Dental sealants are heralded as one of the ‘great hopes’ to stop tooth decay in modern culture. Numerous research studies about sealants for teeth over the past 20 years have shown that sealants decrease tooth decay.
But what’s really going on here? Are the results of the studies accurate or being manipulated to paint a pretty picture? And most importantly, given that most of the modern dental culture still functions from within the story that the mouth is separate from the rest of the body, what about the whole body impact of sealants?
Today let’s explore 5 reasons why we are very cautious about dental sealants as well as a powerful strategy you can employ if you choose to have sealants placed on your child’s teeth to help mitigate much of the potential risks of sealants.
According to WebMD, “Dental sealant is a thin, plastic coating painted on the chewing surfaces of teeth – usually the back teeth to prevent tooth decay. The sealant quickly bonds into the depressions and grooves of the teeth, forming a protective shield over the enamel of each tooth.” According to the ADA, sealants reduce the risk of decay by up to 50%.
The reasoning behind sealants is that the chewing surfaces of our molars have deep fissures and cracks in them which oral hygiene isn’t always able to get down deep enough into to clean out. Sealants supposedly protect these vulnerable areas from tooth decay by ‘sealing out’ plaque and food.
On the surface it makes sense.
However, like so many subjects, those of us willing to look below the surface and look at the whole story see that the details with dental sealants aren’t all rosy.
Part of the issue is that sealants are based strictly on the story that the only cause of decay is ‘bad bugs’ on the surface of the teeth. However, by now most of you know the primary cause of tooth decay. While bad bugs do play their role in the decay process, it’s not as simple as just keeping bad bugs from the crevices in our molars.
1. Do sealants really stop decay like we’re told?
Stories are so powerful, especially when they give us hope for something positive. Every parent knows the stress of feeling like they aren’t providing the best possible chance for their child to live a healthy, happy, fulfilled life.
So, when a dentist comes along and tells us that our child has some decay, we feel some sense of ‘parental negligence’ which makes us vulnerable to the dentist’s follow up suggestion (and hope for a better future). The industry is all too happy to capitalize on the parent’s dread by offering the story of hope that sealants provide. “This simple, rather inexpensive treatment will protect your child’s teeth from decay” is the sales pitch.
But is it true?
Research studies point to a substantial decline in rates of decay on teeth treated from sealants.
However, studies are funded by large commercial interests looking for validation of the efficacy of their products. We all know results can be skewed to paint a pretty picture.
We have the unique privilege of being friends with a number of rockstar holistic dentists. Many of our professional friends have shared with us that sealants just simply don’t work like we’re told they do.
One dentist friend, in particular, confided in us that every sealant he removes has active decay under it. Every single one. Ok, so that’s only one dentist. But he does his best and is very astute with many aspects we share here including using ozone, microscopic precision and the whole body impact of dentistry. Add to that the fact that he is a naturopathic doctor AND dentist. In other words, we listen to his opinions.
So why would there be active decay under sealants?
1. It could be that the sealant was cracked so bad bugs were able to get under the sealant.
2. It could be that bad bugs slipped under the edge (called the margin) of the sealant.
3. It could be that the dentist didn’t sufficiently remove all diseased tissue prior to placing the sealant.
Needless to say, if sealants don’t stop decay as well as we’re told by the industry, that substantially lowers any perceived benefit from placing them.
2. All sealants contain compounds known to cause cancer
This issue deserves some clarification as there are plenty of internet myths circulating on this subject.
Bisphenol A (BPA) is a common compound used in plastic production. Many of us recall the uproar of BPA being used in children’s toys and baby bottles.
Very few dental sealants contain BPA these days. However (and it’s a big however in this case), all dental sealants contain BPA derivatives that convert to BPA by reacting with enzymes in our saliva.2
The ADA states, “dental materials used to treat and prevent caries can contribute to very low-level BPA exposure”.
However, research suggests that this ‘very low level’ is sufficient to cause changes in human breast cancer cells.
In a test called the ‘E-screen test’ which is based on the ability of human breast cancer cells to proliferate in the presence of estrogens, cell cultures treated with 4 different bis-GMA based sealants proliferated six times more than control cultures.3
One study concluded, “The use of bis-GMA-based resins in dentistry, and particularly the use of sealants in children, appears to contribute to human exposure to xenoestrogens”.3
There are strategies to lower the exposure to BPA when sealants are placed which we will discuss below.
3. Sealant manufacturers don’t disclose the ingredients of their products
This fact is just an ethical pet peeve of ours. If a company doesn’t have to disclose their ingredients and chooses to not do so, what are they trying to hide? Sure, they may be trying to keep proprietary information secret from competing companies, but is that all the story? It just seems like good business to disclose the ingredients. That way, the company empowers the consumer with the information. That is unless they don’t want the consumer to have the information…
With the internet, we are living in the ‘age of transparency’. If a company wants to continue and thrive in this current market, they have to step up and be honest, be transparent. Recent news with Volkswagen shines a light on what happens in this age of transparency if a company tries to play the game like they did 20 years ago.
To toot our own horn a bit, we are not required by law to list the ingredients of our HealThy Mouth Blend. But keeping that information from you would be hiding from you and in the complete opposite direction from how we choose to live and do business.
Instead, what we choose to do is stand up tall, face to face with you and say, “Here are our ingredients. They help. You can try to make your own if you want.” Thankfully, you appreciate our work and find benefit from using our products and purchase them from us.
4. Sealants wear off over time
The next time a dentist urges you to consent to sealants for your child, ask them the following questions.
“Do sealants last forever?” (which of course they will answer ‘no’)
The follow-up question is, “Where do the sealant materials go when they ‘go away’?
Of course, when the plastic sealant materials flake off the molars (which they always do), the child consumes the tiny plastic pieces.
While this isn’t a huge known risk of BPA exposure, we still think there is cause for concern.
In our modern age, we have an unprecedented exposure to environmental toxins, especially plastics. Never before in known human history have we been exposed to so many toxic substances and in such crazy combinations. If sealants work to stop decay 50% of the time, then we may have to consider this risk more closely. However, since there are many actions/steps we can take to lower our risk of decay (without knowingly exposing our already burdened systems with a known carcinogen), is the risk really worth the potential benefit?
5. The cracks and fissures in our molars are there for a reason
Dr. Ellie Phillips is our new professional ‘best friend’. 🙂 We recently had a super engaging phone conversation with her comparing notes across the boards of all things holistic oral health related.
In our conversation, when we got to the subject of sealants, she shared with us her perspective. The cracks and crevices in our molars are home to health-giving bacteria which are part of our healthy oral microbiome. By sealing these nooks and crannies, we are removing the very places that these health-giving microbes call home.
Stay tuned for a new expert interview with Dr. Phillips. She is a wealth of knowledge and has so much to share.
How to lower exposure to BPA when having sealants placed
The main risks of BPA exposure from sealants are in the few hours after having the sealants placed. In other words, the research does not suggest that sealants constantly off gas BPA (like amalgam fillings off-gas mercury vapor). So, the game is to reduce our exposure immediately after the sealants are placed.
The research clearly shows that the part of the sealant that is exposed to air while curing is the part that won’t fully cure. It’s this uncured plastic that is at risk of being converted to BPA by our saliva.
Thankfully, there are steps dentists can take to significantly reduce the amount of BPA the patient is exposed to when placing the sealant.
Rinsing with water: Rinsing with room temp water for 30 seconds immediately after sealants are placed has been shown to reduce exposure to uncured sealant materials by 68%.
Rubbing with cotton: Dentists can reduce our exposure by 85% by rubbing the sealant surface with a cotton swab.
Rubbing with pumice: The best strategy known to lower BPA exposure is for the dentist to clean the surface of the sealant with a soft grit pumice immediately after curing. This strategy does not compromise the strength of the sealant and lowers BPA exposure by up to 95%. 4
In a follow-up article, we will lay out specific questions you can ask your dentist about the details of their use of sealants to best care for your family’s long-term health.
Now it’s your turn. Given this information on sealants, do you think they are a wise choice? Why or why not? What is your experience with sealants? Do you have a story to share with us to help others better navigate their own path to greater oral health? Together we can learn so much.
Cheers to the age of transparency!!
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