Fact sheet: Tooth sealants for children and young people

Brushing your teeth every day, as well as avoiding foods and drinks that are bad for your teeth, can help prevent tooth decay (dental caries or cavities). The regular use of a toothbrush and fluoride toothpaste not only cleans the surfaces of teeth, but also provides them with a small amount of fluoride. That makes them harder, which means they have better protection against tooth decay. The chewing surface of molars (back teeth) are most at risk of tooth decay. This is because bacteria can become permanently stuck in the dents and grooves (called fissures), particularly if they are very deep.

Once children’s “milk teeth” molars have been replaced by permanent ones, dentists sometimes suggest using a fissure sealant to try to prevent decay. This seals the grooves in the teeth, which stops bacteria from building up there. Some sealants also release fluoride to strengthen the teeth. You can read more about why fluoride is important here (URL: http://www.informedhealthonline.org/here.96.en.html) .

What does the treatment involve?

Having your teeth sealed does not hurt and only takes a few minutes. The dentist first prepares the teeth by cleaning the chewing surfaces and roughening them up a bit with a special gel. This helps the sealant stick to the surface of the tooth when it is applied. The gel is then rinsed off using water. Once the dentist has dried the teeth, he or she fills the fissures with a resin (plastic) liquid, and then uses a special light to make it go hard. The sealant is usually white in colour. After it has hardened, the dentist will check whether the teeth in your upper and lower jaw still fit together properly when you bite.

Other types of materials can be used as sealants too, such as so-called glass ionomer cement. For some of these materials, there is no need to prepare the teeth with the gel or make the sealant go hard using a special light.

At what age might sealants be considered?

Sealants are mainly used to protect the chewing surfaces of the permanent back teeth (molars). The first of these molars grow when children are about six years old. Another set comes about six years later. Sealants are used as a long-term preventive measure. They clearly lower the risk of tooth decay on the chewing surfaces of molars. Resin sealants last longer than glass ionomer cement. Dentists check whether the sealant is still there during routine check-ups. If the sealant has worn away, it can be re-applied.

The sealants that are used nowadays are generally thought to be safe. Some people have had allergic reactions to them, but that is rare. You can read more about the benefits of using tooth sealants here (URL: http://www.informedhealthonline.org/here.95.en.html) .

How good are sealants compared to other strategies?

Sealants should by no means replace daily toothbrushing with fluoride toothpaste. Another preventive treatment that dentists offer is the application of special fluoride gels and varnishes to the whole tooth. The main aim of this is to stop the spread of early stages of tooth decay in the enamel (the outer layer). But using tooth sealants in the grooves of molars provides better protection against tooth decay than applying fluoride gels or varnishes. You can read more about preventing tooth decay here (URL: http://www.informedhealthonline.org/dental-caries.269.56.en.html) .

Who covers the costs?

In Germany, health insurance funds cover the costs of sealants for the permanent back teeth (molars) of children and teenagers between the ages of 6 and 17. If a dentist recommends using sealants for other teeth – such as milk teeth and premolars – statutory health insurances will not cover that. In other countries, check with your dentist or insurance programme about costs.  


Author: German Institute for Quality and Efficiency in Health Care (IQWiG)