Fissure Sealants for Kids: Are They Worth It?

Fissure Sealants for Kids: Are They Worth It?

Tooth decay remains the most common chronic disease in Australian children. According to the Australian Institute of Health and Welfare, approximately 42 per cent of children aged 5 to 10 have experienced decay in their baby teeth, and 24 per cent of children aged 6 to 14 have decay in their permanent teeth (AIHW, Oral Health and Dental Care in Australia, 2023).

Fissure sealants are one of the most effective preventive tools available to change these statistics. A Cochrane systematic review (Ahovuo-Saloranta et al., 2017) found that sealants reduce decay in permanent molars by up to 80 per cent over two years compared to unsealed teeth. Yet many parents have never heard of them, or are unsure whether they are worth the cost.

At Townsville Dental Clinic, we recommend fissure sealants as a routine part of children’s dental care. This guide explains what they are, how they work, when to get them, and why the evidence overwhelmingly supports their use.

What Are Fissure Sealants?

Fissure sealants are thin, protective coatings applied to the chewing surfaces of the back teeth (molars and premolars). These teeth have deep pits and grooves (fissures) on their biting surfaces that trap food particles and bacteria. The grooves are often narrower than a single toothbrush bristle, making them impossible to clean effectively with brushing alone.

The sealant material — a tooth-coloured or clear resin — flows into these grooves, fills them, and creates a smooth, sealed surface that is easy to clean and resistant to decay. Think of it as a raincoat for the tooth: it forms a physical barrier that prevents bacteria and food from settling into the vulnerable grooves.

How Do Fissure Sealants Work?

The protection mechanism is straightforward:

1. Physical barrier — the sealant fills the deep grooves where 80 to 90 per cent of childhood cavities begin, preventing bacteria from colonising these areas
2. Smooth surface — the sealed surface is easier to clean with a toothbrush than the natural pitted surface
3. Fluoride release — some sealant materials release fluoride, providing additional decay protection over time

Research consistently demonstrates that sealed teeth are significantly less likely to develop cavities than unsealed teeth. A study published in the Journal of the American Dental Association (Wright et al., 2016) found that sealants reduced the risk of cavities in permanent molars by 80 per cent at two years and 60 per cent at four or more years.

The Fissure Sealant Procedure: What to Expect

The application is quick, painless, and requires no drilling or anaesthesia. Here is the step-by-step process:

Total time per tooth: approximately 5 minutes. Sealing four first molars takes about 20 minutes. The child can eat and drink normally immediately afterwards.

There is no pain, no needles, and no drilling. Most children tolerate the procedure easily, and it is one of the simplest dental appointments your child will experience.

When Should Children Get Fissure Sealants?

Timing is important. Sealants should be applied as soon as possible after each set of permanent molars erupts, before decay has a chance to start.

The first permanent molars erupt behind the baby teeth (they do not replace a baby tooth), so parents sometimes miss their arrival. These are the most critical teeth to seal because they are the most cavity-prone teeth in the mouth and must last a lifetime.

Why Timing Matters

Newly erupted teeth are most vulnerable to decay because:

• The enamel is not yet fully mineralised
• The grooves are deepest before any natural wear occurs
• Children’s brushing skills are often still developing at ages 6 to 7

Sealing within the first year of eruption provides maximum protection during this high-risk window.

Effectiveness: What Does the Research Say?

The evidence for fissure sealants is among the strongest in preventive dentistry.

The numbers are clear: fissure sealants are one of the most cost-effective interventions in all of dentistry. Preventing a single cavity saves the child from a filling that may need to be replaced multiple times over their lifetime, potentially escalating to a crown, root canal, or extraction.

Cost of Fissure Sealants

Cost Comparison: Prevention vs Treatment

A $30 to $60 sealant can prevent thousands of dollars in future treatment. When covered by the CDBS, the cost to the family is zero.

CDBS Coverage

Fissure sealants are a covered service under the Child Dental Benefits Schedule. Eligible children (aged 0 to 17, families receiving Family Tax Benefit Part A) can receive sealants at no cost when bulk-billed. At Townsville Dental Clinic, we bulk-bill all CDBS services, including sealants.

For more on CDBS eligibility and how to maximise benefits, see our comprehensive CDBS guide.

How Long Do Fissure Sealants Last?

Fissure sealants typically last 5 to 10 years with normal chewing and wear. Some sealants last even longer. The key factors affecting longevity are:

• Application technique — proper isolation (keeping the tooth dry during placement) is the most critical factor for long-term retention
• Chewing forces — heavy grinders or patients who eat very hard foods may wear sealants faster
• Sealant material — resin-based sealants generally last longer than glass ionomer sealants

Your dentist checks the integrity of sealants at each routine dental checkup. If a sealant chips, wears, or partially debonds, it can be easily repaired or reapplied — the process is just as quick and painless as the original application.

Even partially retained sealants provide protection. Research shows that teeth with sealants that have partially worn away still have lower decay rates than teeth that were never sealed, likely because sealant material remains in the deepest parts of the grooves where decay is most likely to start.

Safety: Are Fissure Sealants Safe for Children?

BPA Concerns

Some parents have raised concerns about bisphenol A (BPA) in dental sealants. Here are the facts:

• Most modern sealants used in Australian dental practices are BPA-free or contain only trace amounts far below any established safety threshold
• The American Dental Association states that sealants expose patients to less BPA than handling a receipt or breathing indoor air
• A systematic review in Pediatrics (2012) concluded that the levels of BPA released from dental sealants are biologically insignificant and do not pose a health risk
• If BPA is a concern, ask your dentist about the specific sealant material they use — BPA-free options are readily available

General Safety

Fissure sealants have been used for over 50 years with an excellent safety record. No systemic adverse effects have been documented. The procedure involves no drilling, no anaesthesia, and no removal of tooth structure — making it one of the most conservative dental treatments available.

The ADA, the World Health Organization, the US Centers for Disease Control and Prevention, and the Australian National Health and Medical Research Council all endorse fissure sealants as safe and effective.

Do Adults Need Fissure Sealants?

Fissure sealants are most commonly applied in childhood, but adults can also benefit in certain situations:

• Deep, unfilled grooves — if you have reached adulthood with deep grooves that have not developed cavities, sealants can help keep them cavity-free
• High decay risk — patients with dry mouth, high sugar intake, or a history of frequent fillings
• Newly erupted wisdom teeth — if retained, wisdom teeth with deep grooves can be sealed

Adults considering more extensive dental work may want to explore options such as dental implants for teeth that have already been lost.

Your dentist can assess whether adult sealants are appropriate based on your individual risk and tooth anatomy.

Fissure Sealants as Part of a Preventive Strategy

Sealants work best as one component of a comprehensive preventive dentistry approach:

• Fissure sealants protect the chewing surfaces of back teeth
• Fluoride strengthens all tooth surfaces, including smooth surfaces between teeth
• Regular checkups detect problems early and allow your dentist to monitor sealant integrity
• Good oral hygiene — brushing twice daily and flossing — protects the surfaces that sealants do not cover
• Healthy diet — limiting sugar and acidic foods reduces overall decay risk

No single measure provides complete protection. Together, these strategies give your child the best possible chance of reaching adulthood with healthy, cavity-free teeth.

Book Your Child’s Fissure Sealant Appointment

If your child’s first permanent molars have erupted (usually around age 6 to 7) or their second molars are coming through (age 11 to 13), now is the ideal time to book a sealant appointment. The procedure is quick, painless, and — for CDBS-eligible children — completely free.

Ready to book? Contact Townsville Dental Clinic to schedule your child’s fissure sealant appointment. We will check CDBS eligibility at the time of booking and ensure your child receives this highly effective preventive treatment at no cost to your family.