Why would I need pit and fissure sealants?

Share this article

Pit and fissure sealants form a protective finish over the chewing surface of molars, sealing off bacteria.

Preventive dental care can help people of all ages avoid unnecessary treatment, expense and discomfort. Over 90% of U.S. adults have a history of dental caries¹, but early intervention can decrease the number of decayed, missing, or filled teeth. Pit and fissure sealants offer a proactive way to protect teeth against damage from tooth decay.

What are pit and fissure caries?

Dental caries, commonly known as cavities, occur when the outer layer of tooth enamel weakens and breaks away. The mouth hosts over 700 species of bacteria, including certain bacteria that reside in the pits and grooves of teeth.² Like all living organisms, bacteria need energy. It thrives on simple sugars and other carbohydrates and produces acidic waste products. Although teeth are the hardest substance in the body, these acids can erode tooth enamel and help form cavities.³

A background decorative of Blue color

Permanent molars erupt into place between ages six and 12 and the primary molars generally fall out between these years. The chewing surfaces of molars often feature distinctive grooves that help grind food. But these crevices can be susceptible to pit and fissure caries.

The risk of cavities in permanent teeth increases if baby teeth develop cavities.⁴ While some practices only use sealants on permanent teeth, baby teeth also benefit from these applications. Plus, primary teeth have thinner enamel and can decay in susceptible individuals. A family dentist or children’s specialist, a pedodontist, can help parents decide on the best sealant strategy for their children.

How do pit and fissure sealants work?

Pit and fissure sealants form a protective finish over the chewing grooves of molars, effectively sealing off the area from bacteria. Several different techniques are available, but they all can help protect against tooth decay. After cleaning the grooves with gentle sandblasting or scrubbing, a bonded resin is placed. A bright light hardens the resin within a few seconds. 

After checking and adjusting the bite, the teeth are protected and ready for chewing. Sealants don’t require numbing and they usually last for several years.⁵

Advantages of pit and fissure sealants

Proven effectiveness

Once applied, sealants protect against 80% of cavities for two years and continue to protect against 50% of cavities for up to four years. Elementary-age children without sealants have three times as many cavities on their first molars as kids with sealants.⁶

In 2017, a review of 38 studies covering nearly 8,000 kids evaluated the effectiveness of pit and fissure sealants. The findings revealed that permanent molars with sealants had between 11% and 51% less decay compared to those teeth without sealants.⁷ After four years, the evidence suggested that sealants may need reapplication to remain effective. But this cost-effective treatment can usually be completed within a few minutes.

Less treatment

Early dental experiences often shape a person’s future perception of dental care. If a child experiences dental pain, they may avoid the dentist or become more difficult to manage in the future.⁸ Sealants offer a simple, non-invasive treatment for young patients to learn the benefits of dentistry.

Insurance assistance

While dental insurance plans vary, many plans provide coverage for sealants on children’s teeth. This non-invasive preventive service costs less than a filling and can help reduce the risk of more expensive treatment later.

Cavity protection

A cavity starts as a small area of deterioration on a tooth’s outer enamel. As it progresses, the damage reaches the inner layer of dentin and spreads toward the nerve center of the tooth. A sealant can stop an early stage cavity that’s not beyond the enamel layer.⁹ Sealants don’t protect the smooth surfaces of teeth, but fluoride varnishes applied one to four times each year can help stop smooth surface decay.¹⁰ A preventive strategy that combines sealants, fluoride, regular dental visits, and good home care habits can help keep cavities away.


The American Dental Association (ADA) has confirmed the safety of sealants, although they contain micro amounts of bishpenol A (BPA). A 2016 report found that a 6-year-old child is exposed to more BPA from food, drinks, sunscreen, shampoo, body wash and other cosmetics, and air and thermal paper (such as cash register receipts) than from the amount that is in dental sealants. The U.S. Environmental Protection Agency recommends a limit of 1 million nanograms of BPA per day in an average 6-year-old.  ADA testing demonstrated .09 nanograms per day released from twelve dental sealants.¹¹

A preventive strategy

Preventive dentistry involves a combination of techniques and habits that limits the risk of tooth decay and gum disease. While nothing replaces good brushing and flossing habits, timely interventions can help protect against oral problems.  

Consider these habits to help kids avoid cavities and get a healthy start:

  • Brush morning and night with a fluoride toothpaste

  • Use an age-appropriate flosser or waterpik to clean between teeth

  • Visit the dentist twice each year

  • Ask about the use of pit and fissure sealants

  • Ask for professionally applied fluoride varnishes

  • Limit sugary food and drinks and other simple carbohydrates

Links to external sites are provided for your convenience in locating related information and services. Guardian, its subsidiaries, agents and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-party sites, organizations, products, or services and make no representation as to the completeness, suitability, or quality thereof.

Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice. It is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.


Insights for the people.

Join our new digital insurance community that includes tips, resources and useful information from Guardian Direct.


  1. https://www.nidcr.nih.gov/research/data-statistics/dental-caries/adults, 2018

  2. https://newsinhealth.nih.gov/2019/05/mouth-microbes, 2019

  3. https://www.sciencefocus.com/the-human-body/how-hard-is-tooth-enamel-compared-to-other-materials/ (Last accessed March 2020)

  4. https://www.dentalhealth.ie/dentalhealth/teeth/primaryteeth.html (Last accessed March 2020)

  5. https://www.aapd.org/media/Policies\_Guidelines/G\_Sealants.pdf, 2016

  6. https://www.cdc.gov/oralhealth/dental\_sealant\_program/index.htm, 2019

  7. https://www.ncbi.nlm.nih.gov/pubmed/28759120, 2017

  8. https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-017-0338-9, 2017

  9. https://jada.ada.org/article/S0002-8177(16)30475-5/abstract, 2016

  10. https://www.sciencedirect.com/topics/medicine-and-dentistry/fluoride-varnish, 2019

  11. https://www.ada.org/en/publications/ada-news/2016-archive/august/bpa-in-dental-sealants-safe, 2016