Chewing teeth are molars and premolars. They can be considered as millstones for grinding food. They have their own structure, different from other teeth: the tip of the tooth in the form of a platform is uneven, with tubercles, it is not smooth. Nature has foreseen this need precisely for grinding food, which would not have been with smoothness. The tubercles act as mini-cloves. These wide conical tubercles resemble dunes by the sea. Their bases converge, and between them there are hollows-grooves of various shapes. They are divided into funnel-shaped, poly-shaped, conical, droplet-shaped. Their depth varies from 0.2 to 3 mm. These depressions become a favorite place for the accumulation of food debris and the reproduction of microbes. It is these natural gaps that are fissures. Because of their narrowness and depth, they do not lend themselves well to a toothbrush, which means they lead to caries. The fact is that due to poor access, plaque accumulates on them - the main cause of caries. Only fissure sealing can stop its development.
Fissure mechanism
The existence of these gaps can be compared with a mini-ravine, in which, what sank to the bottom somehow disappeared. In this case, rotted. And decay leads to the expansion and deepening of the gap, because as a result of this process, organic acids are formed. They are very weak, but the problem is that they act around the clock, according to the principle - a stone wears a drop. The tooth enamel eventually collapses.
The more residues accumulate on such a bottom, the more rapidly the gap deepens and expands until a hollow notorious for many appears in its place. This is nothing more than a through hole through all layers of enamel, with a continuation of the deepening into the underlying tissue. But if you can fall asleep and level out an ordinary ravine, this will not work with fissure.
You can only make the gap safe if it is cleaned and partially closed to preserve the overall relief. This will be the sealing of the fissures of the teeth. It can be done at any age and for absolutely everyone - for children it is useful, for adults - it is desirable.
Indications and contraindications for sealing
General indications for sealing are fissures in the form of deep narrow slots, which the brush cannot reach when cleaning. For children, this is useful because tooth enamel is not yet formed and easily caries.
Cases of self-cleaning fissures in a natural way are known. And if there is no risk of caries, they do not need to be sealed. This applies to wide, interconnected slots. Only the dentist can determine the advisability of sealing them. If the tooth is already carious, it cannot be sealed, since the destruction process will continue. In case of caries fissures before sealing, they must be cleaned to healthy tissues, as in the treatment of a tooth.
Age of procedure
Sealing of fissures of teeth in children is especially desirable. They have a process of saturation of enamel with all necessary substances, i.e., mineralization of the tooth, takes a relatively long time and it is important to seal them before caries.
There are some restrictions, for example, if the fissure was not damaged by caries before four years, such a tooth is not needed for sealing. Sealing milk teeth in children is often done by parents. This is due to the fact that fissure caries in a child is a common phenomenon. It usually develops in children who cannot or do not want to brush their teeth thoroughly. After sealing, the risk of caries is reduced to zero.
Sealing of the fissure of the tooth is carried out on the permanent teeth, too. It is optimal to carry out sealing after the eruption of the molar over the next three months, in extreme cases, after six months. This is a recommendation from dentists. There is no need to delay this, because the concentration of microbes is constantly growing.
Sealing procedure
Sealing or sealing fissures is a procedure for treating molars with a special composition. It completely protects the tooth from caries by 100%. Frozen sealant does not allow anything to penetrate inside the tooth. Fissure sealing is one of the most effective preventative methods.
Stages of sealing
Sequencing:
- In order to conduct the entire procedure with the expansion and opening of the fissures in case of their narrowness and great depth, their position, i.e. topography, is determined by an X-ray.
- Next is the preparation of the teeth. With circular brushes, the surface is cleaned using abrasive paste. If this turned out to be insufficiently effective, use an ultrasonic or sandblasting apparatus. After all, the tooth is washed from the remnants of the abrasive. Then it is treated with an antiseptic and air-dried using a dental gun.
- The next step is called pickling. It consists in acting on the enamel layer with a special acid - this is done in order to increase the contact area of the tooth and sealant. The degree of adhesion also increases. Before coating the tooth surface with acid for etching, it is isolated from saliva. For this purpose, they simply cover the tooth with cotton wool rollers. Phosphoric acid is applied for 15 seconds, then it must be washed off with a stream of water and air dried. When using phosphoric acid, it is held for a minute.
- Sealing. Sealing fissures with sealant is carried out by applying a composition from the syringe pen with its uniform distribution in the tooth cavity. The dentist removes the excess. The silant must harden, for this they are affected by a light-curing lamp.
- After curing the silant, the treated tooth surface is ground and polished. You should now check the closure of the teeth to detect malocclusion after the silant. To this end, the dentist uses occlusal or special copy paper. If there is a lot of silant in any place, the bite will increase and this will be expressed in the fact that a thick colored dot appears in this place. This area is immediately polished and polished.
The procedure for sealing fissures for children lasts an average of about 40 minutes. Patients feel very comfortable because there is no pain. With high-quality sealing of the fissure of the tooth, it becomes protected from any foreign bodies for five years or more.
Sealing tactics in children
Fissures of teeth in children are assessed by the initial level of mineralization (IUM).
- High IUM - the enamel is dense, shiny, the probe does not get stuck, but glides over it. Such fissures are resistant to caries for a very long time, and they do not need sealing.
- Medium IUM - single fissures are chalky in color, sometimes the probe gets stuck in the deepest. Here caries is present in 80% of cases. Therefore, the eruption of such a tooth must be combined with taking fluoride, calcium and phosphorus preparations for a month, and then perform the sealing procedure.
- Low IUM (hypomineralized fissures) - the enamel is dull, the color is whitish everywhere, the probe can even extract softened enamel, caries is 100%. With such teeth, acid is not used for etching during sealing. Only fiberglass sealants are used.
Do seals do adults?
Fissure sealing in adults is carried out with a high probability of caries. How is this done? Sealing fissures for adult patients, since the enamel is already fully formed, resembles the process of treating a carious tooth - opening, cleaning and processing. Often, fissure pigmentation is detected in adults.
To find out what is in such a fissure is impossible. As a result, an adult dentist is more limited in methods than a child. The doctor polishes the tooth and gains access to the enamel, which is located under the pigmented area.
Another problem in adults is the wisdom tooth. Until it cuts through and is under the tissues, there is no access to it. And when it erupts, it often already has a carious cavity. Therefore, such a tooth is best removed.
Spontaneous sealing
Such a phenomenon is not so rare. It happens naturally. In these cases, dense highly mineralized heterogeneous formations are found at the very bottom of the fissures. Not the last role in this case belongs to the dentinal fluid or cerebrospinal fluid - this is the fluid that fills the internal cavity of the tooth. Why is it at the bottom - because here the centrifugal currents of this fluid from neighboring tubercles and folds are concentrated at one point, that is, the fissures are naturally sealed by it.
Sealing result
According to statistics, 80% of silants are airtight two to three years after the procedure. The next five to seven years continue to remain airtight 70%.
After 10 years, only 30% function. But numerous reviews suggest that silants can serve for more than 10 years, subject to high-quality daily brushing.
Advantages and disadvantages
Sealing provides complete, 100% protection against caries, prevents a relapse of the carious process. In addition, the sealant itself further improves the fixation of existing fillings. There are no disadvantages to the procedure.
Sealant materials
At its core, fissure sealing materials are low-viscosity composite resins that can cure under the influence of a UV lamp or naturally. Their basis is polyurethane. They vary in durability and transparency. Often, their composition is additionally enriched with fluoride ions, which in itself inhibits the development of caries.
Sealing a tooth fissure with sealant - what is it? This is the use of silants. Silant in translation means "sealant", which acts as a physical barrier to cariogenic bacteria and organic acids.
Transparent sealants can serve as indicators of the condition of the fissures, but they themselves are difficult to visualize and evaluate their condition.
Opaque silants additionally contain titanium dioxide. Due to it, a pleasant creamy color is acquired and on the chewing surface they do not stand out. Their advantage is that they allow you to control your condition during the wear process.
Most often, dentists use the following sealants - Fissurit F and Grandio Seal. Any composition of the silant is hypoallergenic and does not damage the enamel.
Types of sealing
Sealing of fissures of the teeth is carried out by two methods - invasive and non-invasive. In the first case, the dental tissues are polished. Fissures are usually complex - closed and narrow. More commonly used in adult patients.
Non-invasive sealing is not accompanied by grinding of enamel, cracks are filled only with a silant. It is used in children with milk and permanent teeth. But fissure should be uncomplicated in structure and without a hint of caries.
Reviews
Reviews of many parents talk about the mandatory fissure sealing in children. They indicate the very high efficiency and reliability of the method, which is indeed becoming the best prevention of caries. No negative reviews have been registered to date.
The procedure is considered very fast, wonderful, painless and aesthetic. This is especially good for lazy children who are hard to get to brush their teeth thoroughly. The only problem is finding a competent and attentive dentist so that fissure sealing is done correctly. The average price for sealing one tooth varies from 600 to 900 rubles.