Chris Martin
Jann Ingmire

Nearly 30 Years of Research Supports the Effectiveness of Sealants

CHICAGO -- Dental sealants have proved to be effective at not only
preventing tooth decay before it starts, but also halting the progress
of tooth decay in its earliest stages. Some of the more critical
research that has been published in the past 30 years is summarized
Early research done in the 1940s showed that decay did not progress
after being sealed by a filling. When dental sealants were developed in
the 1970s, dentists were concerned that sealants would seal in decay,
allowing the bacteria to multiply unchecked underneath the sealants.
However, R. E. Micik published a study in the Journal of Dental Research
in 1972 that demonstrated that progression of decay within tooth
structure could be inhibited if the tooth were using a sealant.
S.L. Handelman corroborated this research later that year. Dr.
Handelman used a small number of teeth with cavities and sealed them.
Then, the teeth were opened after one month and examined. For each pair
of teeth examined, fewer viable bacteria were recovered from the sealed
than the unsealed teeth. Statistically, the sealed teeth had
approximately 50 times fewer cavity causing bacteria than the unsealed
While this study took a short-term look at sealants' effectiveness, the
truer test of the plastic coating's durability began to emerge in
long-term studies done in the late 70s. This time, researchers examined
the bacteria count of teeth both sealed and unsealed at 1, 2, 4, 6 and
12 months. These samples demonstrated a major reduction in viable
microorganisms within the first two weeks after sealant placement, and a
gradual reduction in bacterial count followed during the next two years.
In fact, the researchers found that the bacteria count decreased 1,000
fold after one year and 2,000 fold after two years. This study put to
rest concerns that dental sealants would seal in decay and allow it to
grow unchecked.
Finally, a researcher in Minnesota set to work on a long-term study
that examined how long dental sealants were retained on teeth and if
they demonstrated long-term effectiveness. Begun in 1976 and published
in the Journal of the American Dental Association in 1991, Dr. Richard
Simonsen showed that 27 percent of the sealants applied were completely
retained, and 35 percent were partially retained. He also calculated
that 82 percent of the surface in the unsealed teeth had cavities while
only 31 percent of the sealed teeth showed signs of decay.
Dr. Simonsen concluded that if the sealants were reapplied when
appropriate, dentists could approach 100 percent cavity protection.


ADA Report Underscores Importance of Dental Sealant Use

CHICAGO -- A report published in the February Journal of the American
Dental Association (JADA) to coincide with National Children's Dental
Health Month concludes that dental sealants are highly effective in the
prevention of tooth decay on the chewing surfaces of teeth.
The report, co-authored by two ADA councils -- Scientific Affairs and
Access, Prevention and Interprofessional Relations -- found that 92 to
96 percent of all dental sealants placed on chewing surfaces of teeth
remain intact one year later, and up to 82 percent are retained after
five years. Dental sealants that are placed using appropriate
techniques and are retained, are virtually 100 percent effective at
preventing tooth decay.
The report also provides advice about which patients are most likely to
benefit from dental sealants. Children and adults who have one or more
of the following characteristics are good candidates to receive dental
sealants: if the patient is at moderate or high risk for tooth decay;
if the patient has cavities limited to the enamel of the pits and
fissures of teeth; if the patient has existing pits and fissures that
are susceptible to decay; or if the patient has sufficiently erupted
permanent teeth with susceptible pits and fissures.
In addition to preventing the emergence of tooth decay, dental sealants
can also stop tooth decay in its earliest stage. Sealants stop the
development of cavities by shutting off two essential elements decay
needs to progress: oxygen and bacteria from food.
While the effectiveness of dental sealants is unquestionable, the
percentage of school-aged children who have them has historically been
low. A study published in the March 1996 JADA reported that less than
20 percent of the nation's school-aged children have dental sealants on
their permanent molars.
The report also addresses the issue of dental insurance reimbursement,
often thought to be one barrier to widespread acceptance of dental
sealants. The dental benefit code for sealants was developed by the ADA
in 1982, and since 1987 the ADA's policy statement on Preventive
Coverage in Dental Benefits Plans has included sealants as one of the
procedures that should be a covered benefit. Additionally, a study of
state dental Medicaid programs found that 33 states offer some form of
coverage for sealants, from 100 percent reimbursement to coverage for
first permanent molars only.


Sealants Beneficial for All Ages

CHICAGO -- Even though February is National Children's Dental Health
Month, it's important to point out that dental sealants aren't just for
children. Patients of all ages may be good candidates for dental
sealants, according to the American Dental Association (ADA).
"Dental sealants are a wonderful preventive treatment for children,
teenagers, adults and older adults," said Maria Lopez-Howell, D.D.S., a
consumer advisor for the ADA and a clinical associate professor at the
University of Texas Health Science Center at San Antonio.
Dr. Lopez-Howell pointed out several factors that can make an adult a
good candidate for dental sealants:
* Changes in personal habits - "I see kids who come home from college
with all kinds of oral health problems because of the changes in their
diets away from home and especially the change in their oral health care
routine," Dr. Lopez-Howell explained. "Suddenly, these young people are
not seeing the dentist as regularly, and they're not brushing and
flossing as often as they should. The result is more tooth decay, and
sealants might help protect their teeth during this time."
* Changes in health status - "Many people suffer loss of motor skills
because of arthritis or a stroke, which means they have a harder time
brushing and flossing," Dr. Lopez-Howell said. "In some cases, sealants
may help protect teeth that aren't being cleaned as well as they should
because the patient is no longer able to do as thorough a job at
maintaining a healthy mouth."
* Medications - Some medications actually increase the risk of tooth
decay because of their side effects. "One of the biggest problems I see
is dry mouth or xerostomia," Dr. Lopez-Howell stated. "Dry mouth is a
problem because saliva helps protect against tooth decay. With a dry
mouth, the patient is much more susceptible to tooth decay and, again,
sealants may be an option for prevention."
When asked about the cost of sealants, Dr. Lopez-Howell says the
benefits of dental sealants outweigh the relatively low cost. "The cost
of sealing teeth is less expensive and less invasive than filling the
teeth. The best advice is to ask your dentist whether or not you would
be a good candidate for sealants."
As a final caution, however, Dr. Lopez-Howell reminds patients that
sealants do not excuse anyone from maintaining a healthy mouth. "It's
still important to brush at least twice a day with a fluoride toothpaste
using a soft-bristled toothbrush and to clean between the teeth daily
with floss or an interdental cleaner." The ADA recommends consumers
look for these products with the ADA Seal of Acceptance and to eat a
healthy diet and visit the dentist regularly.


Sealants Inexpensive, Comfortable Way To Avoid Tooth Decay

CHICAGO -- Today's parents can take immediate and cost-effective steps
to ensure their children's back teeth never are attacked by tooth decay.
Dental sealants, not widely available when many of today's baby boomers
were children, are now a part of most dentists' tooth decay prevention
arsenal, according to Dr. Heber Simmons, Jr., a spokesperson on
pediatric dental issues for the American Dental Association (ADA).
"Dental sealants are one of the best tools we have to create a
cavity-free generation," he said. "In my practice, I have patients who
are in college who had dental sealants placed on their molars and they
still do not have any cavities."
In addition to this space-age wonder, dental sealants have two other
advantages parents appreciate: they are cost-effective and the
procedure is quick and pain-free.
"Dental sealants cost about half of what a filling costs," said Dr.
Simmons. "When you think about avoiding the expense and the damage done
to teeth by tooth decay, it really makes dental sealants worth
investigating. Often, the cost of a sealant is less than half that of
a filling. According to the ADA's 1995 Survey of Dental Fees, the
average cost of a sealant is $24 per tooth while a filling costs
approximately $53.
Dr. Simmons explained that the entire procedure takes only minutes per
tooth and is painless. First, the tooth is thoroughly cleaned and then
etched with a solution to help the dental sealant adhere to the tooth.
Then, the sealant is applied to the tooth with a small, soft brush, he
said. In some cases, a curing light is used to help the dental sealant
How do parents know whether their child is a good candidate for dental
sealants? Although parents should consult their child's dentist, any
child who has teeth with deep groves that can trap bacteria which causes
tooth decay is a good candidate for dental sealants.
Dental sealants work by creating an impenetrable barrier between the
tooth's enamel and the bacteria that causes tooth decay. If the
bacteria cannot penetrate the tooth's surface, it will be unable to
multiply in the numbers necessary to become dangerous, Dr. Simmons said.
Additionally, if sealants are placed on teeth that have the beginning
of tooth decay, the sealants can act as an extinguisher, snuffing out
the bacteria by denying them the two things they needs to grow: oxygen
and food.
"Research has shown that dental sealants can reverse early signs of
tooth decay, so parents should not feel hesitant about having sealants
placed on teeth that might have small amounts of decay," Dr. Simmons
Still other research has proven that dental sealants, when properly
applied, can last up to 15 years without being reapplied.
"I regularly check the condition of the sealants I place and reapply
them if necessary," said Dr. Simmons. "Most parents who care for the
oral health of their children's teeth know the importance of sound home
oral health care and regular check ups, too."


Fact Sheet on Dental Sealants

A dental sealant is a plastic material used to protect the chewing
surfaces of the teeth. Dental sealants are painted on decay-prone
surfaces of the teeth, usually the back molars and pre-molars.

Dental sealants are beneficial because they act as a protective barrier
against acid and plaque which can attack the teeth and cause decay.
Sealants are especially beneficial for coating the natural pits and
fissures that form in the chewing surfaces of the tooth's enamel that
are out of reach from toothbrush bristles.

About 19 percent of children age five to 17 years had sealants on their
permanent or primary teeth, according to a study published in the
Journal of the American Dental Association (JADA). More than 50 percent
of school-age children in that study had no cavities. The use of
dental sealants was one of the contributing factors to that decline in
the number of cavities in children's teeth.

A dentist can apply sealants in just a few minutes per tooth. The teeth
to be sealed are cleaned and then the chewing surfaces are conditioned
to help the sealant adhere to the tooth. The sealant is then painted on
the tooth enamel where it bonds directly to the tooth and hardens.
Sometimes a special curing light is used to help the sealant harden.

Dental sealants are painless and cost-effective. Sealants help reduce
or even eliminate tooth decay, thereby minimizing the need for restoring
the damage done to the tooth, such as filling a cavity. Prevention is
better than treatment as sealants are less expensive than amalgams
(silver fillings), composite resin (white) fillings and caps or crowns.
According to a 1995 ADA survey, sealants cost an average $24 per tooth
while the average cost for fillings is $53.

Adults can get sealants, too. Dental sealants can be as beneficial for
adults as they are for children. Your dentist can evaluate whether you
would be a good candidate for sealant protection.


A video news release "Sealing Out Tooth Decay in Children" will be
distributed via satellite from 2 - 2:30 p.m. EST, Tuesday, February 4,
1997, at the following coordinates: Telestar 401, Transponder 19, Dual
Audio 6.2 & 6.8.

Register for reporter access to contact details