The use of rubber dams

What are they?

Also known as the dental dam or rubber dam is a rectangular sheet of latex used in dentistry, in particular endodontic therapy, to reduce contamination, and where dental composite are being placed, due to the need for the area to remain dry during filling placement.

When are they used?

A dental dam is used mainly in endodontic treatment and when putting fillings into teeth.

What are its functions?

The main function is to isolate the tooth being treated from its environment, in particular from the bacteria in the oral cavity. Another function of the rubber dam is to protect the patient's airway from any materials that may fall into it during treatment.

How are they used?

The rubber dam is held over individual teeth or groups of teeth by appropriate rubber dam clamps or threads (ligatures) along the edge of the gum. The tooth crown stands out from the rubber dam through individual holes made by a hole punch. This permits a clean and dry operative field, retracts the lips and cheeks, and enables treatment of the appropriate tooth without contamination from blood or saliva.

What are the many techniques?

There are three techniques. 1. Dam first. 2. Clamp first. 3. Dam and clamp together.

What are the advantages and disadvantages of isolation technique? Advantage: For adhesive dentistry procedures involving bonding

dental composite it is to be encouraged as the operative field must avoid moisture contamination in order to get maximum bond strength from restorative material to tooth substance. Glass ionomer cement is affected by moisture during its setting reaction and thus a rubber dam is considered advisable during placement. The advantages of using a rubber dam are well-known when performing operative and endodontic procedures. These benefits include the following: isolation of the operating field to keep it dry and clean; improved access and visibility; potentially improved properties of dental materials; protection of the patient and dentist; improved operating efficiency.1

Disadvantage: Routine use of dental dams is not always

appropriate because of some difficulties: for instance communication with the patient is significantly reduced and the patient may feel restricted. However for endodontic procedures it is considered mandatory.

Saliva Reduced salivary flow = reduced alkaline buffer state = more acidic environment Diet Consuming high in sugar content foods Long exposure to Oral hygiene Disabilities Some medical conditions impair the salivary flow Difficulty brushing teeth thoroughly Local factors Receding gums-exposed root (cementum is softer than enamel, thus more vulnerable and easier to be demineralized by acids