Are dental sealants safe for your child?

Are dental sealants for children a good option for your family? You can use this guide to help you decide with your dentist what will be best.

What are dental sealants? 

Dental sealants are thin, plastic coatings that are applied directly onto the vulnerable chewing surface of the back teeth (molars and premolars) that have deep narrow grooves. 

When properly placed, they can prevent decay (cavities) from forming in areas that are inaccessible by a toothbrush. 

Dental sealants function a lot like the calking in your shower. It fills in a deep narrow crevice that would otherwise be nearly impossible to keep clean and would in turn be a breeding ground for bacteria, mold, fungus, etc. 

That being said, although dental sealants are a great option for preventing decay in children, they are in no way a substitute for good oral hygiene and a healthy diet. 

If you’re taking showers, but never cleaning the shower… 

Guess what?! 

You will grow bacteria and mold in your shower AND it will usually start right along the borders of the calking. 

The same idea applies to dental sealants. 

Consider dental sealants as more of a safety net in addition to healthy habits. 

Dental sealants can be placed by your dentist, dental hygienist, or other trained dental professional- depending on your state’s governing dental board laws. 

I personally recommend dental sealants for children when they can be properly placed, at the right time, and with safe materials. 

Do dental sealants prevent cavities?

Yes, dental sealants prevent cavities… when they are properly placed. 

According to the CDC, dental sealants prevent 80% of cavities in the back teeth… where 90% of cavities occur. 

A Cochrane review found that a tooth with a sealant was up to 50% less likely to have a cavity than a tooth without a sealant. 

These are pretty positive statistics! 

But it’s important to take into account all of the other factors that could be helping that statistic. 

Like the fact that children from affluent families are 20% more likely to have access to sealants. 

These are also the children that are likely to see a dentist more regularly, have access to healthy foods, and may have better homecare routines when it comes to brushing and flossing. 

Dental sealants have a higher rate of success when they are placed soon after the adult teeth erupt… at ages 6 and 12. 

The longer those teeth are in the mouth, the longer they have been exposed to bacteria and a potentially acidic environment – increasing the potential for decay to develop in those deep grooves. 

The last thing you want is to cover up and seal in decay; making it go undetected until it becomes a bigger and potentially painful problem. 

How are dental sealants applied to the tooth? 

This is a quick, easy, and painless procedure. 

There’s no need for an anesthetic, but the area does need to be kept very dry and clear of saliva in order for the sealant to properly bond to the tooth. 

1. The tooth will be examined to ensure there is no decay present. 
2. The tooth will be isolated with materials that help to keep it dry. 
3. The chewing surface will be cleaned with an etchant that roughens the enamel to help increase retention of the sealant material. 
4. The etchant is thoroughly rinsed and suctioned away. 
5. The tooth will be thoroughly dried. 
6. A bonding agent may be applied, depending on the type of sealant material being used. 
7. The sealant is placed onto the chewing surface. 
8. A curing light will be used to harden the sealant material. 

Some dentists will use Ozone to make sure there is no bacteria on the tooth before placing the sealant. 

If a small cavity is found during the exam, it can simply be cleaned out using a drill or laser before placing the sealant. 

Should a sealant be placed over existing decay? 

There is a school of thought that if there is a small shallow cavity, placing a sealant over it will suffocate the bacteria and stop the decay from spreading. 

I would recommend against placing a sealant over any decay regardless of how small it is. 

It is better to try to remineralize the tooth structure and reverse the decay if possible or remove the decay altogether and restore the tooth. 

I have seen too many sealants with deep decay underneath to feel comfortable recommending experimenting with placing a sealant over a small cavity to see if it will halt its growth. 

Just address the decay. 

How long do dental sealants last?

Dental sealants can last anywhere from 2-10 years and sometimes even longer!

A lot of the success of a sealant depends on the technique used to place it. Think… was the tooth properly isolated and kept dry? Did the dentist lightly drill into the grooves to create a better surface for the sealant to bond to? 

Sealants may not last as long if your child:

• Clenches/grinds their teeth
• Has acid reflux
• Eats a highly acidic diet 
• Eats lots of super sticky/chewy foods

How do you take care of dental sealants? 

Once dental sealants are placed in the mouth, they are as hard as they will ever be and your child can go about everyday life as normal. 

Your child should continue to maintain healthy eating habits and a good oral hygiene routine.

They can eat and drink right away, but be aware that eating really sticky or chewy foods can cause the sealant to pop off. 

Sealants are clear or tooth-colored and so may stain from foods that could stain a white t-shirt (ie. berries).

Use a soft-bristled toothbrush and use a good remineralizing toothpaste. 

Risks of dental sealants

The major risks with dental sealants have to do with technique/placement and the materials used. 

Improper Placement 

If a dental sealant is not properly placed and there are rough edges or it’s not properly isolated and so parts of it chip away, it actually leaves the tooth more vulnerable to decay (cavities). 

It’s much easier for bacteria, food, and plaque to latch onto a rough surface. 

And it’s also more difficult to keep these areas clean. 

If the tooth is not properly examined before placing a sealant, you could be trapping existing decay underneath the dental sealant. 

I have seen many instances where a sealant is removed only to find extensive decay underneath and the tooth needing a filling or root canal therapy. 

Material Safety

Most dental sealants contain BPA and/or bis GMA, both of which should be avoided in little growing bodies as they are known endocrine disrupters. 

The exposure is highest at the time of placement and levels out from there within the next 24 hours. 

The current conclusion is that there is no risk of BPA toxicity with the placement of dental sealants and according to the ADA, “there is not enough BPA in dental sealants to cause you or your loved one’s harm.”

This is all based on levels found during salivary testing rather than blood serum and so further testing may be needed in the future. 

If exposure to BPA or bis GMA is a concern to you, then you may consider having a ceramic-based sealant placed instead. 

Can dental sealants be removed? 

Yes, they can easily and carefully be removed without damaging the tooth using a dental drill or even a laser. 

But they usually aren’t removed unless the patient/caregiver requests or the dentist notices something amiss. 

Some reasons to remove a dental sealant include:

• Replacing the sealant with a “cleaner” or “safer” material like ceramic 
• To remove and restore decay that has developed beneath the sealant
• To replace a poorly placed, chipped, or cracked sealant 

Cost of dental sealants

A dental sealant for one tooth could cost anywhere from $30-60. If you have dental insurance it will be less or even no money out of pocket for you. 

Sealants are an inexpensive way to prevent cavities and can save you money in the long run by avoiding the cost of a filling or crown. 

Are dental sealants covered by insurance? 

Most dental insurance companies will cover dental sealants for children as a preventative procedure.

Some insurance companies only cover sealants for certain teeth by a certain age or an exam before dental sealants are placed to ensure they aren’t being placed over existing decay. 

Who should get dental sealants?

Dental sealants can be placed as soon as the adult molars have erupted and are accessible- around 6 years old for the 1st molar and 12 years old for the 2nd molar. 

Dental sealants are rarely placed on baby teeth. The grooves normally aren’t as deep and honestly, it’s really tricky to keep the teeth dry and hard for really little ones to hold still or keep their mouth open for the procedure. 

Dental Sealants for children are a great option if they check these boxes:

• Have deep grooves on the chewing surface of their back teeth (molars and premolars)
• Eat a lot of starchy or sugary treats 
• Have poor brushing and flossing habits

Or

• Have special needs or a disorder that makes it difficult to brush & floss or eat a healthy diet

If your child checks all three boxes, dental sealants are an option you may want to consider for your child. 

Let’s look a little closer at each box.

Deep Grooves

If your child does not have deep grooves the sealant will not last and will likely pop off anyways with normal chewing. 

The problem with this is that the entire sealant may not fall out completely on its own, leaving the tooth worse off than it was before with rough edges for bacteria and food to stick on to. 

That is completely negating the purpose of the dental sealant in the first place!

Be sure that you are placing a dental sealant because the chewing surface has deep grooves that are hard to keep clean, not because your dental insurance covers it. 

Poor Diet and Oral Hygiene

I am grouping these two together because they go hand-in-hand. 

Say your child does have deep grooves, but they are at low risk for decay because they don’t snack all day long, they eat lots of tooth-friendly foods, and they brush and floss like a boss. 

In this case, dental sealants may not be completely necessary. 

Weigh the risks vs benefits. 

Could you help your child maintain good habits and prevent decay in this way? 

Or is there a hereditary component that makes it extra difficult to keep decay at bay? 

Some examples may be enamel hypoplasia, gluten intolerance/celiac disease, or disorders that cause decreased dexterity (ability to properly brush and floss). If this is your child, you know. 

Are dental sealants right for your family? 

Not every child is the same.

You know your’s best. You know your family situation best.

Talk with your dentist about your child’s teeth and don’t hesitate to ask questions about their individual need for dental sealants. 

It’s ok to ask by whom and how the sealants will be placed. 

It’s ok to ask about the materials being used.

If your child has deep grooves, a less than desirable brushing and flossing routine, and eats lots of processed foods and treats, then I would consider dental sealants for them. 

Are you comfortable with the materials and technique your dentist uses to place sealants? Then I would consider having them placed. 

How to prevent cavities without sealants 

The best way to prevent cavities is to balance the oral microbiome. 

It may seem counterintuitive, but Bacteria is your friend… the friendly bacteria that is. 

When the oral Microbiome is balanced, the mouth will be a less acidic environment- leading to stronger teeth and fewer cavities. 

So instead of focusing on sterilizing your mouth, focus on feeding the good bacteria. 

• Eat the rainbow! Think nutrient-dense foods like fruits and veggies. Bonus points if they are crunchy!
• Avoid snacking all day long… especially on over-processed foods (crackers, chips, pretzels), sticky foods (cereal bars, dried fruit, fruit snacks), or sweet treats (candy). 
• Opt for water and limit juice, sports drinks, and soda 
• Use Hydroxyapatite toothpaste to strengthen and remineralize the teeth
• Ditch the mouth rinse– as I said, we want to avoid sterilizing our mouth
• Breathe through your nose all day and night. Mouth breathing can cause dry mouth and an imbalanced Microbiome.
• Regular dental check-ups. Twice a year. 

Closing Thoughts

Brushing and flossing, eating a rainbow of foods, opting for water, using a remineralizing toothpaste, balancing the oral microbiome, and making sure to avoid mineral or vitamin deficiencies are all great ways to avoid cavities for our little ones. 

But we are not always there to make those choices for them. And in some areas brushing and flossing just can’t reach into every narrow little nook and cranny of their teeth, but food and bacteria can!

Dental sealants for children can be a great insurance policy- preventing food and bacteria from being able to fester in deep grooves that would be unreachable by a toothbrush. 

By preventing cavities using a quick and pain-free procedure, you are also preventing potentially traumatic dental experiences. 

I am all for creating positive dental experiences… AND preventing negative dental experiences for our little ones. 

Dental sealants for children are a great option for preventing decay if placed properly, at the right time, and with the right materials.