Sealants are a plastic material applied to the chewing surface of permanent molars that provide a physical barrier to bacterial invasion of pits and fissures. Sealants are effective because 90% of caries in school-aged children occur in the pits and fissures of molars, the place a sealant covers.
The first permanent molars erupt at age 6 and the second permanent molars around age 12, so these are the target ages for sealants, although they can be applied any time. For an individual tooth, a properly applied sealant is virtually 100% effective in preventing a
An area of decay in a tooth .
at the site of the sealant. However, sealants are only effective as long as they remain on the tooth.
Using sealants is a cost-effective
strategy because they typically last 5 to 10 years and 1 sealant costs less than half the cost of a single filling. (View MMWR information on sealants.)
Sealants should be applied to all high-risk children around the ages of 6 and 12. Sealants need to be in addition to fluoride, because fluoride primarily benefits the smooth surfaces of teeth, whereas sealants protect the grooved surfaces.
Fluoride is very effective in the prevention of caries and should be provided both topically, through toothpaste, mouthrinses, gel, or varnish, and systemically, through drinking water or fluoride supplementation. (Refer to Chapter 6: Fluoride
for more information.)