Cavities and Sealants
posted: Oct 13, 2018.
How do we know if you need a Sealant or a Filling?
We used the DIAGNOdent!
The DIAGNODENT uses laser fluorescence to help with early detection of decay that allows for minimally invasive dentistry and possible fillings without anesthesia
Clean and healthy tooth structure will have minimal or no fluorescence
The amount of fluorescence will yield a number and the higher the number, the deeper the cavity.
0-10 healthy tooth structure, patient is a great candidate for sealants
11-20 early enamel decay
21-30 deep enamel decay
30+ dentin decay
Helps detect "iceberg" cavities before they infect the nerve. Like an iceberg that is bigger underwater, Iceberg cavities start with a small hole on the top of the tooth and grow rapidly underneath. Sometimes they are hard to see on an xray. The picture below shows a tooth before the cavity is opened and shortly after showing how deep the cavity became:
Some teeth have deep grooves on their biting surface, which make them hard to keep clean even with daily brushing and flossing since the brush bristles cannot access deep enough to remove plaque.
To prevent decay in those deep grooves, we often place sealants when children get their 6 year and 12 year molars. Our sealants do not contain Fluoride and are tooth-colored.
However, some children are not good candidates for sealants if they have a history of decay as they may already have enamel decay. It is important that we use the DIAGNOdent to determine if your child is a great candidate for sealants or if they need fillings, as sealants will not prevent the cavity from getting bigger.
Adults are also great candidates for sealants, but unlike children, most insurance plans do not cover sealants for anyone over the age of 12. Nonetheless, This is a conservative approach to preventing decay and helps prevent decay in adults as well because, as we age, our body's ability to heal from decay diminishes. This is accelerated more when we take medications that cause dry mouth, snack a lot or have autoimmune diseases like diabetes, heart disease, thyroid disease that prevent our body from fighting infection as easily as a healthy adult.
Contact Dr. Hana if you have any questions about sealants and cavities. (916) 780-1955