How important is fissure sealant on children's teeth?

[sofia31]

At £200 per child, is this worth doing? No NHS dentist anymore and had a big shock at the new private dentist. This isn't a one off either, as the back teeth aren't all through yet. Plus everything else they want eg £78 for a quick scale that the NHS used to do in a 10 minute checkup. Feeling rather concerned for the future but appreciate we are lucky not to have paid up until now.

I had it on NHS. No fillings age 51.

My children have deep fissures in their teeth so I paid for it - they're adults now and never had a filling.

Is this the caramel stuff they put on their teeth at the end of each check up or something different?

Fissure sealants are only on back (molar) teeth and essentially make the grooves in those teeth much shallower, which make them easier to clean, and that reduces the chances of decay. Decay can still happen if there is too much sugar in the diet or poor oral hygiene.

The associations of posters here who have them never needing fillings are just a correlation- if they were brought to the dentist as children for sealants, it's likely they had motivated and engaged parents who also enforced good diet and oral hygiene.

If brushing/ diet isn't adequate decay can still occur on other teeth.
They're a good, non-invasive preventative measure though.

One of my DC has had them. £170. Can’t say it’s necessarily worth it? She’s 12 so no long term reports. She has deep fissures in her teeth.

I’ve spent £63 on DS teeth this month as he’s got a brittle tooth that is snapping off. Driving me mad that we can’t access an NHS dentist.

What on earth are we all talking about? I’ve never heard of these things?

I had it as a child and I've had loads of fillings.

Ds 13 has had it free at the NHS dentist because he has deep grooves in his teeth. No fillings for him yet

I had it done as a child. I’m 45 now and not a single filling.

I had it as a child and have had lots of problems over the years (partly caused by wisdom teeth) so it's not guaranteed but it sounds like it works for some!

I'm 37 and have never heard of this, if there was a sealant I could put on my kids teeth that would prevent fillings down the road I would do it straight away!

I had it and have pretty good teeth, maybe two fillings. I have never bothered with the DC, the dentist never mentioned it, and 1 filling between three of them.

@Chairwoman i think that is flouride varnish, which lasts about 6 months. I think the sealant lasts years?

I had it and it's been great. My two DS were lucky to both have it as part of dental surgery and I was very happy!

I'm 52. I had it and no fillings. Perfect teeth

I'm another one who has never heard of it. But I will be asking the dentist about it next time I take my kids!

My brother and I had it as kids and we don't have any fillings even now in our forties.

I’ve refused fissure sealants for my DC for now. I’m very cautious about what chemicals are introduced into their mouth/ close to soft tissues. Although they can prevent cavities (if done properly and perfectly by the dentist) they contain BPA and the more they do the higher the toxic load. It’s a balance. Study here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539392/

Im very cautious as my mum has dementia and Parkinson’s and has a mouthful of mercury fillings in her head. Whilst no-one has confirmed the mercury has directly caused the illnesses, it is widely known now that mercury is highly neuro toxic to humans and is no longer used. I worry that in the future they’ll say the same about newer substances.

If my dc had issues with their teeth I might consider them but at present they don’t (teens) so I hold off. Yes some say prevention is better than cure but Im of the view that if it ain’t broke…

My other issue is that if they are not done perfectly, tiny cracks and gaps can appear over time which can actually cause food and bacteria to get into them and cause decay!

Should add I never had them as a child and I have perfect teeth with no fillings so it’s more complex than just slapping a sealant on.

Some study results

www.cochrane.org/CD001830/ORAL_sealants-preventing-tooth-decay-permanent-teeth

I had never heard of them until last year when the dentist recommended them for my children. He likened them to a layer of polish to seal up the biting surface of the tooth to prevent cavities. It cost £70 per tooth for 4 teeth each child... ouch! But otherwise a relatively straightforward process.

Both of my DDs had fissure sealants as children. We were really lucky our dentist did this as a matter of course. Now at 25 and 27, neither have any fillings. Definitely worth it!

My dentist doesn't rec them . Says they leak. I had them sand I'm full of fillings.

This is the problem with them. They work well if they are done absolutely perfectly and they stay pristine.

As soon as there’s a tiny crack or any degradation they cause more harm than good as food/bacteria gets trapped.

Difficult one.

If children are 'high risk' of decay (so have had holes in baby teeth) or have very deep grooves then there is evidence they can help. Generally regular fluoride applications (the caramel/banana gel that is painted on) is equally effective in low risk children

As a pp said, good brushing twice daily (especially bedtime - spit don't rinse) and no sugary snacks/drinks is the most effective way of preventing decay

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9308902/

Would you refuse any filling then?

The two main materials used are amalgam (mercury-based in minute concentrations, no confirmed links to any health issues), or composite resin- the same material used for fissure sealants. It's a more solidified form used for definitve fillings, it's applied in a runnier form for sealants.

If your child had a cavity would you just not let them have a filling?