Chewing teeth are molars and premolars. They can be considered millstones for grinding food. They have their own, different from other teeth, structure: the top of the tooth in the form of a platform is uneven, with tubercles, it is not smooth. Nature provided for the need for this precisely for grinding food, which would not have been the case with smoothness. The bumps act like mini teeth. These wide-conical tubercles are reminiscent of dunes on the seashore. Their bases converge, and between them there are hollows-grooves of various shapes. They are divided into funnel-shaped, polyp-shaped, cone-shaped, drop-shaped. Their depth varies from 0.2 to 3 mm. These recesses become a favorite place for the accumulation of food debris and the reproduction of microbes. It is these natural cracks 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.
Mechanism of fissures
The existence of these cracks can be compared to a mini-ravine in which everything that fell to the bottom was lost. In this case, it's rotten. 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 operate around the clock, according to the principle - a drop wears away a stone. The enamel of the tooth is eventually destroyed.
The more residues accumulate on such a bottom, the more rapidly the gap deepens and expands until the infamous hollow 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 tissues. But if an ordinary ravine can be filled and leveled, this will not work with a 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 - it is useful for children, it is desirable for adults.
Indications and contraindications for sealing
General indications for sealing - fissures in the form of deep narrow crevices, which the brush cannot reach when cleaning. For children, this is useful because the enamel of the teeth is not yet formed and is easily subject to caries.
There are known cases of self-cleaning of fissures in a natural way. And if there is no threat of caries, they do not need to be sealed. This applies to wide, communicating slots. For them, the expediency of sealing can determineonly a dentist. If the tooth is already carious, it cannot be sealed, since the process of destruction will continue. In the case of caries, fissures should be cleaned to he althy tissues before sealing, as in the treatment of a tooth.
Age of procedure
Fissure sealing is especially desirable in children. Their process of saturating the enamel with all the necessary substances, i.e., the mineralization of the tooth, takes a relatively long time and it is important to seal them before the onset of caries.
There are some restrictions, for example, if the fissure has not been damaged by caries for up to four years, such a tooth does not need sealing. Parents often do sealing of milk teeth in children. This is due to the fact that fissure caries in a child is a common phenomenon. It usually develops in children who are unable or unwilling to brush their teeth thoroughly. After sealing, the risk of caries is reduced to zero.
Fissure sealing is performed on permanent teeth too. It is optimal to carry out sealing after the eruption of the molar within 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 fissure sealing is a procedure for treating molars with a special composition. It completely protects the tooth from caries by 100%. The cured sealant prevents absolutely nothing from penetrating into the tooth. Fissure sealing is one of the most effective methodsprevention.
Printing steps
Sequence of actions:
- To carry out the entire procedure with the expansion and opening of fissures in case of their narrowness and great depth, their position, i.e. topography, is determined by an x-ray.
- Next comes the preparation of the teeth. With circular brushes, the surface is cleaned using an abrasive paste. If this proved to be insufficiently effective, an ultrasound or sandblasting apparatus is used. After all, the tooth is washed from the remnants of the abrasive. Then it is treated with an antiseptic and air-dried with a dental gun.
- The next step is called etching. It consists in exposing the enamel layer to a special acid - this is done in order to increase the contact area between the tooth and the sealant. The degree of adhesion also increases. Before coating the surface of the tooth with acid for etching, it is isolated from saliva. For this purpose, they simply cover the tooth with cotton wool rolls. Orthophosphoric acid is applied for 15 seconds, then it must be washed off with a stream of water and dried with air. When using phosphoric acid, hold it for a minute.
- Sealing. Fissures are sealed with a sealant by applying a composition from a syringe pen with its uniform distribution in the tooth cavity. The dentist removes the excess. The sealant must harden, for this it is exposed to a light curing lamp.
- After curing the sealant, the treated tooth surface is ground and polished. You should now check the occlusion of the teeth to identify violationsbite after silant. For this purpose, the dentist uses occlusal or special carbon paper. If there is a lot of sealant in any place, the bite will increase and this will be expressed in the fact that a thick colored dot will appear in this place. This area is immediately sanded and polished.
Fissure sealing procedure for children lasts on average 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
Tooth fissures in children are assessed by baseline mineralization level (BMI).
- High IUM - the enamel is dense, shiny, the probe does not get stuck, but slides 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 one. Here caries is present in 80% of cases. Therefore, the eruption of such a tooth must be combined with the intake of fluorine, calcium and phosphorus preparations for a month, and then carry out the sealing procedure.
- Low IUM (hypomineralized fissures) – enamel is dull, the color is whitish everywhere, the probe can even extract softened enamel, 100% caries. With such teeth, acid is not used for etching during sealing. Use only glass polymer sealants.
Do adults do sealing?
Fissure sealing in adults is performed when there is a high likelihood of caries. How is it done? Sealing fissures in adult patients, since their enamel is already fully formed, resembles the process of treating a carious tooth - opening, cleaning and processing. Fissure pigmentation is often detected in adults.
It is impossible to find out what is in such a fissure. As a result, an adult dentist is more limited in methods than a children's one. The doctor grinds the tooth and gets access to the enamel that is 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 at the bottom - because here the centrifugal currents of this fluid from neighboring bumps and folds are concentrated at one point, i.e., fissures are naturally sealed by it.
Sealing result
According to statistics, 80% of sealants are airtight two to three years after the procedure. The next five to seven years continue to be sealed 70%.
After 10 years, only 30% are functioning. But numerous reviews speak ofThe fact that sealants can last more than 10 years, subject to high-quality daily brushing.
Pros and cons
Sealing provides complete, 100% protection against caries, prevents the recurrence of the carious process. In addition, the sealant itself further improves the fixation of existing seals. The procedure has no disadvantages.
Sealant materials
At its core, fissure sealants are low-viscosity composite resins that can be cured under the influence of a UV lamp or naturally. They are based on polyurethane. They differ in wear resistance and transparency. Often, their composition is additionally enriched with fluorine ions, which in itself inhibits the development of caries.
Sealing a tooth fissure with a sealant - what is it? This is the use of sealants. Sealant in translation means "sealant", which acts as a physical barrier for cariogenic bacteria and organic acids.
Transparent sealants can serve as indicators of the condition of fissures, but they themselves are difficult to visualize and assess their condition.
Opaque sealants contain additional titanium dioxide. Due to it, a pleasant creamy color is acquired and they do not stand out on the chewing surface. Their advantage is that they allow you to control your condition in the process of wear.
Most often, dentists use the following sealants - "Fissurit F" and "Grandio Force". Any composition of the sealant is hypoallergenic and does not damage the enamel.
Types of sealing
Fissure sealing of teeth is carried out by two methods - invasive and non-invasive. In the first case, dental tissues are ground. Fissures are usually complex - closed and narrow. More commonly used in adult patients.
Non-invasive sealing is not accompanied by grinding of the enamel, the gaps are filled only with sealant. It is used in children with milk and permanent teeth. But the fissure should be simple in structure and without a hint of caries.
Reviews
Reviews of many parents speak of the mandatory fissure sealing in children. They point to a very high efficiency and reliability of the method, which really becomes the best prevention of caries. No negative feedback has been registered to date.
The procedure is considered very fast, wonderful, painless and aesthetic. This is especially good for lazy children who are difficult to get to brush their teeth thoroughly. The only problem is finding a competent and attentive dentist so that the fissure sealing is done correctly. The average price for sealing one tooth varies from 600 to 900 rubles.
