Cavities are among the most common health problems in childhood, and they're also among the most preventable. Alongside brushing at home, a few simple treatments at the dentist can keep your child's teeth strong. Here's how dental sealants, fluoride and silver diamine fluoride (SDF) work, and when we recommend each one.
Dental sealants
Back teeth (molars) have deep grooves on their chewing surfaces. Food and bacteria settle into those grooves, and a toothbrush bristle often can't reach the bottom. That's why most cavities in children start on the chewing surfaces of molars.
A sealant is a thin, tooth-colored coating painted into those grooves. It hardens in seconds and creates a smooth surface that's much easier to keep clean.
What to know about sealants:
They're quick and painless. There's no drilling and no numbing. We clean the tooth, apply the sealant and set it with a light.
They're usually placed on permanent molars as they come in, typically around ages 6 and 12. Some baby molars with deep grooves can benefit too.
They work. The CDC reports that sealants prevent most cavities on the back teeth for years after they're placed.
They're checked at every visit. Sealants can last many years, and we touch them up if they wear.
Fluoride treatments
Fluoride is a natural mineral that makes enamel more resistant to acid and can help reverse very early decay. Children get fluoride from toothpaste and, in many Delaware communities, from tap water. A professional fluoride treatment adds a stronger, concentrated dose.
At First Smile, fluoride is a quick varnish brushed onto the teeth. It comes in flavors kids like, sets right away, and you only need to avoid hard or sticky food for the rest of the day.
Pediatric dental guidelines recommend professional fluoride every three to six months for many children, starting when the first teeth come in. We'll suggest a schedule based on your child's risk of cavities.
Fluoride toothpaste at home:
Under age 3: a smear about the size of a grain of rice
Ages 3 to 6: a pea-sized amount
Help your child brush until they can do it well on their own, usually around age 7 or 8
Silver diamine fluoride (SDF)
Sometimes a cavity has already started. For some children, especially very young children or kids who can't yet manage a filling comfortably, silver diamine fluoride is a gentle option.
SDF is a liquid painted onto the cavity. It can stop decay from progressing, with no drilling and no numbing. It takes about a minute.
Things parents should know about SDF:
It permanently stains the decayed area dark gray or black. Healthy tooth structure isn't affected, but the treated spot will look dark.
It's often used to buy time. It can hold a cavity steady until a child is older, or until treatment can be done comfortably.
It may need to be reapplied at follow-up visits.
We'll always talk through the pros and cons with you before using SDF.
Everyday habits that prevent cavities
Professional treatments work best alongside good habits at home:
Brush twice a day with fluoride toothpaste, especially before bed.
Floss once a day once your child's teeth touch each other.
Limit sipping and snacking. It isn't just how much sugar your child has; it's how often. Every snack or sweet drink starts a new "acid attack" on the teeth.
Make water the go-to drink between meals.
No bottles or sippy cups of milk or juice in bed.
Keep up with checkups every six months so we can catch problems early.
Ask us about your child's cavity risk
Every child is different. At your child's next visit we can look at their cavity risk and recommend the right mix of sealants, fluoride and home care. See all of our preventive services, or request an appointment at our Middletown or West Dover office.