Dental Sealants
Biting surface decay is almost 100% preventable because of a procedure called a sealant or preventive resin.
The shape of the biting surface is one of hills and valleys with a thin groove running through the middle. Also, there are often isolated pits in various places near the center of the tooth. These grooves and pits can be very irregular and extend quite far into the depths of the tooth. They are like a very thin and narrow mine shaft or vein of ore, where bacteria can accumulate untouched, and use as a pathway to travel well into the tooth where they can hide, breed, eat and produce acid which ultimately dissolves away the enamel, (which at the base of this groove is very thin) and causes decay.
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Here is a lower molar showing staining in the pits and grooves. This could well be decay. But because the groove is so narrow, a dentist's explorer may not reach to the bottom, and there may be no "stick" when it is poked. With old technology, there was no way to tell if there was decay here or not, except to drill into the groove and explore. |
And the troublesome thing is that, just as an explorer can't get to the bottom of the groove, neither can a toothbrush bristle. So no matter how well you brush, you can't stop or even slow down the decay process. Old-fashioned dentists would just say, "let's watch this one," and they would watch it while the decay grew from checkup to checkup.
To the bacteria, these grooves are great hiding places. Dissolved food substances percolate into the groove, and they multiply, unmolested, while the acidic waste they produce dissolves away the thin enamel at the base of the groove. What's worse is that, since the groove often ends deep within the tooth, the decay starts off deep, and doesn't have far to go before it threatens the pulp of the tooth.
The answer is a dental sealant or a preventive resin restoration, used in combination with air abrasion technology. Air abrasion forces a stream of tiny aluminum oxide particles into this groove to remove everything soft. Without any novocain, the decay can be removed, leaving a clean surface ready for sealing or restoring. And the healthy tooth structure is left intact.
After the above tooth has been cleaned with air abrasion and the dental sealant placed, this is how it would look. The sealant is bonded to the enamel and will stay on for many years. The tooth now has no susceptible grooves, and the chances of getting decay on the biting surface are minimal. |
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This is how I like to practice dentistry—prevent decay before it starts, or at least intercept it as early in the process as possible and do as little alteration of the tooth as possible. Please see our home page, Boca Raton dentist, for more information about my preventive and ultraconservative dentistry philosophy.
If you would like to make an appointment, give us a call at (888) 688-0068 or visit our free consultation page.