Fissure sealants to prevent tooth decay: who needs them?

Tooth fissures are the deep pits and grooves on the surfaces of your teeth, which can lead to tooth decay if debris becomes trapped. Fissure sealants are coatings (or “protective coverings”), which are painted onto these grooves to stop food and bacteria from becoming stuck and to prevent dental cavities. Here, Dr Moira Wong of Moira Wong Orthodontics in London explains more…

What is a tooth fissure?

If you can imagine the biting surface of the teeth as being made up of the tops of mountains, with the fissures being the valleys between these mountains. The morphological shape of the teeth (in this case the “valleys”) may be narrow and deep. When you are chewing, particles of food can get stuck if these valleys are deep and narrow. If food becomes trapped in these valleys where it is difficult to clean, then decay can occur.

How common are tooth fissures?

Everyone has tooth fissures. Some are shallow and wide, so easy to clean. Others are deep and narrow and are therefore difficult to clean. The shape of fissures determines how prone to decay that your teeth are.

What causes tooth fissures?

Tooth fissures are the morphological shape of your teeth, which is genetically determined. If your fissures are shallow and wide, then you don’t have a problem but if they are deep and narrow then you are more susceptible to decay.

What is a fissure sealant?

Deep and narrow fissures are more prone to decay. A sealant fills up (or ‘seals’) the area, changing it to a shallow fissure where food is less likely to get trapped, hence reducing the likelihood of a cavity occurring.

Normally, the molars are the teeth that are affected the most. These erupt at the age of six-years-old. At this age, children do not have the optimal dexterity skills to brush their back molars thoroughly.

It is normally at this age that we examine the teeth to diagnose if their molars have deep or narrow fissures and to see risk assess these for decay and cavities. Children that are diagnosed with deep and narrow fissures are then referred for the placement of fissure sealants.

How is the fissure sealant procedure performed? Does it hurt?

Firstly, we clean the fissures to ensure that all debris has been removed. Then the enamel is treated with a special agent, which prepares the surface of the tooth to form the sealant.

The sealant is a clear resin and a blue light is shone onto the tooth to harden it. This leaves a smoother surface on the teeth.

No anaesthetic is required, and the procedure is not painful at all. Think of it as providing a protective covering over the tooth. Fissure sealants are usually carried out in one or two appointments.

What does aftercare of a fissure sealant involve?

It is advised not to eat or drink for an hour afterwards. Then we just ask that you continue with your dental routine as normal. This includes your regular hygiene check-up so the hygienist can check that your fissure sealants remain intact. In some cases, they may need resealing as they get worn down.

You can book an appointment with Dr Wong via her Top Doctor’s profile here! Can’t make it in person? Dr Wong is available for a video call using our e-Consultation tool.