a lot of tooth substance has become unnecessarily broken in the meantime.

Actually, I don’t need to explain much now, do I? In many cases, the supposed security one thinks one can buy with tooth sealing turns out to be a dangerous trap afterwards. Tooth damage often becomes unnecessarily large under the beautiful, white plastic layer and, when it is finally discovered, requires disproportionately large repairs in which a lot of tooth substance can be lost. In addition, there is also an unfavourable psychological effect: many of us love our comfort and believe that we can at least partially free ourselves from the necessity of thorough dental care by having our teeth sealed. Many parents who have difficulties with their children’s dental care because they do not want their children to have their teeth cleaned by their parents also believe that they can buy themselves off their obligation with a tooth seal. In the case of small children, the parents are absolutely responsible for the condition of their children’s teeth. Only from elementary school age can one expect that children themselves can make an active contribution to the care of their teeth. Before that they are usually simply too clumsy. Unfortunately, poor children have to endure the painful, rotten results of such an attitude to dental care. The parents, however, are happy to reject any responsibility because they have “even” had a tooth seal applied.

So you can clearly see the reasons why I don’t offer tooth sealants in my practice. I prefer to regularly and sensibly check the teeth of my small (and large) patients. Then I can recognize damages in time and do not need to drill away a lot of tooth substance, if a small rotten spot occurs. This way I can do much more to keep my patients’ teeth healthy for a lifetime than by the apparent and deceptive “safety” of a tooth seal.

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Christina Cherry
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