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Dental Fissure Sealants

Pit and fissure sealants for caries prevention: indications, application, and longevity

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Dental Fissure Sealants?

Fissure sealants are most commonly resin-based (filled or unfilled, light-cured) or glass ionomer cement (GIC). Indications: deep occlusal pits/fissures with caries-susceptible morphology (Type I-V Nagano classification), non-cavitated incipient caries (sealing prevents progression), patients with high caries risk, special needs patients, recently erupted molars (most vulnerable in first 2-4 years post-eruption).

Application protocol: cleaning (prophylaxis paste, pumice, air abrasion - controversial), isolation (rubber dam ideal, cotton rolls + saliva ejector), etching (35% phosphoric acid 15-30 sec), rinse and dry, sealant application, light cure (20 sec). Some clinicians use bonding agent (improves retention). GIC for high-caries-risk young children (fluoride release, minimal moisture sensitivity).

Effectiveness: 60-80% caries reduction in molars (Cochrane meta-analysis). Retention: 50-90% at 1 year, declining over time. Replacement/repair: every 3-5 years if loss/wear. Modern alternatives: hydrophilic moisture-tolerant sealants, glass ionomer-based, self-etching systems. AAPD/ADA guidelines recommend sealing first/second permanent molars in all children, regardless of caries risk.

Symptoms

(Fissure sealants are a preventive treatment, not a disease)
Indications for sealant application:
Newly erupted permanent first molar (age 6-7)
Newly erupted permanent second molar (age 11-13)
Deep occlusal pits and fissures
High caries risk (multiple existing caries, salivary tests)
Special needs patients (limited oral hygiene)
Pre-cavitated white spot lesions in fissures
Newly erupted premolars in caries-prone individuals

Risk Factors

Indications for sealant placement:
Pediatric patient with newly erupted molars
Deep occlusal anatomy (Class I-II Nagano)
High caries activity (DMFT >2)
Past history of caries
Inadequate oral hygiene
Frequent sugar exposure
Reduced saliva (medications, radiation)
Special needs (autism, intellectual disability)
Limited contraindications: pre-existing cavitated caries (need restoration), allergy to bisphenol A (rare)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • First molar eruption (age 6-7) - schedule sealant assessment
  • Second molar eruption (age 11-13) - schedule sealant assessment
  • Pediatric dental check-up (sealant evaluation)
  • High caries risk identified (multiple caries siblings, parental caries)
  • Pre-orthodontic evaluation (additional caries risk during treatment)
  • Special needs assessment (anesthesia for sealant if needed)
  • Sealant retention check (every 6-12 months)
  • Discoloration or loss of existing sealant

Treatment Methods

01
Comprehensive caries risk assessment
02
Identification of caries-susceptible teeth/surfaces
03
Pre-application: prophylaxis (pumice paste), evaluation
04
Isolation: rubber dam (gold standard) or cotton rolls
05
Surface conditioning: 35% phosphoric acid etching 15-30 seconds
06
Rinse 15-20 seconds, dry until frosty appearance
07
Bonding agent application (optional, improves retention)
08
Sealant material: resin-based (most common), GIC (high-risk young children)
09
Light cure 20-30 seconds (visible light, ~470 nm)
10
Occlusion check, adjust if interference
11
Fluoride application (combined preventive)
12
Retention check at 6-month recall
13
Repair/reapplication every 3-5 years
14
Patient education: brushing technique, fluoride toothpaste, dietary advice
15
Cost-effective preventive measure (vs. restoration)

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.