Sealants – Will they work and are they safe?
I had a parent ask me about sealants the other week. She asked if the sealants that her daughter had done a year ago were toxic because that is what she had heard from a friend. So, I thought I would write an article about what sealants are and also the safety of sealants in case there were other parents out there with the same question.
The American Academy of Pediatric Dentistry states that sealants that are maintained are scientifically-sound and cost-effective techniques to prevent pit and fissure caries, which means cavities on the biting surface of the teeth. The key is also that they are maintained. The importance of checking their integrity at each dental exam is also very important. Also, keep in mind that a sealant cannot prevent a cavity on other surfaces of the tooth besides where the sealant is placed, like the surface that touches another tooth (that area needs to be flossed daily to prevent tooth decay).
The most recent statistics show that 68% of children in the United States have had a cavity by 17 years of age. In fact, 90% of all cavities in school-aged children occurs in the pits and fissures (those grooves on the biting surface of your teeth). The teeth at the highest risk for cavities are the permanent (adult) first and second molars (those teeth all the way in the back) because fluoride has less of an effect on the pits and grooves of these teeth. On average, these adult molars come in around age 6 for the first ones and age 12 for the second ones. Any tooth, including the baby teeth and adult teeth other than molars may benefit from sealants if those teeth have deeper grooves and pits and also if the patient is at a higher risk of tooth decay.
It is important to know and remember that sealants can be lost over time and that is why it is important to have them checked regularly at periodic exams. With the proper follow-up care and maintenance, the success rate of sealants may be 80-90%, even after a decade.
Now, on to the question of their safety. The main concern raised about sealants is due to BPA (bisphenol A) which has been found to be present in many consumer plastic products and food packaging since the 1960s. Some studies have suggested that BPA may have adverse health effects, which has raised concerns about its use. Dental materials used to treat and prevent cavities can contribute to a VERY LOW-LEVEL BPA exposure for a FEW hours after placement. It can be found in dental composites (white fillings) and sealants for two reasons. First, it is a by-product of other ingredients in the filling materials that have degraded. Second, it is a trace material left-over from the manufacture of other ingredients used in dental fillings and sealants. Research has shown that BPA is NOT used as a formula ingredient in dental materials.
The U.S. Department of Health and Human Services (HHS) provides scientific guidance on issues that affect the health of Americans and the U.S. Food and Drug Administration provides advice and recommendations on dental product safety. A 2008 report from the HHS stated, “Dental sealant exposure to BPA occurs primarily with the use of dental sealants that have BPA dimethacrylate. This exposure is considered acute (short) and infrequent with little relevance to estimating general population exposures.” Furthermore, BPA in food and beverages accounts for the majority of daily human exposure.
The ADA (American Dental Association) fully supports continued research into the safety of BPA; but based on current evidence, the ADA does not believe there is a basis for health concerns relative to BPA exposure from any dental material. The ADA is a professional association of dentists committed to the public’s oral health. They support ongoing research on the safety of existing materials used in dentistry and in the development of new materials. Based on current research, they agree with the authoritative government agencies that the low-level of BPA exposure that may result from dental sealants and composites poses no known health threat.
I also thought you may like to know some current statistics from the CDC. Dental caries (tooth decay) is the most common chronic disease of children 6 to 19 years of age. It is still 4 times more common than asthma among adolescents aged 14 to 17 years. Untreated tooth decay can cause pain, dysfunction, absence from or poor performance in school, poor appearance and can lead to the spread of infection. These are all problems that greatly and negatively affect a child’s quality of life. Using composite resin materials (white fillings) for both restoring dental health and preventing cavities is well established.
So, the bottom line is: Yes sealants are great tools in our “toolbox” to help prevent cavities and they are safe. My son will be getting them and I also have mine, still! 🙂
Dr Reid is a Pugh Award distinguished board eligible pediatric dentist. She earned her pediatric specialty training through UCLA’s program at San Diego Rady Children’s Hospital. She has also served our servicemen as a Dental Officer at the Marine Corp Air Station, Miramar in San Diego. She’s also mommy to 5 year old Ezra. To follow her monthly blog posts, follow her at PediatricDentistSanDiego.com.