Due to their special anatomy, the chewing surfaces of premolar teeth are at particular risk of caries. Here, many small lateral fissures emanate from a curved longitudinal fissure. Although this layout and structure is highly functional for chewing, particularly on young patients it can cause problems in terms of oral hygiene, as the fissures cannot be cleaned properly even when perfect cleaning techniques are employed.
Fissures have a structure like a bottleneck, but only offer very narrow access. This is problematic especially for the brushes of a toothbrush, as cleaning is made impossible by the narrow access, and provides ideal conditions for bacteria to thrive, which make their way into the fissures via the food being chewed. As a result, caries can occur underneath the fissure. The caries then spreads from the bottom of the fissure, which is separated from the dentine underneath only by a very thin layer of enamel. Not only does this undermine the integrity of the tooth, but it is extremely difficult to detect as the tooth enamel can remain completely intact for a long period of time in the process. Sealing these access points for bacteria is therefore a very sensible precaution and an effective prophylactic treatment for the prevention of caries. If the fissures are attacked by caries, sealing can reduce the problem by up to 75 percent.
But when is the right time to perform fissure sealing on patients? As a general rule, patients are suitable for this treatment from the age of 6. This is when the first permanent molars erupt, which are particularly susceptible to fissure caries. In addition, childhood is a very active period in terms of caries, and young patients often haven't yet adopted perfect oral hygiene practices. This is why teeth need particular protection during this time.
It is also important that the area is completely dried for fissure sealing. As a result, children are not always ready for this treatment at the age of 6.
The best way to perform fissure sealing is with a sealing material made of light-curing, low-viscosity composite material on an acrylate basis. The Lunos Fissure sealant is available in two different variants: a clear version without fluoride, which is specially designed for aesthetic sealing, and an opaque version with fluoride, which provides lasting protection against fissure caries.
To prevent potential complications, such as partial loss of the sealing material (due to moisture ingress during the process, insufficient conditioning or lack of compliance on the part of the patient), regular checks of the fissure sealing are recommended every six months.