9 Simplified Steps Needed For Putting Dental Dam Into Action For Beginners

DENTAL RUBBER DAM

  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 requirefor 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
   What are ways in which you can apply a Dental Rubber dam ? 

There are 3 ways in which you can apply a rubber dam 

1) Clamp first rubber dam sheet over it (Done while performing posterior teeth in children and adults)

2)  Punched Rubber dam sheet first and clamp later (Done while performing procedures on Anterior and Premolar teeth )

3)  Clamp and punched rubber dam sheet together over teeth (Done when you are treating third molars)

   What are steps involved in Rubber Dam Application ?

The following are steps for Clamp first,rubber dam sheet later over it technique:-

STEP 1

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

Rubber dam
Rubber dam

                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

Rubber dam


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

Rubber dam

STEP 3

4. Now take your punched rubber dam sheet and push the sheet through the clamps over the teeth through the holes 

Rubber dam

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

Rubber dam

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

Rubber dam

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

Rubber dam


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


 

<! [1] https://www.aae.org/specialty/2020/06/02/aerosols-and-coronavirus-in-dentistry/

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