Fissure Seals FAQ’s
A fissure is a naturally occurring groove, or crack that occurs naturally on most premolar teeth (side teeth), and almost all molars (back teeth).
Fissures, or grooves in the teeth are natural weak points of the back teeth. Pits are like small holes in the teeth that have not yet decayed. Food naturally collects in them, and toothbrushes cannot clean the microscopic grooves. Because of the stagnant food, teeth often decay in these grooves very very quickly after the tooth has come through.
A fissure seal is a small amount of dental material (composite resin or glass ionomer cement) that is applied to the surface of the tooth, covering up the groove.
Usually, they are tooth coloured, but can be white, and even pink. The pink ones release flouride to protect the teeth, and some dentists like them as they can easily see them at future visits.
According to many decades of research, they will stop approximately 80-90% of the decay in the grooves of the teeth. Traditional fissure seals do not protect in between teeth.
The tooth is thoroughly cleaned, with an ultrasonic scaler or similar instrument. Some acid is used to microscopically clean and etch the tooth. Some bonding resin is placed. The fissure seal material is placed. It is set, or ‘cured’ with a blue light.
Depending on cooperation, five minutes or so.
No needles or anesthetic are needed for a pit or a fissure seal.
Yes, decay is often found while thorougly cleaning out the grooves of a tooth. The grooves are often stained, and have food debris in them, and it is only after cleaning them out that an accurate inspection can really be done.
The small amount of decay is removed, and then a small white coloured filling is placed using almost exactly the same technique as before.
Typically, almost all six and twelve year old molars are sealed, as they are highly likely to decay in the grooves of the back teeth.
Premolars have grooves, but the grooves are much less defined, and a lot less likely to decay. I tend to seal them in cases where they are deeper than usual, or if a patient has a high decay rate. There is some good evidence that fissure seals will reduce the bad bacteria in the mouth that can cause decay elsewhere.
Occasionally, there is a deep groove in an upper incisor (front tooth) that will need sealing.
Some lucky people have very shallow grooves in back teeth that will almost certainly not decay. In these cases, they are best left alone. Often, premolars are not sealed. Most people do not have grooves in their incisors, so they do not need to be sealed.
It is very hard to say. How long is a piece of string? I have seen them last many years, and sometimes only six months. A lot depends on how well it was done in the first place. It can be very difficult to have a six year old in the chair staying still long enough to keep a tooth perfectly dry, and then applying a fissure seal nicely.
Even when they are lost prematurely, there is much scientific evidence that the benefit of the seal is long lasting. This is thought to be due to microscopic remnants of the fissure seal still protecting the tooth, the fissure seal actually maturing the enamel of the tooth while it is in place, making it more resistant to decay. The passage of time also helps. If a seal lasts two years, then the patient is now two years older, has better dexterity with a toothbrush, and a better diet, and knowledge of how to keep their teeth clean properly.
Modern sealants using composites were done in the 1960s. However, like most new good ideas, it took about two decades for the research to show that they were of great benefit, and justified their cost. The use of fissure seals rapidly expanded during the 80s and 90s.
Less than half the cost of a small filling.
Yes, all health funds cover them, as well as the new Child Dental Benefits scheme (link to previous page please!)
When I am seeing a family of patients, i am happy to do their preventive care (which i personally say is check and cleanings (link to page) , x rays (link to page please ) flouride treatments (link to page) and fissure sealants.
Hence, I am happy to accept the health fund rebate as full payment for the service. I am also happy to bulk bill the health fund through our HICAPS machine, to save you time.