Dr. Pranav Nirmalbhai Shah
Dr. Suhani P. Shah
P.F. Sealents
What is a Sealent?

A sealant is a clear shaded plastic material that is applied to the chewing surfaces of the back teeth where decay occurs most often. This sealant acts as a barrier, protecting the decay-prone areas of the teeth from plaque and acid attack.

Why are Sealents necessary?

When the teeth are developing, depressions and grooves form in the chewing surfaces of the enamel. These features are called pits and fissures. They are tough to clean, because the bristles of a toothbrush may not reach into them. Therefore, pits and fissures are snug places for plague and bits of food to hide. By forming a thin covering over the pits and fissures, sealants keep out plaque and food and thus decrease the risk of decay.

Who should have Sealent applied?

Although children receive significant benefits from sealents, adults can also be at risk for pit and fissure decay and thus be candidates for sealents. Sealents are also recommended for those who receive topical applications of fluoride and who live in communities with fluoridated water. Fluoride helps fight decay on the smooth surfaces of the teeth, but it is less effective in pits and fissures.

How are Sealents applied?

Each tooth takes only a few minutes to seal. First the teeth that will be sealed are cleaned. The chewing surfaces are then etched (roughened) with a weak acidic solution to help the sealant adheres to the teeth. Finally, the sealant is brushed on the tooth enamel and allowed to set. Some sealant need a special curing light to help them harden, others do not.

Do Sealents need to be applied?

When the sealent is applied, finger like strands penetrate the pits and fissures of the tooth enamel. Although the sealant cannot be seen with the naked eye, the protective effect of these strands continues. As a result, it may be several years before another application of sealant is needed. Reapplication of the sealant will continue the protection against decay and may save the time and expense of having a tooth restored. Sealant will be checked during regular dental visits to determine if reapplication is necessary.

Bone Grafting

Sometimes, when resorption has excessively reduced the jawbone, it can be rebuilt through modern bone grafting techniques. Bone grafts can build up or fill in jawbone defects allowing the placement of dental implants. These techniques represent one of the greatest advances in modern dentistry.

There are generally four types of bone grafts used:

Autografts are those where the bone to be grafted to the jaw is taken, or harvested, from your own body. The area where the bone is harvested from, known as the donor site, is usually the mouth or the hip. This is your own bone and is very compatible with your body. Autografts are generally the best graft technique and usually result in the greatest regeneration of missing jawbone.

Allografts are taken from human donors. Many countries have donor programs where you can specify that in the event of your death, parts may be harvested from your body to save or improve the life of others. Heart transplants are one type of allograft. This can represent one of the greatest "gifts" you can ever give. Bone obtained in this mannor undergoes rigorous tests and sterilization. Your body "converts" the donor bone into your natural bone, thereby rebuilding your resorbed jawbone.

Xenografts are harvested from animals. The animal bone, most commonly bovine (cow), is specially processed to make it biocompatible and sterile. It acts like a "filler" which in time your body will replace with natural bone. After this replacement process is complete dental implants may be placed to support teeth.

Alloplastic grafts are inert, man made synthetic materials. The modern artificial joint replacement procedure uses metal alloplastic grafts. For bone replacement a man made material that mimics natural bone is used. Most often this a form of calcium phosphate. Depending on how it is made, it may be "resorbable" or "non-resorbable". That is, your body may or may not replace the alloplastic graft with your natural bone. In those cases where it is not replaced it acts as a lattice or scaffold upon which natural bone is built. In either case, the end result is to create enough bone for the placement of dental implants.

Modern bone grafting techniques can be nothing short of a miracle for those needing bone replacement.