Types of Pit and Fissure Sealants: Indications Explained

Pit and Fissure Sealants

Pit and fissure sealants are thin coatings of resin-based or Glass Ionomer materials that are applied to pits and fissures on the teeth (primarily the molars and premolars) to protect them from dental caries by blocking access of the grooves from plaque and bacteria.

Types of pit and fissure sealants

The types of pit and fissure sealants are classified by their material, the way they are polymerized, their filler content, and their appearance.

Resin-Based Sealants

• They are the sealants that are used most frequently, and they offer great retention and durability.

Types:

• Light cured sealants: harden with curing light, provide better control of working time.
• Set automatically when two components are mixed together: Self-cured (chemical-cured) sealants.
• Dual-cured sealants: Use an all-in-one light- and chemical-curing sealant.

Advantages:

• Excellent retention.
• High wear resistance.
• Protection against caries for a long period of time.

Glass Ionomer Sealants (GIC) 

• GIC: Glass ionomer sealants are fluoride releasing materials that chemically bond to tooth structure and will continue to release fluoride over time.

Advantages:

• Release of fluoride occurs and aids in caries prevention.
• Can withstand slight contamination by moisture.
• It is recommended for partially erupted teeth.

Resin-Modified Glass Ionomer (RMGI) Sealants

• These have the properties of resin and glass ionomer materials.

Advantages:

• Better strength and holding capacity than conventional GIC.
• Fluoride release.
• Resin based sealants are less tolerant of moisture.

Classification by Filler Content

Filled Sealants

• Contain filler particles.
• More durability and strength.
• May need to be adjusted after placement.

Unfilled Sealants

• Run with ease into deep holes and fissures.
• Generally do not need to be adjusted to the occlusion.
• Less wear resistant than filled sealants.

Classification by Appearance

Clear (Transparent) Sealants

• Mix in with natural tooth.
• Less obvious, evaluation is more challenging.

Tinted Sealants

• Gently dyed to make them easier to spot when placing them.
• Fewer problems with monitoring post follow up examinations.

Opaque (White) Sealants

• Highly visible.
• Make it easier to recall to evaluate sealant retention.

Classification by Fluoride Release

Fluoride-Releasing Sealants

• Emissions of fluoride over time.
• Offer extra protection against demineralizing of enamel.
• Glass ionomer or some resin-based materials.

Non-Fluoride-Releasing Sealants

• Offer physical protection of plaque/bacteria.
• Rely mainly on mechanical means for caries control.

Pit and fissure sealant indication

Pit and fissure sealants should be used on teeth that have an increased susceptibility to occlusal dental caries, especially in children and adolescents.

Newly erupted permanent molars

• Permanent first molars around the time they erupt (6-7 years).
• After eruption of the permanent 2nd molars (around 11-13 years old).
• Sealing should be made as soon as possible as possible when you can get adequate isolation.

Deep and Narrow Pits and Fissures

• Teeth that have a deep, narrow and/or complicated groove on the occlusal surface, which is not easily cleaned.
• Gaps that allow food and bacteria to easily enter.

High Risk of Dental Caries (HRDC) patients 

• History of several caries lesions.
• Poor oral hygiene.
• High sugar intake.
• Reduced fluoride exposure.
• Orthodontic appliance wearers.
• People with special health care requirements.

Non-Cavitated Occlusal Lesions

• White spot lesions (early enamel caries) limited to pits and fissures.
• Stained fissures with no cavitation.
• Teeth that have questionable fissures, but no dentinal involvement.

Primary Teeth

• Children between moderate and high risk of caries with deep pits and fissures on primary molars.
• In particular where the primary teeth are to be left in place for several years.

Premolars

• Deep developmental grooves or pits (carious) on premolars.

Patients with high susceptibility to caries

• Xerostomia (dry mouth).
• Developmental enamel defects.
• Diseases or drugs that predispose to caries.
• Patients receiving radiation to the salivary glands.

Contralateral Teeth

• When one molar tooth has developed occlusal caries, because of a correlation between opposing molar teeth, the opposite tooth is sometimes considered as a candidate for sealant application as a preventive intervention.

Dental pit and fissure sealants

A dental pit and fissure sealant is a thin layer of resin-based or glass ionomer material that is applied to the chewing surface (occlusal) of the back teeth (molars and pre-molars). They fill the natural pits and fissures of the teeth to stop the accumulation of food particles, plaque, and bacteria in the teeth that lead to tooth decay.

Sealants are among the most successful preventive measures in modern dentistry, especially for children, adolescents and high-risk patients.

Clinical Procedure

• Wipe the surface of the tooth.
• Isolate the tooth (rubber dam or cotton rolls).
• Dry the tooth thoroughly.
• Prevent enamel etching, use 35-37% phosphoric acid for 15-30 seconds.
• Rinse and dry until enamel is chalk white.
• Apply bonding agent (if recommended by the manufacturer).
• Apply sealant into pits and fissures.
• Light cure (Light Cured materials).
• Assess retention and occlusion.
• Offer follow-up and re-assessments.

Conclusion

Pit and fissure sealants are a highly effective and preventive dental intervention that helps to prevent decay on chewing surfaces of molars and premolars. Sealants are effective at reducing the odds of developing occlusal caries because they seal deep grooves and fissures where plaque and food particles tend to get trapped. They are particularly advantageous for children, adolescents and those with moderate to high risk for dental caries. It's quick, painless, minimally invasive and cost-effective, and it's an investment in long-term oral health. When applied properly, combined with good oral hygiene and regular dental visits, pit and fissure sealants can be a long-lasting barrier and help keep natural teeth healthy for years.

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FAQ

Does the sealant procedure hurt?

• No. It is totally pain-free, non-surgical and generally doesn't require drilling or local anaesthetic.

What is the life of pit and fissure sealants?

• Using proper care, sealants can last for 5-10 years, depending on the quality of the sealant and how often you visit the dentist. They should be examined periodically and repaired or replaced if necessary.

Do sealants work for adults?

• Yes. Sealants can also be used for adults who have healthy teeth with no cavities or restorations and have deep grooves.

Is it safe to have pit and fissure sealants?

• Yes. Dental sealants have been safely used for many years, and endorsed by dental professionals around the world as a successful preventive procedure.

Do sealants prevent all types of cavities?

• The main purpose of sealants is to help seal the chewing surface (occlusal) of the teeth. They do not stop interproximal or gingival caries, so it is still very important to brush, floss and use fluoride regularly.

What can I do to maintain the health of teeth with sealants?

• Brush at least twice a day with fluoride toothpaste, floss daily, limit consumption of sugary foods and drinks, and get regular check-ups with your dentist.