Rubber dam isolation<br />By <br />Amin Abusallamah<br />
ADVANTAGES<br />Complete isolation of the teeth from saliva, blood, or gingival fluid exudate is possible. (esp. required for bonded restorations)<br />Aids isolation from bacteria in saliva.<br />Also indicated when infection for the rest of the mouth must be excluded, for example in direct and indirect pulp capping and endodontic treatment.<br />
Cont ….<br />protects the patient from swallowing or inhaling instruments<br />protects the dentist from infection from the patient<br />has the effect of psychologically, as well as physically, separating the dentist from the patient (patients are more relaxed)<br />
DISADVANTAGES<br />The patient can no longer speak easily. Conversations thus become one-sided and cease.<br />A few patients dislike the rubber dam intensely, feeling claustrophobic when it is in position.<br />
Cont ….<br /><ul><li>dam takes time to apply and remove, although the more experienced the dentist is in its use, the less time is taken.
The rubber is held on posterior teeth with clamps, and a tooth which has been clamped may be sensitive for some hours after the clamp has been removed.</li></li></ul><li>Guidelines for Application<br />For incisors isolate from canine to canine. (no clamp required)<br />For canines isolate from 1st premolar to 1st premolar. (variation)<br />For posterior teeth include two teeth distal to the working tooth and teeth up to opposing lateral incisor.<br />Minimum isolation should include at least three teeth, one distal and one mesial to the working tooth.<br />
RUBBER DAM APPLICATION<br />Parts of the rubber Dam kit<br />Rubber dam sheet<br />Rubber dam stamp<br />Rubber dam punch<br />Rubber dam clamps<br />Dental floss<br />Rubber dam lubricant<br />Rubber dam clamp forceps<br />Rubber dam cutting scissors<br />
WHEN TO APPLY THE DAM<br />IDEALLY BEFORE STARTING THE CAVITY<br />
Rubber dam punch<br />The smaller holes in the platform of rubber dam punch are used for incisors, canines and premolars, the larger holes are reserved for molars.<br />
Rubber dam clamps<br />A dental clamp for supporting a flexible sheet around a tooth during a dental operation,<br />Select the proper clamp for the anchoring tooth.<br /> <br />
Dental floss<br />Use dental floss to prevent the patient from aspirating or swallowing the rubber dam clamp, and attached the sheet into inter proximal area .<br />Attach rubber dam sheet to the frame keeping.<br />
Rubber dam lubricant<br />Lightly apply the water-based lubricant around the punched holes on the under surface of the dam.<br />Pass both wings of the anchoring clamp through anchor hole of rubber dam sheet.<br />
Rubber dam forceps <br />An instrument used to place a clamp on a tooth, adjust a clamp, or remove it from a tooth.<br />
Removal of the Dam<br />Stretch the dam to cut the inter-dental septas of the sheet with a scissor.<br />Remove the dental floss/rubber dam sheet from the non-working end first.<br />Disengage the clamp from the anchoring tooth with the help of clamp forceps.<br />
THANK<br />YOU<br />Reference : Art and science of operative dentistry 2000<br />
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