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Sealants: Revisited

© Tracey Ryan

During the past several months I have been part of an online discussion group which focuses on hygienists, their jobs, concerns, and goals. The "hot topic" has been sealants-how they work, what works best, and why they are an integral part of preventative dentistry today.

As a follow-up to my previous article on sealants, I would like to present a quote from a dentist who is part of the discussion group. He makes a valid point of the "eventual cost" of not sealing teeth. The following excerpt is by Dr. Larry Burnett via RDH@Onelist :

"There was a time when I didn't believe sealants were advantageous and my eyes always seemed to catch the literature that agreed with me. Here's what changed my mind. I hope it works with your dentist:

I came across a piece of research that was comparing the cost over the patient's lifetime of using amalgam versus tooth colored fillings. The results showed that over the lifetime of the patient, that first little occlusal filling would cost the patient $2200 to $2700 adjusted for inflation no matter what material was used.

That's because we don't have any filling material yet that is as good as tooth structure. That little occlusal amalgam or composite would have to be replaced sometime. And each time you replace it, you don't just take it out and fill the same hole. Fact is you must take away more tooth structure each time and make the hole bigger. So after x number of replacements you eventually go to an MO then an MOD, the MODBL, the crown, the root canal and on and on. I'm sure we've all seen this over and over. 75% of the work a dentist does is replacing previous dental work done by him and others. This is how that ONE tooth causes an expense of $2500 over their lifetime.

When I start explaining this to patients they usually are nodding their heads in agreement because many of them, depending on their age, have seen it happen to themselves.

In this day of modern preventive dentistry, a good hygienist is the one person, who can keep that FIRST filling from ever happening. Fluoride is great, but 75-80% of new cavities now occur on occlusal surfaces because fluorides don't work there as well as they do on smooth surfaces.

We can now, with the use of sealants, stop that first cavity from ever happening and even treat and stop the early carries with a sealant.

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