The prevalence of caries ( cavities) has decreased in past few decades due to water fluoridation, toothpastes, improved oral hygiene , changes in diet and awareness. Despite reductions in caries, the disease still continues to occur during childhood. Pit and fissure sealants are the major cornerstone of modern preventive dentistry in prevention of caries in a childrens.
Pits are small depression on the tooth , fishers are deep clefts between tips of teeth. Pit and fissure catches debris and microorganism forming plaque. This plaque accumulation increases caries. Recently erupted teeth have porus enamel lining and fissures are rich in organic debris which increases plaque accumulation.
Pit and fissure sealant is term used to describe a material that is introduced into pits and fissures of caries susceptible teeth,thus forming Micromechanical Bond
and Protective layer cutting access to carries producing bacteria from their source of nutrients.
In which cases pit and fissure sealant given ?
- Deep pit and fissures, which can retain food and cause caries (cavities)
- Stained Pit and fissure with minimum appearance of decalcification(Cavity)
- Caries pattern ( cavity pattern ) indicator of more than one cavity per year
- Shape of pit and fissure is such that it increases risk of cavity
- As part of a routine dental Care and active preventive dentistry program.
Procedure should be carried out at earliest possible time after eruption to make effective and preventive use of pit and fissure sealant.
Procedure Of pit and fissure sealant
is simple, Cleaning booth, application of a bonding agent, application of sealant and then curing and evaluating.
Recall and check up of patient is done at subsequent visits. It is necessary to re-evaluate sealed tooth surfaces for loss of materials, any voids and development of caries, especially in first six month of a placement . Although a single application of the pit and fissure sealant has been shown to be beneficial in reducing caries in the teeth.
Recall visits every 6 to 12 months are necessary.
Current status of pit and fissure sealant
- Flouride Releasing sealants: Laboratory studies has concluded that greatest amount of fluoride release by 24 hours after mixing and then it slows down
Sealant material composed of modified urethane base BIS-GMA resin. - Coloured Pit and fissure sealant: Sealant is clear to begin after polymerization( setting) it changes its colour. It is easy to see during placement and recall appointment.
- Flourescing pit and fissure sealant: With use of UV pen light the sealant fluoresces blue or white colour.
- Moist bonding pit and fissure sealant-
- Pit and fissure sealant with ACP: Light cure sealant which contain Amorphous calcium phosphate( ACP) is more flexible and create stronger and longer lasting sealant.
ACP is referred as a smart material as it only releases calcium and phosphate ions when pH drops
to 5.9. Once the calcium phosphate is released , it will act to neutralize the acid and prevent cavities. It also reinforce to tooth’s natural defence system. - Hydrophilic fluorescent BPA free sealant.
In such way a pit and fissure sealant are simple and Cost effective way of caries prevention in susceptible teeth.
