Dental Sealants

Hi, Ellie


1. What are your thoughts on dental sealants? Our pediatric dentist has recommended them for my second and third sons, based on the surface anatomy of their molars, but not for my oldest son. All three are cavity free, thank goodness. When, if ever, do you think that sealants are a good idea?
2. When traveling (or whenever you need to carry a toothbrush with you for any reason), how do you store it in order to keep it clean?
Thanks a lot.
L

Hi L,

I have to be really careful when discussing sealants, because I have already incurred the wrath of local dentists.You must take this as a descriptive ( a narrative about sealants).I am going to present the idea of sealants from the other side.

I’d like to discuss why NOT to have sealants but please don’t take this as a diagnosis or advice I am already in trouble for advising against sealants. There is research to show that regular use of xylitol over time can offer the same benefits as sealants but without some of the problems.

What are the problems with sealants?
As a parent I would be very concerned if the sealant material contained Bisphenol A (otherwise known as BPA) the product that has recently generated concern because it leaches out of plastic baby bottles. Bisphenol A can mimic estrogen hormone even at low doses. To be fair, the sealant companies in recent years, have begun making sealants materials without Bisphenol A.

The theory behind sealants is that they block up the crevices of the teeth.
When cavity forming mouth bacteria get into these crevices or fissures, they lodge inside the walls of the deep cracks. These bacteria are very difficult to remove and in essence they become the place where mouth bacteria multiply quickest becoming “fountains of bacteria”.
Research shows that the kind of bacteria in crevices is the same kind of bacteria found all over the mouth.
Problems begin when the crevices are populated with bacteria that form cavities. Then, every time you eat or drink you feed them they multiply they form acids they destroy your tooth down at the bottom of this crevice.

On the other hand, if the bacteria in the crevices are “xylitol” ones healthy ones your mouth will have healthy bacteria the kind that cannot produce cavities (because they don’t produce acids). This healthy kind of bacteria will block up the crevices and keep your mouth and teeth healthy.

So how do you know if your grooves of fills with harmful or healthy bacteria? If you’ve never had a cavity, the chances are your mouth bacteria are healthy ones. If your child has had a history of cavities throughout life without any xylitol in the last few years then there’s certainly a great risk from bacteria in these crevices and fissures. Sealants do not change the kind of bacteria in your mouth but they block up the crevices so they cannot get decay.

Sealants do not change or remove bacteria they temporarily remove some risk especially for children who are at high risk for cavities because their mouths are infected with cavity forming bacteria. You can do a test a saliva test that measures the number of harmful bacteria in your child’s mouth.It is an idea.

If sealants had no risk attached , I might shrug my shoulders and say “why not”. BUT I have zero tolerance for any treatment that is not necessary. Since a cavity takes approximately one year to form I would definitely go slowly. If you’re worried, you could ask about a fluoride varnish this is useful alternative.

A fluoride varnish blocks up the grooves with a slow release fluoride resin. Personally, I like this idea because it offers protection for the immediate time but requires no maintenance no repairs no ongoing observation

As for your toothbrush question
I throw my toothbrushes into the garbage as I leave a hotel and take new Zellies toothbrush when I go traveling.

I hope this helps!
Ellie

Ellie Phillips DDS

Dental Health for Everyone!
Author, Kiss Your Dentist Goodbye
26 Corporate Woods, Rochester NY 14623



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  1. Thanks for providing articles on dental problems and issues. chandler dentists

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