RUBBER DAM

Dr.Nilesh Rathi

Introduction
 Dr

Sanford Christie Barnum in 1864.

 Rubber

dam method application by
Dr Hodson in 1870.

 Protects patients from swallowing or inhaling the instruments. gingival exudates.  Prevents  Creates infection of patient to the dentist a psychological barrier between patient and dentist.  Aids isolation from bacteria of saliva. .Advantages  Isolation of the tooth from saliva. blood.

Additional uses  After periodontal surgery along with periodontal pack  Root planning  Thermal test  Electric pulp testing .

.Disadvantages  Patient cannot speak  Claustrophobia  Time consuming  Sensitivity to teeth for some time after removal.

Contraindication  Contact  Metal allergy crowns  Ceramic  Mouth crowns breathing  Respiratory problems .

Classification  Winged and Non winged  Metal and Polycarbonate (Endo-technic)  Bland and Retentive .

Armamentarium  Rubber dam sheet  Rubber dam frame  Rubber dam clamp  Rubber dam clamp holder  Ainsworth rubber dam punch  Floss or wedges or wood stick  Rubber dam template  Rubber dam lubricant  Napkin .

Armamentarium .

Armamentarium Rubber dam frame Clamp forcep Punch forcep Rubber dam clamp .

Armamentarium .

Armamentarium Rubber dam template Rubber dam Sheet Lubricant .

Steps of Rubber Dam Application  Cleaning of teeth  Selection of clamp  Punching of hole in rubber dam  Flossing the clamp  Application of the rubber dam  Application of lubricant & flossing through contact with lubricant  Application of napkin and holder .

3. 4. 2.Pre Operative Assessment 1. Patient`s mouth – calculus or any sharp edges of instrument Contact points Rinse and dry mouth Local anesthesia before application .

 For sub gingival restoration use  Ferrier 212 clamp Thick rubber dam .Selection of clamp  Four point contact below the maximum coronal diameter.  Try bland type first followed by retentive  Measure M-D crown length at gingival margin and select clamp just smaller to it.

Clamp selection S No Clamp Teeth 1 #8 A. #4. #1. #212 Anteriors 3 #00. Primary first molar #2 4 #3. Upper right molars Lower left & upper left molars . #14 A For irregularly shaped. Primary incisors and Canine Large Bicuspids. #7. #8. structurally compromised or partially erupted molars 2 #9. Maxillary Premolars. #W56 Molars 5 #12A #13A Lower right.

006 2 Medium 0.15 0.008 3 Heavy 0.010 4 Extra heavy 0.012 5 Super heavy 0.Rubber Dam Sheet Sr No Type Thickness (mm) Thickness (inches) 1 Thin 0.014 .35 0.20 0.25 0.30 0.

Colour of sheet Sr No Colour Special Uses 1 Blue/ Green Photography 2 Black For contrast with enamel for fillings 3 Grey Alternative for black colour 4 Transparent Endodontics .

First primary molar 4 D Upper incisors 5 E Lower incisors .Punch holes S No Hole Teeth 1 A Mandibular 1 molar. Large maxillary molar 2 B Maxillary molar small. Second primary molar 3 C Canine . Premolars.

Floss Method .

Fissure sealants 2. 3. Class I and Class V cavity restoration 3. Preferably winged clamp for retaining Preferably wingless clamp for retaining Posterior most tooth or operating tooth Premolar to premolar .Rubber dam fixation Single tooth isolation Multiple teeth isolation 1. premolar to contra lateral lateral incisor Bleaching Class II restoration Multiple restorations . Endodontics 1. 2.

Method of Application Sr No Methods Utility 1 Clamp before rubber dam Posterior teeth in children and adults 2 Clamp along with rubber dam Third molars 3 Clamp after rubber dam placement Anteriors and Premolars .

Guidelines Sr Teeth Teeth applied with rubber No Operatin dam g 1 Incisors Canine to canine (Clamp not compulsory) 2 Canines 1st premolar to 1st premolar 3 Posteriors Two teeth distal to lateral incisors of contralateral side 4 Any other At least one tooth distal and one tooth mesial .

forceps Punches .Sterilization Autoclave Hot Air Oven Clamps. frame.

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 Raymond Braham.References:  Sturdevent. Textbook of Operative Dentistry. . Rubber Dam in Clinical Practice.

Thank you .