RUBBER DAM ISOLATION BENEFITS

All restorative dentists need to learn how to apply the rubber dam for a number of reasons. I’ve listed my top 4 benefits below: 

Visibility- If the rubber dam is applied correctly, you will automatically have increased visibility on the teeth that need to be restored. A tight cheek, large tongue & over-active salivary gland immediately vanish behind the rubber dam sheet which allows you to focus intently on the task at hand. Your work becomes easier when your focus in on teeth & teeth alone. 

Retraction- Your assistant will thank you for helping them retract the tongue in lower quadrant cases where a curious tongue tends to drift towards the high speed drill. This can be incredibly tiring especially if you have a long appointment scheduled with your patient. 

Aspiration- You haven’t felt fear until you have seen a crown or implant screw swimming around the back of the patients throat. A “throat pack” does not give you necessary protection from aspiration.

A properly placed rubber dam gives you a much higher probability of protection from liquids or dental objects being displaced in the lungs of your patients. 

Bonding- If you are practicing biomimetic dentistry then you should be concerning yourself with obtaining the highest degree of bonding in your restorative work. Rubber dam placement prevents moisture contamination much better than a cotton roll or dry angle will ever do. 

RUBBER DAM CLAMP SELECTION

Let’s dive into how each clamp helps. 

The 12A/13A rubber dam clamps are used as the master clamps on posterior teeth. It holds the rubber dam & is attached to the anchor tooth. The serrations give you more grip on the tooth and the smaller width side is applied to the lingual surface of the teeth. This is a general rule and should be considered for quadrant dentistry. 

The B1,B2,B3 wingless rubber dam clamps are used for prepped molars, partially erupted molars or small molars. Consider using some of the clamps if you need to deliver a posterior ceramic restoration & require adequate isolation. 

The B4 clamp is useful to isolate anterior teeth or premolars during delivery of ceramic veneers & crowns. 

The B5 or B6 clamps are used when margins are deep ad stronger force is required to reposition the gingival tissue. Dr. Calin Pop shows a technique in one of his lessons where he cuts the clamp into two in order to deliver 2 units at the same time. 

The “No 2” clamp from the hygienic fiesta kit can be used as an anchor clamp to provide more visibility & access as your work. It is typically positioned on the contralateral premolar w/out perforating the rubber dam. 

Once again, thank you to Dr. Calin Pop for organizing & reassembling my rubber dam clamps in a way that makes sense. His course can be found here.

RUBBER DAM TEMPLATE

RUBBER DAM CROWN PREPARATION

Believe it or not, it is possible to prepare a crown with the rubber dam on. The same principles apply as mentioned above with a slight modification. The majority of the crown preparation can be complete using occlusal reduction burs and creating a circumferential margin with your preferred diamond bur. 

However, if you need to perform sub / equigingival margins to mask discoloration on a tooth or to remove a deep cavity, the rubber dam can get in the way as you prep the tooth.

At this point you can create a split dam or you can remove the entire apparatus to finish the preparation including the cord placement and margin refinement. 

To be honest, I do not do this often but I plan on implementing crown preparation under rubber dam isolation in the near future. 

I will continue to update this blog post as I have more information regarding rubber dam placement. Thanks for reading!

Full disclosure: I receive a commission if you purchase the dental products through my referral links. This helps me run this blog & I appreciate the support. 

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