Meaning of Fissure Sealing

Fissure sealing or tooth sealing is usually carried out on the back teeth (molars). The aim of this measure is to prevent tooth decay. It usually takes place in childhood or adolescence. The risk of fissure caries is particularly high in the first two years after the posterior teeth have erupted.

  • When sealing a fissure, the doctor puts a thin filling material into the furrows of the chewing surface to noticeably reduce the tooth’s susceptibility to caries.
  • The tooth seal usually consists of a plastic based on dimethacrylate, sometimes also of glass ionomer cement.
  • Doctors usually seal the chewing surface on children between the ages of 6 and 17.
  • The statutory health insurance only pays the treatment costs for under 18-year-olds and only for the two rear molars.

What is a fissure sealant?

The chewing surfaces of the molars have fine grooves and furrows that dentists refer to as fissures. Usually each posterior tooth has a longitudinal fissure and several transverse fissures. Such grooves in the teeth make it easier to chew food, but they are problematic in terms of oral hygiene. Caries bacteria can accumulate relatively easily in the fissures. The bacteria are difficult or impossible to remove even with the best possible toothbrushing technique.

In the case of fissure sealing, the attending physician fills the furrows of a molar tooth with a filling material in order to considerably reduce the susceptibility of the chewing surfaces to caries. This simple and painless method is extremely effective. A tooth seal lasts about ten years on average.

The course of treatment for a fissure sealing

There are two different methods for sealing fissures: the preventive and the extended or invasive method. Which of the two is used depends on whether the molar has visible discoloration or caries or not.

With preventive fissure sealing, the tooth is first drained and cleaned. Then the doctor roughen up the chewing surface with phosphoric acid so that the sealing material adheres optimally. He then irradiates the seal with a special UV light, which forms a stable coating. The doctor now checks whether there are any disturbing bumps and grinds them off if necessary. Finally, he applies a fluoride gel to the tooth to strengthen the tooth enamel.

In the case of invasive fissure sealing, the dentist first removes discolored areas of the tooth furrows. In this way, he ensures that there is no tooth decay under the areas. The further treatment steps correspond to those of preventive tooth sealing.

Which materials are used to seal fissures?

Nowadays, dentists typically use plastics for tooth sealants, which are mostly made of dimethacrylate. Sometimes dentists also use glass ionomer cement. Seals with this special cement have a shorter shelf life, but they provide the tooth with better fluoride than plastics. In addition, flaking occurs less often.

Fissure sealing in children

Fissure caries occurs especially after the teeth have erupted. It is therefore advisable to seal the molars at an early stage. As a rule, doctors seal the teeth of children between the ages of 6 and 17. The prerequisite for this is that the permanent molar has already erupted. This must already be visible so far that the gums no longer cover the chewing surface.

Who bears the cost of fissure sealing?

Whether the statutory health insurance pays the cost of a tooth seal depends, among other things, on the patient’s age. For children and adolescents under the age of 18, health insurance pays for treatment costs. However, the benefits of the statutory health insurance only include the sealing of the large permanent molars (posterior teeth 6 and 7). If the sealing is to be carried out on a deciduous, anterior or canine tooth, you bear the costs yourself.

The private dental insurance pay depending on your plan and adults a fissure. In the case of children, they also cover the costs of sealing the premolars (front molars).

Pros and cons: arguments for and against fissure sealing

From a medical point of view, tooth sealing is an effective preventive measure that, with good oral hygiene, lowers the risk of tooth decay by 70 to 80 percent. This type of treatment is therefore basically suitable for people with an increased risk of caries. Fissure sealing is also useful for people with a physical or mental disability who cannot perform adequate oral hygiene themselves.

However, there are also arguments against tooth sealing. Some scientists are of the opinion that the plastics used for sealing release monomers and formaldehyde. However, since the quantities are only very small, there is no health risk according to the German Society for Dentistry, Oral and Maxillofacial Medicine (DGZMK). In addition, bacteria may become trapped under certain circumstances. In the worst case, tooth decay forms under the seal, which remains undetected for a long time.