Dental Sealants and Fluoride

For Children & Adults

Brushing and flossing, twice a day, are the basics for the prevention of dental disease. But, they are not the only tools available to assist with keeping our teeth healthy. Watching our, and our children’s, intake of sugary and sticky foods, is equally as important. But, even with diligence to a healthy diet, it’s difficult to avoid the acids that attack our enamel and set the stage tooth for decay. Fortunately, we have other tools in our toolbox – dental sealants and fluoride.

Dental Sealants

It’s easy to brush our front teeth as we stand in front of the mirror and smile. But, more difficult to clean, and hence keep free of decay, are those in the back of our mouth. Not only is it harder to floss in the posterior areas, but these teeth also have more crevices and that makes it more challenging to remove bacteria with a toothbrush, even an electric one. Sometimes the bristle of the brush is actually thicker that the crevice in the tooth. One additional way to protect our pre-molars and molars, especially for children who are not as adept at brushing, is to place a thin, glass ionomer, (a combination of water, a powder, and a liquid acid) on the chewing surfaces of the back teeth. The material hardens and acts as a barrier, keeping decay-causing bacterial plaque from sitting directly on the occlusal surfaces.

The application of ‘pit and fissure’ sealants is a safe and simple procedure, one that has been available since the early 1960s. After your teeth are professionally cleaned, the solution is placed on the tooth and dries naturally. Once applied your hygienist, or dentist will check to ensure the occlusion (bite) is even. It takes but a few minutes per tooth. The sealant is strong enough to withstand the forces of chewing and typically lasts a few years before a reapplication is indicated. When you, or your children, are seen for a dental cleaning and examination either Drs. Hochberg, Diora or To will examine the dental sealants to see if they exhibit wear. If so, replacement of the dental sealant may be recommended. We suggest that parents consider sealants as soon as their children’s premolars and molars have erupted, with reapplication throughout the early teenage years. And, protecting molars that are susceptible to decay need not be limited to children. Adults benefit from sealants as well.


According to the National Institute of Health (NIH), “Sealants and fluoride together can prevent almost all tooth decay.” This is especially seen when patients are conscientious about their dental home care regimen and their diet. However, even if you or your child has sealants that were placed on the chewing surface of posterior teeth, they do not protect the teeth’s smooth surfaces of teeth. As stated by the NIH, fluoride, another readily available and inexpensive tool, is the second way we help patients maintain excellent oral health.

The outer structure of a tooth, the enamel, is strong and able to withstand biting into foods and chewing them. But, this structure is not impervious to harm. Damage can occur due to trauma to the tooth but often occurs due to dental disease. The minerals in our enamel – calcium, and phosphorus – that help keep the enamel strong can be leached out by ‘acid attacks’ from the foods we eat and the liquids we drink. The fluoride in our drinking water and in ADA-approved toothpaste serves to both neutralize those acids while helping to replace these two important minerals. Research has shown that fluoride not only helps to prevent tooth decay by protecting the enamel it also helps to strengthen weakened enamel. And there are patients who benefit from additional fluoride treatment; Drs. Hochberg, Diora and To may recommend a fluoride varnish or a fluoride rinse.

The benefits of fluoride begin even before birth, while teeth are forming, and continue throughout a lifetime. In fact, later in life, there is the potential for gum recession, exposing the tooth’s roots to risk, and a reduction of saliva, which helps wash away food particles. It’s just as important to use fluoride when older as in youth.

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Dental Sealants

Q: What are dental sealants?

A: A dental sealant is a liquid-like filling material that is flowed over the chewing surface of newly erupted teeth. It finds its way into the small pits and grooves of the tooth and is then activated to cure hard. This helps to prevent bacteria from setting up shop on the chewing surface. And because today’s dental sealants also contain fluoride, it is wonderful at preventing decay in our younger patients.

Q: How long do dental sealants last?

A: Typically a few years, but they’ve been known to last up to 10 years. Does dental insurance cover sealants? Each insurance policy is unique. If you have questions, please ask your HR department or we can send in a predetermination of benefits. In any instance, sealants and fluoride treatments are significantly more cost-effective when compared to fillings. And, keeping teeth healthy, rather than repairing damaged teeth is always the goal.

Q: What if there is the beginning of a cavity and a dental sealant is applied?

A: There are small lesions, called ‘incipient lesions’ that may be on the enamel only. Oftentimes, a sealant serves to help halt the progression of a small spot into an area in need of restoration, especially inasmuch as the glass ionomers contain fluoride, which can help to restore the tooth’s enamel.

Q: Do dental sealants really work?

A: According to the American Dental Association, there is an 80% reduction of risk in those that have sealants on permanent molars. And, the plus of glass ionomer sealants is that they contain fluoride, a further protection to the tooth’s structure.

Q: Are dental sealants safe?

A: Yes, the older resin-based sealants, had a minimal amount of BPA, however, there was no evidence of risk. In fact, according to the ADA, the risk of exposure to BPA is 100 times greater when breathing air. However, glass ionomer sealants do not contain the same materials and, as with the older sealants, have been found to be both safe and effective.


Q: When can children use fluoride toothpaste?

A: The protocol has changed. So important is fluoride to dental health that once teeth have erupted, fluoride toothpaste, used in very small amounts by the parents, should be used. The best way to care for your children’s first teeth, and tips for helping your child remain dentally healthy, are important topics to discuss with Drs. Hochberg, Diora and To.

Q: Does drinking water provide adequate amounts of fluoride?

A: It’s a big help, but there is still the need to use fluoride toothpaste with the American Dental Association seal of approval. Your dentist will advise you if additional fluoride treatments are recommended. And remember, bottled water does not contain fluoride – drink tap water.

Q: Why is fluoride recommended for patients with dry mouths?

A: Medications, age, and declining health can all cause a reduction in saliva production. Saliva is nature’s oral rinse. When it’s not present, food substances, which lead to acid formation and ‘plaque attacks’, increase the chance for the development of dental decay. Fluoride rinses may be recommended; they often help to minimize the risk of disease.