Dental sealants can prevent cavities in children and adults for years, but are they worth the cost and potential risk?
Brushing your teeth is important, but dental sealants may be the best way to prevent kids from getting cavities.
Dental sealants are a thin coating that is painted on teeth to protect them from cavities.
This painless procedure can be $30 to $60 per tooth, although some insurance or discount plans can reduce that cost.
“Considering that less than half of children have them, I’d say [the trend of dental sealants] it still is gaining traction,” Ashley Grill, a New York-based dental hygienist, told Healthline. “Dental sealants are safe and effective, and they’ve been safe and effective for over 40 years.”
The CDC report states that dental sealants prevent 80 percent of cavities for two years after application.
They also continue to protect against 50 percent of cavities for up to four years.
The sealants can be retained in the mouth for up to nine years, according to the CDC.
About 43 percent of 6- to 11-year-old children have a dental sealant. Children from low income households were 20 percent less likely to have sealants than children from higher income households.
School-age children without sealants have almost three times more cavities than children with sealants.
Applying sealants in school-based programs to the nearly 7 million children from low income households who don’t have them could save up to $300 million in dental treatment costs, the CDC reported.
Dr. Valerie Barba, a dentist in New Jersey, told Healthline that sealants are the “most conservative” noninvasive treatment in dentistry.
The sealants need to be monitored and maintained during regular care visits to ensure they do not wear away.
They are technically sensitive to where they are placed, so practitioners who do not apply them correctly may not have the best success rates.
Grill noted that children can report lost school time due to tooth decay, as it can interfere with sleep, eating, and other regular activities.
In addition to preventing cavities, sealants can ensure the teeth stay intact.
“Once a tooth is drilled and filled, restored, or extracted, the natural structure is compromised. There is a lifetime cost associated with maintaining the restored tooth or implant,” she noted.
There are some disadvantages or potential problems with sealants, Grill said. They may need to be reapplied if they fall out, chip, or wear away. In replacement, excess material may need to be drilled down or removed with a scaler.
“I understand the environmental exposure concern about synthetic estrogens such as bisphenol A (BPA),” Grill said.
Salivary BPA levels from exposure to BPA peak three hours after a procedure and return to baseline within 24 hours, she said. Grill added that blood serum levels of BPA have not been detected in clinical studies, but more research is needed.
“I’ve never observed an adverse reaction to dental sealants, and none have been reported in the literature,” said Grill, who applies sealants. “People tolerate dental sealants well.”
If parents are concerned about BPA more than the risks of tooth decay, they should note that treating tooth decay can involve a wealth of dental materials that have more chemicals than BPA. Alternative sealant materials exist, though Grill is not sure if they work better than those containing BPA.
Another issue with sealants is that a person’s bite can feel abnormal after application due to the extra layer on the tooth, Dr. J. Kolby Robinson, a board certified pediatric dentist from Oregon, told Healthline. Some of that wears away over time.
“The main problem with dental sealants is lack of awareness,” Grill added.
Most children don’t benefit from prevention because of overregulation and restrictions at all levels on preventive dental care, Grill said.
Some are insurance barriers, such as only covering certain teeth for sealants. There are also rules imposed by state boards that only allow hygienists working with dentists to place sealants, or requiring a dental examination with a dentist before prevention is allowed.
If the application technique is perfect, dental sealants can last a lifetime. More often than not, though, they do need to be replaced, Grill said.
“As soon as your child is getting new teeth in with grooves called ‘pits and fissures’ like molars and premolars, get them sealed once they are erupted,” she said. This happens at 6, 12, and 18 years of age.
Baby or primary teeth can be sealed, but the child should be old enough to tolerate the painless procedure, which involves being able to hold their mouth open and not move for a few minutes. Usually, treating younger teeth is performed only on those with an increased risk of tooth decay.
“I recommend getting individual advice on when to seal from your dental team. You can seal any vulnerable surfaces, but retention is best in the pits and fissures,” she said.
Adults can also benefit from sealants.
“All people, no matter age can benefit [from sealants], even adults,” Barba said.
With age, our exposure to decay increases, and the protective quality and biochemistry of saliva changes with certain medications over time. That said, adults are also candidates for this treatment.
But if you already have a restoration or implant, then that tooth will not benefit from a sealant, Grill noted.
“Sealants have proven to be safe and effective,” Robinson said. “The benefits outweigh the risks.”