Fissure sealants: what they do and what to expect

The grooves on the chewing surfaces of back teeth can be difficult to clean. A fissure sealant covers these pits and grooves with a thin protective layer, helping to keep food and plaque out. It is one part of preventing tooth decay, alongside fluoride toothpaste, sensible eating habits and dental reviews.

Sealants and fluoride varnish are different

A fissure sealant usually forms a physical barrier in the grooves of a tooth. Fluoride varnish is a separate treatment that delivers fluoride to the tooth surface. Your child may be advised to have one or both, depending on their needs.

Grooves are normal tooth anatomy; they are not the same as cavities caused by decay. Before applying a sealant, the dental professional checks the tooth and decides what care it needs.

When are sealants used?

Sealants are commonly placed on permanent back teeth as they come through. The first permanent molars usually appear around six to seven years of age, with further molars later. SDCEP guidance recommends considering each child’s circumstances when deciding whether to place sealants.

There is no universal rule that every child needs sealants at two or three. The decision considers which teeth are present, their grooves and condition, decay risk and whether the tooth can be kept dry during placement. Selected milk teeth or adult teeth may also benefit after assessment.

Sealants are not limited to teeth with no early change whatsoever. A dentist may use sealing as part of managing selected early decay, with follow-up to check that it remains effective. This does not mean that a deep cavity or painful tooth can simply be covered over without diagnosis and appropriate treatment.

What happens during placement?

For a preventive resin sealant, the tooth is cleaned and kept dry. Its surface is prepared, the sealant is placed into the grooves and a curing light is usually used to set it. The dental professional then checks the result and the bite.

Routine preventive placement usually does not need drilling or an injection. The child may notice suction, air or water and the need to keep their mouth open. Explain this calmly and let the team know if your child is anxious or needs a break. The exact steps depend on the material and the tooth.

Do sealants last permanently?

They can last for years, but may wear or come away. The dental team checks them at reviews and repairs or replaces them where needed. A sealant cannot protect every surface of every tooth, so it does not remove the need for daily care.

Help your child brush twice a day with an age-appropriate fluoride toothpaste and spit out the excess without rinsing. Supervise brushing and help where needed. Keep sugary food and drinks to mealtimes where possible and follow the review interval recommended by the dentist.

How to decide what your child needs

Ask which teeth would benefit, whether there are any early areas of decay, and how the sealants will be monitored. If your child already has pain, mention it when booking rather than waiting for a preventive appointment.

You can contact the practice to discuss an assessment. Decay in milk teeth needs attention too, but it does not mean a child is certain to lose their permanent teeth. Practical support for the family is more useful than blame.