Dam it, Janet!

I knew had a day off from work today, so took the opportunity to book myself on a course for ‘hands on practical guide for placing rubber dam’ in Manchester.

My boss at the new place in Clitheroe is keen for me to start doing more cosmetic treatments, so being able to isolate the teeth beforehand is a must!

Although it looks like some medieval form of torture, it’s actually quite pleasant from a patients point of view.

I felt I learned a lot today. Although we were taught about it at uni, shamefully I’ve never used it since qualifying.

Post-covid, dentistry has had to change and one of the main recommendations is to use rubber dam where possible, as it’s been shown to reduce spatter and reduce surface contamination with bacteria by 80-99% at a distance of up to one metre. When used in conjunction with high volume suction, this helps to reduce the risk of transmission via aerosol.

I’ve added more info below for anyone who is interested. Maybe you’ve had it at the dentists but didn’t know why. ;-)

DQ x

A rubber dam is a thin sheet of latex (or non latex) that creates a barrier between the working field and the rest of the mouth. We punch holes in it for the teeth to slip through.

This has an incredible number of advantages to the dentist, the dental assistant, and most importantly, the patient.

Rubber dam prevents contamination of the cavity with saliva or blood when bonding the filling. The number one cause of sensitivity after a white filling is contamination during the bonding process. Not only can this make your tooth hurt for weeks, but it also decreases the longevity of the filling. Poorly bonded fillings break down at the margins, allowing them to leak. Plus, when this occurs, decay then has an easy path under the filling.

It also retracts and protects lips, cheeks, tongue, and even the gums.
This also allows the dentist and assistant to focus more of their attention on your tooth and the procedure. The contrast in color from the rubber dam and the tooth also makes visibility better. Every step in a dental procedure requires a great level of attention to detail; the dam enables this.
Protection of the gum tissue. It also allows a clean working field.

We use a lot of small tools, which can be dropped. It is very comforting for patient and doctor to have the dam as a safety net, so that if anything is dropped, it can’t be swallowed!

It helps to keep bad tastes out. Many dental products we use taste pretty bad, (dunno why, the manufacturers know they’re going in a mouth so why not make them taste better??) the dam will allow these products to be rinsed without touching any soft tissues.

Rubber dam also keeps vapour from your breath out of the working field. Not only does this fog up our mirrors, making it hard to see, there is enough water in your breath to contaminate your filling.

It catches amalgam scraps. While it is not as critical to have a dry field for a silver filling, we still use the rubber dam for the above reasons and also to catch any scraps that fall off as we carve your filling. The dam also catches any pieces of fillings or crowns that are removed when drilling.

It keeps bacteria from saliva out of the tooth during root canals. Root canal is the procedure that has been most associated with rubber dams; in fact, many dentists will only use the rubber dam for this procedure. It is used for good reason, as we use small files and caustic irrigating solutions that we do not want in your mouth.

Although cumbersome looking, it helps patients to relax. Many patients find it comforting to have the protection in place and also not have to worry about what to do with their tongue.