Today, the obvious fact is that the level of quality of dental treatment has increased significantly. What affects the quality and long-term treatment is sometimes hidden from the patient’s eyes or he does not attach importance to it. For example, in this article we want to talk about the use of such an auxiliary element in treatment as a rubber dam. It also has other names used: optidam or rubberdam.
Sometimes it may seem to the patient that the dental clinic uses such “add-ons” in order to make the treatment procedure more expensive. Believe me, this is absolutely not true. Below we will tell you why the use of a rubber dam in treatment is indispensable if you want to receive high-quality treatment with long-term results.
Scope of application of rubber dam.
- Endodontic dental treatment . When treating root canals, it is extremely important not only to maintain ideal sterility for the tooth, but also to prevent accidental contact with the oral mucosa of medications that can cause an allergic reaction.
- Restoration of teeth with light-curing fillings and artistic restorations. In order to achieve reliable adhesion of the filling material to the tooth surface, the conditions of absolute dryness of the treated surface must be met, which the rubber dam invariably helps with.
- Teeth whitening. To ensure that the whitening composition, which affects the enamel, does not injure the mucous membrane, the gums must be isolated using a liquid rubber dam. Professional teeth whitening is not complete without the use of a rubber dam.
- Fissure sealing. For high-quality fissure sealing (coating the chewing surface of the tooth with a special composition in order to protect the enamel from destruction by caries), a perfectly dry tooth surface is necessary.
- Splinting of teeth. When splinting, the adhesive material adheres better to the enamel surface when the risk of accidental saliva ingress is eliminated.
General overview
A rubber dam is a material with which the dentist isolates a diseased tooth during treatment.
Most often this term refers to a piece of latex with a hole. In fact, this is a broader concept, since in addition to standard 15x15 cm flaps, there are also rolled forms of rubber dam, three-dimensional latex plates, as well as its liquid version.
The invention is not new at all. Dental treatment using this technology was first performed in the mid-19th century. Who owned the original idea is a moot point, since both the Frenchman La Roche and the American Sanford Christie Burnim claimed authorship.
One way or another, but since 1867, rubber dam (from the German Kofferdam) or rubber dam (English version Rubberdam) have entered the practice of dentists everywhere.
The traditional material for rubber dam is cis-1,4-polyisoprene, obtained from the sap of a tropical plant - Hevea brasiliensis.
Nowadays, International Rules for performing a number of dental procedures require the mandatory use of a rubber dam.
Why rubber dam has positive aspects for the doctor and for the patient.
- Doctor. The specialist can focus on the treatment process, having the most convenient access to the tooth. The working field is visible much better due to achieving optimal cleanliness and dryness through insulation. The treatment process is monitored more efficiently and time is used rationally.
- Patient . Additional protection from accidental injury to the mucous membranes, gums, and lips. Saliva can be safely swallowed; medications used in treatment and elements from dental treatment do not get into it. The muscles and jaw joints experience less stress and are less tired because treatment time is reduced. All this creates greater comfort.
An undeniable advantage is that the installed filling or restoration will last much longer than during treatment without the use of a rubber dam. The main goal is to improve the quality of treatment. The cost to the patient during treatment of using a rubber dam is negligible, and in the long term, it definitely leads to cost savings.
Tatyana Borisovna Sitenkova
Dentist, therapist
33
years of experience
All types of therapeutic treatment, artistic restoration, hygiene procedures of any degree of complexity.
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Alternatives
The main role of the rubber dam is to ensure the isolation of the tooth from possible moisture. Traditionally, this is solved using cotton rolls that are placed around the tooth. But they have to be changed frequently, they interfere with the dentist’s view and cause discomfort to the patient.
A more modern option is saliva absorbent pads (Dry Tips) . They have greater absorbency and fit more comfortably in the mouth. But their insulating characteristics are still inferior to rubber dam.
For timely removal, a saliva ejector is used . But its use requires the constant presence of an assistant. This device takes up a certain place in the mouth and can interfere with the dentist’s work.
The following isolation methods are less often practiced:
- retraction thread;
- fum tape;
- liquid rubber dam;
- Tofflmayr matrix holder with metal matrices;
- sectional matrices and wooden wedges.
Learn about the advantages of the device and one of the application methods from the video.
Contraindications and disadvantages.
- If a person has impaired nasal breathing, the use of a rubber dam is contraindicated, since the patient will not be able to breathe normally. Also, the use of rubber dam is not applicable for people with Alzheimer's disease, with epileptic seizures, provided that there is an allergy to talc, rubber or latex. In case of allergic reactions, special sponges and rollers are used to absorb moisture; a saliva ejector also helps to cope with the secretion of saliva. But these measures do not provide such high-quality isolation of the tooth being treated and the service life of the filling is significantly reduced.
- If the doctor is not highly qualified, then when using a rubber dam there is a risk of damage to the interdental papillae.
- To install a rubber dam, it is necessary to work “with 4 hands”, that is, the doctor works in tandem with an assistant.
- Relative disadvantages also include a slight increase in the cost of the treatment procedure. But, taking into account the prospect of a long service life of the filling and high-quality canal filling, the use of a rubber dam makes treatment cheaper.
- The process of installing a rubber dam is often not a very pleasant procedure. But, taking into account further greater comfort during the treatment process: shorter time, less tired facial muscles, no penetration of medications and tissues of the treated tooth into the oral cavity, the discomfort from the installation can be considered minimal.
Yana Dmitrievna Mitskevich
Dentist, therapist
13
years of experience
All types of therapeutic treatment, including endodontic treatment using a microscope, microprosthetics, hygienic procedures of any degree of complexity.
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Terms of use
Installing a rubber dam is an easy task. After developing a certain skill, the dentist, especially with the help of an assistant, can cope with the application of the veil in a matter of minutes.
The rubber dam is fixed using two types of clamps – with and without wings. This affects the sequence in which staples are installed. Options with wings are first placed on the latex, and then attached to the tooth; without wings - vice versa.
The latex napkin itself should be positioned on the face as follows: the smooth side of the surface inside the oral cavity, sprinkled with talcum powder, faces the doctor.
4 methods of applying rubber dam have been developed. An experienced doctor, knows everything and applies the appropriate one for each specific case.
Installation methods:
- The “wings” method is used to work with molars and premolars. To do this, the main plastic material is attached to the frame, and a clamp with wings is installed in the hole for the tooth, fixed with forceps.
An intermediate napkin is applied to the face. Then the installation of the curtain itself begins. The prepared clamp is placed on the tooth, secured under the equator. Finally, the latex is removed from the wings using a special smoothing iron. - The “rubber dam first” option is performed with the participation of an assistant. To do this, an assistant with both hands carefully guides the latex stretched onto the frame onto the problematic tooth, threads it through and holds it in this position.
The doctor uses a specialized thread to pull the material into the interdental spaces and then installs clamps. - The “clamp first” option involves initially installing a bracket without wings on the tooth, and only then stretching the latex over it and onto the frame.
- The “arch” method is designed for manipulating lower molars. In this case, valves without wings are preferable.
Step one: the clamp arc is inserted into the rubber dam and secured with forceps, while the flap itself is folded into a bundle. Step two: the clamp is placed on the tooth. Step three: the flap is straightened and pulled onto the frame.
Removal method:
The process of removing an elastic flap is not particularly difficult, especially when working with one tooth.
You just need to remove the clamp and the latex will come off easily. If there were several working units, the napkin is trimmed with scissors. This takes a little over 1 minute, but it is important to make sure that there are no small pieces of rubber left.
Types of rubber dam.
Classic rubber dam.
This is a latex napkin, which in turn varies in density and thickness. Depending on the purpose, a certain type is used. There are also differences in colors that determine the scope of application. The colors are: light beige, blue, pink, green, gray, blue.
Liquid rubber dam.
Made on a gel basis, when used it tends to be distributed evenly and is fixed when exposed to special light. This type of rubber dam is used for teeth whitening, sometimes in combination with endodontics (canal treatment).
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AT THE GERMAN AESTHETIC DENTISTRY CENTER ES-DENT, specialists provide a guarantee for dental treatment and are responsible for the long-term quality result, ensuring the most comfortable condition of the patient during the treatment procedures. That is why the use of a rubber dam has positive aspects for both the patient and the doctor.
Liquid material
Rubber dam in the form of methacrylate gel is a good solution for many dental procedures.
First of all, it is easy to apply, effectively isolates the gums, penetrating into the most difficult interdental areas.
The method of applying it is as follows: retractors are placed in the oral cavity to move the cheeks and tongue, a saliva ejector is inserted and the working surface is dried using cotton rolls.
Then the periodontal tissues are covered with a gel, which polymerizes in 20 seconds. The patient is ready for further manipulations. The protective material is removed with careful movements using a special trowel.
Since the liquid version does not protect the entire oral cavity, its main areas of application are:
- professional enamel whitening;
- microabrasion.
Liquid rubber dam is used when additional protection is needed for gums covered with a classic latex curtain.
