Normal pits and grooves on the chewing surfaces of back teeth (molars) can trap food that cannot be removed by brushing or be washed out by water or saliva. A sealant is a tough, BPA-free plastic material designed to bond to tooth enamel. Sealants are tooth-colored and are painted onto the tooth surface to “seal” the pits and grooves and protect against decay. They are generally applied to children’s first and second permanent molars. They can also be useful for adults in certain situations. Most children do not lose their baby molars until they are 12 years old. Sealants on baby molars are recommended if the child is at high risk for decay (e.g., history of previous cavities, sugary diet, exceptionally deep or stained grooves).
Sealants are an excellent way to protect the chewing surfaces of teeth from decay. They are a much better financial investment than treating decay after it has started.
Sealants are not permanent. They generally last about five years with normal wear but can wear or chip away earlier in certain instances, such as if the child grinds his or her teeth, eats hard sticky candy, or chews ice. Also, sealants do not prevent decay between teeth or the onset of gum disease, so regular home care and dental visits are important.
There are no appropriate alternatives to sealants. If a tooth has decay, it will need a filling or other restoration.
If a baby tooth is prematurely lost due to an accident, severe decay, and/or abscess, space should be saved for the future eruption of the permanent teeth. A space maintainer is a combination of bands and wires designed to hold the remaining teeth in a position that will allow the future permanent tooth to erupt in the proper location. A space maintainer is typically placed where a back tooth is lost. Space loss does not usually occur when front teeth are lost; therefore, space maintainers are usually not recommended for front teeth.
Prompt placement of a space maintainer will give the permanent tooth the best chance of erupting in the mouth in the correct location. This will minimize orthodontic problems caused by premature loss of a baby tooth and shifting of teeth.
Your child will need to wear the appliance until the permanent tooth erupts. If not kept clean, decay can occur under the bands.
If a space maintainer is not placed, the teeth will shift into the open area, making it difficult, or in some cases impossible, for the permanent tooth to erupt. This requires orthodontics to remedy the situation.