What do you know about "sealants" for kids' teeth?

[wide eyes & laughter]

I have shied away from sealants b/c I couldn't understand why one would want to compromise the structure of the tooth by sanding/smoothing it so the sealant could adhese and protect the tooth. I tend toward "If it ain't broke, don't fix it". My dc have no cavities in their permanent molars, so they "ain't broke".

But today, I took dc to a new dentist and they recommended sealants and explained things a little differently than I understood them prior. As in, no sanding necessary. They will only clean out the bacteria, then apply the sealant. When I asked about the adhesiveness for the sealant, they quickly added "some sand-blasting type method would be used, but nothing like sanding. Btw, I don't do flouride either and this seemed to push some hot buttons for the hygenist who became a bit pushy to say the least. I don't like to feel pushed, especially by someone who seems to be on her high-horse Establishment agenda, kwim? I guess this is turning into a "vent" and I didn't intend for that! Just want to know what you think about sealants. Do your kids have them? Why/why not?

Thanks very much!

[Faith]

My younger son does get sealants and they really do help alot.

But, we also get flouride so maybe you don't want to take my advise... lol

[Rhondabee]

I was the kid who would have 3 cavities every time I went to the dentist, no matter how carefully I brushed and flossed. So when my permanent teeth came in, my mom got sealants on my teeth. I can't tell you how they have saved me from the misery that my dad has endured with root canals, etc.

Fast-forward: I was *so* angry at our dentist when he told me that he had been watching a few places on my ds's permanent teeth (he had never even OFFERED sealants - he's a "cosmetic" dentist, so I guess he viewed my ds as a future potential customer). My son had to have *7* cavities filled at one time. And, they were in permanent teeth! I know they would not have developed if he had gotten the sealants, but I was waiting for the dentist to offer them. And, now it's too late. Once there's a filling, they can't seal the tooth.

So, I would obviously spring for them just to be on the safe side. DH, maybe not - he's never ever had a cavity, ever. Unfortunately, our dc have my teeth. :mad: Guess it depends on your family history.

[Adrianne]

He has never had a cavity. My second ds5, cannot have it done b/c he has had a cavity.

My last hygenist, who I trusted, said she highly recommended it. So we went with it for my older one.

[ChocolatePrincess]

We do sealants.......at our dentist they clean the tooth and then seal the molars. All of my dc have inherited my deep crevices in my molars. This has help with cavities.....they don't have any yet! Sometimes the sealant falls out and they have to do it again. That has happened twice. Our insurance also pays for it, so for us it works great!

[Christy B]

I have never heard of any sort of sanding being done to make the sealants adhere. The molars are not exactly flat and smooth, you know?

Um, we also do fluoride: I had a dear friend who lived in the country (well-water) and had a son born the same time as my dd. We lived in the city and had treated (fluoridated) water. By kindergarten, my friend's dd had endured countless fillings. He now has a bridgework appliance in his mouth because he has already lost a permanent tooth to decay. My dd, thus far, has had zero cavities.

I am not trying to build my soapbox to an equal height and start an argument, but since you brought up the fluoride issue, I wanted to point out that not everyone who chooses to use fluoride does so in an effort to conform to the establishment -- there are plenty of us who are simply convinced that it is a valid choice for dental health reasons.

[dirty ethel rackham]

We generally don't do sealants. Nor do we do flouride treatments. While I can see them as being useful for some children who have weaker teeth that are prone to cavities, I don't think they are necessary for the general population. It seems like a money maker for dentists. I always get aggravated by dentists who tell me that my boys need them (who have had 1 cavity a piece.) They always say that the kids have "deep crevices" and that a cavity will happen any day.

Aside from the expense, I don't want any more foreign stuff in my kids mouths than necessary. The composite they use (which is the same composite they use for fillings) can leach bisphenol A, which is a potential endocrine disruptor. Now, dd7 had very weak teeth. She had several cavities by age 2 (and was raised on the same whole foods diet as her siblings). We chose to do sealants on hers (basically sealed the teeth that didn't already have cavities.) We also worked on nutrition to help strengthen her teeth. Since she hasn't had a cavity in 4 years (and sealants don't work between teeth where she had some cavities before), we don't plan on putting them on her permanent teeth.

And that is my very opinionated opinion!

[Mama Bear]

We do sealants (and fluoride -- soft teeth with lots of cavities run in my family). So far, zero cavities in my kids except for contact spots in between baby molars in a kiddo whose mouth was too small at the time, but has since grown nicely -- thus, no more impossible to floss spots.

Sealants would have saved me a gazillion cavities in my molars. Improvement in oral health is linked to dramatically better long-term heart health (and more). I have had a funky mitral valve thing (esp when pregnant). I don't know that the two are linked, but I do wonder from time to time.

HTH :D (had to add that smiley for the giant teeth!)

[Lorna in the boonies]

We do sealants! My teeth are horrendous and two of my kids have inherited them.

I just took my kids to a 'sealant day' offered by the local dental hygienists' association this past Saturday. Between my three kids, we were able to have 14 teeth sealed for free (as opposed to going to the dentist, who charges $39/tooth).

We always spring for sealants for the two kids with bad teeth, but my oldest (no cavities) has never had them (only for financial reasons). We were thrilled to be able to have them done this week.

I can't imagine not doing them, especially if one has insurance (we don't) -- then again, I'm sure that my mouth full of root canals has led me to be a bit biased in this department.;)

[Ria]

Get them. Sealants are worth every single cent. My kids with sealants have had 95% fewer cavities than their siblings. Amazing. Absolutely amazing. I only wish the first ones had been born sooner!

Ria

[momo4]

We did sealants, but I wouldn't do them again. I have heard that unless the teeth are perfectly clean they can actually seal in bacteria. UGH. The ones we had put in had to be redone 3 times for one of my ds.

Drs and the people in their office are often touchy when you don't want to do what they think is good and necessary. Stick with your choices. This often gives me a heads up that I am in the wrong office and that other choices I might make won't be accepted either.

Our dentist wanted to give our 8yos laughing gas for a filling. I thought an 8yo could handle a filling fully awake. That didn't sit well with our dentist, but he couldn't say that there were no side effects so in the end he did it without. We moved out of state shortly after, but I wouldn't have gone back only because imo, he wasn't willing to be flexible on something so small.

[Old Dominion Heather]

I am so, so glad. I wish I could get them! It was super easy and we have had NO problems with the teeth that were sealed. The ones that weren't are a whole 'nother story.:eek:

[ccm]

As a dental hygienist, I have placed many sealants. There have been some children who do not need sealants, but the vast majority of children I see need them and benefit from them. I worked in an office with the air-abrasion system that was used by the dentist prior to the placement of the sealant. This procedure would clean out the fissures. In the office I am in now, we don't have the air-abrasion system, so I use a pointed prophy brush with a non-fluoride paste to clean the grooves. Next, the etch gel is placed on the tooth for 15 seconds and rinsed thoroughly. I use a wet-bond sealant material which is great because of the increased saliva flow in many of my young patients. This material wears well and protects the grooves of the teeth from decay.

Let me preface this next paragraph by saying I dislike unneccessary additives or preservatives in my food and don't like various chemicals in my drinking water, BUT I have worked in various parts of the country and have seen over the years the difference in dental health between children who drank fluoridated water and those who did not. The majority in fluroidated water areas had hard enamel that can withstand years of mouth and food acids and wear-and-tear of daily chewing and grinding, saving hours in the dental chair and hundreds of dollars in dental expenses. The optimal benefit of fluoride is when it is incorporated into the forming tooth. Topical fluoride is good, but if a parent does not want her child to have a topical fluoride treatment, that's fine with me.

Cyrena

[wide eyes & laughter]

We happen to have awesome dental coverage. Sealants are considered preventative and would be completely covered, not even a deductible applied. But, I feel as you stated about the composite and potential leaching -- don't want my kids' bodies spongin' toxins. That concerns me over the long term. I didn't realize it affected endocrin and would like to do more reading on that.

I recently had some of my amalgam (sp?) fillings replaced with that composite stuff.

Anyway, I have a small theory going on here: I've heard/read about acidity and how there are varying degrees in people. My dh, I suspect, has high acidity. For example, his t-shirts have always worn little holes in them and, though he takes better care of his teeth than I do, had a couple cavities at his last appt. I think my dd7 also has this same acidity. Comparing her w/ds9, he does not take *better* care of his teeth than she does but he has no cavities and she has 3.

So, my question is: Have you considered or do you know anything about this line of thinking? Ie: how can acidity/ph levels be decreased or balanced to affect saliva and, hopefully, prevent cavities?

I would mostly be interested in natural means: Are there certain foods that would help create a balanced ph?

Thanks for any further help or direction!

[Karin]

We got them for our two eldest, but had I known they only word for a few years before needing to be redone and that they're made of a form of plastic, I would have declined them. Ds won't get them. Guess I didn't ask enough questions!!! Usually I ask tons, but I think I was influenced by fatigue and the fact that I got tons of fillings when I was a kid due to deep, tiny crevaces in my molars.

[Claire]

My dd has deep fissures in her molars. Our dentist advised sealants specifically for this problem, as he says this type of tooth is very prone to cavities. We got the sealants, and dd (17yo now) has had no cavities in these teeth.

[LN in WI]

The composite they use (which is the same composite they use for fillings) can leach bisphenol A, which is a potential endocrine disruptor. !

This is why we don't.:)

Ellen

[wide eyes & laughter]

Specifically, what about those composites leaching and affecting the endocrine by leaching Bisphenol A? How often do composite fillings or the sealants need to be replaced? What other side effects do you know of?

Also, I appreciate hearing from both sides here. I appreciate your professional input, too.

Thanks for any further help or direction you can provide me!:)

[wide eyes & laughter]

nt

[Dana in OR]

I, on the other hand, have a mouth full of metal (from a young age).

My vote is for sealants.

[Kendra]

Drs and the people in their office are often touchy when you don't want to do what they think is good and necessary. Stick with your choices. This often gives me a heads up that I am in the wrong office and that other choices I might make won't be accepted either.

Our dentist wanted to give our 8yos laughing gas for a filling. I thought an 8yo could handle a filling fully awake. That didn't sit well with our dentist, but he couldn't say that there were no side effects so in the end he did it without. We moved out of state shortly after, but I wouldn't have gone back only because imo, he wasn't willing to be flexible on something so small.

As the wife of a dentist, I see things a little differently. They are called "Dr." because they went to medical or dental school, and because that is now their profession. They are trained to do medicine or dentistry, and while they don't have all the answers, they certainly know more about the human body or mouth than I do. If a dentist thinks something is "good" or "necessary" for me or my children, I tend to think they know more than I do. I guess I don't understand why someone would go to the dentist in the first place if you think your choices are better or more educated or more experienced than the, um... dentist.

As for the laughing gas, here's what I've learned. My kids (and probably yours) are better behaved than 99% of the child patients my husband sees. While you know that your child can probably handle a filling while awake, the dentist is assuming that he/she can't, based on his prior experience with the rest of his patient population. My husband has been screamed at, bitten, thrown up on, and cussed at by children who have virtually never been told "no", or how to properly behave in the dental chair. They haven't been taught to trust the dentist or that the dentist is doing the work for their own good.

Dentists have the highest suicide rate of any professional. What do people say when they find out my dh is a dentist? "Oh, I HATE going to the dentist." So right off the bat, most people don't want to be there. Then when he looks inside their mouths or at an x-ray and sees problems he knows he can fix or prevent, what is the patient's response? Scoffing, doubting, anger at the price they might have to pay to keep their teeth.

Can you maybe see how a dentist and his staff would be touchy when a patient opposes a treatment plan, one that the trained and educated dental professionals know to be "good" and "necessary?"

[Amy in Orlando]

Get them. Sealants are worth every single cent. My kids with sealants have had 95% fewer cavities than their siblings. Amazing. Absolutely amazing. I only wish the first ones had been born sooner!

Ria

What Ria said.:D

[Claire]

Specifically, what about those composites leaching and affecting the endocrine by leaching Bisphenol A? How often do composite fillings or the sealants need to be replaced? What other side effects do you know of?


Not a professional here and not an expert on Bisphenol A, but here's my lay opinion FWIW.....

We are surrounded by plastics that leach endocrine-mimicking chemicals. This includes the computers we are using, the chairs we are sitting in, and most of the items in our homes. Most of the food in our homes too, unless it's all certified organic (and then I wonder), contains traces of chemicals and pesticides. Wooden kitchen cabinets can be outgassing chemicals, new carpet commonly outgasses chemicals.

I would weigh the potential effect of outgassing from tooth sealants against the probability of cavities.

Children who don't get cavities, especially if their parents also don't get cavities, probably have genetically strong teeth and don't need sealants.

I have very bad teeth. If sealants had been available when I was a youngster, I would have accepted the chemical risk because it would have saved me countless hours in the dentist's chair, literally tens of thousands of dollars worth of dental work, and I would have not had the daily discomfort of a poor bite made worse by so much dental work.

[wide eyes & laughter]

nt

[Tammy]

Hmmm...Kendra..... I am sure you feel that way 'because' your dh is a dentist. Just because a dentist is a dentist doesn't mean he is always right about your treatment....same with medical doctors. It certainly doesn't mean you are never to question their decisions...right?

If I listened to my medical doctor....I would have had a hysterectomy 3 years ago....now....I am not having the problems I did them....because I switched doctors...

One of my children went in for a NORMAL cleaning....and by the time they finished....the bill was 300 bucks. They did all kinds of Xrays....most of which were not necessary....they even charged me for 'counceling' my child...which never happened...and it goes on from there. You really can't just walk into a dentist office and JUST get your teeth cleaned....they 'require' you to get a host of Xrays.....which the costs are so totally inflated....it isn't funny.

I will also bet....if you go to 4 different dentists.....you will probably get a different 'solution' from each one.....

I have heard plenty of 'horror' stories about doctors and dentists....right here on these boards!

[dirty ethel rackham]

If a dentist thinks something is "good" or "necessary" for me or my children, I tend to think they know more than I do. I guess I don't understand why someone would go to the dentist in the first place if you think your choices are better or more educated or more experienced than the, um... dentist.


Can you maybe see how a dentist and his staff would be touchy when a patient opposes a treatment plan, one that the trained and educated dental professionals know to be "good" and "necessary?"

While I respect the dentist's education, I am responsible for decisions regarding my child's health. I am a firm advocate for the right of informed consent or refusal, and the dentist's opinion is only part of the information I take into consideration when making decisions. I listen to what the dentist says, but I also do my own research and ask questions. this is simply being prudent - and I do the same with doctors as well. I consider dentists (and doctors) to be my partners in helping me maintain the health of my family. I do not subscribe to the paternalistic idea that anyone with a more advanced degree than me knows what is best. Been down that road and got burned. I am still living with the consequences of the choices rammed down my throat at my oldest child's birth by a doctor who "knew best." That was the end of the honeymoon for me as far as absolute trust in the white coat.

To the dentist, the child may be the patient, but not always a person and the dentist does not have to bear the consequences of bad decisions in the same way the child (and the parent) does. To the dentist, many patients are looked at as a source of income.

I have seen many dentists "churn" patients - recommend treatments that were not really necessary, but helped the dentist's bottom line. That happened to my mom - and this was a dentist that I had thought highly of. he took advantage of her memory issues and did $2000 worth of work that she did not agree to. My friend had a dentist boyfriend who was looking for another practice because he didn't like what he saw - lots of unnecessary procedures. I am NOT saying that all dentists are like this, but there are enough out there that it is a concern. I'll go out on a limb here and say that I think universally pushing sealants on patients who do not have a history of decay issues is "churning."

I am fortunate to have found a couple dentists who are not so wrapped up in their fancy initials that they can't treat me as an intelligent person who is capapble of making informed decisions. I fired several doctors until I found one who was willing to treat me as a partner in health care decision making rather than a patient who must obey.

[Kendra]

Girls, I am with you. I hear you. I've had two homebirths because the medical side of obstetrics drives me batty. Pregnancy is not an illness. But I digress.

But we have become a society of skeptics. We question EVERYTHING, particularly us independent, free-thinking home educators. And while we need to be informed, we also need to recognize when someone *might* know more than we do on a subject.

Personally, the men my dh considers peers are not the money-hungry men you are describing. My dh drives an old beat up work truck. He runs his practice above board and pays his staff above average. He has kept the same staff members for years because he is a boss with a reputation for being a "good guy".

If you cannot find a dentist like my dh or the other men in our community who care about their patients, then I am truly sorry. But they do exist. And when you find one, I hope you can recognize when to take their wisdom and experience and run with it. I hope you can trust them. It is the skeptical, untrusting patient who regularly communicates their disdain for doctors and dentists that is causing my dh to seriously consider another career. And when we drive the good guys away, we'll only be left with the ones we have reason not to trust.

[Gwen in TX]

We do sealants.......at our dentist they clean the tooth and then seal the molars. All of my dc have inherited my deep crevices in my molars. This has help with cavities.....they don't have any yet! Sometimes the sealant falls out and they have to do it again. That has happened twice. Our insurance also pays for it, so for us it works great!


We actually had a few baby teeth sealed (large with huge crevices), and when permanent teeth came in, those too. I have lots of fillings (even though my DDS said he could tell I took care of my teeth, I had lots of cavities), and I wanted ds to avoid that.

[HiddenJewel]

While I respect the dentist's education, I am responsible for decisions regarding my child's health. I am a firm advocate for the right of informed consent or refusal, and the dentist's opinion is only part of the information I take into consideration when making decisions. I listen to what the dentist says, but I also do my own research and ask questions. this is simply being prudent - and I do the same with doctors as well. I consider dentists (and doctors) to be my partners in helping me maintain the health of my family. I do not subscribe to the paternalistic idea that anyone with a more advanced degree than me knows what is best.

Ditto! If I believed that anyone with a higher degree knew best, I would not be homeschooling my children.

[Karin]

But we have become a society of skeptics. We question EVERYTHING, particularly us independent, free-thinking home educators. And while we need to be informed, we also need to recognize when someone *might* know more than we do on a subject.


I'm piping in here, because I've never hated going to the dentist, with the exception of one when I was a child--even his daughter (married to my cousin) says he should never have worked with children. I've had tons and tons of work done and it has done a lot for me. I'm a huge advocate of modern dentristy. On the other hand, I had my babies in a hospital for certain health reasons (high bp with my first, for one.)

We did the sealeants without question because of my tooth history. However, I wish that the dentist had told me:
1. how long they last. 3 years after my eldest had them done he said it was time to have them done again. Since I've never needed to have a filling replaced (even the dentist I didn't like was fabulous at his job, and the one I had in high school was fun--takes a 6 week whale watching break each fall to avoid the pitfalls of depression that can come with dentistry.)

2. That they were plastics. Not that we can avoid it all, but my dd has so many sensitivities I might have done more research first.

I've seen many dentists as I've moved so often over the years, so I've seen the good, the bad and the ugly (the ugly are the ones who are just in it for the money, just like some doctors--and I'm from a family with 3 MDs, so don't shoot me!!!) What I want is INFORMATION without always having to dig for it, and that can be hard to come by anywhere.

[ccm]

Specifically, what about those composites leaching and affecting the endocrine by leaching Bisphenol A? How often do composite fillings or the sealants need to be replaced? What other side effects do you know of?

Also, I appreciate hearing from both sides here. I appreciate your professional input, too.

Thanks for any further help or direction you can provide me!:)
I'm tired from a full day of work and an evening CPR course and I need to prepare for a co-op class I'm teaching tomorrow, but I will research this and check back with more information.

Cyrena

[ccm]

I am happy to report that the sealant we use in our office does not contain Bisphenol A! :D Pulpdent Embrace WetBond Pit and Fissure Sealant is a well-known brand, so it may be the product used in your dental office.

http://www.dentaleconomics.com/display_article/311274/54/none/none/DEPnw/New-pit-and-fissure-sealant-contains-no-Bisphenol-A

I will continue to research other sealant materials and composite resins, but I wanted to pass this information along.

HTH!

Cyrena :)

[ccm]

Here's a good article, written in 2001, that answers a lot of the questions about sealants:

http://www.dentaleconomics.com/display_article/103749/56/none/none/Feat/Seal-of-Approval

Cyrena

[ccm]

Anyway, I have a small theory going on here: I've heard/read about acidity and how there are varying degrees in people. My dh, I suspect, has high acidity. For example, his t-shirts have always worn little holes in them and, though he takes better care of his teeth than I do, had a couple cavities at his last appt. I think my dd7 also has this same acidity. Comparing her w/ds9, he does not take *better* care of his teeth than she does but he has no cavities and she has 3.

So, my question is: Have you considered or do you know anything about this line of thinking? Ie: how can acidity/ph levels be decreased or balanced to affect saliva and, hopefully, prevent cavities?

I would mostly be interested in natural means: Are there certain foods that would help create a balanced ph?

Thanks for any further help or direction!


Here's a link to a site that talks about the benefits of 100% xylitol gum (most "xylitol gum" contain 2% xylitol). It mentions that mothers can affect their baby's dental health by chewing 100% xylitol gum to avoid infecting their children with cavity-causing bacteria. This site seems to be promoting a product (buyer, beware), but the information on the site seems to concur what I've read elsewhere.

http://www.zellies.com/store.asp?pid=9683&catid=19708

Edit: I do not agree with some of the statements on the Zellies website, especially about fluoride.

Edit(again): another link~

http://www.xylitolinfo.com/cms/connect/xylitol/benefits/dental_benefits.htm

[Cherrie]

My two oldest kids 27, 18 had them done still working on the youngest. No filling with any of my kids. My oldest has chrones, I think the sealant has properly saved her teeth. The 18 year old is asthmatic and was on antibiodic alot which have stained his teeth.

[ccm]

Two more links...and I'm done. :)

http://www.ada.org/prof/resources/positions/statements/bisphenola.asp

https://www.ada.org/prof/resources/topics/science_cancer_bisphenol.asp

A common misperception in dentistry is that bisphenol A is present in dental sealants, which are frequently placed on teeth for caries prevention. In fact, bisphenol A is not used as an ingredient in the manufacture of resin-based dental sealants. Among the many manufacturers of dental sealants, only one product may result in trace levels of bisphenol A (detectable only in saliva, not in serum) up to 3 hours after a sealant is placed. 5 This is due to the hydrolysis and salivary esterase conversion of BisDMA, an ingredient not used in sealants made by other manufacturers. Researchers have concluded that there is no systemic bisphenol A detectable when this sealant product is used and the concern about potential estrogenicity may be unfounded. (Quote from link above).

[readwithem]

Just another thumbs up for sealants :) Deep fissures here. Sigh. I wish I could have had them as a teenager, I might not have *three* crowns in my mouth now. (I joke that I should be the queen I have so many crowns:)

[LadyAberlin]

I had sealants as a kid but they came off and so I had them resealed and they came off again. So after that my mom gave up.

[skimerinkydo]

I jumped at the chance for sealants to save my children from the dental problems I have had. My children have crowded teeth and and are prone to cavities. I feel that we are doomed by genetics and I'm very thankful for a solution.