Fissure sealants at Victorian Dental Group

The biting surfaces of back teeth are not smooth. They carry a pattern of grooves and pits — fissures — and on some teeth those grooves are deep and narrow enough that a toothbrush bristle cannot physically reach the bottom of them. Food and plaque can.

A fissure sealant fills and seals those grooves with a protective coating, so there is nowhere for decay to start.

Why brushing is not always enough

Fluoride in tap water and toothpaste protects the smooth surfaces of teeth well. It works far less effectively in a deep fissure, because saliva and fluoride do not flow easily into a groove narrower than a bristle. That is why the chewing surfaces of molars are the most common site of decay in children and teenagers, even in children who brush conscientiously.

Sealing the groove removes the problem rather than managing it.

It is worth saying plainly: a molar with deep fissures developing decay is not evidence of neglect. The anatomy of the tooth is inherited, the fissure is narrower than the tool available to clean it, and no amount of effort with a brush changes that. Parents often arrive expecting to be told off, and there is nothing to be told off about.

Which teeth, and at what age

Sealants are most commonly placed on the permanent molars:

First permanent molars, which usually appear around age six, behind the baby teeth rather than replacing them. Many parents do not realise these have arrived, because nothing fell out to announce them — and because they arrive at the back, they are easy to miss when brushing.
Second permanent molars, usually around age twelve.
Premolars, and occasionally deeply grooved baby molars, where the anatomy warrants it.

The useful window is soon after a tooth erupts, before decay has had a chance to begin. That said, sealants are not only for children — adults with deep, sound fissures and a history of decay can benefit too.

Not every child needs every tooth sealed. Your practitioner assesses the depth of the grooves, your child's decay history and their overall risk, and recommends only where there is a reason.

Who benefits most

Higher benefit	Lower benefit
Deep, narrow, stained-looking fissures	Shallow, broad, self-cleansing grooves
Previous decay in this child or in siblings	No decay history and low-sugar diet
Newly erupted molars, still partly covered by gum	Molars sound and sealed-looking after years in the mouth
Orthodontic appliances making cleaning harder	Excellent access and established cleaning routine
Medical or developmental conditions affecting cleaning	—
Reduced saliva flow from medication	—

What the appointment involves

Placing a sealant is quick, and most children find it comfortable:

The tooth is cleaned and dried, and isolated so it stays dry.
The surface is prepared. At our clinic this is often done with drill-free air abrasion, which uses a fine stream of particles rather than a rotating bur — no vibration and no drill noise.
The liquid sealant is flowed into the grooves.
It is set hard with a curing light, which takes seconds.
Your practitioner checks the bite and polishes away any excess.

No anaesthetic is normally required and no healthy tooth structure is removed. For an anxious child, this is often a good first restorative-style appointment precisely because there is nothing to endure.

Sealant material is white or clear composite resin, similar to a white filling, so it is not visible when your child smiles.

Keeping the tooth dry is the whole trick

The one thing that determines whether a sealant lasts is whether the tooth was completely dry when the material went in. Saliva contamination is the main cause of early failure, which is why your child will be asked to keep their mouth open a little longer than the procedure itself seems to require, and why a partially erupted molar with gum still over part of the biting surface is sometimes better sealed a few months later.

Where a tooth genuinely cannot be kept dry — a very young child, or a molar only half through — a glass ionomer material may be used instead. It tolerates moisture and releases fluoride, but wears faster, so it is often treated as a temporary measure until a resin sealant can be placed properly.

How long do they last?

Sealants are durable but not permanent. They wear with chewing and can chip or partially lift over time, particularly on a heavily used molar. We check them at every routine examination and repair or replace them when needed — a sealant that has partly come away is worth attending to, because a gap under a remaining edge is harder to clean than an unsealed tooth.

As a rough guide, a well-placed resin sealant on a molar commonly lasts several years, with many still sound well beyond that; a glass ionomer sealant is expected to be shorter-lived. Either way, the sealant is not the whole prevention plan — it is one part of it.

Keeping your child's six-monthly check-ups is what makes sealants work over the long term.

Sealant, or filling?

A sealant is preventive — it protects a tooth that is still sound. Where decay has already begun, the decayed tissue has to be removed first and the tooth restored with a filling; sealing over active decay would trap it.

Where there is a very early, shallow area of demineralisation, your practitioner may recommend sealing it and monitoring rather than restoring immediately. This is a judgement call and we will explain the reasoning either way.

How sealants fit alongside other prevention

Measure	What it protects	What it does not do
Fissure sealants	The grooves on biting surfaces	Nothing for the surfaces between teeth
Fluoride toothpaste	Every surface the brush reaches	Reaches poorly into deep fissures
Fluoride varnish	Smooth surfaces and early white-spot areas	Does not fill or seal a groove
Flossing	Between the teeth — the other common decay site	Nothing for the biting surface
Diet and snacking frequency	All surfaces, by reducing acid attacks	Cannot compensate for an unclearable groove

The useful way to think about it: sealants close off one specific site that nothing else reaches well. They do not replace anything else on the list.

Afterwards

There is no recovery period. Your child can eat and drink normally as soon as they leave, since the sealant is fully set before you go. Brushing continues exactly as before — a sealed tooth still has four other surfaces that need cleaning, and sealants do nothing for decay between teeth, which is what flossing is for.

A sealed tooth can feel slightly different to bite on for a day or two while your child adjusts. If it still feels high after that, ring us — it takes a minute to adjust.

Cost, Medicare and health funds

Eligible children aged 0–17 may be able to have sealants covered under the Child Dental Benefits Schedule (CDBS), which provides up to $1,158 over two calendar years for basic dental services. Eligibility is determined by Medicare and Centrelink, not by us — you should receive a letter if your child qualifies. We can provide the statement you submit to claim.

For private health cover, we claim on the spot through HICAPS: bring your card and pay only the gap. Your practitioner will confirm the fee before the appointment.

Questions we are asked

Does it hurt? Nothing is drilled and no healthy tooth is removed, so no anaesthetic is normally needed. Your child will feel the tooth being dried and will need to hold their mouth open, which is the hardest part for a small child. Individual experiences vary.

Do sealants contain BPA? Resin sealants can release trace amounts of BPA-related compounds in the minutes immediately after placement. The quantities are very small, regulatory and professional bodies regard sealants as safe, and rinsing and wiping the tooth after curing reduces exposure further. If you would prefer a glass ionomer material, say so — it is a reasonable conversation to have.

Can decay still start under a sealant? An intact sealant seals the groove. The risk comes from a sealant that has chipped or lifted at an edge, which is exactly what the six-monthly check is looking for.

My child is nervous about the dentist — is this a bad first appointment? Often the opposite. It is short, requires no injection and has an obvious finish, and many anxious children find it a manageable way to start. See dental anxiety.

Are they worth it for an adult? Sometimes. If you have deep, sound fissures and a history of decay, yes. If your molars have been sound for thirty years, the benefit is smaller.

Book a fissure sealant appointment

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145

Phone (03) 9088 5808 · Monday to Friday, 8:00am–5:00pm · closed weekends and public holidays

Book online at any hour, or read more about our family and children's dentistry.

This page is general information and does not replace advice from a registered dental practitioner about your own circumstances. Please see our Disclaimer.

What is a fissure sealant?

A thin coating of tooth-coloured or clear resin bonded into the natural grooves on the biting surfaces of the back teeth. The grooves are narrower than a toothbrush bristle, so food and plaque sit in them where brushing cannot reach. Sealing them makes the surface smooth and much easier to keep clean.

Why are sealants needed if I brush and use fluoride toothpaste?

Fluoride works well on the smooth surfaces of teeth but does far less for deep pits and fissures, and a toothbrush bristle cannot get into them. The biting surfaces of molars are where most decay starts in children and teenagers, which is why that is where sealants are placed.

How effective are sealants?

They substantially reduce decay in the sealed surfaces while they remain intact — but they reduce risk rather than remove it. They protect only the surface they cover, not between the teeth or along the gum line, and they do not replace brushing, flossing or limiting sugary food and drink.

What happens during the appointment?

The tooth is cleaned and dried, the surface is conditioned so the resin bonds, the liquid sealant is painted into the grooves, set with a curing light, and the bite checked and adjusted. It takes a few minutes per tooth. No injection is needed and in most cases no drilling — the tooth is not cut. Keeping the tooth dry matters, so a child needs to be able to sit still with their mouth open for a short time.

When should sealants be placed?

Soon after a permanent molar comes through, while the grooves are still sound — the first permanent molars appear around age six, the second molars around twelve. Premolars and some front teeth with deep pits are sometimes sealed too. Adults with deep grooves and a history of decay can also have them.

Can a sealant be placed over a tooth that already has decay?

Not over established decay. Sealants are for surfaces that are sound, or that show only the very earliest change before a cavity has formed. Where decay has broken into the tooth it must be removed and the tooth restored — sealing over it would hide the problem while it continued underneath. That is why the teeth are examined, sometimes with X-rays, before sealants are recommended.

How long do sealants last?

Often several years, but they wear and can chip or partially come away, particularly in the first year or two. They are checked at every routine examination and repaired or replaced when needed. A partly lost sealant offers less protection than an intact one, so the checks matter.

Are there any downsides?

Few. The main one is that a sealant which fails without being noticed can leave a groove that is harder to inspect, which is the reason for regular review. Some people ask about BPA — resin-based sealants may release trace amounts immediately after placement, at levels well below established safety limits, and wiping and rinsing the tooth after curing reduces this further. The decay risk they prevent is the larger consideration.

Are sealants covered by Medicare or private health insurance?

Sealants are one of the services covered under the Child Dental Benefits Schedule for eligible children aged 0 to 17, which provides up to $1,158 of benefits over two calendar years — eligibility is checked with Medicare before treatment. Most private health extras cover preventive items; the rebate depends on your policy and limits. You receive the item numbers and costs before anything is done.

How do I book?

Victorian Dental Group, 291 Wattletree Road, Malvern East VIC 3145. Phone (03) 9088 5808 or email info@victoriandentalgroup.com.au, Monday to Friday 8:00am to 5:00pm, or book online. Sealants are usually assessed and placed as part of a routine check-up.