Card #1 (of 3) Topic: Dental Decks Part II 2016 - Operative - Rubber Dam rubber dam The two most frequently quoted disadvantages of using the rubber dam are: + Time consumption * Patient objection = Cost * Staff allergies to material* Time consumption * Patient objection + However, if you become proficient in placing the rubber dam and explain to patients the advantages of using it, these claims will be eliminated. Advantages of using the rubber dam: * Dry, clean field * Access and visibility + Improved properties of dental materials * Protection of the patient and the operator * Operating efficiency The following conditions may preclude the use of the rubber dam: * Severely tilted teeth + Some third molars * Teeth that are not erupted sufficiently * Some respiratory problems, such as asthma or severe colds, in which breathing through the nose is difficult Remember: The use of a rubber dam is the standard of care when performing endodonties.Card # 2 (of 3) Topic: Dental Decks Part Il 2016 - Operative - Rubber Dam rubber dam The rubber dam can still be used effectively even if teeth are crowded and overlapped because the hole punch pattern does not always have to be followed. * Both the statement and the reason are correct and related + Both the statement and the reason are correct but not related + The statement is correct, but the reason is not « The statement is not correct, but the reason is correct + Neither the statement nor the reason is correct* Both the statement and the reason are correct and related In this case, you can punch the holes closer or in a similar pattern to the teeth, allowing for the elimination of wrinkles and avoid having papillae protruding through. Five functions of rubber dam isolation: + Retracts soft tissue, such as lips, cheeks, and tongue * Provides for clean, dry field * Protects the patient by eliminating the possibility of swallowing debris or instru- ments. Protects the dentist somewhat by isolating him/her from possible infectious conditions in the patient's mouth. + Provides for maximum physical properties of materials. For example: The rubber dam provides a dry field, which is essential for placement of amalgam restorations as well as cements. Remember, the cements that are placed under dry conditions have maximum strength. Also, a dry field prevents delayed expansion of amalgam. * Saves time tubber dam saves time because the operator can work more efficiently in a clean, dry field where visibility is not impaired. Important: For or a rubber dam clamp to be stable, all four points of the jaws of the clamp must contact the tooth gingival to the height of contour. They should not extend beyond the line angles to prevent impingement of the interdental papilla and possible interference with placement of a wedge. 1.A frequent cause of interdental papillae protruding from beneath the rubber Notes dam is holes that were punched too close together. 2. Wrinkling of the rubber dam between isolated teeth is the result of holes that were punched too far apart.Card # 3 (of 3) Topic: Dental Decks Part Il 2016 - Operative - Rubber Dam rubber dam The Young rubber dam frame is used more than the Woodbury version, because it provides less soft tissue retraction. * Both the statement and the reason are correct and related * Both the statement and the reason are correct but not related. + The statement is correct, but the reason is not * The statement is not correct, but the reason is correct * Neither the statement nor the reason is correct+ Both the statement and the reason are correct but not related *** [tis true that the Young rubber dam frame provides less soft tissue retraction than the Woodbury, However, that is not why it is used - it is simply more convenient. Important points about using the rubber dam: + Apply lubricant to the lips and comers of the patient’s mouth. * Plot the hole on the rubber dam. Always isolate a minimum of three teeth. Punch the appropriate size hole for a particular tooth. For a tooth bearing a clamp, the hole should be one size larger than those without a clamp. + An appropriate clamp is selected that will fit the most distal tooth to be isolated. The dam may either be stretched over the clamp with the clamp in place on the tooth, or the clamp may be carried with the dam and placed on the tooth in one step. + Once the dam is placed, it is secured with either a Woodbury or Young holder (frame). + The rubber dam is inverted into the gingival sulcus using floss and/or a blast of air and an instrument such as a plastic instrument — this will prevent seepage of saliva. Removal of the rubber dam — very important: Removal is the reverse of application, except all ligatures (interdental septum of dam) must be eut and removed before the dam is removed.