Dental Sealants for Kids: Are They Worth It?

What are dental sealants and how do they work?

Sealants are a thin plastic or resin coating painted onto the grooves and pits on the chewing surfaces of the back teeth — typically the molars and premolars. These grooves are naturally narrow and hard to clean thoroughly with a toothbrush. Bacteria and food particles collect there and cause cavities more often than on smooth tooth surfaces.

The sealant flows into those grooves and hardens to form a protective barrier. The procedure takes only a few minutes per tooth, requires no drilling or anesthetic, and is completely painless. The tooth surface is lightly etched with an acidic gel, rinsed, dried, and then the sealant liquid is applied and cured with a light.

Do dental sealants actually prevent cavities?

Yes, evidence from clinical trials supports that sealants reduce cavities on the surfaces they cover. The ADA's evidence-based guideline on nonrestorative caries treatments includes sealants as a recommended preventive intervention 1Ref 1Slayton RL, Urquhart O, Araujo MWB, Fontana M, Guzmán-Armstrong S, Nascimento MM, Nový BB, Tinanoff N, Weyant RJ, Wolff MS, Young DA, Zero DT, Tampi MP, Pilcher L, Banfield L, Carrasco-Labra A (2018).Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association.ADA evidence-based guidance supporting sealants as a nonrestorative preventive treatment for caries2Ref 2Dhar V, Pilcher L, Fontana M, González-Cabezas C, Keels MA, Mascarenhas AK, Nascimento M, Platt JA, Sabino GJ, Slayton R, Tinanoff N, Young DA, Zero DT, Pahlke S, Urquhart O, O'Brien KK, Carrasco-Labra A (2023).Evidence-based clinical practice guideline on restorative treatments for caries lesions: A report from the American Dental Association.ADA guidance on managing early carious lesions including the role of sealants on pre-cavity lesions. The key qualifier is that the protection applies to the specific surfaces the sealant covers — it does not protect between teeth or on any surface where the sealant is not present.

The CDC has tracked oral health data in children and notes that sealants remain an underutilized preventive measure, particularly in lower-income populations 3Ref 3Centers for Disease Control and Prevention (2024).2024 Oral Health Surveillance Report: Dental Caries, Tooth Retention, and Edentulism.CDC data on dental caries in children and underutilization of preventive measures including sealants. For children at moderate to high cavity risk — which includes most children during the cavity-prone elementary school years — sealants on permanent molars are widely recommended by pediatric dentists and the American Dental Association.

Which teeth and at what age?

Sealants are most commonly applied to the permanent first molars, which typically erupt around age six, and the permanent second molars, which arrive around age twelve. Getting them sealed shortly after they come in — before cavities have a chance to form — provides the greatest benefit.

Some dentists also apply sealants to baby molars if a child is at high cavity risk, though this is less universal. Sealants can also be placed on teeth that have early pre-cavity lesions (not yet fully cavitated) to arrest further decay — this is addressed in ADA's restorative guidance 2Ref 2Dhar V, Pilcher L, Fontana M, González-Cabezas C, Keels MA, Mascarenhas AK, Nascimento M, Platt JA, Sabino GJ, Slayton R, Tinanoff N, Young DA, Zero DT, Pahlke S, Urquhart O, O'Brien KK, Carrasco-Labra A (2023).Evidence-based clinical practice guideline on restorative treatments for caries lesions: A report from the American Dental Association.ADA guidance on managing early carious lesions including the role of sealants on pre-cavity lesions.

How long do dental sealants last?

Sealants can last several years, but they are not permanent. Over time they can chip, wear, or partially come loose — particularly with hard or crunchy foods and with grinding or clenching. At each dental check-up, the dentist or hygienist checks sealants and can repair or reapply them as needed. A partially intact sealant can still provide some protection but should be assessed.

The cavity-prone years for permanent molars are the school years — sealants applied during this window provide protection when the child is most at risk and oral hygiene habits are still developing.

Are sealants safe?

Sealants are generally considered safe. Older sealant materials were sometimes made with BPA-containing compounds; many modern sealants use materials that do not contain BPA, and even in formulations where trace amounts are possible, the exposure is very low. If this is a concern, ask your child's dentist which material they use.

The procedure itself carries no meaningful risk — there is no drilling, no needles, no discomfort.

Do sealants replace brushing, fluoride, and dental visits?

No. Sealants are one layer of cavity prevention, not a complete solution. Fluoride toothpaste twice daily is supported by strong evidence for reducing tooth decay 4Ref 4Walsh T, Worthington HV, Glenny AM, Marinho VCC, Jeroncic A (2019).Fluoride toothpastes of different concentrations for preventing dental caries.Fluoride toothpaste effectiveness for preventing dental caries, as complementary to sealants. Regular dental visits allow the dentist to catch decay early, check sealant integrity, and address areas between the teeth that sealants do not cover. A diet lower in sugar and sticky foods also matters. Sealants work best as part of this layered approach.

Gale and pediatric dental care

Sealants are placed by a dentist or dental hygienist — Gale can help you find a pediatric dentist and think through questions to ask at your child's next visit. Gale's pediatric care providers can also discuss broader preventive dental health as part of your child's overall well-child care.