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QUESTION: Hello Mr. Dalin,

I was wondering if you could help me with some questions that I have been meaning to ask a dental professional. I am 22 and I have 2 cavities filled when I was younger. They are mercury fillings because composite fillings weren't popular when I was younger. I have one on the right side of my upper molars and the other on the left side of my lower molars. Well I haven't had a cavity filled in about 10 years maybe more.

Well a few months back I went to my dentist. I have been going to the same dentist since I was 9 or 10. He detected some staining on my back molars and said that I have some deep fissures. He put some sealants on them. The composite he used was filled and thick like a paste. He said its the same material he uses to fill cavities. Which I thought was a little odd because I thought sealants were thin and flowing

Its been a few months since then and I have a cleaning in May. I was looking through my mouth with a flashlight and I detected some light brown staining under a sealant. I am concerned that the sealant has a microleak and that there might be decay growing under.

I am very concerned and I am going to ask my dentist is he could remove them. I managed to keep my mouth cavity free for many years and I think that I don't need the sealants. I just wanted to know if these sealants would be easy or difficult to remove? I'm thinking that my dentist is going to have to drill it out and I don't want to damage my tooth because of these dumb sealants.

Thank you for reading this and any information is greatly appreciated.

ANSWER: karen,
if the sealants are working well and sealed well, then they are tough to get off...sometimes we can pop them off with a small explorer tip. sometimes they have to be polished off. but if they are leaking, then they should be easy to pop off with a small explorer tip. talk to your dentist about this and make sure he/she understands your feelings here. you do not want the sealants any longer...you do not want your teeth hurt by removing them...you merely want him/her to try to pop them off which is simple and noninvasive.

see if this helps.

jeff dalin, dds

---------- FOLLOW-UP ----------

QUESTION: Thanks so much for your quick response. I will make sure to ask my dentist if he could take them off so that he can check if the stain is decay or not. I had a couple more questions, if that is okay.

Could the light brown stain I'm detecting under the sealant be decay? I know that if the sealant is leaking than there is definitely a possibility that bacteria is getting under the sealant. I also cannot brush there so the bacteria is free to feed and damage the tooth. The only reason I ask is because I got these sealants back in January. Can decay grow this fast in a matter of months? I detected this brown stain in the beginning of March.

Last question is about brushing and rinsing. I have asked my dentist this question and he said that it didn't matter how I brushed as long as I did. That answer isn't good enough and I wanted a second opinion. I normally brush with regular crest cavity protection toothpaste because its not as harsh and abrasive as other toothoastes in the market. I always take at least 3 or 4 mins brushing every morning and at night. I also floss before I go to bed and maybe in the middle of the day if I get food stuck on my permanent retainer. After brushing I normally don't spit out the toothpaste and instead I sip a very small amount of water and swish with the toothpaste slurry for 20 to 30 seconds and then spit. I don't rinse with water because I heard that its good to leave some toothpaste in the mouth so that the fluoride has some time to work and essentially put a protective layer on teeth.

I'm hoping what I am doing is right because there are so many opinions about brushing out there. I was also thinking of maybe using a Flouride rinse like ACT. I am just worried about the sorbitol in it because bacteria can feed on it. I know it is not as damaging as sucrose. I mean my toothpaste contains it too but at that point there is nothing I could do about that. I used to use Listerine a few years ago but then I read some studies that it doesn't really kill bacteria that causes cavities.

I have also been hearing a lot about xylitol and how it inhibits bad bacteria that causes bacteria in the mouth. I also heard that xylitol also helps balance the PH in your mouth. I was thinking of purchasing gum or mints with 100% xylitol so that I could chew them after meals like lunch.

I apologize for this really long question and again any information is greatly appreciated.

Answer
Karen
you have a lot of good questions here. I will try to answer them one by one.

as far as the stain goes, i think this is kind of quick for decay to form. it really sounds more like coffee/tea stains at the edges of the sealants. an xray can tell you if there is decay under the sealant (you cannot feel the groove with sealants in place). so get a quick bitewing xray and it will tell you. plus you want to see if the sealants can be simply popped off.

as far as your brushing habits go, you are doing above and beyond what most people do. we want 2 minuytes 2 times a day. you are going over that so i imagine you are doing a great job. i know what your dentist meant by quality is better than quantity (brush properly, each surface...more than just a time thing). leaving the paste in a little does help with fluoride uptake. do you need a rinse like act or fluoroguard? normally i would say no because you do not have a decay issue. but using it 1-2 times a week will not hurt anything. just do it as directed.

sorbitol is an okay sweetener but you are right about the research on xylitol. just do not overdo the xylitol. it can cause stomach upset if you use too much of it.

good luck with everything...i hope my answers help you out

jeff dalin, dds

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Jeff Dalin DDS

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general dentistry questions with topics ranging from cosmetic dentistry to dentistry for children

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Fellowships in American College of Dentists, the Academy of General Dentistry, and the International College of Dentists.

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