The sealing of the fissures, i.e., the profile of the occlusal surfaces, protects the enamel of the teeth as well as against caries. The procedure is recommended for children’s newly erupted teeth, for example, as their enamel has not yet hardened, and they are therefore particularly susceptible.
What are fissures?
The occlusal surfaces (occlusal area) of our molars have a profile that changes throughout life due to wear. This relief of high and deep edges serves to grind our food and consists of tooth cusps interrupted by the longitudinal and transverse fissures. In the resulting larger and smaller grooves and pits, caries bacteria, inaccessible to daily oral hygiene, deposit and attack the tooth. Furthermore, in addition to the visible part, there is also the distance from fissure entrance to fissure base, which can be up to one millimeter deep.
When and for whom is the procedure recommended?
Fissure sealing is a procedure that specifically serves to protect the chewing surfaces. It is used depending on individual conditions (in the case of fissured, deep fissure relief), current oral hygiene (to treat enamel caries) and the condition of the teeth (in the case of increased caries risk). Targeted, they relieve the tooth and also mineralize it. Treatment is especially recommended after the eruption of permanent teeth in adolescents. Fresh teeth are particularly susceptible to caries during the first two years, as their enamel has not yet hardened. It is recommended that the sealant be applied within six months and the eruption of as many as possible or, ideally, all new teeth. Sealing gives the teeth the time they need and provides further protection (this also applies to any other tooth so treated) in subsequent years.
Fissure sealing is divided into two variants, the preventive and the invasive variant. The invasive method involves one more step than the preventive method. Here, special instruments are used at the beginning to remove discolored areas on the occlusal surface relief and also to guarantee that no bacteria are trapped during sealing. Such an intervention is due to modern technology, but it also damages the tooth substance for more safety. Previously, the only method available was preventive sealing, which otherwise proceeds in the same way. Here, first of all, the tooth is professionally cleaned and checked for any damage that could affect the treatment. This is followed by conditioning (the targeted "roughening") of the enamel surface using an acid gel. Once this is done, the tooth is rinsed and dried, and then the sealing material is applied, and light cured. This is usually dimethacrylate-based resin, sometimes enriched with fluoride. Finally, an occlusion test must be performed. If it is found that natural occlusion is prevented, regrinding is required.