Many young kids have a sweet tooth.
They’d rather drink juice than water and they don’t turn down candy often.
So, often pediatric dentists will suggest that dental sealants could keep tooth decay at bay in permanent molars.
Any type of preventive thing we can do to help keep a child’s smile beautiful, we want to do.
But a child’s mouth is part of an ongoing debate over whether enough kids get the liquid plastic coverings that protect “the most decayed tooth in the mouth.”
Only about 20% of children at poverty level and only 40% of kids from higher-income homes actually receive recommended sealants, according to studies by the Centers for Disease Control and Prevention.
That confounds pediatric dentists. Decades of research demonstrate that coating the biting surfaces of 6-year molars with a resin-based sealant can reduce cavities by up to nearly 80% immediately -- and up to 60% for four years or more.
It’s imperative that as soon as those adult teeth erupt, that they be sealed.
In practice, however, less than 40% of dentists actually follow the recommendations of the ADA, according to a 2011 study. The study tracked whether dentists were willing to seal teeth with the beginnings of decay, but no actual cavities.
The lack of dentists doing dental sealants for kids is a very silent and probably the most significant issue to care we face among children. Parents should be asking for sealants and not taking no for an answer.
Gordon J. Christensen, who publishes Clinicians Report, widely regarded as the “Consumer Reports of dental products,” says that sealants done properly are “an excellent technique” for combatting decay. But, he adds, the success of the sealant depends largely on the skill of the person who applies it.
“They have to seek out a practitioner who knows what they’re doing,” he said.
Christensen is concerned about so-called “non-cavitated caries lesions,” early signs of tooth decay that have not yet resulted in cavities. He worries that sealants trap plaque on the tooth, creating an environment that fuels future decay.
CDC researchers say studies have shown that decay does not progress once sealants are added.
Dental sealants are formed when a plastic-like liquid is dripped onto the biting surface of the tooth, coating the pits and fissures that typically trap food and foster bacterial growth.
They’re applied to the permanent molars and set with ultraviolet light, ideally between the ages of 5 and 7, when the teeth erupt. Cost can be $30 to $40 for each tooth and is typically covered by most dental insurance policies.
Studies consistently showed that sealants warded off decay in high proportions of permanent teeth, sometimes for up to a decade.
Between 45 million and 55 million sealants are applied each year in the U.S., with pediatric dentists performing more than twice as many procedures as either general dentists or dental hygienists.
Support for the sealants is shared by oral health experts at the Centers for Disease Control and Prevention, who are particularly in favor of school-based sealant programs that reach kids without regular care.
For many middle-class parents whose children do see the dentist, the problem is that the subject of sealants may not even be raised.
Some dentists, mostly those who treat few children, might be leery of sealants because they can be tricky to place, or because they didn’t learn to use them in dental school and aren’t in the habit of offering the treatment.
To be clear, not all children need sealants because their teeth are naturally not prone to decay or they have exceptional oral hygiene habits. But only a dentist can tell and parents should at least inquire.
But many do, and not just children typically at high risk. Recent studies have shown that boys in higher-income homes had the greatest prevalence of decay.
For those who do require sealants, they may mean the difference between a lifetime of healthy teeth and the pain and health risks of chronic decay.
What folks need to know is that 90 percent of decay in the adult is on the biting surface on the back tooth.
Dentistry is a very demand-based health service. Patient demand really affects what dentists do in their practices.
For more information on dental sealants for kids, contact Today’s Dental of Boxborough.