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SEALANTS
Sealants were
a very important preventive aid in dentistry. It is true that millions of sealants have
been placed into the grooves in the top of molars and bicuspids...
BUT.....
It is now being discovered that sealants when
placed directly onto the tops of teeth are actually sealing in
decay. Don't misunderstand, sealants were a terrific idea when first introduced. The
theory that they would prevent the need for fillings was something that everyone could
benefit from. But now that a number of years have passed, it is becoming clear that
sealants did not do a very good job in actually preventing decay, they may however have
slowed the rate of decay down.
I have taken out many sealants (some placed by myself)
only to discover that there was decay within the tooth. So what is the solution to this
problem? Is there something to replace sealants or made to improve them? Well sort of.....
Instead of placing sealants directly over the
grooves, now we cleanse the grooves out and remove any stains and/or decay. This can be
accomplished in different ways. The two most common approaches are; (1) with an air
abrasion unit or (2) with a dental hand piece and a small polishing tip. With either it is
important to note that a very minute amount of tooth structure is removed - so slight an
amount that numbing is not usually required. This procedure is performed under
magnification so as to allow the most conservative preparation of tooth. The areas that
are prepared are so small that a special stain is required to show if any decay has been
missed. After the tooth surface has been adequately prepared, a special composite resin is
flowed into the teeth to fill them.
Now, when I see stains in the grooves, I absolutely know
there is decay present. This decay does not usually show up on check x-rays either. It
amazes me sometimes just how much decay is present and undetected until the tooth is
prepared.
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