Fissure Sealants

A fissure sealant is a preventive treatment that closes off the deep, narrow grooves (fissures) on the chewing surfaces of the molars with a thin, flowable resin. These grooves are often narrower than a single toothbrush bristle; food debris and bacteria stay trapped in them, and a large share of decay in children starts on exactly these surfaces. A sealant turns the grooves into a smooth surface that can be kept clean.

That is why, in Turkey, sealants are popularly called a "tooth vaccine": protection put in place before the disease starts. But it is not a vaccine. There is no medicine in it and nothing is injected into the tooth. All it does is put a physical cover over the groove.

Which teeth are sealed, and at what age?

Tooth	Typical age it comes through	Note
First permanent molar (the "six-year molar")	6–7 years	Priority; one of the earliest adult teeth to decay
Second permanent molar	11–13 years	A second round of sealing in adolescence
Premolars	10–12 years	If the grooves are deep
Baby molars	While the baby teeth are in	In some children at high risk of decay

There is a common misunderstanding about the six-year molar: it does not replace any baby tooth, but comes through quietly behind the last baby tooth. That is why many families take it for a baby tooth and pay it little attention. In fact it is a tooth for life. The right time for a sealant is when its chewing surface has fully emerged from the gum; the first years after it comes through are the period when the risk of decay in these teeth is high.

If the tooth is still half under the gum, resin does not bond well. During this stage we apply a temporary glass ionomer sealant and replace it with resin once the tooth is fully through. Children who have had decay in their baby teeth, whose brothers or sisters have a lot of decay, or whose grooves are noticeably deep benefit most from sealants.

How does the procedure work, step by step?

1. The chewing surface is cleaned with a rotating brush and paste.
2. The tooth is kept away from saliva: cotton rolls are placed on the cheek side and suction keeps it dry.
3. A gel with a sour taste is applied to the surface for a short time; it roughens the enamel at a microscopic level. It is then rinsed off and the tooth is dried.
4. The flowable sealant is applied into the grooves and set within seconds with a blue light.
5. The bite is checked, and any high spot is adjusted.

There is no numbing, no drill touches the tooth, and no healthy tooth tissue is removed. It takes a few minutes per tooth; all four molars can be done in the same session. Success depends less on the technique itself than on keeping the tooth dry. If saliva gets in, the sealant does not bond well and comes off early.

What can you tell your child?

All your child has to do is keep their mouth open for a few minutes and keep their tongue relaxed. Saying "We're going to paint a clear protective coat on your teeth and then dry it with a light" is enough. Knowing in advance that the sour taste of the gel only lasts a moment and will be rinsed off straight away reassures most children. You can also explain that the rotating brush used for cleaning only polishes the tooth and just feels ticklish. Choosing a time when your child is not tired or hungry also makes it easier to keep the tooth dry. For a six-year-old, doing four teeth in one go can feel long; if so, we split the work into two short appointments.

How long does it last, and how well does it protect?

A well-bonded sealant can stay in place for years. Over time it can wear under chewing forces, or an edge can chip off; that is why we check it at every visit and top up any missing part in the same session. Studies show that molars with sealants develop markedly less decay on the chewing surface over the years. Sealants can be clear, white or lightly tinted; white or tinted ones are often chosen for children because they are easy to see at check-ups. They do not show when your child smiles, because they sit only on the chewing surfaces of the back teeth.

It is just as important to know the limits: a sealant protects only the grooved chewing surface and has no effect on decay that starts between two teeth. That is why cleaning between the teeth, fluoride toothpaste and, where needed, fluoride varnish are still necessary.

Can a tooth that already has decay be sealed?

A brown line in the grooves does not always mean decay; sometimes it is only surface staining. A sealant is not placed over decay that has already formed a cavity. At the examination we assess the grooves, with an X-ray if needed. If the decay is confined to the enamel and at an early stage, a sealant can cover it and stop it progressing. If the decay has reached the dentine, we first clean it out and place a composite filling; the healthy grooves on the same tooth can be sealed in the same session. We cover the treatment of decay in baby teeth on the baby tooth treatment page.

Can your child eat straight after a sealant?

Yes. Because the sealant is set with light, your child can eat and drink straight away. For the first few hours the bite may feel slightly high when biting; if this lasts more than a few days, come back and we will adjust it, or see your local dentist if you have travelled home. If your child's tongue feels something rough on the surface, it is usually the edge of the set sealant; most children get used to it within a few days, and if there is a sharp edge we smooth it. Crunching hard sweets or ice with the teeth can crack a sealant. The cost depends on how many teeth are sealed; you receive a written, itemised quote after the examination at our clinic in İzmir.