Teeth sealing is an effective prevention of tooth decay at any age - a dental procedure, the purpose of which is to eliminate the predisposing conditions for carious destruction. Depending on the teeth' general condition, the enamel's structure and properties, specific techniques are used for its implementation.Sealing materials.
During the procedure, the dentist obturates (seals) the grooves between the cusps of the teeth and other natural cavities, filling them with dental material. This sealant creates a barrier between the enamel and external cariogenic factors (stuck food debris, microorganisms, pH of the environment), which prevents caries damage for a long time. The quality of the procedure and the duration of the enamel protection mostly depends on the fillers used. Preventive dentistry has a wide selection of sealants that differ in composition, physical properties, and durability. All materials can be divided into three groups:
- Composite Sealants
- Glass ionomer cement sealants
In each of the groups, there are quickly cured materials with a lamp (light-cured) and cured naturally. Composite sealants have the highest resistance to mechanical stress; therefore, their safety is most durable. There are many types of composites, including transparent materials and white, flowable, and everyday materials. The use of transparent sealants allows you to control the cavity's condition and detect signs of caries or demineralization in time. Dental sealing is often performed with a fluid type of composite; such a material exactly repeats the grooves' anatomical shape, which has a positive effect on the quality of the procedure.
Glass ionomer cement sealants are less resistant to mechanical (chewing) stress, so they are less durable. This group of sealants has a significant plus - providing teeth with additional anti-carious protection due to fluoride content in the composition. After being sealed for a specific time, the material releases fluoride, which strengthens the enamel. Compomers are materials that combine the favorable properties of composite sealants and cement.Sealing technique.
There are non-invasive (simple) and invasive methods of performing the obturation.
- With the non-invasive sealing method, the first step is to clean the chewing surface and dry the tooth. A particular adhesion promoter goes over the treated area, and then the recesses are sealed with the material.
- The invasive method involves changing the shape of the tooth surface and removing discolored (demineralized) areas. For this, after examination and thorough cleaning, the fissures are opened: using a bur, a small layer of enamel is removed to remove spots in which food usually gets stuck. If there are no lesions, the selected sealant goes over the cavities.
Dr.Regina's sealing technique choice will depend on the structure and depth of the grooves of any individual tooth. The presence of caries and the enamel properties also play a huge role. There are the following types of fissures, differing in anatomical structure, which can be very complex in some patients, and in the degree of mineralization:
Funnel-shaped fissures have the most favorable anatomical shape; they are well mineralized and open. The absence of demineralization signs (discoloration, rough surface) may not need filling with a sealant. With other varieties, food residues may get stuck and not be washed out by saliva or during cleaning for a long time, which creates conditions for reproducing cariogenic bacteria. In such cases, invasive fissure sealing is often used as a preventive measure against caries development.Who needs adult tooth sealants?
Clinical observations show that for adults, sealing is the most effective protection against tooth decay. The procedure urged under the following conditions:
- the presence of pigmented fissures;
- signs of demineralization of enamel in the area of depressions;
- deep and narrow, teardrop-shaped, polypoid cracks.
Some areas will need to be remineralized before sealing to restore the mineral composition in some clinical cases.
Fissure groove sealing is contraindicated in case of:
- poor oral hygiene, abundant soft deposits, and the presence of tartar;
- caries found at the bottom of the groove;
- the lateral surfaces are affected by caries.
Contraindications are temporary. A complex professional cleaning is prescribed in case of unsatisfactory hygiene, including treatment with an ultrasonic handpiece, an Airflow machine, and a thorough polishing. Without removing deposits, it is impossible to apply the sealant reliably. There is also a risk of bacteria getting under the sealant material, which will lead to the gradual destruction of the enamel. The dentist needs to treat any detected tooth decay or other complications, and only after that, the doctor assesses the advisability of sealing in a specific clinical case.Dental sealing time.
The length of time that the sealant effectively remains in the tooth depends on observing the procedure's rules and the type of material used. The more stress the sealant can withstand, the longer the protection against caries will be provided by the dental sealing. Obturation with composite sealant in adults is the most durable - on average; the recesses remain sealed up to 8-10 years. Cement as a sealant lasts for about 1-3 years. Therefore, when using JRC, it is recommended to re-seal every 4-6 months to strengthen the protection.
The quality of its adhesion to the enamel surface also limits the sealant's longevity. Better attachment of the sealant material is achieved by treating the enamel layer with a particular etching solution before sealing.
The procedure's duration ranges from several minutes if it is necessary to treat one permanent tooth and an hour when sealing the entire chewing group. If a light-curing sealant was used, you can drink and eat immediately after the procedure. We recommend coming in for a second appointment in about a week to monitor the teeth' condition and correct if necessary. Invasive and non-invasive fissure sealing techniques are completely painless for the patient, and there is no need for anesthesia.Ionomer cement.
Glass ionomer cement is used in various dentistry branches: as a material for fixing crowns, for permanent fillings in children, and temporary fillings in adults. The use of JRC as a sealant is widespread due to its physical characteristics and chemical properties. The main advantage of the material is the ability to saturate the enamel with fluoride ions.
In adults, JIC can be used to seal fissures for:
- thin enamel, signs of hypersensitivity;
- detection of areas of demineralization;
- the inability to completely dry the surface;
- low caries resistance.
Tooth enamel is constructed from a variety of hydroxyapatite crystals, packaged explicitly for superior strength. One of the most unfavorable cariogenic factors affecting the enamel layer is organic acids formed during bacteria's life. Fluoride, embedded in the hydroxyapatite shell, significantly increases the resistance of hard tissues to acid dissolution and thus protects teeth from caries. Glass ionomer cement sealant releases fluoride most actively in the first hours after application. For the rest of the time, it remains an ion reservoir. Fluoride from the sealant is discharged directly into contact with the enamel and into the surrounding saliva, which continually provides the content of beneficial ions in the entire oral cavity and additional prevention against caries of other teeth.
As a filler, both light-curing and chemical JIC can be used. The first type of sealant is more expensive. Still, it is more convenient to use, which increases the quality of the seal produced. Its complete curing occurs in a few seconds under the light of a dental photopolymerization lamp. Chemically cured cement fully cure within a few hours after application.Tooth sealants.
In the course of clinical observations and research work, the following parameters were determined that the sealants (materials for the sealing procedure) should have:
- high resistance to chewing stress;
- resistance to aggressive chemical factors;
- lack of absorption of dyes from food;
- the strength of the connection with the tooth;
- the similarity to natural enamel with high aesthetic requirements of the patient;
- Ability to fill all micro-incisions and depressions.
The durability of the seal and the effectiveness of the protection against caries largely depend on the doctor's experience and the level of his manual skills. At Cedar Park Dental Wellness, Dr. Regina Yunusov mastered the advanced dental methods and have rich clinical experience. The optimal technique is selected for the patient, and professional recommendations are given based on the diagnostic data. During the initial consultation, you will find out in more detail what it is - the sealing of the intertubercular fissures of the teeth, and whether the procedure will be useful in your case.