Short answer: A fissure sealant is a procedure that covers the deep grooves on the chewing surface of the molars with a thin protective layer. Fluoride treatment aims to make the tooth enamel more resistant to acid attacks. Both are preventive methods that help reduce the risk of decay in children; however, they do not replace brushing and a healthy eating routine.
What is a fissure, and why is it prone to decay?
The chewing surface of the molars naturally has narrow and deep grooves; these are called fissures. These grooves can be so narrow that the bristles of a toothbrush cannot reach into them. Food residue and plaque build up here, and decay most often starts in these areas. For this reason, the first permanent molars, which erupt at around six years of age, are priority teeth for preventive procedures.
How is a fissure sealant applied?
The procedure is usually short, and in most cases the tooth does not need to be drilled or ground down. The steps are as follows:
- The tooth surface is cleaned and dried.
- The surface is prepared so that the sealant will adhere.
- A flowable sealant material is applied to the grooves.
- It is hardened with a special light and the bite is checked.
The sealant can wear down over time or partly come off. For this reason, its condition is assessed at check-up appointments and it is renewed if necessary.
What is fluoride treatment?
Fluoride is a mineral that becomes part of the structure of the tooth enamel, increases its resistance to acid and can support the repair of early-stage enamel demineralisation. The fluoride applied in the clinic is generally in the form of a varnish or gel, applied to the teeth with a brush or applicator. The frequency of application is determined by the clinician according to the child’s decay risk, eating habits and oral care.
Fluoride use at home
- The fluoride in toothpaste is the most practical source for daily protection.
- The amount of toothpaste should be adjusted to age: generally a smear the size of a grain of rice is recommended for young children and a pea-sized amount for older ones.
- Because young children may swallow toothpaste, brushing should be done under adult supervision.
- After brushing, spitting out the residue is enough rather than rinsing with plenty of water; your clinician may give different advice.
Who is it especially recommended for?
- Children who have had decay before
- Those whose diet includes frequent sugary snacks and drinks
- Children whose permanent molars with deep fissures have just erupted
- Children who have difficulty with oral care or who have a dry mouth
These procedures are planned according to the child’s oral condition; the same schedule does not apply to everyone. For other ways of preventing decay, you can read our article on tooth decay in children, and for the check-up schedule by age, our article on children’s dental health.
What to look out for after the procedure
- Unless the clinician gives a different instruction, you may be asked to avoid eating and drinking for a short time after fluoride.
- For teeth that have had a sealant, staying away from very hard and sticky foods helps the sealant last.
- Brushing twice a day and regular check-ups support the effect of the procedures.
When are they planned?
The most suitable time for a fissure sealant is the period after the molar has erupted sufficiently and before it has decayed. The first permanent molars mostly erupt at around six years of age and the second permanent molars at around twelve. Because the surface cannot be kept free of moisture before the tooth has finished erupting, the clinician determines the suitable time during a check-up. Fluoride treatment, on the other hand, can come into question from the baby tooth period onward.
Is a preventive procedure enough?
No, a preventive procedure on its own is not enough. Decay results from a combination of factors such as plaque, sugar intake, the structure of saliva and time. For this reason, the following habits are also important alongside the procedures:
- Brushing twice a day, especially before bed in the evening
- Reducing the frequency of sugary snacks and acidic drinks
- Helping and checking young children’s brushing as an adult
- Coming for check-ups at the intervals set by the clinician
Are these procedures comfortable for children?
Fissure sealants and fluoride treatment are short procedures that children generally accept comfortably. Because no injection or drill is used, the real step for children is often not the procedure itself but getting used to a new environment. Meeting the clinician at the first appointment, seeing the instruments and having a short trial increases the child’s confidence. If any sensitivity or marked discomfort is felt, it should be reported to the clinician.
Frequently asked questions
Are fissure sealants also applied to baby teeth?
If considered necessary, they can also be applied to baby molars. The decision is made by the clinician according to the structure of the tooth and the decay risk.
Is too much fluoride harmful?
Excessive fluoride intake can affect the enamel; for this reason, the amount of toothpaste should be adjusted to age and the child should not swallow the toothpaste. The age-appropriate amount and any need for additional fluoride are clarified by the clinician’s assessment.
Do these procedures completely prevent decay?
No. They help reduce the risk of decay, but they do not replace brushing, a healthy eating routine and regular check-ups.
How can you find out what suits you?
The information here is general; the right plan for your child is determined by examination and clinical assessment. At our clinic in Oran, Çankaya, Ankara, we go through your questions together. For appointments and directions, you can look at our contact page.
