selants recommended?
- Thread starter Yogi Bear
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For sure, 100% recommended. EXTREMELY safe and one of the best things you can do to ensure oral health. I can't think of any reason NOT to recommend them.
It is such a simple and easy method of prevention and the problems/time sealants can alleviate are enormous.
It is such a simple and easy method of prevention and the problems/time sealants can alleviate are enormous.
i wouldn't recomend them to anyone...mostly those that are most at risk for carries should get them (i.e. history of occlusial caries or deep pits and fissures on the surface of the tooth.) sealants do have a tendency to fall off after a couple years and depending also it depends on the technique of the dentist. If they do a really poor job making sure that the patient is back in normal occlusion, it could be potentially harmful to the tmj among other things. you should get an exam and see what your dentist recommends.
cusp of carabelli said:
1) every child/teenager is at risk for caries. Of course that is a broad statement and an overstatement, but the degree of proper oral hygiene for these age groups simply isn't where it ought to be. Sealants can alleviate some of the problems associated with this lax hygiene.
2) Sealant lifetime is 100% dependant on the technique of the individual placing it. Properly placed sealants can last for 15-20 years.
3) The problems you mention regarding TMJ and sealants are also valid concerns with amalgam and composite, not to mention removing massive amounts (in some cases) of tooth structure.
Sealants are a much better way to go, IMHO.
Yogi Bear said:
None at all. Sealants are merely highly flowable composite materials.
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ItsGavinC said:
I still have sealants that I had put on 16-17 years ago. I keep meaning to make an appointment for my daughter to get them. We both have molars with really deep crevaces in them (I'm sure there's a proper dental term for them, but I don't know it 🙂)
ItsGavinC said:
isn't that second statment just as broad as the first? and the fact that carries rate has been going down doesn't really support this...
3) The problems you mention regarding TMJ and sealants are also valid concerns with amalgam and composite, not to mention removing massive amounts (in some cases) of tooth structure.
Sealants are a much better way to go, IMHO.[/QUOTE]
i'm not against sealants...and i would DEFINATELY recommend them...if my patient was not very good at taking care of their teeth or if i thought the tooth was at high risk for getting pit and fissure caries. but if the person was not at high risk for these caries then it might not be cost effective to give them sealants...but i just think that if "it ain't broke don't fix it"....
gavin is totally right that they are safe and are good preventive measures...I still think the number one preventive measure though is education and fluoridation...and also educating parents...on the importance of maintaining good oral health. too many parents think it's okay for baby teeth to rot away b/c there are new teeth that will replace them.....
you are exactly right about TMJ problems with amalgams and composites...that's why they shouldn't be done unless it's necessary. If there was an incipient lesion on a tooth you don't have to go in and carve a huge class I/II prep to get it out. It's okay to educate and monitor it. Same thing for sealants. Another thing to factor in is cooporativity of the patient. You mention technique being related to the lifespan of the sealant but if the patient isn't cooperative, then it may be hard to have good technique thus leading to a shorter life span of the sealant. I just don't think they are necessary for everybody...imho
p.s...hey gavin...are you one of those that are "mimicking toothbrush motions" at the oral b lunch and learn in the newest edition of MOUTH? 😀
Cusp, excellent points you've made.
I haven't seen the newest edition of Mouth yet, but I wasn't one of the ones up there. I just look goofy on SDN, I'll save the real-live stuff for my classmates. 😀
I haven't seen the newest edition of Mouth yet, but I wasn't one of the ones up there. I just look goofy on SDN, I'll save the real-live stuff for my classmates. 😀
DrMom said:
deep pit(s) & fissures 😉 hence, the Fissurotomy bur which is used to prepare (drill) the teeth for sealants.
Only a thin surface layer (enamel) of the tooth is taken off to be filled with sealant materials. That's why local anesthetic is not needed. Novocaine is no longer used in dentistry but the name is still used when referring to the local anesthetic by patients.
just thought u might wanna know 😉
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thanks, Inn2. 🙂
To play Devil's advocate with you here Cusp, you could very well argue that one of the causative factors associted with the decline in the caries rate is the increase in the placement of sealants in the last 15 years 😱 😕cusp of carabelli said:
The other BIG factor though is in the dietary control over the population where sealants are most beneficial, children and teens. The sugar consumption rates amongst that generation is increasing, and the parental control is often very difficult with whats available in many schools systems and that doesn't even begin to hit on the peer pressure factor (i.e. "mommy, little Johnny has Gatoraide with his lunch, why can't I??" if you don't have kids, just wait, you'll see what I'm talking about 😉 )
From what I see in my practice, kids that don't get their 1st molars sealed will on average have restorations placed in 2 of them by the time their 2nd molars errupt, kids that get the 1st molars sealed will have less than 1 restored by the time their 2nd molars errupr(that's the real world numbers from my office in rural Connecticut).
The thing that I really find ironic in situations like this, is that the most common reason why parents won't have their children's teeth sealed in my office is money(my partner and I recommend sealants to every child). In these kids, if they get a carious lesion on one of those teeth, those same parents will be the first one's insisting that their child's teeth be restored with "tooth colored" material. The real irony is that in my office, the cost of a 1 surface posterior composite is $15 more than the cost of 4 sealants 😱 In a sense, by trying to save money, those same parents just paid more, or as I like to put it, they just contributed to my vacation house fund 😀
hey dr. jeff..
I would say that yes i'm sure sealants did have some role in the reduction in caries rate over the years...but correct me if i'm wrong but sealants were not as popular in previous decades as they are now. also although caries rates are declining, the decline was not as great as it was when water started becoming fluoridated. Another thing that i might be concerned with is that if you give a child sealants, that they would think that their teeth are impermeable to cavities b/c the doctor "put this protective stuff on me to keep me from having cavities"...and this would lead to being more lax in brushing and cleaning interproximally. That's why i think education is a bigger factor in reducing caries than just placing sealants on everybody. Another thing is sealants aren't 100%...there could be times that the dentist doesn't completly cover a pit/fissure and then a carious lesion develops.
as for sugar consumption...you're right also....it is tough when a child is pressuring mommy/daddy for that happy meal for dinner or to drink gatorade b/c shaq is drinking it...that's why education has to include all parts of keeping teeth healthy including diets. tell them the positives of sugarless gum with xylitol. kids get their gum, teeth get protection, everyone is happy. 😀 I know it's not that easy but i know it's also part of our jobs....to hopefully have an influence on others...i mean isn't that what most people wrote on their admissions essays anyways? I sure read a lot of them from applicants last year and expect to read more next year...so let's step up people!!!
whether it works or not wont be up to us to decide...but at least we tried!
hehehe...some parents are ignorant..and hey...if they don't wanna spend the money for the sealants for the kids who have shown the risk of having cavities, then they'll just have to learn the hard way.....just make sure to hang your vacation pics in the waiting room lobby and thank them for a wonderful time...😀
I would say that yes i'm sure sealants did have some role in the reduction in caries rate over the years...but correct me if i'm wrong but sealants were not as popular in previous decades as they are now. also although caries rates are declining, the decline was not as great as it was when water started becoming fluoridated. Another thing that i might be concerned with is that if you give a child sealants, that they would think that their teeth are impermeable to cavities b/c the doctor "put this protective stuff on me to keep me from having cavities"...and this would lead to being more lax in brushing and cleaning interproximally. That's why i think education is a bigger factor in reducing caries than just placing sealants on everybody. Another thing is sealants aren't 100%...there could be times that the dentist doesn't completly cover a pit/fissure and then a carious lesion develops.
as for sugar consumption...you're right also....it is tough when a child is pressuring mommy/daddy for that happy meal for dinner or to drink gatorade b/c shaq is drinking it...that's why education has to include all parts of keeping teeth healthy including diets. tell them the positives of sugarless gum with xylitol. kids get their gum, teeth get protection, everyone is happy. 😀 I know it's not that easy but i know it's also part of our jobs....to hopefully have an influence on others...i mean isn't that what most people wrote on their admissions essays anyways? I sure read a lot of them from applicants last year and expect to read more next year...so let's step up people!!!
whether it works or not wont be up to us to decide...but at least we tried! hehehe...some parents are ignorant..and hey...if they don't wanna spend the money for the sealants for the kids who have shown the risk of having cavities, then they'll just have to learn the hard way.....just make sure to hang your vacation pics in the waiting room lobby and thank them for a wonderful time...😀
