Ajay Dhunna outlines an effective, efficient and very safe protocol for rubber dam isolation.
Rubber dam isolation is a phrase that invokes many emotions from everyone in the dental surgery. The dentist thinks: ‘This is going to make my life so much easier and make my photos look so great’.
The dental nurse thinks: ‘Oh great, here we go again… 30 minutes to put it on for a five-minute filling’.
While the patient thinks: ‘What is he doing with this piece of rubber near my face?’.
The reality in most dental practices is that rubber dam is not used routinely. The main reason for this is because of this very problem… it is not used routinely. Dentists are not efficient at placing rubber dam, meaning dental nurses get fed up of essentially ‘wasted time’ and the patient loses faith in the extensive time it takes to place the dam before treatment has even started.
In fact, rubber dam isolation for routine dental work (that, for the sake of this article, will be classed as quadrant dentistry) should take less than five minutes to place accurately and efficiently.
This article will hopefully help you achieve this; however, the main reality will come from you yourself practising and placing rubber dam as often as possible.
Why isolate?
Modern-day dentistry is all about adhesive dentistry, making rubber dam so important for dentists to get used to using. Adhesive dentistry relies on clean and dry substrates to have the best results.
We all have colleagues that say their isolation is fine with cotton wool rolls, but what about those times when you are restoring a lower seven and are in a constant battle with the patient’s tongue and then the patient decides to swallow and your perfectly etched cavity prep has a saliva shower?
Rubber dam isolation is the predictable and repeatable way to achieve total isolation in an efficient and comfortable way.
Some of the reasons why every dentist should learn to isolate include the following:
- When you get efficient, after practice, it actually saves you time, as you are not wasting time battling the patient’s tongue or having to re-etch and re-bond
- Longevity of restorations. As stated, modern dentistry relies on clean dry substrates. Therefore, by isolating teeth effectively, you are giving a great canvas to bond to
- Patient comfort. Once the patient is numbed up, rubber dam isolation is actually preferred by patients because it prevents water building up at the back of the mouth. The patient can also rest on the tautness of the dam, helping them stay open easier
- Controlled environment
- Gives you more space to work, as you are preventing the tongue and cheek of getting in the way
- The whole procedure is a lot more relaxed and will aid the flow of the appointment if everything is controlled
- It aids your photography, as it gives a neutral background to photos too, making comparison easier.
What do I need?
To find out and to gain CPD for this article, simply visit www.dentistry.co.uk/cpd.
