Services · Prevention
Cleanings, fluoride & sealants
The unglamorous work that keeps small teeth out of trouble. A polish, a minute of varnish, and resin run into the grooves of the back teeth before decay gets there first.
- Ages
- All ages
- Appointment
- 30–45 minutes
- What it includes
- Gentle cleaning and polish · Fluoride varnish · Sealants on permanent molars · Silver diamine fluoride where it fits
The cleaning itself
A prophylaxis, in the notes. A tickly spinny toothbrush, to your child. Marisol works round the mouth with a slow rubber cup and a gritty paste in whichever flavour was chosen at the start — bubblegum, strawberry, mint or, for reasons nobody has explained, cookie dough.
Where there is hard deposit she will use a hand scaler, which feels like scratching rather than anything sharp. Most children under about eight have very little of it. Then floss between any teeth that are touching, and a demonstration of the bit you are missing at home — because there is almost always a bit, and it is almost always the inside of the lower front teeth.
The whole cleaning takes ten to fifteen minutes of a thirty to forty-five minute appointment. The rest is the examination, the varnish, and the talking.
What the examination covers
Five per cent sodium fluoride
Fluoride varnish
One of the cheapest, best-evidenced things in paediatric dentistry. It strengthens enamel and slows early decay, and for most children we apply it at every check-up from the first visit onwards.
Under a minute
Five per cent sodium fluoride varnish, painted on with a tiny brush. It sets on contact with saliva, so there is no waiting with trays in the mouth.
It feels sticky
For an hour or so the teeth feel furry and look faintly yellow. That is the varnish sitting where it is meant to sit, not a stain.
Soft food, then bed
Soft, cool food for the rest of the day, nothing crunchy, and skip brushing that night. Brush again the next morning as normal.
If your child has an allergy to colophony or sticking plasters, tell us — some varnishes contain a rosin base and we will use a different one.
Sealants, step by step
The chewing surface of a back tooth is not flat. It is a landscape of pits and fissures narrower than a single toothbrush bristle, which is why brushing alone never quite gets in there. A sealant fills them in.
We clean the grooves
The chewing surface is brushed and washed out. Anything sitting in the fissures has to come out first, or it gets sealed in.
We keep the tooth dry
Cotton rolls and a little suction. This is the fiddly part and the reason a wriggling six-year-old sometimes needs two goes.
A conditioning gel goes on
It sits on the enamel for about fifteen seconds to give the resin something to grip, then it is rinsed off. It tastes sour and that is the worst of it.
The resin flows in
A thin liquid resin is run into the pits and fissures with a fine brush. No drilling. No injection. Nothing is removed from the tooth.
A blue light sets it
About twenty seconds per tooth. Then we check the bite, ask your child to tap their teeth together, and adjust it if it feels tall.
When
Around age six for the first permanent molars, which arrive at the back without anything falling out first — so plenty of families never notice them come through.
Around age twelve for the second permanent molars, behind those.
We check every sealant at every recall and repair it when it chips. A sealant is a thing we maintain, not a thing we place once and forget.
What a sealant does not do
A sealant covers the chewing surface and nothing else. It does not protect the surfaces between two teeth that are touching, and in older children that is precisely where decay starts. Flossing and fluoride are not optional extras alongside sealants. They are the other two thirds of the same job.
Honest about the trade-off
Silver diamine fluoride
SDF is a liquid painted onto a cavity that already exists. It arrests the decay — stops it progressing — with no drilling, no numbing and no injection. For a two-year-old with decay in the front teeth, or a child who cannot yet manage a filling, or a baby tooth that is going to fall out within a year or two anyway, it can be exactly the right answer.
Here is the trade-off, stated before you ask for it: the treated area turns permanently black. Not the whole tooth, and not a stain that can be polished away — the arrested decay itself goes dark, and it stays dark until the tooth is either restored over the top or lost naturally.
We show every family a photograph of a treated tooth before anyone consents to it. Some parents look at the photograph and say yes immediately, because the alternative for their child is a general anaesthetic. Some say no, and that is an entirely reasonable answer too. What we will not do is paint it on and let you discover the colour at home.
When a filling is the better call- Stops the cavity progressing
- No drill, no injection, about a minute per tooth
- Can buy years for a child too young to sit a filling
- Stains the treated decay permanently black
- Does not restore shape — a hole is still a hole
- Usually needs reapplying, and needs checking every recall
Ohio Medicaid covers sealants for children
It does, and a surprising number of families have never been told. Cleanings and fluoride varnish are covered too. Kelly will check your plan and tell you what is covered before the appointment rather than after it, and if something is not covered you will hear the number first.
Questions about cleanings and sealants
Does a sealant involve drilling or a needle?
No, neither. Nothing is removed from the tooth and nothing is numbed. The chewing surface is cleaned, dried, conditioned with a gel for about fifteen seconds, painted with a liquid resin that runs into the grooves, and set with a blue light. For most children the hardest part is keeping the tooth dry, and for a child who cannot manage that yet we simply come back in a few months.
Which teeth get sealed, and at what age?
Usually the first permanent molars, which arrive at the very back at around age six, and then the second permanent molars at around twelve. Those two are the deepest-grooved teeth in the mouth and the ones that decay first. We sometimes seal deeply grooved premolars, or a baby molar in a child at high risk. We do not seal a smooth tooth just because it is there.
How long do sealants last, and what happens when one chips?
Some last for years and some chip within a year, usually because a corner did not bond well or the tooth was not fully erupted when we placed it. We check every sealant at every recall by looking and by running an explorer over the edge. If one has chipped or worn we repair or replace it there and then; a partly missing sealant is not a disaster, but it does need topping up.
If my child has sealants, do we still need to floss?
Yes, and this is the part that gets missed. A sealant only covers the chewing surface. It does nothing at all for the surfaces between two teeth that are touching, and that is exactly where decay starts in older children. Sealants plus fluoride plus flossing is the set. Sealants on their own is a third of a plan.
What is silver diamine fluoride, and why is it black?
It is a liquid painted onto an existing cavity that stops the decay progressing, without any drilling or numbing. The silver in it reacts with the decayed tooth structure and turns it permanently black — not the whole tooth, but the treated area, and it does not polish off. It is genuinely useful for a very young or very anxious child, or for a baby tooth that will fall out soon anyway. We show you a photograph of what a treated tooth looks like before you decide, every time.
If your child finds a cleaning genuinely unbearable rather than merely annoying, read sensory-friendly care — a cleaning can be broken into three short visits, and often should be.
Book a cleaning
Cleanings, varnish and the examination happen in one appointment. Tell us if your child has had a hard time somewhere else and we will book longer.