Children's Sealant (Pit-and-Fissure Sealant) Health Insurance Guide: The Rule for Molars at Age 18 and Under

A children's sealant (pit-and-fissure sealant) is covered by National Health Insurance when placed on cavity-free first and second molars of a child aged 18 or under. The copayment is 10% of the cost at both clinic and hospital outpatient care, lowered in October 2017 from 30-60% for outpatient care. Baby molars, premolars and molars that already have cavities are not covered, so confirm the target teeth before the procedure.

Published 2026-11-08 · Updated 2026-11-08 · DentalStatics editorial team

Key facts

Eligible age	18 and under (source: National Health Insurance Service (NHIS, 국민건강보험공단))
Eligible teeth	First and second molars that are sound, with no cavities (source: National Health Insurance Service (NHIS))
Copayment	10% of the cost (same for clinic, hospital and general hospital outpatient care) (source: Health Insurance Review and Assessment Service (HIRA, 건강보험심사평가원))
Copayment reduction	Lowered to 10% from 30-60% for outpatient care in October 2017 (source: Ministry of Health and Welfare)
Medical Aid Type 2 children	The Medical Aid fund pays 95% of the sealant cost at hospital level or above for outpatient care (source: Health Insurance Review and Assessment Service (HIRA))

What kind of treatment is a children's sealant?

The chewing surface of molars has narrow, deep grooves that toothbrush bristles do not reach well, so food and bacteria settle there easily. A sealant is a preventive treatment in which the grooves are cleaned, a flowable resin is applied and hardened with light to fill the grooves shallowly.

The tooth is not drilled and anesthesia is usually not needed, so the child can go through it relatively comfortably. However, the sealant material does not stick well if saliva touches it, so the child needs to cooperate by keeping the mouth open and waiting during the procedure.

Clean plaque and food off the chewing surface of the molar
Treat the groove surface with a chemical, then rinse and dry
Apply the flowable sealant material to the groove and harden it with light
Have the child bite the upper and lower teeth together to check the height

What are the conditions for an insured sealant?

National Health Insurance medical care benefit standards treat cavity-prevention care such as fluoride application and sealants as non-covered in principle, with one exception: sealants on cavity-free first and second molars of people aged 18 and under are covered. All three conditions must be met for the 10% copayment to apply.

Age: 18 and under
Tooth: permanent first or second molar
Condition: sound tooth with no cavities

When is the best time to get a sealant?

A sealant can be placed when the molar has come far enough out of the gum that the whole chewing surface is visible. The KDCA sees around 54-65 months as the time permanent teeth begin to appear and recommends a dental checkup, so from around then it helps to have regular checkups confirm whether the first molar has come in.

The second molar comes in several years later than the first molar, so it is often not finished in one go but split into two periods. A newly erupted molar has a surface that is not yet hard and can get cavities quickly, so check its condition as soon as it comes in.

If you delay because of school and after-school schedules, a cavity may already have formed in the molar groove, putting it outside the coverage condition. Because insured sealants require a tooth without cavities, it is advantageous to discuss it at the first checkup after the molar comes in.

When is a sealant not covered by insurance?

Sealants on baby molars, premolars, molars that already have cavities needing treatment, and molars at age 19 and over are treated as preventive care and are non-covered. Non-covered prices differ by clinic, so before the procedure ask for a tooth-by-tooth breakdown of what is covered and what is not.

Covering an early cavity that is hard to see with a sealant can cause its progression to be missed. So the dentist checks the groove before the procedure and, if a cavity is suspected, may recommend cavity treatment first instead of a sealant.

How do you care for teeth after a sealant?

A sealant can wear down from chewing force or partly come off, so its remaining condition is checked at regular visits. If you see a spot where it has come off, discuss with the dentist whether it can be reapplied or repaired. If the child says a molar feels rough or that a small piece was chewed, it may be a sign that part of the sealant has come off.

A sealant blocks only the grooves on the chewing surface, so it cannot prevent cavities between teeth or at the gumline. Brushing with fluoride toothpaste, flossing, and regular fluoride application are needed together to protect the whole molar.

Common myths and facts

Myth: Once a sealant is placed, that molar will not get cavities.

A sealant blocks the grooves on the chewing surface, so it cannot prevent cavities between teeth or near the gum. Brushing, flossing and regular checkups must continue.

Myth: Any molar of a child is covered by sealant insurance.

Coverage applies only to cavity-free first and second molars at age 18 and under. Baby molars and premolars are non-covered.

Frequently asked questions

How much is the copayment for a children's sealant?

For an eligible tooth, you pay 10% of the cost. The actual amount varies because the fee schedule by type of institution and the consultation fee are added, and you can confirm it in the insured copayment column of the receipt. If several molars are done on the same day, the cost adds up by the number of teeth.

If a sealant comes off, can it be redone with insurance?

Whether it can be reapplied and whether coverage applies depend on the condition of the tooth and the timing of the procedure. If you find that one has come off, ask that dental clinic about its redo criteria and the copayment.

Does a sealant cause sensitivity or pain?

Because the tooth is not drilled, there is usually no pain. If it feels high when chewing right after the procedure, the dentist can adjust the height.

How long does a sealant procedure take?

It varies with the number of teeth and the child's cooperation, but it is not a major procedure. Keeping saliva away is important, so it is best to book when the child is in a condition to wait with the mouth open.

Do Medical Aid children also have a sealant copayment?

When a Medical Aid Type 2 child receives a sealant at outpatient care at hospital level or above, the Medical Aid fund pays 95% of the benefit cost. The sealant copayment varies by type of institution and eligibility, so confirm your Medical Aid eligibility and type at the reception desk before treatment.

References

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