Dental sealants can prevent tooth decay 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 children from developing cavities.
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Dental sealants are a thin coating that is painted on teeth to protect them from cavities.
This painless procedure can cost $30 to $60 per tooth, although some insurance or discount plans can reduce this cost.
“Considering less than half the kids have them, I’d say [the trend of dental sealants] is still gaining traction,” Ashley Grill, a New York-based dental hygienist, told Healthline. “Dental sealants are safe and effective and have been safe and effective for over 40 years.”
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The CDC report states that dental sealants prevent 80 percent of cavities two years after application.
They also continue to protect against 50 percent of cavities for up to four years.
Sealants can be kept in the mouth for up to nine years, according to the CDC.
About 43 percent of children ages 6 to 11 have a dental filling. 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 nearly three times as many cavities as 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 said.
Dr. Valerie Barba, a dentist in New Jersey, told Healthline that sealants are the “most conservative” non-invasive treatment in dentistry.
Sealants must be monitored and maintained during regular maintenance visits to ensure they do not wear out.
They are technically sensitive to where they are placed, so practitioners who do not apply them correctly may not have the best success rates.
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Grill noted that children may report missing school time due to tooth decay, as it can affect sleep, eating and other regular activities.
In addition to preventing tooth decay, sealants can ensure that teeth remain 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,” he noted.
There are some disadvantages or potential problems with sealants, Grill said. They may need to be reapplied if they fall, chip or wear. When replacing, excess material may need to be drilled or removed with a step.
“I understand the concern about environmental exposure about synthetic estrogens like bisphenol A (BPA),” Grill said.
Salivary BPA levels from BPA exposure peak three hours after the procedure and return to baseline within 24 hours, he said. Grill added that serum levels of BPA have not been detected in clinical studies, but more research is needed.
“I’ve never had 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 dangers of tooth decay, they should note that tooth decay treatment can include a variety of dental materials that contain more chemicals than BPA. There are alternative sealants, although Grill isn’t sure if they work any better than those that contain BPA.
Another problem with sealants is that a person’s bite may feel uneven after application because of the extra layer on the tooth, said Dr. J. Kolby Robinson, a board-certified pediatric dentist from Oregon, to Healthline. Some of them wear out over time.
“The main problem with dental sealants is a lack of awareness,” Grill added.
Most children don’t benefit from prevention because of over-regulation and restrictions across the board on preventive dental care, Grill said.
Some are insurance barriers, such as covering only certain teeth for sealants. There are also rules enforced by state boards that allow only hygienists working with dentists to place sealants or require a dental examination by a dentist before prevention is allowed.
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If the application technique is perfect, dental sealants can last a lifetime. Most of the time, however, they need to be replaced, Grill said.
“Once your child has new teeth with grooves called ‘pits and fissures’, such as molars and premolars, seal them as they erupt,” she said. This happens at ages 6, 12 and 18.
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, treatment of younger teeth is only done in people 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 the hold is better in the pits and cracks,” he said.
Adults can also benefit from sealants.
“All people, regardless of age, can benefit [from sealants]even adults,” Barba said.
With age, our exposure to wear and tear 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 won’t benefit from a sealant, Grill noted.
“Sealants have been shown to be safe and effective,” Robinson said. “The benefits outweigh the risks.”
