Six-Year Molars Fully In? When to Get Sealants and How to Care for Them

Once the six-year molars are fully in, sealing their grooves is one of the best ways to prevent cavities. When to get sealants, aftercare, and common myths.

Once the first permanent molars (the six-year molars) come in, sealants are the next thing to think about. You may have heard the dentist recommend them, but you might wonder what they are exactly, when to get them, and what changes afterward. Here's what parents should know about sealants on permanent molars.

Why seal the permanent molars?

The chewing surface of a permanent molar is full of bumps and grooves, like little hills and valleys. These grooves are narrower and deeper than a toothbrush bristle, so no matter how carefully you brush, you can't reach the bottom. That's why molar cavities so often start in these grooves.

Sealants (pit-and-fissure sealants) cover these grooves with a thin layer of resin so food and bacteria can't get in. The American Dental Association and the American Academy of Pediatric Dentistry recommend them, and they've been shown to greatly reduce chewing-surface cavities. They're one of the most effective ways to prevent cavities in molars.

Sealants matter most on newly erupted molars. The six-year molars have to last a lifetime, yet they sit at the very back, where kids have the hardest time brushing on their own. Once a cavity starts, it often means repeated treatment, so it's best to seal the grooves before a cavity forms.

The right time is after the molar is fully in. The whole chewing surface needs to be showing so it can be kept dry during the procedure. If gum tissue still covers part of the chewing surface, the whole groove can't be sealed. If your child has a high cavity risk, the dentist may use a different, temporary protection (such as a glass ionomer sealant) even before the molar is fully in, so talk with the dentist once you see a new molar. The four molars often don't come in at the same time, so seal each one as soon as it's fully in. If the molars come in late, the sealants can simply wait until they do. Later, when the second permanent molars come in behind them, those can be sealed the same way.

Getting sealants, and caring for them afterward

1. Have the dentist confirm that all four first permanent molars are fully through the gums.
2. Get sealants on each molar as soon as it's fully in. It's a short procedure with no numbing: the tooth is cleaned and the sealant is painted on, so most kids handle it well.
3. Before the visit, explain it in a short, easy way, like "The dentist is going to paint a thin shield on your back teeth."
4. Right after a sealant, the bite may feel a little high. That usually settles within a few days. If it doesn't, the dentist can smooth it.
5. At every checkup, have the sealants checked for chips or loss, and reapplied if needed.

The most common myth is "Sealants are done, so no more cavity worries." Sealants only cover the grooves on the chewing surface. They don't cover the sides of the teeth or the spaces between them. So keep brushing and flossing just as before, with a pea-sized amount of fluoride toothpaste. Keep the habit of giving snacks and sweet drinks only at set times, too.

Another myth is "There's no cavity yet, so we can do it later." Sealants are a preventive treatment for healthy molars without cavities, so the best time is before a cavity ever starts. They can also be placed over a very early chewing-surface cavity that hasn't formed a hole yet, to help stop it from getting worse.

Frequently asked questions

When to see the dentist

• The six-year molars are fully in, and you haven't talked about sealants yet
• The grooves on a molar look brown or black
• A sealant seems to have come off, or the surface feels rough
• The bite still feels high several days after a sealant
• Food often gets stuck in a molar, or your child has pain when chewing

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The information in this article is for general educational purposes and does not replace professional dental care. Talk to a dentist about your child's condition.

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