What Are Pit and Fissure Sealants, and Does My Child Need Them?

The chewing surface of a molar is not flat. It has pits and narrow grooves, some of them finer than a single toothbrush bristle. Food and plaque settle in them and the brush cannot clear them completely.

Fluoride protects the smooth sides of a tooth well, but it works less well deep inside a groove. That is why decay in children so often starts on the chewing surface of the molars rather than between the teeth.

A sealant fills in the groove with a smooth surface, so there is nothing left to trap. It does not replace brushing or fluoride. It covers the one part of the tooth that brushing and fluoride reach least. For the full picture of what causes decay in children, see cavities in milk teeth.

The first permanent molars come through at about six years of age, behind the last milk tooth, which is why parents often mistake them for milk teeth. The second permanent molars follow at about 11 to 12. These are the teeth most often sealed, ideally soon after they have fully erupted and before decay has begun.

Sealants make most sense for a child with deep grooves, with earlier decay in other teeth, with a sugar-heavy diet, or who finds brushing hard to do well. A child with shallow grooves and good brushing may need little. The dentist decides tooth by tooth after looking.

Milk molars can also be sealed in some high-risk children, though the main use is on permanent molars. The age order of eruption is in when milk teeth fall out.

It is a short visit with no drilling and no injection. The tooth is cleaned and dried, a mild conditioning gel is applied for a short time to roughen the surface, and the tooth is rinsed and dried again. The sealant is painted into the grooves and set with a curing light.

The tooth has to stay dry throughout, so a child who cannot keep still or keep the mouth open may need to come back when they are calmer. A fresh, clean, fully erupted tooth is the best candidate. A tooth that is still partly under the gum is harder to seal.

Afterwards the child can eat normally. The coating feels like a thin film at first and the tongue gets used to it within a day.

A sealant can last for several years and often longer, but it can wear or chip, especially in a child who bites on hard objects. It is checked at every routine visit and topped up if part has come off. A sealant that has partly failed can trap bacteria under it, so the check matters.

Sealants do not treat decay that is already there. If a groove already has a cavity, it needs a filling instead. Sealing over an established cavity is not the usual advice.

Sealants reduce the risk of decay on the sealed surface only. Smooth surfaces and the spaces between the teeth still need brushing, flossing once teeth touch, and fluoride. See fluoride treatment for children for that side of prevention. The wider approach is on the kids dentistry page.

Sealants are among the less expensive preventive treatments in dentistry because there is no drilling and the visit is short. A sealed molar is far cheaper than a filling, pulpectomy or crown on the same tooth later. Call the clinic for a current price per tooth.

For how children's treatment is priced more generally in Lucknow in 2026, see the tooth extraction cost page, where milk tooth work sits at the low end.