Sunday, January 24, 2010

Sealants for 6yr Molar?

Hi Dr. Ellie,

Today my dentist noticed a pit in the 6yr molar, on the tongue side, of my 8yr old daughter. There is no cavity, and the pit is still partially below the gumline. He is concerned it could form a cavity and wants to seal it. I have read about sealants and want to avoid them. I have 5 children from 18 mos to 11 years. None have sealants except my 11 year old daughter, before I knew any better. Her sealants are about 2 years old. The office is wanting to make appointments to seal the children's teeth. They have asked me many times about this! I have turned them down every time. Can you advise me, especially with regard to my 8yr old?

Thank-you, I appreciate it so much!

M

Hi M,
I am not in a position to tell you whether or not you need a filling in this tooth. I would be disqualified as a dentist if I diagnose through a computer!

This kind of filling (on the tongue side of a 6-year molar) is usually caused by sucking sweets and hard candy/cough lozenges/ taking late night medications or juice before bed. I would recommend that you ensure this child rinses her mouth with ACT rinse before going to bed - and that she understands the dangers of eating or sucking hard candy/ lollypops. (I am interested to know if I am correct about the candy or lollypops??)

It will take about 6 months to reverse this cavity. On the other hand, if she continues to damage this tooth - in 6 months this cavity may have reached the nerve inside the tooth (the nerve is not far away from the outside of the tooth at this particular spot).

This moment will never come again!
You can either turn the situation around or your daughter will have a filling in this tooth for life.
Besides putting in a filling will do nothing to stop the disease - next will be a filling on the other similar tooth on the other side of her mouth....then more and more.

This is a very serious spot to have a cavity - and also a difficult place to put a filling (your dentist would agree that it is very hard to do nice long-lasting fillings in this area by the tongue). I would beg you and your daughter to have a good talk about this - you need her help.

If she loves sweets, consider Zellies 100 percent xylitol fruit mints. They are yummy and delicious. Zellies cinnamon gum is great - we have it in bulk bags. Use xylitol with ACT anticavity rinse - use the rinse every night without fail - and also in the morning.

If your child has trouble cleaning her teeth - at least get her to rinse and/or brush ACT on this cavity often. Better yet is Crest Regular toothpaste brushed on this cavity - followed by ACT.
I am assuming she will not do the entire system just yet ......and that is OK.......get her started when and if you can.....

The most important thing is that
a) Her toothbrush is clean
b) If she eats at night, she eats ONLY Zellies after cleaning her teeth.
Also she should have Zellies after any candy or drinks during the day.
c) She needs to rinse with ACT at least twice a day - maybe three times on the weekends
d) All the family should join in and understand that cavity bacteria pass from person to person when sharing food and kissing. Help your daughter become bacteria free by getting rid of mouth bacteria in the entire family.
e) Put a date on the calendar - in about 4-6 months to go back and have an evaluation of this cavity. It is in too dangerous a location to leave this potential cavity for any longer than 6 months - The good news is that you may be able to "Wow" your dentist and have him wonder where it went! I really hope so!

Best Wishes and please let me know if you have any other questions,

Ellie


1 comment:

GLH said...

I too am curious about the sealants? Our pediatric dentist recently recommended Fuji Triage, which is a high flouride sealant. Supposedly goes on without any abrasive techniques. Hopefully Dr. Ellie will be able comment on your original question as I too am in the same dilemma.

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