Should fissure sealants be done before or after tooth replacement?

In general, whether pit and fissure sealing should be performed before or after tooth replacement depends on the specific situation. Under normal circumstances, pit and fissure sealing is recommended after permanent teeth have erupted; however, if a patient has malocclusion, it may be advisable to perform the sealing before tooth replacement. The detailed analysis is as follows:

1. After Tooth Replacement

Pit and fissure sealing is a procedure that protects teeth without damaging tooth structure. A sealing material is applied to the occlusal surfaces, buccal, and lingual pits and fissures of the crowns. Once the material flows into and penetrates the fissures, it hardens, forming a protective barrier that covers the grooves. This prevents cariogenic bacteria and their acidic metabolic products from attacking the tooth surface, thus preventing pit and fissure caries. Pit and fissure sealing is typically performed after permanent teeth have erupted. It is generally recommended within six months to one year after all permanent teeth have fully emerged. This is because the pits and fissures become more distinct once the permanent teeth are fully erupted, allowing for better effectiveness of the sealing. Additionally, performing the procedure after permanent teeth erupt effectively helps prevent the development of dental caries.

2. Before Tooth Replacement

It should be noted that if a child's teeth have not fully erupted and there are issues such as misalignment or malocclusion, pit and fissure sealing may be necessary before tooth replacement. Furthermore, for high-risk areas prone to decay—such as malformed lingual pits in anterior teeth or fusion lines in fused teeth—dentists may recommend sealing before permanent tooth eruption based on the individual's dental condition.

If patients experience any discomfort or symptoms, they should promptly visit a hospital for evaluation to avoid delays in treatment.