Should I Get a Dental Sealant to Prevent Cavities (and Save Money)?

Happy Teeth

Image source: yomi955 via flickr

I’m an adult now, but for the first time in my life, my dentist found cavities. I didn’t understand it, as I religiously follow all of the American Dental Association’s guidelines for oral hygiene (brush twice, floss, eat balanced meals, visit dentist regularly).

Why did I get the cavities? My dentist told me “sometimes food particles get stuck” and hinted these things just happen. After he filled my teeth, he suggested I consider a dental or tooth sealant as a preventative measure.

As I understand, dental sealants are plastic resins that fill in the pits and fissures of teeth to create a smooth cleaning surface. This allows toothbrush bristles to remove food particles, especially in hard to reach places in the back teeth, like the molars.

My dentist left me the job of deciding. What thoughts are running through my mind?

The Appeal

Dental sealants appear to work, anecdotally at least. My friend tells me how he didn’t have cavities years after he got a dental sealant. In fact, his next cavity happened when the sealant wore off (about 10 years).

Sealants are also highly recommended by the American Dental Association, even for some adults. They write in their FAQ about sealants, “Ask your dentist about whether sealants can put extra power behind your prevention program” [my emphasis].

It was not pleasant getting my cavities filled. Staring at a bright light, getting my saliva sucked out of me, and getting drilled was among the most painful experiences in recent memory. I would certainly pay something to avoid a repeat. So that brings me to the next question of value.

Are dental sealants cost effective?

The Numbers

Preventative measures, like dental sealants, are worthwhile if the benefits can justify the costs. A careful analysis is necessary to avoid excessive effort. For instance, exercising for longevity, a common pursuit, might be a misleading goal–the longevity benefits roughly equal the exercise time cost, as I wrote about before.

To analyze sealants, I’ll consider the cost of the procedure versus the savings in getting fillings for cavities, relative to insurance.

No dental insurance

This is the case where you’d have to pay for everything. Sealants appear to be a good deal.

From my research, I found that dental sealants cost about $25 to $50 per tooth (source 1, source 2). This is compared to getting non-mercury cavity fillings that can cost $150 to $200 (source).

Since sealing a tooth costs less than filling a cavity, the procedure would seem to make sense.

With dental insurance

Many times sealants and fillings are covered by insurance. In this case, cost isn’t really an out of pocket expense. This distorts incentives and might make dentists trigger happy to suggest or not suggest sealants, depending on how they make money (I have no clue about this).

Take note of the dentists’ position. I’m sure many dentists do give honest advice, but as an economist, I know that incentives matter.

The risks

It would be short-sighted to stop the analysis here. I need to consider the risks and the full impact of getting a dental sealant. This is the area where I let myself be a full skeptic. I’m motivated by three main questions.

  • Does the procedure hurt?

The procedure should not hurt much, according to the American Academy of Pediatric Dentistry page on sealants. They describe it as a single visit where the dentist cleans the tooth, and then conditions and dries it under a special light. One can eat right after the appointment.

  • What are the long-term health impacts?

The long-term health impacts bother me, despite what the authorities says. I’ve skimmed about 50 articles from dentists and government websites that all say there is no evidence dental sealants are unsafe. But absence of evidence is not evidence of absence.

But I haven’t found any compelling arguments on why dental sealants are unsafe either. Some sealants contain bisphenol-A, a plastic that appears to be damaging. Studies at the University of Granada in Spain and the Boston University are not necessarily conclusive, and some still question the use of sealants. The American Dental Association says dental sealants are appropriate.

  • Do I want plastic on my teeth?

This seems like a very unnatural state, at a minimum. Sealants require some kind of binding agent, and they ultimately wear off. Do I want to be slowly ingesting whatever plastic is there?

I am worried about these questions and I don’t have answers. But there is one option I’m considering.

What’s missing: lifestyle changes

Let’s recap my visit with the dentist. He found I had two cavities. I told him I followed good oral hygiene. He filled my cavities, suggested cavities happen, and then suggested a sealant.

Isn’t there anything else I can do?

I didn’t have time to ask this question, but I doubt I would have gotten a positive answer. The way my dentist answered, he said cavities just happen as food gets stuck. In fact, that’s the consensus of the American Dental Association.

Why was I given the advice to get plastic put over my teeth before I was suggested lifestyle changes to address the cause of cavities?

Perhaps my dentist has seen too many patients and knows that people don’t change. They don’t floss or brush or avoid sugary foods, no matter what he tells them.

I, like many people I know, am more disciplined and care about these things. I will change. What should I and other disciplined people do?

Three possible changes

I already follow the mainstream American advice on oral hygiene, so perhaps it’s time to do something different.

Three things I might try:

  • clean teeth after every meal
  • avoid potato chips
  • avoid brushing until an hour after meals

The first step is obvious. I brushed twice a day, but I was not cleaning after lunch. If food particles getting stuck are the problem, I can easily eliminate that.

The second change is a surprise to me. I had heard that sugary foods caused cavities, but I never ate them so it didn’t matter. No one told me about other starchy foods like potato chips, one of my few indulgences. According to the Mayo Clinic, this is a big deal:

For instance, although candy bars, jelly beans and caramels are sticky and sugary, they’re easily washed away by saliva, making them less of a threat than are potato chips, which stubbornly stick to your teeth.

Potato chips are probably not good for my health anyway, so I’m going to start eating some alternative snacks.

The final change is a shocker. I had always heard it was best to brush right after meals to avoid food buildup. But it looks like I was brushing too soon, according to the British Dental Health Foundation

Eating and drinking naturally weakens the enamel on your teeth, and brushing straight afterwards can cause tiny particles of enamel to be brushed away. It is best not to brush your teeth until at least one hour after eating.

This one sounds very strange to me, so if you know better, please share in the comments.

My conclusion: proceed with caution

Regardless of cost, I would like to avoid putting plastic on my teeth. I don’t know about the health impacts, and it’s not a reversible procedure.

I’m going to try these lifestyle changes and see how things look at my next dentist appointment.

What’s your take? Have you gotten a dental sealant? Did it work? Is it safe? Did your insurance cover it?

Update May 2010

I thank you all for your comments and emails on this topic. I am grateful for the support and knowledge.

Two years since writing this article, I decided that dental sealants were a good choice for me. I’ve written about an article about this including information on why I got adult dental sealants to prevent cavities and save money.



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  • Bret

    The sudden appearance of cavities makes me wonder about a medication change. A friend who started a new antidepressant that gave him a dry mouth suddenly got 5 cavities after a flawless record for many years. Saliva is essential for protecting and repairing teeth.

  • http://www.mawsoft.com/blog RohoMech

    Hmm, what about going with Wooden Teeth, it worked for George Washington, and we all know how awesome he was:

    http://youtube.com/watch?v=sbRom1Rz8OA

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Brett: Thanks for bringing up this point. Medication isn’t an issue with me, but for some it could be. It’s interesting how hard it is to balance risks.

  • Chris

    @Brett — definitely true. Methamphetamine causes severe tooth decay for exactly the same reason if memory serves me correctly.

    @ Presh — I remember as a kid, it was rather routine to get sealants on your adult molars once they grew in — both from the insurance standpoint and dentist standpoint as you have observed…but seeing as I haven’t been to the dentist since high school…i dunno anything about getting sealants redone as an adult.

    Because in your analysis, the monetary costs to you as an individual are nearly equal due to insurnace, i think the most critical issue for you to weigh is the following:

    1.) Is there a proven reduction in dental carries with the use of sealant?

    2.) How do i weigh this reduction against possible long term consequences of sealant chemicals?

    I suspect that in kids, #1 is easily proven and probably has been proven or else pediatric dentists wouldn’t be so gung ho about it (and insurance so willing to pay). My suspicion is that it also holds true in adults as well. It’s a lot easier to clean a driveway that has been crackfilled and sealcoated than one that hasn’t. No clue if there is actual objective analysis to prove it — adults don’t like going to dentists. Kids get dragged by their parents.

    As for #2, that’s gonna have to be up to you as an individual. If it were me, and insurance paid for it, I would without hesitation get my teeth resealed.

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Chris: You introduce the interesting question of why insurance would want to pay for things. On the surface, it would seem that insurance companies would want to reduce costs, but in some cases, this is not true.

    In one case, my friend’s insurer was not willing to pay for malaria medicine when he was visiting a foreign country, but had he contracted malaria, the insurance would have paid for all the treatment.

    As for your two questions, I suspect there is evidence that sealants reduce dental caries. That is probably why so many dentists and the ADA recommend it.

    The long-term health issues bother me. Moreover, I wonder why I need to go to an extreme solution. Aren’t there less intrusive ways to approach the problem than to stick plastic on my teeth?

    That’s what irritates me the most. My dentist recommended what I considered an extreme solution before considering any lifestyle changes.

    Since sealants aren’t reversible, I’d like to research every possible low-tech option available to me.

    It’s the same reason I’d change my diet before considering taking a supplement.

  • Kyle Johnson

    I noticed you did not address Rohit’s suggestion. How curious.

    I hate getting cavities filled (or searched, but thats another tale for another time) and I am human so I forget things, that I even do out of habit, at least in the morning. I got a lot of cavities as a child, but after I lost those teeth, I had no cavities for quite a long time, with a very very lax teeth-brushing schedule, but now that I work crazy hours, I’ve had 4 fillings put in.

    Maybe this sealant thing is a good long term back up plan.

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Kyle Johnson: Not much to add to Rohit’s suggestion–it’s an interesting point :)

    Sealants might work like an insurance policy, but I prefer to do everything in my control before doing it. If you end up going for it, I’d be curious to know if insurance covers it for adults.

  • http://www.zakstar.wordpress.com zak

    My mom had the dentist put sealant on my teeth when I was a kid. I was pretty much a decade before I had a cavity. . . I’ve actually never had a dentist offer to put sealant on my teeth again as an adult, though they always remark that there are still traces of sealant from years ago, which must be why I have so few cavities. I need to look into a reseal when I have health insurance again.

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Zak: Thanks for sharing your story about dental sealant–it is more evidence to me that they really do work.

    Now if I can just overcome my paranoia about their safety…

  • tom french

    Surely other things you could consider:

    a. sealant prevents cavities thus having positive effects on a) your smile b) breath?

    b. does it (sealants) have any effect on your ability to eat/masticate?

    c. are sealants always fitted well, no follow-up etc.?

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Tom French: Good points. I had to look up what masticate means, so I learned another word today :)

    Deep down I suspect sealants are a shotgun approach to the real issue of dental hygiene, but perhaps I’m just feeling this ways because I’m skeptical of using a mechanical approach to a biological problem.

  • Jen

    I had sealants put on my teeth when I was about 12 or 13 years old. Having them put on was a fairly easy procedure, and once they are on, you can’t feel the sealants at all. I have never had a cavity, even with a lax brushing schedule, and an almost non-existent flossing schedule. Never had a cavity, until now, that is.

    I’m now 25, and my last visit to the dentist was pretty grim. My sealants have either worn off or chipped away, and I now have two cavities that need to be filled. I generally dislike people poking around in my mouth, and I’m dreading the whole process. However, in addition to filling my two cavities, I’m having my dentist buff any stains and remaining sealant off my teeth right away and re-seal my back eight molars.

    As far as I’m concerned, the sealants helped protect my teeth for 12 to 13 years, and I’m happy to have them put on again to protect my teeth for another decade or so. Unfortunately, my insurance doesn’t cover sealants for anyone over the age of 15, so I’ll be paying out of pocket for it, but not having any more cavities is definitely worth it to me.

    Then I can go back to eating chocolate, drinking sweet tea, and not bothering to brush before bed.

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Jen: Thanks for sharing your story. It appears sealants really are powerful and not too invasive.

    I like how you assess risks of dental annoyance versus lifestyle changes. I too find filling cavities to be very invasive and a hassle.

    Now you certainly are informed and have the right to choose sealants to continue to live a lax cleaning schedule.

    What bothers me is that dentists assume everyone prefers that path. For me, I would much rather stop eating sweets and brush better than have a sealant put on me.

    Why is it considered extreme to change lifestyle habits and it’s considered conventional to cut people open and fill cavities?

    I’m going to try to change my habits, but if that still doesn’t work, I’ll be grateful to know your story that sealants do work.

  • Heidi

    I’m a mom of a 8 year old- who at this point has already had 12 cavities! Same life style as his 10 year old sister of only 1 cavity.
    Genetics are not mentioned nearly enough in the writings of dental decay.

    And the sealants are only for the inside, chewing surface of the molars. They aren’t designed to fasten to the slick parts of a tooth. Thus leaving you to floss as usual.
    But, if you only ran the numbers, without insurance…
    12 cavities = $1800
    12 sealed = $600
    leaving me possibly $1200 to spend on the fillings for the outside of the teeth.

    But, I’m with you on this. I’m not convinced of the long tern effect of plastic coatings. He doesn’t seem to mind the poking around in his mouth. He does like the time out from school for the appointments. And after a few more cavities, his teeth will be covered by fillings anyway.

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Heidi:
    Thanks for sharing the story. I too have many siblings with the same habits end up with different dental health. You’re right, genetics probably does play a larger role.

    Yes, I also wonder how safe fillings are versus sealants. But everyone’s got them, so they can’t be too bad, right? That’s what I’m banking on ;)

    In the meantime, I have switched over to more “whole” foods and felt an improvement. I hope my dentist confirms my own suspicion.

  • Erik

    Hi Presh, I’m finally catching up to your blog posts from the summer.

    I share Heidi’s suspicions about genetics with cavities, as I have had none myself. My mom always credited my grandfather for my good fortune, although I don’t know how much sugar was in an American farmboy’s diet in the early 20th century.

    I do have some weak gums though, which I can blame on slightly lax toothbrushing habits. Good luck reducing the starches in your diet, and I can certainly understand the dentist suggesting the easy route.

    My guess is if your diet were more fish-based/macrobiotic/Japanese/whatever, you would have fewer problems and very white teeth. I base this mostly on reading “The Beach,” though. The Japanese don’t support this either, since they have horribly plaqued teeth. I suspect that comes from the American sweets and fast food, which are analogous to zebra mussels in Lake Michigan. :)

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Erik:
    Welcome back and thanks for the comment.

    My diet change has been slow since I have only found one group that claims a dietary cure to cavities (Weston Price). I have been hesitant because they recommend a high-fat and high cholesterol diet and recommend drinking raw milk, which is not legal in my state.

    But I find some of the things made a lot of sense. They say it is our store food that has gotten us store teeth. I have looked more for “whole foods” and felt much less like my teeth were getting destroyed, though I’ll let the dentist judge that one…

  • Pingback: Websites tagged "cavities" on Postsaver

  • Jane

    Hi,

    I run a dental sealant program in schools. I feel that any tooth is prone to decay whether you have great hygiene or not. There are tiny microscopic pits and fissures in teeth that toothbrush bristles will not reach. Bacteria on the other hand make their way in them and thrive causing decay. Sealants are great tools in preventing decay on the chewing surface of a tooth. We use minimal amounts of the sealant material. Over time fillings need to be replaced and more tooth structure is lost replacing them. If we can avoid this lifetime domino affect I am all for it. Think of how much plasic is in a denture :-)

    If we put sealants on children’s teeth as soon as they appear in mouth just think how much time money and discomfort is eliminated over a lifetime. An ounce of prevention is worth a pound of cure.

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Jane:
    Thanks for the information. It is useful to get first-hand stories about dental health. My only concern being a skeptic is whether some of these problems could be avoided with lifestyle changes. Not a single dentist I talk to brings up the topic of not eating sugar or other sticky starches. I myself may never give up those foods, but it would be useful to know as a reference.

    But yeah, given that cavities happen any way, the choice is between a sealant versus an expected filling, so it sounds like a sealant may make sense.

  • Jen

    Sealant is resin and so are composite fillings – the same material so if you have to get a filling you are still putting the “plastic” in your mouth. Have been in the dental field for 15 years. They’re such a good investment – resealed mine whenever they needed to be redone – 31 years old and only 1 cavity. It’s as safe as anything else we have in our environment, put in our mouths, etc. Don’t worry about it and I do recommend them as a person with them, not because I’m in the industry! Good luck – filling hurt, sealants are a breeze, quick, easy, and no discomfort!

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Jen:
    Thanks for the advice–I was motivated by the fact that fillings hurt, so good to know sealants do not.

  • Sidra Ahmed

    If you just have slight surface decay, then you can try what I did. I got a full dental cleaning to remove plaque, followed by a fluoride treatment. I continued my normal brushing/flossing/fluoride mouthwash regimen but i changed my diet to more alkaline foods and less starch. For drinks I only had water. The pH level of the mouth is important for allowing calcium to mineralize the teeth. I went to a different dentist at Nova Southeastern University a few weeks ago and they said I had no cavities. Of course, if you have a visible spot, go right away, because getting a filling is better than getting a root canal later. But if you have very mild decay with no pain (this means the decay has not reached the dentin yet)….try to remineralize rather than drill right away.

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Thanks for the suggestion. I unfortunately eat a starch heavy diet so this might be a bit hard for me! But this gives me some ideas for improvement–very interesting stuff.

  • http://www.smarthealthbuyer.com ronald welsh

    Dear Presh, thanks for sharing this story. In order to help your decision, you can use http://www.smarthealthbuyer.com to look up prices for dental sealants in your area, as well as the cost of fillings, crowns or root canals. Once the enamel is compromised, its just a question of time before dental caries will set in. The first filling will greatly reduce the strength of the natural tooth, and further decay is almost bound to happen. Anything you can do to prevent the initial breakdown of the enamel will pay you back in dental gold crowns….

  • Tim

    I actually am a dentist, in the midst of my residency in a very poor area in the Bronx. Sealants are an amazing preventative care.

    I’ve read through the comments and, I know I’m late to the party, I wanted to add a few things.

    First, one of the foundations of prevention is diet and hygiene counseling. Every dentist ought to discuss both your home hygiene habits and what you eat, frequency, etc. If you’re uncomfortable with what your dentist has said to you, bring up the conversation yourself.

    Second, you call sealants irreversible, however that’s true at all. Irreversible dental procedures are those that alter tooth structure or periodontal structures (gums and bone). With sealants, the conditioner is an acid, which is allows the bond strength to be stronger. However, once a sealant is applied, it can be removed without changing your tooth at all. If you were to lose a sealant after it’s placed, your tooth would be 100% unchanged from it’s pre-sealed state.

    Third, the materials involved in sealing teeth are biocompatible. If you were to lose an entire sealant (or composite filling, for that matter) at once, you’d pass it right through your system with no ill effects. Over the course of time, the material itself will wear in minute fractional quantities. While I understand your concern, I’ve met many patients with similar questions, the short or long term health risks regarding the materials used in sealants are negligible, particularly in light for the potential tooth decay that sealants protect against.

    Fourth, and finally, the efficacy of dental sealants in preventative care is well established. There are numerous studies that have been performed over the last 40 or so years that are readily available (at least their abstracts are) on either pubmed or google scholar.

    Sealants should be expected (reasonably) to last 7-10 years in tact. There was a recent journal article in the last Journal of the ADA that pointed out that while sealants are traditionally applied to pediatric patients, there is a clear benefit to be gained by offering them to adults.

    Adjusting your diet is commendable, but short of entirely eliminating carbohydrates, you will have some amount of caries risk. Exceptional hygiene and an ideal diet will certain get you ahead of the vast majority of the population, you will not bring your risk to 0. Sealants have been shown that, when properly applied, they bring the risk of pit and fissure caries to virtually 0. And, as I said, the health risks are practically non-existent.

    But, as I say to my patients, you are the boss. We can only offer our expert opinion, you have to make the decision.

  • Geoff

    Strangely I had my teeth sealed (Fisher sealing) as a child, and thought that was the main reason for my healthy teeth. It seems obvious now to think it would wear away after several years.

    Being in the same situation last week I was offered different advice.

    I drink too much fruit juices, I have decided to cut down, but it was suggested I drink them through a straw, I am not too sure about this.

    Chewing sugar-free gum. They mention it in the adverts but chewing gum generates saliva and a more alkali mouth, the nasty bacteria prefer a more acidic environment.

    Mouth wash. Remineralises the teeth with Sodium Fluoride.

    I had been taking rear guard action to make sure my gums were healthy, and I had forgotten about the cavities, it had never been an issue for me before.

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Tim, thank you for sharing your expertise about sealants–this really clears things up for me. This is one of the best comments I’ve read.

    (I’d love to hear more of your thoughts on dental hygiene like what toothpaste to use or how one should weigh elective surgery. Please let me know if you are interested in writing a guest post. My email is presh (at) mindyourdecisions (dot) com. Thanks.)

  • Daniel

    Last year applied sealants myself. After brushing them on, I used dental floss to clear excess sealant between my teeth to prevent gluing the teeth together. The curing lamps can be gotten on ebay for around $100. I skipped the acid step. Any statistics on how long the sealant holds without doing the “acid etching”. As I’ve read, there a 2 kinds of sealants: (1) the cheap ones that bond with micro-mechanical bond (little holes created by the etching acid) & cure with UV light, (2) sealants that create a chemical bond with the tooth. I used #1, but in my opinion #2 appears to be better (at least you can verify on google that it’s more expensive). Any comments? ADA please don’t sue me, thank you.

  • Evab

    Hi, just wanted to put in my two cents. I had my teeth sealed at around age 10 and again at age 20. I just had my check-up a month back and no cavities. I also have a pretty lax cleaning schedule. Usually brush and floss in the morning…night time is often neglected.To date I have had no cavities. My parents opted for the procedure because they both have backgrounds of poor oral health.

    You do not notice them nor do they seem to impact my chewing.

    As far as hanging your health habits I think that is a move in the right direction; but this is just another preventive measure(like waxing your car) Not an extreme one.

    Good luck

  • Katie

    Hi, I agree with Evab. I too also had my teeth sealed when I was around 9-10 years old. I floss maybe 2x a week, brush 2x a day and use always use Listerine after brushing. I tend to eat pretty healthy too. To date – I am 23 years old now – I haven’t had any cavities but my dentist did notice some decay starting in one of my teeth at my bi-yearly check up and filled a little part of my tooth. She also re-sealed all of my back molars. She said that doing so would prevent staining and food getting stuck in the deep grooves of my molars. I didn’t object to it at all, because I would much rather have sealants than cavities!!!

  • Debra

    I have a question, my son is 18 and his childhood sealants have for the most part been worn away. We have recently changed to another dentist who just did the check up and is asking us to consider a reseal. They said one was still good enough to save but that my son needed 13 more? I know he did not have that many teeth done as a child and I am a bit lost? How many teeth do most folks have sealed? By the way, the insurance will cover none of the cost but as other posters have pointed out, they will cover a large portion of filling the cavaties? Go figure….

  • ralanein

    Any word/evidence about the use of waterpiks for prevention of the growth of bacteria in the tooth crypts?

  • Mark Rehorst

    One practical indication that sealants work is the fact that insurance companies are willing to pay for them. They have crunched the numbers and know that a sealant placed now prevents an expensive restoration later. never bet against insurance companies- you will lose every time!

    Whether or not a person gets cavities in their teeth depends not just on how they care for their teeth, but also on the anatomy of their teeth. Many molars have deep fissures that can’t be cleaned with a tooth brush. Those deep fissures harbor bacteria that cause cavities. A sealant will close off the deep fissure and prevent the bacteria from having access to food.

    Your dentist’s recommendation is a reliable way to decide about whether to have sealants placed.

    Dentists, plumbers, and auto mechanics have a saying that is applicable here: Pay me now or pay me later!

  • http://www.mindyourdecisions.com/blog/ Presh Talwalkar

    Mark Rehorst: Good analysis that insurance reimbursement means that sealants are cost effective, and hence they prevent cavities.

    Unfortunately, this alone simply means that sealants are good for insurance companies but not for us. Let’s remember that insurance companies also pay for cardiac bypass and statins instead of promoting more healthy practices like diet and exercise. We have to be skeptical even if an insurance company pays.

    But to return to point, I agree with you that sealants work. I also think they are safe, based on my research and the many helpful comments.

    It’s good to be skeptical, but one should avoid being unconventional for its own sake.

  • Anonymous (female)

    I don’t floss much (though I should) and I don’t usually brush after my meals (though I should). I am also a relentless sugar consumer (at least I exercise).

    I am now 19, my teeth are in perfect condition. I have been getting sealants on my teeth my entire life.

    I am rarely sick and have never personally had any complications with the sealants. I have NO trouble chewing with the sealants (though when they are newly applied it might feel funny for a day). The only procedure I have ever had done on my teeth have been the sealants and routine cleaning.

    You are lucky your dentist is willing to do this procedure for you. It took me A LONG TIME for me to find a dentist that would put sealants on my teeth even as young as I am.

    I strongly recommend you do the procedure if you feel comfortable.

    Good luck! :)

  • dia

    I had sealants put on my teeth when I was a teenager and it’s probably been about 12 years since then. My sealants are almost all worn away. I haven’t been to a dentist in 6 years now and am very fearful I have a cavity now. I only had one cavity in my life and was very surprised to find out it required a root canal! It made me wonder if dentists are just scam artists. I also had a long history of bad experiences with orthodontists, but I won’t go into all that. I would love to have sealants on my molars again to keep avoiding any cavities, but I didn’t think that dentists gave sealants to adults – if your research is right and it’s at $25 or $50 a tooth is right, that is so worth it! I take very good care of my teeth, but I realize you can’t always prevent the cavities. I do think the sealants have helped tremendously.

  • nina

    I want them! I had them as a kid and now that they wore off I got a bunch of cavites, which were only covered %80 of the silver fillings, but I got white, so I had to pay the diff, $$$$$.

    I have Tri-Care Prime (insurance for Marine spouses/dependents). I just looked up if my insurance covers them as a 21-year-old, and it is NOT COVERED :(

    They are only covered for dependents and spouses 18 and under.

    LOL!!! Spouses under 18???

    Why are kids the only people who need to prevent cavities? Well they just helped me pay a thousand dollars for my fillings and refills, so maybe they should think that over. Along with thinking over not covering white filings. Dentists don’t usually even do silver anymore!

  • Kay

    Comment to Debra:

    I would consider switching dentists. From all of the websites that I’ve read and stories I know, sealants are only put on the molars. Why your doctor wants to put sealants on 13 teeth is beyond me. Seems overboard.

  • http://dentalcool.blogspot.com/2009/10/urgently-seking-oral-surgeon-plan-for.html Katterine @ oral surgeon

    Thanks for presenting such a well thought out article. I would digg in the direction of sealant materials that you started. All plastic is not the same. Especially questionable is the metal content of plastic. Think heavy metals. They might be toxic and could get leached out depending on what kind of acids etc come in your mouth. So maybe do more research on composition of sealants.

    Thanks again for the great insights.

  • Pingback: Getting adult dental sealants to prevent cavities and save money - Mind Your Decisions

  • Sebastian

    Two dentist visits ago I asked if I could get sealants and the nurse told me that they dont really do sealants on older kids and adults, so I let it go. But she said that I still had the remains of three sealants. Then this past visit I found out I got my first two cavities. They were both in my very back molars in the pits of the teeth. I already got one filled and it was a terrible experience for me. I am getting the other one, which is supposedly worse, filed later this week. I strongly regret not fighting to get sealants again because as soon as I lost them I got my first two cavities. I have honestly been so upset for the last week now and can’t get it off my mind. When I went to get my filling I told them that I wanted sealants on my remaining teeth without fillings and they said I probably dont need them but I told them I want them regardless. And even though insurance won’t cover it, $47 a tooth is well worth it for me to never have a cavity again.

  • GC

    Actually, I have done a lot of research on sealants. Eight months ago, I took my 10 year old daughter to a new dentist who used a diagnodent to say she had cavities, then picked off the sealants left with a dental probe. He said he would have to fill the cavities using cavitiy detection dye, possibly down to the roots, although the xray didn’t show this. I went and had three other opinions. The two dentists with the “Diagnodents” all wanted to drill the two teeth (upper twenties and lower 40s readings on the two teeth with picked out sealants). Luckily, I found a dentist that does research that said that the “Possible” cavities were undetectable by xray or probe and evidence over ten year studies shows that even early dentinal cavities stopped progression with sealants. I think I’ll stick with sealants and avoid the scam of drilling into teeth with “questionable” cavities.

  • Ann

    I am beginning to look at sealants as an older adult.
    In my 30s, 40, I had very few cavities. After hitting 50 I averaged two cavities every 6 months.
    Old fillings were drilled out and new ones put in. Now the new ones are beginning to be drilled out as they have developed cavities on the edges of the fillings. My kids had sealants and did not begin to have cavities until they reached 24 years of age (go figure). My dentist says he does not recommend sealants. My question is, can you get sealants around the fillings to protect what is left of my teeth? At the rate I am going my dentist will be rich and I will have no teeth left.

  • MAK

    My dentist put sealants on my kids, and told them they could never chew gum ever. I’m all for prevention of cavities, but telling a child they can never chew gum or have any sticky foods ever again seems a bit extreme. There’s not much of a childhood if you can’t a some fun occasionally. He said this was to prevent the sealants from coming off. Has anyone had their dentist tell them this too? And has anyone had to replace their sealants because of eating sticky foods?

  • Johnna

    Thanks for the great article. informative & unbiased

  • Cognate2

    As to the comment about not brushing your teeth until 1hour post eating:
    -every time you eat the pH in your mouth drops (becomes more acidic) and some of the calcium and phosphate ions in your enamel are leeched out. Waiting to brush means that your saliva has the time it needs to wash food particles from the tooth surface, act as a buffer for the low pH (bring back up to neutral) and remineralize any weakened areas of enamel (saliva is saturated with calcium and phosphate ions which then get put back into the enamel). Not enough time and the weakened enamel microstructure could be brushed away and the acid just brushed around your mouth.

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