Conference moira::parenting_v3

    What your dentist is referring to is "sealing" your son's molars.  John
    Hancock pays for this for PERMANENT teeth - not baby teeth.  It really
    is very simple - they just apply the coating to the teeth and it takes
    about a minute to harden.  My oldest two sons had this done to their
    baby teeth because there were alot of crevices in their molars -
    otherwise they would only have it done to the permanent molars (my
    eight year old has some permanent molars now and they've been sealed).
    
    The only thing my kids didn't like was the fact that their mouths had
    to be really dry before the hygenist could put on the sealant - that
    meant alot of cotton and air.  But, the whole process took less than 5
    minutes.  My dentist charges about $10 - $15 a tooth. 
    
    Linda

    
    I had this done when I was small.  It was nothing and was a very easy
    process.  I believe they take a small brush and brush hte sealant on to
    the tooth.  I had *a lot* of my teeth done too.  It's actually much
    better than getting your teeth cleaned.  The sealant is white too
    so it looks like the tooth has been filled but the color is white not
    silver.
    
    -Chris

    As a direct result of not having this procedure done when he
    needed it; most of my husband's baby teeth had to be pulled at
    a very early age due to unusual decay - the result was no natural
    path for the permanent teeth to follow. This lead to crooked teeth
    as well as large overbite that had to be corrected with braces.
    My lesson is that if any children we have, have my husband's type
    of teeth, I am going to demand this procedure as early as possible,
    (I don't have great teeth either -- I shutter to think about 
    what our childrens' might be like....!)
    
    Monica

I had this done to my molars a few years ago (BEFORE John Hancock paid for
this procedure), even though I have very few fillings and haven't had
a cavity for many years - an ounce of prevention if you will.

As previous replies have said, it's painless, as far as I have read
harmless, and except for feeling like there was something stuck in my teeth
for a few days until the extra stuff wore off, there is no discomfort
involved (read PAIN).  The sealant is clear and goes into the crevices so
it's completly undetectable with the naked eye.

I'd do just about anything to aviod the drill for me or my kids.  YUCK!


~Caryn

Thanks for all the replies.  If he has teeth like his dad, he will thank me
someday for having this done!  Only thing is...if he has teeth like me (no
cavities - nice and straight) it will be a waste of time and money.  Good
thing insurance is paying for it.

-sandy

    A side note - my town (Holden) doesn't have fluoride in the water
    either, and we just use fluoride supplement drops in the kids' juice
    each day.
    

    
    I had my molars sealed just a few years ago.  If I could I would have
    had them all sealed and I never had a cavity until I was 18! (bad
    college habits and no flouride in the water there)
    
    Anyway, JH only pays for it for children.  I think it was $12/tooth.
    Its supposed to last as long as a filling, so it may need to be redone
    sometime.  Mine have been in since 1986 I believe, and even the one on
    my wisdom teeth that she didn't think would take well are still there.
    
    I plan on having it done for my children.  Teeth are a lifetime
    investment to me.
    
    Sue

    This has always sounded like snake oil to me.  How exactly do they get
    this stuff (and what *is* it) to bond to the teeth?  If it doesn't make
    a chemical attachment, doesn't it sound sorta like nail polish, or car
    paint?  And when it starts to go, wouldn't foods and acidic saliva get
    under it and wreak havoc?  And then when you go to have it *redone*,
    how exactly do you get the old "nail polish" off so you can do the job
    right?  Is there a solvent?  Would you want that in your mouth??
    
    Bah humbug,
    Leslie

    It does bond permanently to the enamel of the teeth.  
    
    Kat had hers done years ago, back when we had to pay for it.  She
    hasn't had a cavity since then.  And she'd had more than the
    average number before that, despite having lived in an area with
    naturally high flouride levels in the water and practiced good
    hygiene the whole time.  
    
    --bonnie

    .7> Its supposed to last as long as a filling, so it may need to be redone
                             ^^^^^^^^^^^^^^^^^^^^
    
    Not long enough in my book, and certainly not "permanent."  But I'll
    ask Alex's dentist on our next visit--and get something comprehensive,
    in print, to convince me that we need it more than the dentist and the
    plastic company need our money.
    
    Leslie 

    
    The idea is to get the kids through the "cavity prone" years.  
    In my opinion, I rather pay the $$ (if you have insurance it is 
    covered), rather than risk the kid having a hole in his teeth that
    will need to be filled and possibly re-filled for the rest of his life.
    
    

    This was "offered" to us at AJ's last check up.  We were also told, in
    an authoritative type of tone, that our insurance won't cover it, and
    eluded that this would be expensive.  
    
    Since we're already living on a shoestring, and he hasn't had any
    cavity problems so far, we decided against it.
    
    Now we recently changed to HMO Blue, the old Montachuset plan, but I
    think the dental coverage still remains the same. Can someone tell for
    sure if the dental plan covers this?  I'm willing to do it, it's the
    pocketbook that's protesting!!
    
    Lyn

    Our dentist charged about $12 per tooth ... and it was covered by
    our dental plan (DEC Canada).
    
    

    When the molars grow before eruption, they grow outward from the roots,
    forming cusps. The cusps grow togther and fuse. This gives molars their
    characteristic shape of outer cusps and central fissure.
    
    The central fissure in children features thinner enamel and less
    dentin, and given the crevice mature is prone to collect food providing
    a place for bacteria growth, and eventual decay.
    
    As children grow older the areas thicken and seal more effectively. The
    intent of the applying a seal coating to young children is just that to
    seal the area, and fill any deep crevices of the central fissure to
    prevent the accumulation of decay promoting material. Given that only
    the sealant only has to work in compression, and is only useful in
    crevices it is easy to see that it would last a long time. It is
    quickly worn off contact surfaces, but contact surfaces are generally
    kept clean by normal processes.
    
    Flouride works differently in that it is taken into the enamal matrix
    and 'hardens' it, and makes it more resistant to chemical attack.
    
    When my kids get their permanent teeth, I will invest in this. I only
    wish that it was available when I was growing up.
    
    /jim

    RE:  -1
    
    Thanks for all the good information.
    
    Two questions - do you think the coating is worthwhile on baby teeth?
    
    You mentioned that as the children grow, the cusps grow together.  (I
    think I got it right.)  But I thought the teeth are fully formed when
    the erupt, and don't grow any more after that.  Were you perhaps
    comparing baby teeth and adult teeth?
    
    Laura

    Decay can happen even on baby teeth (ever seen a kid who had "bottle
    mouth syndrome, and the accompanying *horrendous* decay?), and if baby
    teeth, decay (as mentioned in a previous reply, it can cause problems
    for the alignment of the permanent teeth below them.
    
    If you can't afford all the teeth done at once, call your dentist and
    discuss the possiblity of maybe having 2 done a month, or whatever you
    can afford at one time. It is virtually painless (although the air they
    blow in your mouth can give you a terrible "cotton mouth" feeling),
    very quick, and they ususally estimate that it'll last about 15 years
    average. 
    
    The sealant is bonded to the teeth, by using an etching fluid first
    which roughens the surface of the tooth. then the sealant is applied,
    and cured with a special light they shine right on your tooth for
    something like 20 seconds. Whole process for one tooth takes maybe 5
    minutes, counting the time it takes them to lay out and set everything
    up. If more are done, it's less time, because all the setting up is
    already done. The sealant does not chip off like nail polish, but woudl
    graudally wear off, much in the same way that electroplated gold would
    wear off a chepaer base metal, and have to be reapplied. It is not
    toxic, and the wearing down is obviously *very* gradual. While it is
    intact, you *cannot* get a cavity where the sealant is (but you could
    on other tooth surfaces that are not sealed!).
    
    As explained to us, the fissures and crevices ina molar's surface are
    often so tiny, that a toothbrush bristle cannot fit itno them. If the
    toothbrush can't, it won't get clean ... be assured that the food
    particles, particularly when dissoved in saliva, *can* get into the
    fissures and do their nasty work.
    
    
    To us, it was definitely worth it, and I definitely do not think it is
    hype on the part of a plastics company, or just a way for dentist's to
    make more money.
    
    --dave--
    is already done

    OK, let's say Mom or Dad decides to have sealant applied to the
    toddler's baby teeth.  Next question.
    
    My daughter (14 months) freaks out when anyone (me or doctor) tries to
    open, look in, or brush the teeth in her mouth.  That round little jaw
    clamps SHUT and she gets very determined.  She does her own
    toothbrushing in a very haphazard way - mostly just sucks the water
    from the brush and waves it around.  (She doesn't get a bottle in bed,
    btw.)
    
    How do you apply sealant without traumatizing the poor child?  She'd
    have to be physically restrained.  Do you wait until she's a bit older
    and able to understand and cooperate?
    
    Laura

    Re: .15
    
    Ask your dentist about baby teeth. I don't know what the current
    practice is. In general they don't worry as much about baby teeth
    because they are in place for such a relatively short period of time.
    
    Teeth continue to develop throughout the one's lifetime. The dentin
    layer continues to get thicker with age until the pulp areas are
    restricted and the roots begin to die back in old age. Caries, fillings
    and other irritations will increase the pace of dentition.
    
    When children's teeth erupt they are complete, but the enamel and
    dentin are thinner than they will be in later years giving decreased
    resistance to caries. In addition surface features are more 'rough'
    allowing more areas for food to adhere to. In time many of the areas
    will be eroded and filled by normal chewing to give a smoother surface.
    
    
    Re: .16
    
    I believe the plastic is a UltraViolet curing epoxy. 
    
    Enamel despite what it looks like from a macro view is actually porous,
    with there being a natural fluid/mineral interchange occuring. The
    porosity is much smaller than your average bacterium, but the matrix is
    sufficiently rough enough to take a good bond.
    
    /jim

    do they do this to adult's teeth as well?  Just curious.

    Laura; how have other dentist appointments gone? 
    Betcha dentists have all seen this kind of reluctance, and good
    dentists probably have a whole bag of things that they might
    want to try to help getting the child to co-operate. Why don't
    you discuss it with the dentist -- I'm sure they'd have 
    better ideas than us....
    
    Monica
    

    My dentist is part of a family-oriented practice with a lot of 
    emphasis on the kids.  He has 3 young 'uns of his own.  He has told me
    to wait several years before I bring her in.  (About 3 I think?)  He
    said the first few appointments would just be to get her oriented and
    comfortable, and that the actual cleaning would be minimal.
    
    He said the important thing is not to give her bottles or food in bed -
    to prevent bottlemouth.  I also administer flouride drops daily because
    we have well water.
    
    He said to let her play with the toothbrush, but not to expect any
    serious cleaning until she is older.  (btw, she likes to play with the
    dental floss container.  I will give her a demo soon, and let her play
    with a short length.)
    
    He didn't say anything about the coating.
    
    I have an appointment next week for a cleaning, and will verify the
    details at that time, and let you know if they are different from my
    statements above.
    
    Laura

.21 reminded me of something a dentist friend of mine once said.  He said that
a mouth will clean itself naturally if you don't eat more than three TIMES
a day (includes snacks, softdrinks, etc.)  I think the three was just a rule
of thumb but that basically if children are not continually snacking or
sucking on milk or juice, etc., their mouths will naturally clean themselves.

When my kids were small, I used to give them all the sweets they would get for 
the whole day for dessert so the attack on their teeth would be minimal.  I also
always let them eat all their easter or christmas candy (which was never really
that much) in one big go.  They thought that was neat and I considered it just
one attack on their teeth.

Then we only bought raisin sugar bon-bons (sorry, that's a translation from
traubenzucker bonbons) for them.  The sugar in these is very simple and is
broken down by saliva.

Now they are older so it's harder to control what and when they eat but they 
still don't get much in the way of softdrinks.  We simply don't have then in
the house.

And, at 11 and 13 they have no cavities (touch wood).  We also used little
flouride pills the first 2-3 years of their life.  There is no flouridation
in the water here.

I have another question along this line.  Markus who is 11 is STILL losing
baby teeth.  I think he has about two or three left and just lost a couple
a few weeks ago.  We're still waiting for canines and such to come in.  Is
this normal?  He has beautiful straight white strong teeth once he gets them
but it sure seems late.  I mean, Dirk is already getting his third set of 
molars!

Is there any correlation between teething age and other physical development?
I'm thinking about his enuresis.

Cheryl

    This is a subject I have mixed emotions about.  My son - now 3 1/2
    had this procedure done on his 2 front teeth at the age of 2 1/2.
    I (shamefully) let him go to bed with a bottle too long and he had
    very little decay on those 2 teeth.  Instead of filling the teeth,
    the dentist recommended this procedure - since there was no cavity,
    just discoloration.  At the time it made sense to me, however we
    are now seeing a new dentist and after only 1 year, he wants to do
    the procedure again.  There has been no change to these 2 teeth,
    yet he feels it would prevent anymore decay.   My son has been a
    real trooper in brushing and flossing his teeth regularyly - we
    make sure of that, and again there has been no new decaying. 
    
    My concerns are; why put him through this procedure again if
    1.  He just had the procedure done 1 year ago
    2.  There has been no new decay
    3.  His teeth are already starting to loosen, which means those
        baby teeth will be gone soon
    4.  We also live on a shoestring and although my child's health
        is more important than anything, is it really necessary?
    
    At this point my husband and I have decided not to go ahead with
    the procedure, but I have this constant pang of guilt that it
    is the wrong decision (part of being a parent).
    
    Just my thoughts.
    
    Paula

    Paula,
    
    Given the circumstances you just gave, I wouldn't do it again either!
    
    Consider this...cavities in the front teeth are rare aren't they?  Most
    people can brush those quite easily.  It's the ones that are in the
    back, are harder to get to, and have more crevices that should be given
    the attention.
    
    I can't tell you how to feel, but I sure wouldn't lose sleep over it!
    
    -sandy 
    

    My dentist's recommendations stand as reported in my earlier reply; I
    spoke to him yesterday to verify everything.
    
    He recommends applying coating to the permanent molars when they come. 
    He does not think it is worthwhile to coat baby teeth.  He does not
    think it is worthwhile to coat teeth other than molars because the
    coating works in the depressions and grooves in the teeth.
    
    He advises that you find out if the cost of coating application
    includes reapplication if necessary.  Usually the coating lasts a long
    time, but sometimes (due to no fault of the dentist) the application is
    faulty.  In his practice, he reapplies the coating at no charge.  We
    only discussed pediatric dentistry so I don't know if you need it
    reapplied as an adult.  I also don't know for how many years he
    guarantees each application.  Ask your dentist for his/her policy and
    charges.
    
    The following information is from the American Dental Assocation:
    
    "Decay is caused by dental plaque. . .The bacteria in plaque produce
    acids that attack the tooth enamel.  After repeated acid attacks, the
    enamel breaks down, and a cavity (hole) is formed.'
    
    "A sealant is a clear or shaded plastic material that is applied to the
    chewing surfaces of the back teeth (premolars or molars) where decay
    occurs most often.  This sealant acts as a barrier, protecting the
    decay-prone areas of the back teeth from plaque and acid.'
    
    ". . .By forming a thin covering over the pits and fissures, sealants
    keep out plaque and food, and thus decrease the risk of decay.'
    
    [Illustration  shows that a tooth brush bristle is too large to reach
    inside the fissures.]
    
    "Children receive the greatest benefit from having sealants applied to
    their teeth, especially to newly erupted permanent teeth.  Sealants are
    recommended for all children, even those who receive . . .flouride.'
    
    ". . .it may be several years before another application of sealant is
    needed.  Reapplication of the sealant will continue its protection
    against decay. . .Sealants will be checked during your child's regular
    dental visits to determine if reapplication is necessary."
    
    "The American Dental Association recognizes that sealants can play an
    important role in the prevention of tooth decay.  When properly applied
    and maintained, they can successfully protect the chewing surfaces of
    your child's teeth."
    
    Laura