RUBBER DAM APPLICATION
What is a Dental Rubber Dam?
Dental Dam is a thin 6 inch sheet made up of latex or nitrile used in dentistry in isolation of site where treatment is done from the rest of mouth. It was designed by Sanford Christie Barnum from USA in 1864.
Why to use Rubber Dam indental practise during covid 19 ?
Dental Rubber dam is fast emerging as a very important aid for Dentist in this difficult covid times , when renowned Endodontist from university of Ohio was asked about importance of rubber dam in non surgical endodontic treatment she said,
"It is difficult to quantify the reduction in aerosol as a percentage, but there is evidence from several studies that use of rubber dam reduces the amount of aerosol produced, as well as, the microbial load in aerosols. The use of rubber dam has also been advocated by endodontists practicing at the height of the COVID crisis in Wuhan as a measure to reduce cross-contamination". [1]
It clearly indicates that Dental rubber dam is very important and it's being made mandatory now for doing any endodontic treatment.
Here I try to simplify the steps involved in application of Rubber dam
What are materials required for dental rubber dam application ?
To prepare the rubber dam you will need the following items:
- Rubber dam template
- Rubber dam sheet
- A rubber dam frame
- A rubber dam clamp
- Ainsworth rubber dam punch
- The clamp forceps
- A flat plastic instrument wedge
- Dental floss
- Lubricant
1.First take the rubber dam punch, a dial with holes that correspond to the different sizes off the
teeth select the hole according to chart below you need to make sure the punch is free from any rubber dam ensure
the punch aligns well
Holes should ideally be 5 mm apart
2.Take the rubber Dam select the tooth you want to align the hole according to chart below
Now with the marking on the rubber Dam press down making sure the punch goes all the way through
the dam the rubber dam is mat on one side and shiny on the other the matte side should be facing up towards you.
STEP 2
3.Insert the forceps through the holes in the clamp place the clamp around the tooth the beaks of the clamp should be on the tooth only there should ideally be a 4 point contact on teeth do not place the clamp on the gums
STEP 3
4. Now take your punched rubber dam sheet and push the sheet through the clamps over the teeth through the holes
STEP 4
5.Use the dental floss to push the dam below the contacts use the wedge to stabilize the rubber dam the arm of the clamp should be facing posteriorly
STEP 5
6.Next take the rubber dam frame the frame has a curve and it should rest over the chin the open
end should point towards the upper jaw
STEP 6
7.Stretch the rubber dam around the spikes if the rubber dam is covering the nose cut the excess
off so that the patient can breathe the dam should be centralized over the mouth and the frame should lie over the
chin now
STEP 7
8.Invert the margins around the teeth using a flat plastic instrument push the dam so that the
edges are facing towards the gums
9.To remove the rubber dam first you
should remove the wedge by pulling it through the interproximal and not snapping it through the contact remove the
clamp with the forceps separate the prongs and pull away from the mouth then remove the frame pull the rubber dam so
that you can see the interdental sector cut away the interdental sector using a pair of scissors hold the dam from
the other side and gently remove it from the contacts make sure the mouth is free from any rubber dam
