Should We Use a Dental Dam for Teeth Treatment?

The dental (rubber) dam is a piece of thin, stretchable latex or non latex material that becomes a barrier to selected teeth when applied. A dental dam is a protective cover that is placed over a tooth being worked on.

The isolation technique helps protect the teeth for all types of dental procedures including root canals, bleaching, and restoration preparation and delivery. It is held in place by a clamp that surrounds the tooth and a framework that keeps the rubber approximated to the mouth and cheeks. Another name for this device is a rubber dam.

A dental dam is a medical device which is used by dentists to maintain a sterile work area when they are drilling and filling teeth. Safer sex advocates have also adopted the dental dam, because when used correctly during oral sex, it can prevent the transmission of sexually transmitted infections (STDs).

The dental dam’s thickness gauge can vary from thin, medium, and heavy. Thin is used for endodontic, medium is the most popular for easy placement, and heavy for tight contact areas or the need for stronger support of the dam.

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.

The use of a rubber dental dam for oral operative procedures, teeth treatment is an effective but time-consuming technique that often is helpful in protecting the mouth from debris and for excluding moisture from the operative field. Dams are often used in dental school training programs – it is the way some procedures are done “by the book”. However, the real world of clinical dentistry beyond the ivory tower of dental school does not often permit the use of dams for more than a select few procedures, for example, crown preparation is not one of them.

Dental Rubber Dam Picture

Dental Dam Procedure

The dental dam is used during procedures that require drilling of tooth decay or removal of old filling. In addition to these areas, its most frequent use is during root canal treatment. The dam protects the patient and keeps instruments, debris, old filling material and chemicals from being swallowed or aspirated by the patient.

The dentist evaluates the patient’s occlusion to determine the appropriate occlusive reduction for the tooth that is to receive an indirect restoration. He or she places a floss-secured retainer at least one tooth distal to the tooth to be prepared after adequate anesthesia has been achieved. The dentist punches two holes in the rubber dam approximately 1 to 1,5 centimeters apart and then cuts a slit in the dam with a scissors to connect the holes. The rubber dam is placed easily over the retainer.

Certain circumstances will prevent the protective cover from being used. These include but are not limited to: extremely broken teeth, claustophobic patients, patients with breathing disorders or patients that request it not be used.

In general, the rubber dam is a comfortable fit and patients will have not trouble breathing with it on. It is an important part of dentistry that will allow the clinician, as well as, the patient to have a sense of comfort during a procedure knowing the mouth and throat are protected.

A dental dam should be an easy placement for the dentist and the assistant to comply. Placement of the rubber dam should not be a nescience or an option. With today’s new systems, practice and placement makes perfect. So, why are you not using one?