When asking Dental Assistants how many of them use rubber dams in their practice, it’s shocking to see the show of hands. Studies show that only 15% of dental offices use rubber dams for adhesive procedures. Excuses come up such as; it takes too long to place, we just use cotton rolls, and retractors get the same results. With so many new and innovative dams introduced, dam placement takes minutes. Why take chances?
Why Use A Rubber Dam
1.Visibility is much better due to the contrast of colors of the dam and the teeth being prepared.
2. Creates dry and non-contaminated field from saliva and other debris during all bonded procedures.
3. Improves access during dental procedures by retracting the lip, cheek, and tongue from the field of operation.
4. Protects the patient from swallowing any debris such as the removal of amalgam, old porcelain, and composite.
5. Increases the efficiency, productivity and reduces the time required for treatment.
6. Adds comfort for the patient and dentist
7. Infection Control
When Using A Rubber Dam Is Contraindicated
1. Tooth may be too short to hold a clamp.
2. Tooth may not fully erupted and there is not enough tooth to clamp to
3. Patients that may not be able to swallow
Things To Consider When Selecting A Rubber Dam
Dental Dam material is available in pre-cut squares of 6×6 and 5×5 inches. The 6×6 is used for posterior applications. The 5×5 squares are for anterior application and primary detention.
The thickness gauge of a dental dam can vary from thin to heavy. Thin is used for endodontic, medium is the most popular for easy placement, and heavy is used for tight contact and areas that need for stronger support.
Dental Dams come in a wide variety of colors. The most common colors are grey, blue, pink, purple, green, white, and yellow. They can also come scented or unscented, flavored or unflavored. Most dentists prefer the darker shades for contrast.
A dam napkin can be placed between the dental dam and the patients face. This helps to absorb moisture and increase comfort for the patient.
A dental frame is necessary to stabilize and stretch the dam tightly over the teeth. Frames come in plastic as well as metal. Both can be cold or heat sterilized.
Lubricants such as topical such as Ultradents, or KY jelly, can be placed on the underside of the dental dam for easier placement over the teeth and through the interproximal areas.
The dental dam hole punch is used to create holes in the dental dam needed to expose the teeth that are to be isolated. The working end of the punch is used to puncture the dam for the correct hole sizes.
Size 5- The largest size is an anterior tooth
Size 4- The next size smaller is for molars
Size 3- For bicuspids and canines
Size 2- For maxillary anteriors and incisiors
Size 1– The smallest size, for Mandibular Anterior Incisiors
Sometimes it is hard to know where to cut the holes on the rubber dam. This is where a dam template is handy. The dam template and stamp inkpad allow the assistant the exactly where to place the holes if the teeth are out of the arch form.
Dental Forceps are used to place and remove the dental dam clamp. The beaks of the forceps fit into the holes on the jaws of the clamp. The handles have a spring action that allows the forceps when squeezed to open up and fit over the tooth. When the handles are released, the clamp is let go.
A dental dam clamp is used to stabilize the dental dam. The dam clamp holds the dental dam secure on the end nearest the tooth that is being treated. Clamps can be ligated for security and safety of the patient from swallowing if the clamp becomes dislodged during treatment.
Selection of Clamps
Anterior Tooth: Double Bowed Clamp
Pre-Molar: Small, Flat-Jawed Clamp
Mandibular Molar: Flat Jawed Clamp
Maxillary Molar: Curved Jaw Clamp
Partially Erupted: Sub-Gingival Designed Clamp
Placement Of The Traditional Rubber Dam
Placement of the rubber dam should not be an option. With today’s new systems practice and placement makes perfect.
Contemporary Product Solutions provides an expertise in clinical and laboratory evaluation of dental products and equipment from the total team perspective. Their mission is to provide the dental profession with clinically relevant information to all areas of the dental practice. Product review will provide unbiased, up-to-date, evidence-based information on equipment, materials, protocols of treatment, and long term performance. Each evaluation includes a step-by-step tech spec of each product, a clinical overview, a technique video, and an overall rating.