What can you do to prevent cavities? Well, you can brush, that's good. You can Floss. You can use Fluoridated toothpaste. What else? Dental sealants have been proven to prevent decay in the pits and fissures of teeth. Sealants are usually placed on the first and second permanent molars. You can also seal the bicuspids. You also can seal baby molars, but it is not usually done as the anatomy is different and it can be unnecessarily difficult to work on a very young child just for a sealant. Most kids need sealants, but if the grooves of the teeth are smooth and the child is not cavity prone, I may not recommend it. Oh, adults can benefit from sealants as well, but they are most useful on teeth that are newly erupted, you know, the cavity prone years.
The idea is to seal up the little grooves, which the brush can't reach. Here is a brush bristle that can't reach down into that really small groove on a molar. Fluoride helps prevent decay as well by strengthening the enamel. Fluoride seems to work best, however, on the smooth surfaces of the teeth. Sealants are for the grooves, so you usually don't use them on front teeth for instance.
They are really easy to do. You just sort of paint it on (well, there are several steps, but still fairly easy like using a fiberoptic "flash light") The only thing that can make it harder is if the child has a small mouth or a gag reflex or a wiggly tongue that makes it hard to get back there and keep things dry.
If sealed well, the "cavity bugs" can't get down in there. Sealants last several years and may need to be patched or replaced from time to time. If the kid doesn't chew ice or stuff like that, they will hold up fairly well. If they chip or come off, the "Bugs" can get back in there. My kids have sealants and have never had a cavity!
Here is another post I made on the same subject:
The American Academy of Pediatric Dentistry recommends placing dental sealants on the first permanent molars (at around 6 years of age) and the second permanent molars (which come in around 12 years of age).
Why? --Well, basically there are a lot of studies that say placing sealants helps reduce the incidence of cavities. Does it mean you will never get cavities?--no, it still can happen, but sealants can reduce the kind of cavities that form in the pits and grooves of the back teeth, you know on the top of the tooth--you still can get them in between the teeth and on the smooth surfaces.
How long do they last?--Even with a well placed sealant I have seen cavities form in areas previously sealed. Sometimes the sealant wears off (chewing ice for instance), or sometimes just because someone is very prone to cavities. They say they last from 5 to 7 years if you take care of them--even adults can get sealants, but they seem to be most effective in the cavity prone years of youth. What is the material? Well, it's basically the same material as used in white fillings without as much filler/reinforcing material, it's a bis-GMA resin, With less filler the sealant can flow into the grooves better. Sometimes we use "flowable" composite which is kind of in between in it's characteristics.
How are they placed? Does it hurt?--I like to say it's like painting fingernails--you basically just paint it on the tooth--now that can be harder than you think as these teeth are in the back of the mouth. Most of the effort is keeping the area dry.
Do you put them on baby teeth?--you can, but generally no. The enamel in baby teeth is different microscopically, they don't seem to stay as well, but sometimes if there is lots of grooves there, so there may be a benefit to placing them. Another thing to think about is that in preschoolers, placing a sealant is just about as difficult as a small filling because little kids, well it's harder to place the sealants. It is often better to simply have regular checkups to catch things early. Also, like I said many cavities in baby teeth are in between the teeth which sealants do not prevent.
I'm going to try and make a video on this some day.