Dental Sealant: Should I have the treatment?

April 14, 2008 1:10 PM

Dental Sealant: Should I have the treatment?

I've been to the local dental hygienist school for treatment, and one of the things they do is tooth sealant. It would be free, but is it actually worthwhile?

About me: I have very good teeth. To give that some context, it has been 8 years since I've had a checkup/filling, and the dentist (not the student hygienist) at the hygienist school recommended one new restoration, along with replacement of one old filling.

Odds are I will not be a regular dental patient in the future, so I'm only interest in 'fire and forget' treatments. Though I obviously want healthy teeth, it is 100% critical to minimize cost of care now and in the future.

Research so far: The hygienist student said something about etching to improve adhesion, that didn't sound good. There has been talk about possible leeching of bisphenol-A, but It doesn't seem that worrisome. Wikipedia has little to say on the subject, and one very negative comment in the talk pages which might just be a crackpot. Google results are spammed by marketing messages from interested parties instead of objective and useful information. An example of the last, from the ADA:

adults can benefit from sealants as well.

Key ingredients in preventing tooth decay and maintaining a healthy mouth are twice-daily brushing with an ADA-accepted fluoride toothpaste; cleaning between the teeth daily with floss or interdental cleaners; eating a balanced diet and limiting snacks; and visiting your dentist regularly. Ask your dentist about whether sealants can put extra power behind your prevention program.

A bunch of weasel words, with no real recommendation..

So, should I?

posted by Chuckles to health (10 comments total)

And, you know, I'm hoping for technical reasons (effectiveness studies, anecdotes from dentists, that kind of thing). Not "ask your dentist" and "of course, why not". Thanks.
posted by Chuckles at 1:13 PM on April 14

I had sealants done as a kid by my pro-sealant dentist.

I've had exactly one cavity, and that was a back tooth where the sealant had come out after around 10 years. Most of mine are still in. Dentists (since my childhood dentist) have been generally effusively pleased with my teeth, and have commented approvingly of my sealant-ed teeth.

If they were free for me, I'd definitely get my teeth all re-sealant-ed.
posted by that girl at 1:15 PM on April 14

I have sealants and have never gotten a cavity on top of my molars. Between them, however, is a completely different story! I'd recommend you get the sealants and floss a lot.
posted by odi.et.amo at 1:17 PM on April 14

agreed with that girl and odi. especially since it's free!
posted by misanthropicsarah at 1:29 PM on April 14

I didn't see a dentist for eight years. When I finally herded my anxious self in, my dentist attributed my relative lack of problems to the bits of sealant still left on my teeth, fifteen years after their application. He also resealed my molars and said that he was always surprised that dentists have come to accept sealants for kids as one of those things Everyone Does, but dentists generally don't seal adult teeth.

If your main goal is to minimize future treatment despite irregular dentist visits, my eight-year hiatus and experience with sealants says: yes, go for it.
posted by adiabat at 1:33 PM on April 14

I had two sealants done at age 10 on teeth that he said (if I recall correctly) had pre-cavity stuff going on. I had zero cavities for a good 20 years. Then, at age 30, a new dentist told me the two sealants needed to be replaced, as 20 years was pretty much their lifespan. So, he re-sealed them. He said they looked fine.

Two years later my new new dentist (new city) informed me that I had deep cavities under the new sealants. Owwww.

My theory is that the original sealants were good and prevented cavities on those two teeth and that the dentist who replaced the original sealants did a bad job and somehow sealing in those teeth caused cavities. I say this because I don't have any other cavities, I didn't have cavities on those teeth when the sealants were replaced, and nothing in those two years changed (if anything, I ate fewer sweets and chewed less gum than ever, just coincidentally). Also, the dentist was a jerk--rushed through appointments, etc, which adds to my opinion that he was a bad dentist.

Totally anecdotal (you asked...) and IANAD/DH, and it's conjecture, but I guess my point is that it seemed to work...but then once the sealants were put on (badly?) it made things worse.
posted by Pax at 1:34 PM on April 14

I will disagree with the consensus. I had sealants put on my eight back molars when I was seven or eight. The sealants on two molars cracked at some point and cavities formed under the sealants (where I couldn't brush). I have never had cavities in any of my other teeth, and I firmly believe that I wouldn't have gotten them in the molars if I hadn't had sealants there.

Admittedly I had gone about four years between dentist visits before the cavities were discovered, but the hygenist had nothing but good things to say about the rest of my teeth (and was quite surprised to hear that it had been so long between visits). I brush at least once a day and use Listerine regularly.

At my last dental visit I found out that the fillings put in those teeth were badly done and separating from the tooth and I had to have them drilled out and refilled. I'm wondering now how frequently I'm going to have to worry about these teeth causing me problems.

My sister has had similar experiences with her sealants and also blames them for her cavities.

Sorry, anecdotal. But in my opinion if you brush and floss regularly there should be no need for sealants. They have definitely caused me more harm than benefit.
posted by fuzzbean at 1:48 PM on April 14

I had great teeth before I got sealants. If you have great teeth and you brush and floss, I'd leave them alone.
posted by konolia at 3:04 PM on April 14

I had sealant put on as a kid. And about 5-8 years down the road was told that I had dozens of "microcavities" that had formed underneath the sealant. It had to be removed completely and my teeth closely monitored. It was costly, and I blame my few cavities/fillings on this. Put me in the more-harm-than-benefit column.
posted by penduluum at 6:32 PM on April 14

If you have deep grooves in your molars, I would suggest that you not get sealants. I had sealants put on my molars three separate times. Each time they cracked off. Once, one only partially fell off of the tooth and I got a cavity. The dentist finally informed me, after he completed sealing my teeth for the third time, that the sealants may not adhere properly to my teeth because my teeth have deep grooves. After hearing that, I decided never again to have my teeth sealed. Five years later, I have only two remaining sealants and no new cavities.
posted by betty botter at 6:52 PM on April 14