Fissures are located on the chewing surface of small and large molars, more specifically between the elevated tips necessary for chewing. The ruts and holes on the surface of the teeth create favourable conditions for tooth decay. In childhood, this can be prevented by fissure sealing, which means the filling up of fissures. Fissures are sealed with an adhesive and protective material that insulates the depth of fissures, thereby preventing any contamination from sticking to the surface.
This is a completely painless, efficient and safe way to prevent childhood tooth decay. With this method, the chances of childhood caries can be eliminated or greatly decreased.
Fissures on the chewing surface of molars have uniquely varied depth, and at the bottom of deep fissures there are sometime microscopic cracks, narrower than the brittle of a toothbrush, therefore they cannot be kept clean. Fissure sealed surfaces, on the other hand, are smooth and therefore easy to clean.
The dental hygiene specialist will apply fissure sealing in the small and large molars, where its need is determined by the dental examination. Fissure sealing is best applied on healthy teeth, preferably within 6 months of eruption, so between the ages of 6 and 18 continuously. It is always recommended to seal fissures on newly erupted teeth and to constantly check previous sealing, with replacement if needed.
The process of fissure sealing:The dentist or dental hygiene specialist will dry the tooth by blowing air on it, then apply a coloured liquid to it. The liquid is removed shortly, then rinsed with water and dried again. Then the fissure sealing liquid material is applied to the tooth, which automatically covers even the smallest fissure. After this, in cases of materials bonding by light, the specialist applies light for about 20 seconds. If the material hardens by itself, we must wait 1-2 minutes. The “colour liquid” is an acid that is applied for a short time and slightly roughens the surface of the tooth. The fissure sealing material bonds into these rough patches. What happens if the acid reaches surfaces that it should not? Nothing irreversible – the roughened enamel comes into contact with saliva and toothpaste, and the fluoride and other materials in them will be replaced and the enamel is healed. As a last step, we check whether the fissure sealing disturbs the clenching of the teeth.
In case of any suspicions as to the latter, we will thin out the applied material by grinding, and then polish the tooth.
Fissure sealing should be a part of a complex prevention programme, since on its own it will not provide sufficient protection against tooth decay. Finished seals will protect the tooth for 2-3 years from surface decay and continuously release fluoride, which strengthens the teeth. It can also be applied to healthy molars in adults in a slightly varied form. One of the great advantages of fissure sealing materials is their ability to release fluoride. Bacteria are unable to reproduce in a surrounding with a certain percentage of fluoride content, therefore they will not grow on the filling or in its vicinity.
There is usually no need to treat temporary teeth with this method. Exceptions are those that are endangered by dental decay, in which case treatment may be considered.
This intervention is relatively simple, only takes a few minutes per tooth and is not burdensome for the child.