Are pit and fissure sealants necessary for all children?

What are pit and fissure sealants? 

Caries is currently the most prevalent disease in humans. Over the last decades, many preventive measures have been developed to combat it, including pit and fissure sealants.

Pits and fissures represent areas where plaque retention is favoured and where the action of fluoride (mainly found in daily toothpastes and gels applied in clinics) is less effective, possibly because of the difficulty for saliva to 'bathe' the bottom of them. This makes these areas of our teeth more susceptible to decay.

Sealants represent a physical barrier which isolates and separates these surfaces from the oral environment, preventing the accumulation of bacteria and organic debris, while blocking the supply of nutrients to existing organisms, thereby reducing the possibility of caries formation in the areas of the tooth that tend to retain the most food.

When are pit and fissure sealants applied? 

Before a sealant is placed, it is essential to determine whether it is necessary or not, depending on each patient's caries risk and the anatomy of their teeth:

1. Children who are at moderate or high risk of developing caries and who have teeth with deep pits and fissures should benefit from preventive sealing.

2. The main teeth to be considered for preventive sealing, due to their occlusal anatomy, are the permanent molars.

3. In high-risk situations, primary molars, premolars and upper permanent incisors may be susceptible to sealing.

Thus, sealants should be placed in:

  • Permanent first molars: 6-10 years.
  • Second permanent molars: 11-15 years.
  • Premolars in moderate and high caries risk dentition.
  • Temporary molars in high-risk primary dentition.

How are pit and fissure sealants applied? 

The placement of the sealants is really easy and comfortable for the patient, without the need to anaesthetise the area. The following steps are followed:

1. Cleaning of the tooth surface using a brush or rubber cup.


2. Cotton rolls are placed to isolate the tooth from saliva.

A gel is applied to prepare the surface of the tooth.

Permanent molar etching with orthophosphoric acid 37%
Permanent molar etching with orthophosphoric acid 37%

4. Place the sealant and check that it does not interfere with the occlusion.

It is important to follow up, by going to the check-ups scheduled by the specialist in paediatric dentistry or the Paediatric Hygienist, to ensure good treatment status.

Do all children need sealants? 

No; an experienced paediatric dentist will determine whether or not your children need them.based on their caries risk and other criteria:

- Molar teeth with wide, easy-to-clean fissures generally do not require a sealant.

- Those molars with cavitated caries should also not be sealed.

- Molars with initial caries (decalcification spots, which appear as white spots) should be evaluated by your paediatric dentist to determine whether or not they should be sealed.

What are the main products used as pit and fissure sealants? 

The main products used by dental professionals are:

1. ClinProSealantis pink in colour, but turns an opaque off-white colour when exposed to light curing action. The pink colour helps the dental professional with the accuracy and quantity of material applied during the sealing process.

2. Control SealThe transparent, transparent colour gives the possibility of visual diagnosis, diagnosis on the basis of laser-induced fluorescence and control over the development of possible caries under the sealant.

3. Delton FS+which combines fluoride release by two different means: sodium fluoride, which has an initial release effect; and a filler that provides long-term fluoride release.

4. Helioseala product that allows easy control during application to seal pits, fissures and tiny cavities.

5. Ultraseal® XT Hydroa hydrophilic, fluorescent sealant with a filling power of 58%, is radio-opaque and fluorine releasing.