Are Dental Sealants Worth It?
In an article published in the New York Times, "a review concluded that sealants are effective in reducing cavities for at least four years after each application." and that "when your dentist offers sealants for your children, it’s not an upsell, but a deal you should accept."
We agree! We routinely recommend that children have sealants placed on permanent teeth when appropriate. Moreover, it is important that sealants are done properly to ensure that they will last a long time.
For most children and teenagers, yes. Sealants are thin coatings painted onto the grooved chewing surfaces of the back teeth, where most cavities in children start. The CDC reports that sealants prevent about 80 percent of cavities in those teeth for two years and continue to protect against about half for up to four years. Placing them is quick and painless, and they work alongside brushing and fluoride rather than replacing them.
What are dental sealants?
Back teeth have deep pits and grooves on their chewing surfaces. Food and bacteria settle into those grooves, and a toothbrush bristle often can't reach the bottom. A sealant is a thin plastic or glass-ionomer coating that flows into the grooves and hardens, so there's nowhere for bacteria to settle.
How well do sealants work?
In 2016 the American Dental Association and the American Academy of Pediatric Dentistry reviewed the clinical trials and issued a joint guideline. The panel concluded that sealants on the chewing surfaces of baby and permanent molars are effective at preventing cavities compared with no sealant and compared with fluoride varnish alone. They also found sealants can slow early decay that hasn't yet formed a hole. The panel couldn't say that any one type of sealant material was better than the others.
The ADA, citing the CDC, notes that school-age children without sealants have almost three times as many cavities as children with them.
Who benefits from sealants?
Children, as soon as the first permanent molars come in, usually around age six, and again when the second molars arrive, usually around age twelve
Some baby molars, when a child has deep grooves or a higher risk of decay
Some adults with deep grooves and no fillings in those teeth, depending on their cavity risk
Your dentist will weigh the shape of the teeth, past decay and other risk factors.
How are sealants placed?
There's no drilling or numbing for a standard sealant. The dentist or hygienist cleans and dries the tooth, applies a mild gel to roughen the surface so the sealant bonds, rinses it off, paints the sealant into the grooves and hardens it with a curing light. Each tooth takes a few minutes.
How long do sealants last?
Sealants usually last several years. They can wear or chip, so they're checked at regular dental visits and repaired or replaced when needed. A sealant that has come off partway should be looked at, because food can collect under the edge.
Are sealants safe?
Yes. The ADA reports no significant side effects apart from rare allergies to the material. Sealants can also be placed over very early decay to keep it from progressing.
Does insurance cover sealants?
Coverage varies by plan. Many plans cover sealants on permanent molars for children up to a certain age. Check your benefits or ask the office before the visit.
Where can you ask about sealants in Jacksonville?
Our office is at 3675 Hendricks Avenue, near San Marco. Ask about sealants at your child's next dental visit, or at your own checkup if you have deep grooves on your back teeth. For more on protecting young children's teeth, read our parent's guide to early childhood dental problems and our article on fluoride toothpaste and Jacksonville's water. To ask a question, contact the office at 904-398-1549.
Sources
Wright JT, Crall JJ, Fontana M, et al. Evidence-based clinical practice guideline for the use of pit-and-fissure sealants: a report of the American Dental Association and the American Academy of Pediatric Dentistry. J Am Dent Assoc. 2016;147(8):672-682.e12. doi:10.1016/j.adaj.2016.06.001. Retrieved via PubMed (PMID 27470525).
Centers for Disease Control and Prevention. Vital Signs: Dental sealant use and untreated tooth decay among U.S. school-aged children. MMWR. 2016;65(41). Retrieved 2026-10-06.
Centers for Disease Control and Prevention. Vital Signs: Dental sealants prevent cavities. Archived page. Retrieved 2026-10-06.
American Dental Association, MouthHealthy. Sealants. Retrieved 2026-10-06.
Original reference for this post: The New York Times, The Upshot. Defending your children's teeth, and dentists: the value of sealants. September 20, 2016.
About the author. CJ Henley, DMD, is a general dentist in Jacksonville whose practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.
Is There a Needle-Free Dental Anesthetic?
UPI (8/26, Feller) reported in continuing coverage that the US Food and Drug Administration has approved Kovanaze, “a nasal spray anesthetic” for use during a restorative procedure “after it was shown to be safe and effective in clinical trials.”
Yes, for a limited group of procedures. Kovanaze is a nasal spray that the FDA approved in June 2016 to numb upper teeth for fillings and similar work without an injection. It works only on the upper front teeth and premolars, not on lower teeth or upper molars, and whether it is stocked by a given office varies, so ask your dentist whether it is an option for you.
How does a nasal spray numb a tooth?
Kovanaze combines two drugs. Tetracaine is a local anesthetic. Oxymetazoline is the decongestant found in many over-the-counter nasal sprays. When it is sprayed into the nostril on the same side as the tooth, the anesthetic reaches nerves that supply the upper front teeth. The decongestant narrows blood vessels so the anesthetic stays in place longer. Research showed the spray did not work well without it.
Because of where those nerves run, the spray can reach upper teeth from the second premolar forward. It cannot reach the nerves of the lower jaw or the upper molars, so those teeth still need conventional numbing.
What did the main trial show?
The key study was published in the Journal of the American Dental Association in 2016 by Elliot Hersh and colleagues at the University of Pennsylvania and other centers. It asked whether the spray could numb upper teeth well enough to complete a filling without a needle.
Design: 150 adults who needed a single filling on an upper tooth from the second premolar forward were randomly assigned to the active spray or a placebo spray. Neither patients nor clinicians knew which one was used.
Success measure: finishing the procedure without needing a rescue injection.
Result: 88 percent succeeded with the active spray, compared with 28 percent with the placebo.
Side effects: a runny nose (57 percent) and nasal congestion (26 percent) were the most common. No serious adverse events were reported.
A review by the same research group found success rates of 83 to 90 percent across the published trials. It also noted that two of 186 people who received the drug had a rise in blood pressure, most likely from the decongestant.
What are the limits?
It is approved for restorative work such as fillings, not for extractions, root canals or gum procedures.
It covers only the upper teeth listed above.
It is approved for adults and children who weigh at least 40 kg (88 lb).
Because oxymetazoline can raise blood pressure, tell your dentist about high blood pressure, thyroid conditions, heart conditions and all medications before any anesthetic is chosen.
What if needles make you anxious?
Fear of the injection is common, and it is worth saying out loud. Dentists have several ways to make numbing more comfortable, such as a topical numbing gel before the injection and giving the anesthetic slowly. You can read more about how dental numbness works and how long it lasts and about care for anxious patients.
If you are in Jacksonville and want to talk through your options before treatment, contact our office or call 904-398-1549.
Sources
Hersh EV, Pinto A, Saraghi M, et al. Double-masked, randomized, placebo-controlled study to evaluate the efficacy and tolerability of intranasal K305 (3% tetracaine plus 0.05% oxymetazoline) in anesthetizing maxillary teeth. J Am Dent Assoc. 2016;147(4):278-287. doi:10.1016/j.adaj.2015.12.008. Retrieved via PubMed.
Hersh EV, Saraghi M, Moore PA. Intranasal tetracaine and oxymetazoline: a newly approved drug formulation that provides maxillary dental anesthesia without needles. Curr Med Res Opin. 2016;32(11):1919-1925. doi:10.1080/03007995.2016.1238352. Retrieved via PubMed.
National Library of Medicine, DailyMed. Kovanaze (tetracaine and oxymetazoline) nasal spray label. Retrieved October 6, 2026.
About the author. CJ Henley, DMD, is a general dentist in Jacksonville whose practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.