Pit and fissure sealants are materials that are applied over the grinding surfaces of molars and premolars to seal the fissure and prevent dental caries. It is a safe, efficient and effective method of prevention of pits and fissure caries.
Pits and Fissures
- A pit is defined as a pinpoint depression located at the junction of grooves present over the grinding surfaces of the teeth.
- A fissure is defined as a deep cleft between adjoining cusps of a molar or premolar.
The fissures and pits are normal anatomical findings in a dentition and caused by faults in dental enamel. Shallow fissures may not be problematic and be self cleansing and resistant to dental caries (tooth decay). However, deep and narrow fissures tend to lead to tooth decay. Both pit and fissures act as areas of initiation of caries due to food retention.
Since the pit and fissures are more susceptible to develop dental caries, early intervention of caries can be carried out by blocking the pits and fissures. A pit and fissure sealant is a fluid resin material that sets after application. The sealant prevents accumulation of foods and other cariogens over the tooth, thus preventing the tooth from dental caries. Generally pit and fissures sealants are used in children with moderate risk of dental caries.
Age range for application of pit and fissures sealants is as follows :
- 3-4 years of age for the primary molar
- 6-7 years of age for first permanent molar
- 11-13 years of age for second permanent molars and the premolars.
The ideal tooth requirements for application of sealants are as follows :
- Newly erupted primary and permanent molars with completely erupted crown and open or sticky grooves or fissures.
- Stained pits and fissures.
- The affected tooth should have erupted less than 4 years ago.
Contraindications for pit and fissure applications includes :
- Individual with no previous records of dental caries and well coalesced pit and fissures.
- Presence of dental caries over the tooth surfaces evident clinically (upon examination) or radiographically (on x-ray).
- Wide and self cleansing pits and fissures.
- Partially erupted teeth.
- Pit and fissures that have remained caries free for more than four years.
Application of pit and fissure sealants is generally carried out in a single appointment at a dental clinic. The affected tooth is cleaned using slurry of pumice and water to remove dental plaque and debris present over the tooth surface. The tooth is then washed with water and air dried. The surface to be sealed is then etched with a solution of phosphoric acid liquid. The etching process creates micro porosities in the enamel leading to better adaption of sealant material to the tooth surface.
After etching is complete the tooth is dried and isolated form saliva. The most appropriate type of sealant is chosen depending on the patient’s age, tooth condition and ideal requisites. The material is applied in the fissure and allowed to set or cured using the light activation methods. The patient is recalled to check the adherence of sealant and other preventive dental care in further appointments.