Sealing teeth: when is it useful and when is it not?

Sealing teeth: useful or not?

While children’s skin is smooth and wrinkle-free, children’s teeth often have deep grooves and furrows. So that no caries bacteria collect there, dentists often recommend that Seal teeth. But when does this really make sense and in which cases can you do without it? Read all about the advantages, benefits and possible risks of one here dental sealant.

Sealing teeth – what does it mean??

The occlusal surfaces of our molars resemble a mountain landscape: they have elevations and humps that are separated from one another by “valley furrows”. For some people this landscape is very rugged, for others it is less. Deeply furrowed furrows, which the dentist calls “fissures”, are particularly problematic: they are difficult to reach with the bristles of the toothbrush, which is why food residues and dental plaque often accumulate in them. This subsequently causes caries bacteria on the scene, which find ideal living conditions in these niches.

Caries, especially in children, develops preferentially from the fissures. To prevent this, the dentist can seal the teeth. He pours out the grooves and furrows with a special plastic filling, thus leveling the "mountain landscape" somewhat. This makes the tooth easier to clean and caries bacteria are no longer so easy. The procedure is painless and is usually completed within a few minutes.

The procedure is usually carried out immediately after the permanent molars have completely erupted. Because the enamel of these young teeth is not yet so resistant, they are therefore particularly at risk of caries.

Benefit has been scientifically proven

Tooth sealing, also called fissure sealing, is therefore a preventive measure that is intended to prevent the development of caries. The effectiveness of the method has been scientifically well documented: A systematic evaluation of numerous studies has shown that sealed teeth show only half as many caries spots after 4 to 5 years as unsealed teeth.

For children and adolescents between 6 and 17 years old, the statutory health insurance companies therefore also cover the costs for a tooth seal on the posterior, permanent molars. Because with these teeth, the grooves and furrows are most pronounced.

Sealing teeth: Accurate diagnostics are important

But even if the health insurance companies bear the costs: the dentist must always decide in individual cases whether it makes sense to seal the teeth! To do this, he will carefully examine the teeth and also take the patient’s history into account.

Various methods are used to assess the surface structure of the teeth: First, the dentist will use a mouth mirror to get an idea of the patient’s individual anatomy. He can use a probe to measure the depth of furrows and indentations. For exact diagnostics, he often also uses X-rays or illuminations with special lamps and laser light.

Seal teeth: In these cases it makes sense

Very deep furrows: The tooth anatomy can be very different individually. The dentist will likely recommend a tooth seal for patients with very rugged occlusal surfaces that are likely to be difficult to clean.
Increased risk of caries: Regardless of the nature of the teeth, tooth sealing is useful if a child has an increased risk of caries. If, for example, milk teeth or other permanent teeth are already affected, a spreading of the teeth can be prevented. Children and adolescents with fixed braces are particularly at risk because the teeth underneath are difficult to clean. It is also advantageous to seal the teeth in certain previous diseases such as diabetes (diabetes) because the immune system is often weakened.
Superficial caries: If superficial caries has already developed on a tooth, the dentist can carry out a so-called "extended tooth sealing". He first removes the diseased areas thoroughly and then fills the treated area with the sealing material. This is to prevent tooth decay from occurring again. The measure only makes sense if the caries is limited to the enamel. Deeper holes must always be closed with a special filling.

Sealing teeth: when can you do without them??

The decisive factor is always the individual risk of caries: if a child does not have deep grooves on the molars and practices good oral hygiene at home, it is not absolutely necessary to seal the teeth.

Milk teeth are also usually not sealed. In rare cases, this can make sense – for example, if the milk teeth have very deep notches or if a child develops caries very early. Treatment for canines and incisors is only necessary if they have large furrows on the back.

Sealing teeth in adults?

In principle, teeth can also be sealed in adults. It is done rather rarely: In adulthood, tooth decay tends to form from the interdental spaces. If the chewing areas are caries-free by then, they will likely remain so. Tooth sealing is used in adults, for example, in the following cases:

if oral hygiene is difficult due to a disability
with certain orthodontic treatments
if you have dry mouth (xerostomia) because this increases the risk of caries

Are there disadvantages or risks?

Many parents wonder whether surgery on healthy teeth is really necessary. Sometimes the plastic filling material is warned because it should release toxic substances such as formaldehyde or bisphenol A..

Some studies have shown that the plastics used when hardening in the outermost layer form tiny amounts of substances that are hazardous to health. The dentist then removes this layer by polishing. In addition, the amounts are so small that a health impact is very unlikely.

Allergic reactions to the filling material have so far only occurred in isolated cases. With the large number of tooth seals that are carried out every day, the risk is negligible!

Overall, the treatment can therefore be assessed as very safe. It also does not represent a major intervention on the tooth substance. The dentist only has to roughen the tooth surface a little so that the filling material then holds better. He then applies a fluoride-containing varnish to smooth the tooth enamel again.

Seal teeth: No absolute protection against tooth decay!

The greatest risk is that the dentist will miss caries and the bacteria will continue to cause trouble under the filling material. The same can happen if the filling material is not absolutely tight and contains air pockets or gaps. If the dentist works properly, this happens extremely rarely!

The important thing is: Sealed teeth are not a license, so that oral hygiene is no longer so precise, according to the motto: The teeth are sealed and thus protected anyway. Unfortunately, this is not true, sealing teeth cannot prevent tooth decay 100 percent, but only reduces the risk of it. Brushing your teeth thoroughly remains an obligation!

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