What
are Dental Sealants?
Dental sealants
are thin plastic coatings applied to pits and fissures on the
chewing surfaces of the teeth to prevent tooth decay by creating
a physical barrier against dental plaque. Applying dental sealants
to tooth surfaces with pits and fissures shortly after the teeth
erupt helps prevent decay.
Most dental
sealants (tooth sealants) are placed on the teeth of children.
To properly place a sealant a dentist must be able to keep the
tooth dry. So, at a minimum, this means that the chewing surface
of the tooth being sealed must be erupted (fully positioned
through the gums), and also that the patient is at an age where
they can provide some degree of cooperation. The specific age
at which this combination of events occurs will vary from child
to child.
An adult's teeth
can be sealed, although this procedure is typically utilized
as a preventive measure for children so to help protect their
teeth during those years when they are most likely to experience
tooth decay. The need for dental sealants for either a child's
or an adult's teeth should be considered on a case by case basis.
After their examination, a dentist can tell you what they feel
is indicated for your situation.
Which
teeth are dental sealants usually placed on?
Any tooth that
has anatomical characteristics (such as deep grooves) that might
place it at risk for developing tooth decay should be sealed.
By far the most common teeth for a dentist to seal are a person's
"back" teeth, and of these teeth the molars are the
most common teeth on which dental sealants are placed. It is
probably more common for a dentist to seal "permanent"
teeth rather than "baby" teeth, but every person has
their own needs. Your dentist will make their recommendation
for sealants on a case by case basis.
Should
dental sealants always be placed on teeth?
Not all teeth
require the protection that dental sealants can provide. After
an examination your dentist can report to you what they feel
is indicated for you or for your child.
It is the shape of their grooves (pits and fissures) that can
place some teeth at greater risk for cavity formation than others.
Those people whose grooves are deep and narrow will have a more
urgent need for dental sealants than those people whose grooves
are naturally shallow and rounded.
Beyond pit
and fissure anatomy, your dentist will consider other variables
that might indicate that a tooth is at risk for developing decay
and thus a candidate for a sealant. They will evaluate the amount
of dental plaque they find present, the amount of decay the
patient has experienced in the past, and the patient's current
exposure to an appropriate amount of fluoride.
How
long do dental sealants last?
The longevity
of dental sealants can vary. Any sealants that remain in place
and intact for three to five years would be considered a success,
however, sealants can last much longer. It is fairly common
to see sealants that were placed during childhood still intact
on the teeth of adults. Any sealants that do come off sooner
than three to five years should not necessarily be considered
failures. Any length of time a sealant remains in place is a
time period during which a tooth is protected.
A dental sealant
can only provide adequate protection when it is fully intact.
If you notice that a portion, or even the entire sealant, has
come off you should let your dentist know. Additionally, during
your regular check up your dentist will evaluate the status
of your sealants.
One reason
why a sealant might dislodge is because when it was placed the
dentist was not able to keep the tooth adequately dry. In the
case of children this is very often related to the degree of
cooperation that the child can, or chooses to, offer. As a child
becomes older and more mature, it seems likely that the second
attempt to seal the tooth will be more successful.
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Thumbsucking
Overview
You may be
concerned about your child’s thumbsucking and wonder if it is
harmful, at what age your child should stop, or what could happen
if your child doesn’t stop.
Children suck on things because sucking is one of a baby’s natural
reflexes and as infants get older it serves many purposes. It
may make them feel secure and happy and helps them learn about
their world to suck on their thumbs, fingers, pacifiers or other
objects. Young children may also suck to soothe themselves.
Since thumbsucking is relaxing, it may help induce sleep.
After the permanent
teeth come in, sucking may cause problems with the proper growth
of the mouth and alignment of the teeth. It can also cause changes
in the roof of the mouth. The intensity of the sucking is a
factor that determines whether or not dental problems may result.
If children rest their thumbs passively in their mouths, they
are less likely to have difficulty than those who vigorously
suck their thumbs. Some aggressive thumbsuckers may cause problems
with their baby (primary) teeth. If you notice changes in your
child’s primary teeth, consult your dentist.
Children should
have ceased sucking by the time the permanent front teeth are
ready to erupt. Usually children stop between the ages of two
and four years.
Pacifiers can
affect the teeth essentially the same ways as sucking fingers
and thumbs. However, it is often an easier habit to break.
Tips:
• Praise children
for not sucking, instead of scolding them when they are.
• Children often
suck their thumbs when feeling insecure or needing comfort.
Focus on correcting the cause of the anxiety and provide comfort
to your child.
• For an older
child, involve him or her in choosing the method of stopping.
• Your dentist
can offer encouragement to a child and explain what could happen
to their teeth if they do not stop sucking.
• If the above
tips don’t work, remind the child of their habit by bandaging
the thumb or putting a sock on the hand at night. Your dentist
or pediatrician may prescribe a bitter medication to coat the
thumb or the use of a mouth appliance.
Sucking on
fingers or thumbs is healthy and normal when children are infants.
Most children stop somewhere between two and four years of age.
The effects of thumb sucking are usually reversible up until
the age of seven, because children still have their deciduous
(baby) teeth. If thumb sucking continues beyond the age of seven,
when the second teeth are erupting, permanent dental problems
can occur.
Problems
caused by thumb and finger sucking
Excessive thumb
sucking may lead to:
• Buck
teeth - for example, the front teeth may be pushed
out of alignment. This can alter the shape of the face and lead
to an open bite.
• A lisp - pre-school children who suck their
fingers and thumbs can push their teeth out of their normal
position. This interferes with the correct formation of certain
speech sounds.
Helping children
to stop the habit
There are various
things you can do to help your child stop thumb sucking. Focussing
on the positives and rewarding your child are important. Depending
on your child’s age and ability, you might like to try:
• Reward
your child and offer encouragement - for example, with
a hug or praise, to reinforce their decision to stop the habit.
• Limit
nagging - if children feel they are being nagged they
will become defensive.
• Mark
their progress on a calendar - for example, place a
star or a tick for each period (such as a day or week) that
the child does not suck their thumb or finger. Provide a special
outing or a toy if the child gets through the period successfully.
• Encourage
bonding - for example, with a special toy.
• Reminders
- give the child a mitten to wear as a reminder not to suck,
or place unpleasant tasting nail paint (available from chemists)
on the fingers or thumb. Placing a bandaid over the thumb at
bedtime is another reminder.
• Offer
distractions - while a child is watching TV, have toys
available for children to play with. Sit with the child during
this time and give a cuddle to help them not to suck. In the
car, have toys available to keep children occupied.
How
often to reward your child
Younger children
need more frequent rewards. A five to six year old may need
a reward after the first night. You can gradually stretch out
the reward period from one night, to a week and then to 30 days
without thumb sucking.
It may
take several attempts
Children can
easily drift back to their old habit and it may take several
attempts before the habit is completely broken. Remember to
be patient and that the first few days without sucking are usually
the worst.
Where
to get help
• Your dental
professional (dentist or dental therapist)
• Your pharmacist
• Your Community Dental Health service
• Your Maternal and Child Health nurse.
Things to remember
• Children usually stop thumb and finger sucking between two
and four years of age.
• Thumb and finger sucking after seven years of age may cause
dental problems.
• It takes patience to help your child stop the habit.
• Rewarding your child for not thumb sucking may help.
