Does My Child Need Dental Sealants? Pros, Cons, and Costs

Dental sealants are a preventive treatment that protects permanent teeth from tooth decay and cavities (dental caries). Sealants are particularly popular in pediatric dentistry because they can be applied to new teeth as they come in, protecting them immediately.

Even with all the best precautions like good oral hygiene and dental care, some children still develop cavities. Dental sealants can be a valuable part of your child’s oral health if the benefits outweigh the risks, like if they’re at extreme risk of developing tooth decay.

Dental sealants are a thin plastic coating placed on the chewing surfaces of the back teeth (molars) to prevent tooth decay. Acids produced by cavity-causing bacteria can’t reach the tooth through the coating, so cavities can’t form.

Sealants can be applied to permanent molars (first molars and second molars) directly after they erupt through the gums. They sometimes also apply sealants to premolars or smooth surfaces of the incisors, but those applications are less common.

Sealants are sometimes called pit and fissure sealants because they are principally used to fill in fissures and pits (which look like deep grooves) in the molars.

According to the CDC, dental sealants prevent 80% of cavities in molars in the first 2 years after they’re applied. About 90% of cavities form in molars, so it’s particularly important to protect these teeth. After 4 years, sealants still protect against 50% of cavities.

Sealant use is rising, particularly due to school-based sealant programs for low-income children at greater risk of developing cavities. Between 2011 and 2014, 39% of low-income and 48% of higher-income children had sealants on their teeth.

Although dental sealants have fairly good retention rates, they don’t last a lifetime. At most, they’ll stay on for about a decade.

Factors that affect sealant durability include:

• Eating acidic food
• Chewing on hard items, such as ice or candy
• Chewing on non-food items like fingernails
• Tooth grinding
• Using teeth to open containers
• The material used to make the sealant
• How well the sealants are applied

How long do dental sealants last on your teeth? Dental sealants last several years on your teeth, usually at least 2-4 years. However, they can stay on teeth for up to 9 years if they’re properly cared for.

If your child’s sealants come off, it’s possible to reapply them. Just another reason to take your child to their routine dental check-ups — during these visits, their dentist can check the sealants for damage.

What are the benefits of sealants? The benefits of sealants center around cavity prevention. They’re painless to install, and they last for years, unlike other tooth decay preventions.

Sealants can protect minor or deep grooves or pits that toothbrushes can’t reach. Occasionally, teeth have small dips that are too small for even a single bristle of a toothbrush to clean. Sealants can stop cavity-causing bacteria from growing in these spots.

Recently, public health officials have placed a significant emphasis on dental sealants, particularly for children at a higher risk of developing cavities, and they’re less likely to have sealants on their teeth.

However, it’s possible that poor oral hygiene or poor diet could be driving these disparities, not sealants.

What are some of the problems associated with dental sealants? Some of the problems associated with dental sealants include damage that can actually cause cavities and exposure to harmful chemicals like BPA.

If a sealant becomes cracked or chipped, bacteria can get into the space between the sealant and tooth, where they can cause major decay. It’s imperative that you have your child’s sealants checked regularly so that this trapped bacteria doesn’t happen.

One of the biggest risks of sealants is the plastic used to seal the teeth usually contains BPA (bisphenol A). BPA is a known endocrine disruptor that may increase the risk of developing certain types of cancer, cause infertility, and bring about early puberty.

It’s best to avoid products that contain BPA, but in the case of sealants, the benefits can outweigh the risks in certain cases. If your child is at an abnormally high risk of developing cavities, sealants may be a good option despite the risk of BPA exposure.

Children who have exceptionally deep grooves in their molars are ideal candidates for dental sealants. This is because food particles can get stuck in the nooks and crannies of the molars, feeding the bacteria that cause cavities.

Some childrens’ teeth are more prone to decay, like children who have abnormally thin tooth enamel (enamel hypoplasia). Sealants protect the already thin enamel from dental caries and other oral health issues. These kids may need sealants on both baby teeth and adult teeth.

Children who breathe through their mouths often can be candidates for dental sealants. Saliva protects teeth and fights cavity-causing bacteria. Unfortunately, mouth breathing dries out saliva, leaving mouth breathers at higher risk of tooth decay.

If you have a special needs child, you should ask their dentist whether they need sealants. Children with special needs often experience problems with their dental health, and sealants can help prevent some of those oral health problems.

At what age are dental sealants most effective? Dental sealants are most effective when applied right after molars erupt, around 6, 12, and 18 years of age. Sealants are also applied to premolars after they erupt through the gums between 9 and 13.

Having your child’s dentist apply sealants is a relatively straightforward process. Sealant application is routine, and dentists perform in the dental office. It’s completely painless, so the process is also easy on kids.

If you choose to have sealants applied to your child’s teeth, here are the steps your dentist will take:

1. The dentist or dental hygienist cleans the chewing surface of the tooth.
2. The dentist dries the teeth that will be sealed.
3. Cotton is placed next to the tooth so it will stay dry.
4. The dentist applies an acid solution to roughen the tooth’s surface, ensuring that the sealant sticks.
5. The acid is rinsed off and the tooth is dried.
6. The dentist may paint a bonding material onto the tooth if needed.
7. The dentist paints the sealant material onto the tooth and applies a curing light to harden it.

Your child can eat and drink right away after the sealant is cured.

What is the cost of dental sealants? The cost of dental sealants averages between $30 and $60 per tooth. Your dental insurance or health insurance may cover most or all of the cost of your child’s dental sealants.

Dental sealants can reduce your child’s risk of dental caries, but they can’t completely stop tooth decay from happening.

Cavity prevention has many important parts, including:

• Flossing: Flossing is incredibly important to prevent cavities, especially cavities between the teeth (interproximal cavities). The American Dental Association (ADA) recommends flossing daily to remove plaque that can cause tooth decay.
• Brushing with a soft-bristle toothbrush and toothpaste: Ensure that your child is brushing at least twice a day, ideally after every meal. I recommend using fluoride-free hydroxyapatite toothpaste.
• Get regular dental care: Getting regular dental check-ups is one of the best ways to maintain dental health. Your child’s dental hygienist will remove plaque and tartar your child has missed while brushing, and their dentist can catch tooth decay early.
• Eating a tooth-friendly diet: The foods your child eats have a substantial impact on their oral health. A diet rich in fruits, vegetables, and lean protein gives your child the vitamins and minerals they need to grow and support healthy teeth and gums.
• Use oral probiotics: There are both “bad” and “good” bacteria in your mouth. Good bacteria actually fight cavity-causing bacteria and promote oral health. An oral probiotic will help support the good bacteria in your child’s mouth.

Dental sealants are worth getting if your child is at extraordinary risk for tooth decay, which would mean the benefits outweigh the risks. Dental sealants have significant downsides, however, and if your child doesn’t truly need them, it’s not worth it.

Good oral hygiene is much better at preventing cavities than sealants are. Combined with a healthy diet, good hygiene is the best way to maintain oral health and prevent tooth decay.

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