Monday, April 13, 2009

Is there a higher caries risk from lost sealants?

If a child has preventive sealants placed, but then the sealant is totally or partially lost, is that tooth more susceptible to dental caries? I get this question from time to time. I am pleased to say that the answer I have been giving is backed up by a review of several scientific studies. Teeth with fully or partially lost sealants were not at a higher risk of developing caries than were teeth that had never been sealed.

Hey, kids chew ice and other things that may cause a sealant to chip or wear off. Most sealants are supposed to last from 5 -7 years if you take care of them. Sometimes they do not last 5-7 months on some kids. Still it is reassuring that there is not a higher risk.

Of course, there are studies that show teeth sealed have a lower incidence of caries-that's why we recommend them.

Journal of the American Dental Association, Vol 140, No. 4pp. 415-423, 2009.

16 comments:

Dr.Rutledge said...

Hi Dr. Brandon,

I'm a physician and former faculty member at Harvard and Stanford Medical Schools. I discovered your blog while looking for the best health writers on the web. I reviewed your posts, and think your writing would be a great addition to the Dental Health Community on Wellsphere, a top 5 health website that has nearly 5 million visitors monthly. If you would like to learn more about how you can join our Health Blogger Network, republish your blog posts and be featured on the Wellsphere platform, just drop me an email at dr.rutledge@wellsphere.com.

Cheers,
Geoff

Dr. Dean Brandon said...

Just returned from out of the country. I'll check this out.

Nia- foot infection said...

I find your site very informative and helpful. Thank you for sharing this post.

Halifax Dentist said...

Kids eh!
I agree - great writing. Keep it up.

prodds said...

I also had this question, so your answer is really helpful. children should take care of their teeth as well, because afterwards it may be too late.

Dentistry Minneapolis said...

Thank you! That was helpful..

dentist sunnyvale said...

Very informative blog post indeed. You've answered one of the most frequently asked questions. You explained it very simple and easily understood by most people.

Dentist Melbourne said...

The sealant is quickly set to form a durable plastic coating, some sealants have fluoride release to further strengthen teeth. The bite will be checked to ensure it is correct and comfortable. The bite should not feel any different.

So it is a bit hard but easy process..

Dentist Gainesville GA said...

Thanks for the post and a great site. We get the the question about sealants fairly often as well and appreciate the supporting info.

mmuehle said...

Very informative site. I'm going to keep checking here for information. Also check out http://thedentalassistant.com

Cancun Cosmetic Dentistry said...

It's really great Writing.
Thanks

Childrens dentist said...

I routinely place sealants on permanant molars of children who have high caries risk. I have always believed in them. Thanks for sharing your position on dental sealants.

Mary said...

Hi,

This is the assistant editor for Hospital.com which is a medical publication offering hospital news, information and reviews. We also cover a wide variety of medical issues, one of which being Children's Health and the importance of choosing the right hospital. You will notice articles on this topic under Children's tab. If possible I would like Hospital.com to be included within your blog roll, offering our information as a resource to your readers. Please let me know if this addition can be made.

Please email me back with your URL in subject line to take a step ahead and to avoid spam.

Thank you
Mary Miller,
may.hospital.com@gmail.com

Dr. Dean Brandon said...

Mary, at the present time, I amonly posting Pediatric Dentistry Links that are appropriate for this blog. I will however, have this post, well...posted. Thanks and I will keep up with your site. Who knows, I may change things later on.

Anonymous said...

We noticed a small cavity in the middle of my 2 yr olds two top front teeth at a Flouride program. So we took him to a pediatric dentist. They suggested crowns. I felt this was too excessive since it was a small cavity. They said fillings wouldn't bond. So after sleeping on it and getting a 2nd opinion from a dentist that suggested fillings I decided to go back in hopes we could try the filling and if that didn't work I'd try a crown. So he agreed but instead of filling it he shaved 1mm or more off each tooth. Now there is a gap and a light yellow exposure I assume is dentin. Upset about the uninformed procedure I took my son elsewhere and this pediatric is telling me he needs a filling or crown or root canal, plus wants to do sealants to prevent anymore cavities. I feel like I'm being taking for. I don't see anymore cavity. He said he won't know until he starts the work.

Dr. Dean Brandon said...

Well, cavities on front baby teeth often progress rapidly, and the distance between the surface and the pulp (nerve) is very small. Fillings often come out more easily in these teeth as well. That is why crowns are sometimes indicated. In general, I trust the opinion of the specialist pediatric dentist who is not only seeing the cavities, but also evaluating the overall situation. I do fillings in front baby teeth if they are small and I can get some degree of cooperation for treatment. The more you wait, the further decay can progress. The more decay progresses, usually the greater the recommendation for crowns or pulpal treatments or even tooth removal. Good luck. Decay in preschoolers is a challenging situation for everyone.