Oregon calls glass dental sealants into question

The State of Oregon isn’t sure about the value of glass in dental sealants. In the past couple of decades, dentists have taken a new approach to reducing tooth decay among children. Once a child’s permanent molars erupt, dentists seal the chewing surface of the tooth with a sealant, made either from an epoxy resin or newer glass ionomer material. The State of Oregon has determined that it prefers the epoxy resin, under the belief that glass ionomer sealants are inferior.

Initially, the strategy involved using epoxy resins, but newer glass ionomer sealants are also widely in use. States often provide dental care to dependent children who receive Medicaid services. Some dentists prefer glass ionomer sealants because they require a less precise application and tend to form better seals in some cases than the epoxy resins do. Epoxy resins must be applied to a dry surface – something that’s kind of hard to come by in a patient’s mouth!

Glass ionomer sealants also release fluoride, which can help build and protect enamel surfaces in the mouth. In addition to blocking access to spaces in the teeth that might be more prone to decay, glass-based sealants can also deliver fluoride to the surfaces of the teeth over time. Epoxy resins cannot be used to deliver fluoride. Glass ionomer sealants are also better at reaching deep fissures in tooth surfaces – the surfaces most likely to be impacted by decay.

Despite their advantages, glass ionomer sealants are permeable, which means that acids and other tooth-damaging bacteria could pass through the sealant. Studies have shown, however, that glass ionomer sealants produce similar decay-stopping results to epoxy resin sealants. The similar performance is thought to come from the glass sealant’s fluoride delivery – which strengthens tooth enamel and makes it more decay-resistant.

Some proponents of the glass ionomer sealants argue that the sealants work best during the years when they’re needed most. Younger children sometimes have difficulty achieving good oral hygiene. By sealing new teeth when they’re most vulnerable to decay, dentists can preserve teeth early, and then apply additional treatments when the patient is better prepared to take good care of their teeth.

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Photo Credit: Trinity Care Foundation, via Flickr.com