Tech Talk With Dr. Cranska

Stop Childhood Cavities With Dental Sealants And Fluoride Varnishing

To reduce the risk of tooth decay and protect the biting surfaces of new teeth erupting in the mouth, patients can get dental sealants and have their dentist apply fluoride varnishes two to four times per year.

Q: My children now receive full mouth fluoride varnish treatments twice a year at their cleaning appointments. Is this better than gels or rinses?

A: These 5 percent sodium fluoride varnishes provide instant tooth surface protection, minimizing the swallowing risk. Application is recommended for all age groups. Varnish treatments impact the dentition by reducing the occurrence of dental decay on smooth tooth surfaces and between teeth. This is in addition to regular daily brushing with toothpaste and flossing. An enhanced preventative effect is obtained by using this after a professional tooth cleaning.

Fluoride varnish is brushed onto all tooth surfaces in a single application. The white or clear flavored varnish is dispensed from a prepackaged unit dose pack. There is immediate fluoride uptake into the teeth, remaining for several hours while releasing fluoride ions to the most needed areas of the tooth (between the teeth and root surfaces). For increased topical affect, patients should not eat or drink for 30 minutes following the treatment. The therapy is repeated at three- to six-month intervals.

Q: How do sealants prevent tooth decay?

A: Prevention is the answer. The most important time is at 6 and 12 years of age; this is when the first and second molars erupt into the mouths of children. Dental sealants (plastic protective coverings) can be applied to the biting surfaces of back teeth; these seal the grooves, where almost 90 percent of decay (dental caries) occurs, preventing decay from occurring when in place. When decay is found at the time of placing sealants, minimally invasive preventative bonded restorations can be placed.

Q: How is the sealant bonded in place?

A: First, the teeth need to be sealed are cleaned to remove food debris, plaque (bacteria) and stains, and to check that no decay is present. This is ideally done using an air polishing or air abrasive unit (much like a mini sandblaster). The teeth are then conditioned and dried, and the tooth-colored liquid sealant is painted on the teeth and vibrated into the grooves. A special laser curing light is then used to harden the liquid. After the light cures the sealant (less than half a minute), you can eat or drink at any time. The sealant works by always preventing plaque and sugars from ever entering the now-sealed grooves. As long as the bonding stays in place, the sealant works.

This combination of one-time placement of dental sealants (at 6 and 12 years of age) and semiannual application of fluoride varnish are used to prevent childhood dental caries.

We can hope that these and other preventive dental techniques with children will protect teeth and help create generations of dental patients without tooth decay.