Rubber Dam

Presented by- Krishna Naikwade

Introduction• To induce desirable working area in the oral cavity

there should be proper moisture control, visibility and good accessibility .

• If an instrument is swallowed or aspirated during endodontic treatment without a rubber dam, one is likely to confronted with a law suit

• Grossman has stated that ``in the eyes of court, when an endodontic instrument escapes from dentist’s fingers and is ingested or aspirated, expert opinion is unnecessary to justify claims of negligence``

Advantages • Dry clean operating field• Access with visibility• Moisture control• Retraction of soft tissue• Aseptic environment• Prevents tissue damages• Minimization of mouth breathing

Disadvantages • Patient acceptance • Poorly retentive• Trauma to tissues• Frame can cause pressure mark habbits• Latex allergy• Build up saliva• Partially erupted tooth cant receive retainer• Psychological intolerance

Contraindications • Allergy to latex• Patient with respiratory problems• Patient at risk with transient bacteremia • Severe gingival disease

Components of rubber dam• Rubber dam material• Rubber dam clamp• Rubber dam punch • Rubber dam clamp carrying forceps• Rubber dam frame rubber dam template• Wedgets cord dental silk floss• Rubber dam napkin

Rubber dam material • This is available as heavy , medium ,light and in

different colors and standard sizes.• Readymade sheets are available in 5×5’’ and 6×6’’

and rolls according to need which may be conveniently cut into necessary size .

• It is usually made up of latex material.• For patient with latex allergy, non latex rubber dam

material is used in clinics.

• Medium weight thickness is usually recommended for endodontic purpose

Rubber dam clamps• Different types of clamps are available according

to tooth to be isolated • Clamp with wings lead to more rapidity rapidity

of work and efficiency• Plastic clamps are also available

• In summary only five clamps are needed for applying rubber dam to most teeth

• For anterior teeth-HF 9S• For premolars-HF 1 and HF 2• For molars – HF 7 and HF 14A

Rubber dam clamp carrying forceps • It is available from different companies like Ash,

Ivory and Hu-Freidy• This is used to carry the rubber dam clamp on the

tooth

Rubber dam punch• It is used to punch the rubber dam for application

on specific tooth.• It has a moving table with holes of different

diameters.• The smallest one is for lower anterior teeth and

largest one is for the posterior teeth.

Rubber dam punch

Rubber dam holder on frame • These are used to maintain the borders of the

rubber dam in position.• These are made up of stainless steel or plastic.

Rubber dam template• It is provided to clinician to make

an exact punch on the tooth in question for both upper and lower teeth.

Wedget cord• It is used to stabilize the interproximal area of the

rubber dam.• It is flexible elastic material that can be passed

over dam interproximally below the contact area.

Dental silk floss• It is required for rubber dam application specially

for endodontic purposes or during inoffice vital or nonvital bleaching.

Rubber dam napkin• The rubber dam napkin is placed between the

dam and the patient’s skin in order to avoid any latex related allergic reaction

Steps of rubber dam application• Cleaning of teeth• Selection of clamp• Punching of the hole in rubber dam• Flossing the clamp• Application of rubber dam• Application of lubricant & flossing through contact

with lubricant• Application of napkin and holder