Sealants for primary teeth?

My daughter had four cavities filled on her back teeth. Her dentist wants to use sealants on all her teeth. Is this really necessary?


Sealants help prevent decay from forming on the chewing surface of teeth. It is usually not necessary to remove enamel before the sealant is placed. Generally, the procedure for placing a sealant includes thorough and careful cleaning of the surfaces to be sealed. An acid etch solution is then placed on the tooth and rinsed off. This allows for bonding of the sealant to the tooth. The sealant material is then painted on the surfaces and hardened with a special light. The entire procedure is painless and relatively fast.

Most children respond quite well to sealants. Generally, children are older than 2 years of age when sealants are placed since sealants are usually prepared for permanent teeth. I have placed them on primary teeth when the pits and grooves of the chewing surfaces of the primary teeth are very deep. These deep pits and grooves are more susceptible to caries because it is difficult to keep these areas clean. I have found that the level of cooperation improves when the procedure is explained and materials are shown to the child. Sealing teeth void of decay is optional, but it can be a good preventive technique.

If teeth with decay remain, treatment of these teeth is not optional. Since your daughter is only 2 years-old, she will have her incisors for about 4 or 5 more years and her other primary teeth for about 8 to 10 more years. If the decay is left untreated, it will spread and cause problems with the pulp tissue. The pulp tissue includes the nerve and blood vessels inside the tooth. If decay enters the pulp chamber, it can cause pain and infection. This may lead to more involved treatment, including early loss of the primary tooth. Therefore, it is very important that remaining tooth decay is promptly treated. You might consider discussing with your dentist some type of sedation to complete this work in a less traumatic fashion.

Clarify with the dentist if untreated cavities are still present or if a preventive technique is being offered. If more fillings are necessary because cavities are present, discuss options to decrease anxiety and increase comfort for your daughter. If no more caries are present, you will need to decide if the preventive sealant treatment is worth the effort.

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