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Sealants are thin protective coatings painted onto the chewing surfaces of back teeth. Here is what they do, what getting them is like, and what grown-ups can ask.
Back teeth have little grooves on top where bits of food and germs like to hide. A toothbrush has a hard time reaching all the way in. A sealant is a thin coating the dentist paints over those grooves, like a raincoat for the tooth.
Your goal today: learn what a sealant is, how it helps, and what happens when the dentist puts one on.
Sealants are extra help, not a replacement for brushing. Keep brushing your teeth every morning and every night.
When the grooves are covered, it is harder for food and germs to get stuck there, so it is harder for a cavity to start.
Every office does it a little differently, but a sealant visit usually goes like this:
Experts from the AAPD and the American Dental Association reviewed the research on sealants. Here is what they found sealants can do for back teeth.
On healthy back teeth, sealants lower the chance of a cavity in the grooves.
A sealant can also go over a very early cavity spot and help keep it from getting worse.
By preventing or delaying cavities, sealants can mean fewer fillings later on.
Back teeth, called molars. The sealant goes on the chewing surface, where the grooves are.
No. Sealants are extra help for the grooves. You still need to brush every morning and every night.
A strong recommendation. A 2016 clinical practice guideline from the AAPD and the American Dental Association, reprinted in the AAPD Reference Manual, strongly recommends sealants on the chewing surfaces of baby and permanent molars in children and teens, both on healthy surfaces and on early cavities that have not yet broken through (moderate-quality evidence). In the trials it reviewed, sealing permanent molars lowered the chance of a cavity on the chewing surface by about 76% over 2 to 3 years compared with no sealant.
Compared with fluoride varnish. For the chewing surfaces of molars, the guideline also suggests sealants over fluoride varnish (a conditional recommendation, based on low-quality evidence). Varnish may do more for the smooth sides of teeth, so many children benefit from both.
Underused. The guideline notes that sealants are still underused and encourages dentists to use them more, especially for children at higher risk of cavities.
Whether your child needs sealants, and on which teeth, depends on the dentist’s exam and your child’s cavity risk. The AAPD advises sealing at-risk grooves as soon as possible and checking the need again at regular visits, because risk can change. Brushing with fluoride toothpaste, smart snacking and regular checkups still matter. See What happens at a checkup.
Usually the back teeth (molars), both baby and permanent, on the chewing surfaces that have pits and grooves. The dentist decides which teeth to seal based on the exam and cavity risk, and checks again at later visits.
Very well. In the trials reviewed by the AAPD and ADA, sealing permanent molars lowered the chance of a chewing-surface cavity by about 76% over 2 to 3 years compared with no sealant. The guideline gives this a strong recommendation.
Yes. The guideline recommends sealants for chewing surfaces with very early cavities that have not broken through the surface (often seen as a change in color or shine). A sealant can help keep these early spots from getting worse. A cavity that has already broken through usually needs a different treatment, such as a filling.
For the grooves on the chewing surfaces of molars, the guideline suggests sealants over fluoride varnish, though the evidence for that comparison is low quality. Varnish may do more for the smooth sides of teeth. The two are often used together as part of a prevention plan.
The guideline describes four main types: resin-based sealants, glass ionomer cements and sealants, and two hybrid types. It did not find one material better than the others. The dentist chooses based on the tooth. For example, a glass ionomer may be better for a tooth that is only partly grown in and hard to keep dry, and a resin-based sealant may be better when the tooth can be kept dry and long-lasting retention is wanted.
Some sealants contain a small amount of BPA, which has raised questions. The AAPD and ADA guideline says the evidence does not show that the brief, small exposure from sealants puts children at risk, and two trials that looked for side effects found none.
Sealants can wear down or come off over time, and some materials come off more often than others. The AAPD advises checking sealants at regular visits and repairing or replacing them when needed. The guideline notes that teeth that lost a sealant were not at greater risk of cavities than teeth that were never sealed.
The clinical statements on this page come from the AAPD and American Dental Association clinical practice guideline on pit-and-fissure sealants, and from the sealant section of the AAPD periodicity best practice.
Review status: pending. No named reviewer or review date yet.
This website is for education only and does not replace care from your dentist, physician, or emergency services.