Dental Sealants and Fissurotomy

Dental Sealants and Fissurotomy


Deep pits and fissures are the source of some 80% of tooth cavities. This is mainly because food and bacterial plaque lodge in these
tight crevices and are often inaccessible to toothbrush bristles. plaque acids in enzymes at the base of
these grooves cause the tooth enamel to dissolve, eventually leading to cavities. Over the years, many attempts to stop pit and fissure tooth decay have been made. Here are the most common, their strengths
and weaknesses: “Fissurotomy” (or “prophylactic odontotomy”) involves funneling the grooves open with a cone-shaped dental bur. If done early enough in grooves that do not extend through the dentin layer, it may be possible to perform this
procedure and nothing further. More commonly, however, the deepest pits and fissures DO extend close to or INTO the dentin layer, and this procedure must be followed by placement of a filling of some type. The procedure must also be performed by
a dentist, since it involves removal of tooth
structure. The grooves can also be cleaned out less invasively with a microabrasion handpiece, which sprays a stream of abrasive particles deep into the pits and fissures to remove plaque bacteria and roughen the enamel surface. Since microabrasion doesn’t completely
eliminate the deep narrow crevices, it is usually followed by placement of a
dental sealant. If the preparation of the groove extends into the dentin layer of the tooth, a filling is placed instead. Following thorough plaque removal from the pits and fissures, the tooth is isolated from all mouth moisture and the grooves are etched with a mild acid solution. This produces a microscopically roughened surface into which the sealant will adhere. The sealant is then applied to the grooves as a viscous liquid, which hardens on its own or by exposure to a blue light. Once placed, the sealant prevents bulk plaque from being able to accumulate in the pits and fissures. But sealants do have some potential downsides. It is possible for microleakage to occur along the sealant – especially if moisture is present when the sealant is placed. If leakage does occur, it may be difficult to detect until a large cavity develops beneath the sealant. It’s important to remember that sealed teeth are NOT completely resistant to tooth decay. It’s a big mistake to relax nutrition and oral hygiene standards on the belief that
sealants alone will prevent cavities. And remember to see a dentist regularly to have the sealants evaluated for signs of failure – part of any thorough oral exam. Left alone, a poorly contoured failing sealant like the one shown is at least as prone to decay as an unsealed tooth.

Author: Kevin Mason

4 thoughts on “Dental Sealants and Fissurotomy

  1. Please watch this fantastic patient educational video explaining "Dental Sealants and Fissurotomy." I wish everyone on earth would watch their diet and this video! Howard Farran DDS, MBA

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