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Bonded Sealing: A Great Way to Save Fractured Teeth
By Dr. Ed Mapes
Bonded sealing is a process used to seal broken teeth or teeth with enamel hypoplasia.
These damaged teeth are susceptible to the entry of bacteria that can then travel down
the tooth’s interior (the dentin) to set up infection within the root structure. This
eventually causes an abscess that erodes the root and then infects the gum. Needless
to say, this is a painful process that pets usually endure without our knowledge.
This whole scenerio can be prevented by early intervention when a tooth is broken.
Application of a bonded sealant closes the broken surface to prevent bacteria from
entering the tooth’s dentin. This region of the inner tooth is comprised of many fine
tubules that traverse the tooth toward the root. Application of the sealant closes these
tubules and thereby prevents further damage to the tooth and adjoining gum surfaces.
The process starts with dental digital radiographs to visualize the tooth and ensure that
it is healthy. Close examination of the root apex (deepest portion of the root) is
important because unseen infection can exist there. Teeth with damage or infection
involving the root structures will not respond to bonded sealing, since the damage has
already been done. These teeth will require either root canal or extraction procedures at
that point.
Figure 1: Dental X-ray shows that the root of this canine tooth is healthy
With evidence that the root structures are healthy and intact, the technique begins by
rounding off any jagged areas of the fractured tooth with a dental burr. The tooth is then
ground with a series of polishing discs until the surface is very smooth and even.
At this point we etch the surface with a phosphoric acid solution, preparing it for sealing.
Two compounds are subsequently applied to the tooth and heat-treated with a dental
curing light. This process creates a very hard, impervious surface that permeates the
dentinal tubules and seals them against penetration by microbes.
We recommend sealing of any fractured teeth, even if the damage is not recent. As long
as the tooth is stable in its socket and has no radiographic evidence of root damage or
infection, sealing is worth the effort; this process is much less traumatic and more
economical than either the root canal or extraction. We always re-radiograph sealed
teeth six months after the treatment to ensure that the sealant is still present and the
root structures are healthy.
The bonded sealant is very effective in protecting fractured teeth or those with damaged
enamel surfaces. Patients that insist on chewing rocks and fences can eventually wear
the sealant off and require another procedure, but the sealant in the tubules usually
persists unless the tooth is fractured again.