Dental Sealants and Tooth Decay

Dental sealant is a thin, plastic coating painted on the chewing surfaces of back teeth, the premolars and molars. The purpose of coating teeth with sealant is to avoid tooth decay. The sealant bonds into the depressions and grooves of the teeth and forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the teeth and causing decay.

Using good technique of brushing and flossing can remove food particles and plaque from smooth surfaces of teeth. However, only brushing cannot always remove the food and plaque from all the niches and fissures of the back teeth. Sealants protect these vulnerable areas from tooth decay by “sealing out” plaque and food.

Need of Sealant

The most important reason for getting sealants is to avoid tooth decay. Fluoride in toothpaste and in drinking water protects the smooth surfaces of teeth but back teeth need extra protection. Sealants cover the chewing surfaces of the back teeth and keep out germs and food. Having sealants put on teeth before they decay will also save time and money in the long run by avoiding fillings, crowns, or caps used to fix decayed teeth.

Teeth Selection

Sealants are only applied to the back teeth, the molars and premolars. These are the teeth that have pits (small hollows) and fissures (grooves) on their biting surfaces. Dentist will tell you which teeth should be sealed after examining teeth and the fissures on them. Some teeth naturally have deep grooves which will need to be sealed; others have shallow ones which will not need sealing.

Dental Sealant Procedure

First of all, the tooth surface is thoroughly cleaned with a paste and rotating. Next the tooth is washed with water and dried. Then an acidic solution is placed on the fissured area of the tooth’s chewing surface for a number of seconds before being rinsed off. This creates small microscopic areas and a fine rougher surface than the surrounding tooth enamel. The rough surface and microscopic areas enable the dental sealant to attach to the tooth. After the tooth is dried again, the liquid dental sealant is placed on the tooth and hardened. Dental sealants are hardened by using a light that hardens the dental sealant, or sometimes by using a two-component dental sealant that sets without using a light. Once the dental sealant has hardened it becomes a hard plastic coating, and you can chew on the tooth again.

Sealant Life Time

Sealants usually last for many years, but your dentist will want to check them regularly to make sure that the seal is still intact. They can wear over time, and sometimes need to add or replace some sealant to be sure that no decay can start underneath it.

Risk Factors for Periodontitis

Periodontal disease is a serious disease which destroys teeth supporting bone and gum tissues. Teeth are supported by the gums, or gingiva and bone. A tooth’s root is affixed to the bone within its socket by fibers called periodontal ligaments. Gums are not cement attached to the teeth. A shallow, V-shaped gap called a sulcus exists between the teeth and the gums. Periodontal disease affects this gap to widen it. Eventually, in periodontal disease, the tissues supporting the tooth break down. If only the apparent gums are involved in this breakdown, the disease is referred to as gingivitis. If it is more advanced and involves the connecting tissues and bone, then it is called periodontitis.

The main cause of periodontal (gum) disease is plaque, but other factors affect the health of your gums.


Older people have the highest rates of periodontal disease.

Smoking/Tobacco Use

Tobacco users also are at increased risk for periodontal disease. Tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.


Research has indicated that some people may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be more likely to develop periodontal disease.


Stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.


Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health.

Hormonal changes

Hormonal changes may also result in periodontal disease, such as those related to pregnancy or menopause

Clenching or Grinding Your Teeth

Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

Other Systemic Diseases

Other systemic diseases that interfere with the body’s inflammatory system may worsen the condition of the gums. These include cardiovascular disease, diabetes, and rheumatoid arthritis.

Poor Nutrition and Obesity

Because periodontal disease begins as an infection, poor nutrition can worsen the condition of your gums. In addition, research has shown that obesity may increase the risk of periodontal disease.

Symptoms of Gum Disease

Gum disease or periodontal disease, called Periodontitis, begins with bacterial growth in the mouth and may end with tooth loss due to destruction of the tissue that surrounds teeth. Gingivitis or gum inflammation usually precedes periodontitis. However, not all gingivitis progresses to periodontitis. In the early stage of gingivitis, bacteria in plaque buildup, causing the gums to become inflamed and to easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. When gingivitis is left untreated, it can advance to periodontitis. Toxins or poisons, produced by the bacteria in plaque, start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become loose, and tooth loss occurs. Gum disease is the leading cause of tooth loss in adults.

Gum disease is often silent; symptoms may not appear until an advanced stage of the disease. However, warning signs of gum disease include the following:

  • Red, swollen or tender gums or other pain in your mouth
  • Bleeding while brushing, flossing, or eating hard food
  • Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
  • Loose or separating teeth
  • Pus between your gums and teeth
  • Sores in your mouth
  • Persistent bad breath
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures

Infant Oral Care is Important

Parents are surprised when dentist tells them that their infants can develop tooth decay and cavities after appearance of teeth. This is because they think infants are not prone to tooth decay and cavities. Most of the infants facing oral issues are victim of baby bottle tooth decay. Baby bottle tooth decay is caused by the continuing exposure to liquids containing sugars like milk, formula, and fruit juice.

Child’s oral care actually starts with mother’s healthy pregnancy, because baby teeth begin to form before birth. Pregnant mothers should make sure to eat a balanced, nutritious diet and get a sufficient amount of vitamins and minerals. It is vital for pregnant women to have a complete dental examination and have any cavities or gum disease treated.


Child’s first teeth, called Primary Teeth, usually begin to erupt through the gum at about 6 months of age. All of the primary teeth should come in between the ages of 6 months and 3 years. Teething can lead to intermittent localized discomfort in the area of erupting primary teeth, irritability, and excessive salivation; however, many children have no apparent difficulties. Treatment of symptoms includes oral analgesics and chilled rings for the child to gum. Use of topical anesthetics to relieve discomfort is discouraged due to potential toxicity of these products in infants. Every infant should receive an oral health risk assessment by six months of age. This initial assessment should evaluate the risk of developing oral diseases of soft and hard tissues, including caries-risk assessment and evaluate and optimize fluoride exposure

Basic things about infant oral care

It’s best to start good oral health habits before permanent teeth come in.

  • Regularly clean your baby’s gums with a soft cloth or gauze pad to remove plaque.
  • Parents and caregivers often share spoons, forks, and other utensils with babies. The saliva you may leave on the utensil contains bacteria that can cause tooth decay. Sometimes, kissing can also transfer bacteria. Keeping your own teeth and gums healthy reduces the risk of transferring tooth decay bacteria to your child.
  • Do not put your infant or small child to bed with a bottle of milk, formula, juice, or other product that contains sugar. The sugar and acids in these liquids can cause Baby Bottle Tooth Decay. Remove the bottle as soon as your baby is done feeding or is asleep.
  • Discuss your child’s fluoride needs with your dentist. If your child needs extra fluoride, your dentist may recommend a supplement or a gel or varnish that he or she would apply to your child’s teeth.
  • Give your child nutritious foods to maintain healthy gums, develop strong teeth, and avoid tooth decay. These include whole grains, vegetables, and fruits. Try to avoid foods that are high in sugar and processed carbohydrates, such as pastries, pasta, and white bread.
  • Do not give your child mouthwashes that contain alcohol. If your child age 6 or older has cavities, ask the dentist if your child should try mouthwash that contains fluoride.
  • Keep your child away from cigarette smoke. Tobacco smoke may contribute to the development of tooth decay, gum disease, and other health issues.
  • If your child sucks his or her fingers or thumb, help your child to stop.