Develop good habits of caring for teeth from an early age and live a happy life (IV) Pit and fissure sealing to prevent caries and protect teeth

Children's dental caries are more likely to occur in molars. This is because the chewing surface of molars, that is, the surface used for chewing food, is uneven, with many criss-crossing depressions and grooves, which are called pits and fissures. If the teeth are not well developed, these pits and fissures are deep and narrow. Once food and bacteria are embedded in them, it is difficult to clean them out by brushing teeth and rinsing the mouth. These pits and fissures become a breeding base for bacteria, and dental caries are prone to occur. When dental caries occur in pits and fissures, they often progress rapidly, and large dental cavities are hidden under the small black spots (Figure 1, Figure 2).

Figure 1

Figure 2

In order to keep bacteria out of the pits and fissures, doctors will apply a layer of resin material to these grooves, which can not only isolate the erosion of bacteria and their metabolites, but also facilitate cleaning, just like putting a layer of protective clothing on the teeth. This is pit and fissure sealing. The best time to seal the pits and fissures is when the teeth are fully erupted and caries have not yet occurred. Note that when the teeth are fully erupted and the erupting teeth are covered by the gums, pit and fissure sealing cannot be performed temporarily. According to the order of eruption of permanent teeth, the best time to seal the first permanent molars is between 6 and 8 years old, the second permanent molars are between 11 and 13 years old, and the permanent premolars are between 9 and 13 years old (Figure 3).

Figure 3

Pit and fissure sealing is a painless and non-invasive operation that will not damage teeth. Pit and fissure sealing is divided into six steps (as shown below): ① First, use a small brush to clean the tooth surface. This step does not require grinding and will not cause pain. Just like brushing your teeth in the morning and evening, the doctor will use a small brush to clean the dirt on the surface of the teeth. ② The second step is to put cotton rolls on both sides of the teeth, or put on a small raincoat (rubber dam) for the teeth to isolate saliva, and then use a small brush to apply the etchant to the pits and fissures on the teeth; ③ The third step is to rinse off the etchant on the teeth, and then blow dry the surface of the teeth. At this time, the teeth are white like this, which is normal. ④ The fourth step is to apply pit and fissure sealant on the pits and fissures with a small brush. ⑤ The fifth step is to use a light curing lamp (blue) to irradiate the tooth surface to harden the sealant on the pits and fissures. ⑥ The next and last step is to check whether the sealant is completely cured with a probe, and whether there are bubbles and missed pits and fissures (Figure 4).

Figure 4

Some parents may ask, "If my child does not have caries, does he still need to do pit and fissure sealants?" The answer is yes. First of all, pit and fissure sealants are performed on healthy teeth that do not have caries but are prone to caries. However, pit and fissure sealants are not a one-time solution. After pit and fissure sealants are performed, you should not be careless, as there is still a possibility of caries. Pit and fissure sealants are only effective in preventing pit and fissure caries. Even if we have done pit and fissure sealants, if we do not pay attention to oral hygiene and food residues remain on the teeth, the bacteria on the tooth surface will break down the sugar in the food to produce acid, which will damage the teeth and still form caries on the smooth surface of the teeth. Moreover, as we use our teeth, there is a certain probability that the sealant will fall off. If the sealant is worn or falls off, the risk of pit and fissure caries will increase.

Therefore, children should go to the dental hospital for regular checkups, and have the appropriate teeth sealed in time to protect the teeth. After the sealant, doctors recommend that regular checkups should be conducted 3 months, 6 months, 1 year, and every year thereafter to check the protective coating of the teeth.

author:

Lu Youguang, Stomatological Hospital of Fujian Medical University

Si Yan, Peking University School of Stomatology

Contributed by the Oral Preventive Medicine Committee of the Chinese Stomatological Association

The pictures in this article are from "Things that Affect Children's Lives - Children's Oral Health Care" published by People's Medical Publishing House