This is one of the few dental procedures carried out while the tooth is still sound, and one of the least known entitlements under a child's health insurance card.
- Grooves on children's back teeth are often deeper and narrower than a toothbrush bristle, so this is where decay most often starts even in children who brush regularly.
- A sealant covers those grooves with a thin layer of material. It is preventive, placed on a sound tooth, with no removal of tooth structure, so it is usually painless.
- Fissure sealants fall within health insurance cover when prescribed by the dentist, including under student health insurance.
- Sealants protect the biting surface but not between the teeth, so daily brushing and flossing continue as before.
Most trips to the dentist with a child happen once there is pain and a cavity. Fissure sealants work the other way round: applied while the tooth is intact, so the cavity never forms.
What fissures are, and why they decay
Look at the biting surface of a back tooth and you will see it is not flat but crossed by winding grooves and pits. That shape is natural and helps grind food.
The difficulty is that in many children these grooves are very deep and narrow, narrower than a toothbrush bristle. Food and bacteria fall to the bottom of the groove where bristles cannot reach to clean them out. As a result, the biting surfaces of back teeth are where decay most often begins in children, even in those who brush regularly.
This is the part parents find puzzling: the child brushes twice a day and still develops decay in a back tooth. The explanation usually lies here.
What a sealant does
The procedure covers the pits and fissures on the biting surface with a thin layer of material, leaving the surface smoother and flatter. Once the grooves are sealed, food and bacteria have nowhere to lodge, and a toothbrush can clean the surface much more effectively.
It is worth distinguishing this from an ordinary filling. A filling deals with a cavity that already exists: the dentist must remove the damaged tissue before rebuilding. A sealant is preventive, placed on a sound tooth, with no removal of tooth structure.
At what age?
The right moment is soon after a permanent back tooth has erupted sufficiently and the dentist has confirmed the biting surface is sound and undamaged. A newly erupted tooth has immature enamel and clearly defined deep grooves, which is also when the risk of decay is highest.
Baby molars can also be sealed in some cases, depending on the dentist's assessment of that child's decay risk.
Not every child needs every tooth sealed. The dentist examines and weighs up groove depth, oral hygiene, diet and previous decay history. Do ask why it is or is not recommended for your child.
Does it hurt?
Usually not. This is worth mentioning for children who are anxious about dental visits. Because the tooth is sound, no tooth structure needs removing and anaesthetic is generally unnecessary.
The procedure involves cleaning the biting surface, preparing it so the material bonds well, placing the material into the grooves and setting it, then checking that the bite feels comfortable. Each tooth takes only a short time.
For many children this is their first easy experience at a dental clinic, which makes later visits less daunting. That is a secondary benefit, but not a small one.
Are sealants covered by health insurance?
Yes. Fissure sealants fall within health insurance cover when prescribed by the dentist, both with light-cured composite and with glass ionomer cement.
Bring the child's health insurance card, including a student health insurance card, together with photo identification of the accompanying adult. The benefit level depends on the category recorded on the card under the Law on Health Insurance. You can call our hotline and read out the details on the child's card to confirm before visiting.
Worth noting: this is one of the few preventive procedures within the covered scope, yet it is little known, so few parents make use of the entitlement.
Afterwards
- Sealant material can wear or partly come away over time under chewing forces, so it should be checked at regular dental visits and topped up if needed.
- Sealants protect the biting surface but do not protect between the teeth. Interdental spaces still need cleaning with floss.
- Brushing twice daily with fluoride toothpaste continues as before. A sealant supports oral hygiene rather than replacing it.
- Limiting sweets and sugary drinks still matters, particularly the number of times a day a child snacks.
When to bring your child
The natural time to ask about sealants is at a routine check-up, when the dentist can look at the newly erupted back teeth. If your child has never been to a dentist, our article on the timing of a first visit may help.
Ky Hoa Dental provides paediatric dental care at 266A - 268, Duong 3 Thang 2, Hoa Hung Ward, Ho Chi Minh City, Monday to Saturday, accepting health insurance on Saturdays as well, which suits children who are at school during the week.
Frequently asked questions
How do sealants differ from ordinary fillings?
A filling deals with a cavity that already exists, so the dentist must remove damaged tissue before rebuilding the tooth. A fissure sealant is preventive, placed on a sound tooth, covering the grooves with a thin layer of material without removing tooth structure, which is why it is usually painless.
How long do sealants last?
Sealant material can wear or partly come away over time under chewing forces, and how long it lasts varies by child and by tooth. They should therefore be checked at routine visits so the dentist can assess them and top up where needed.
My child has student health insurance. Does that qualify?
Yes. Fissure sealants fall within health insurance cover when prescribed by the dentist, and student health insurance provides entitlement in the same way as other categories under the rules. Bring the child's card together with photo identification of the accompanying adult.