RUBBER DAM ISOLATION

IKRAMA VAID
839 3RD BDS
PURPOSE OF ISOLATION

1. MOISTURE CONTROL
2. RETRACTION AND ACCESS
3. INCREASES ACCESSIBILITY AND VISIBILITY OF THE WORKING AREA
4. PROTECTION OF PATIENT AND OPERATOR
METHODS OF ISOLATION
1. DIRECT METHODS:
2. INDIRECT METHODS:
• COMFORTABLE POSITION OF THE
• RUBBER DAM
PATIENT AND THE RELAXED
• COTTON ROLLS AND COTTON ROLL ENVIRONMENT
HOLDER
• LOCAL ANESTHESIA
• GAUZE PIECES
• DRUGS- ANTI SIALAGOGUES
• ABSORBENT WAFERS
ANTI ANXIETY DRUGS
• SUCTION DEVICES
MUSCLE RELAXANT
• MOUTH PROPS
• CHEEK RETRACTORS
• GINGIVAL RETRACTION CORD
.
RUBBER DAM ISOLATION

 ARMAMENTARIUM:

1. RUBBER DAM SHEET:

• IT IS AVAILABLE IN 12.5 X 12.5CM OR 15 X 15 CM SHEETS.
• THICKNESS OR WEIGHTS AVAILABLE ARE: THIN( 0.15MM )
MEDIUM( 0.2MM)
HEAVY( 0.25MM)
EXTRA HEAVY( 0.30MM)
• LIGHT AND DARK DAM MATERIALS ARE AVAILABLE, AND DARKER COLOUR ARE GENERALLY PREFERRED FOR CONTRAST.
• A THICKER DAM IS MORE EFFECTIVE IN RETRACTING TISSUE AND MORE RESISTANT TO TEARING.
• A THINNER MATERIAL HAS THE ADVANTAGE OF PASSING THROUGH THE CONTACTS EASIER.
• RUBBER DAM MATERIAL HAS A SHINY SIDE AND A DULL SIDE. BECAUSE THE DULL SIDE IS LESS LIGHT REFLECTIVE, IT IS GENERALLY
PLACED FACING THE OCCLUSAL SIDE OF THE ISOLATED TEETH.
 2. RUBBER DAM RETAINER OR CLAMPS:
• THESE ARE USED TO SECURE THE DAM TO THE TEETH THAT ARE TO BE ISOLATED AND MINIMALLY
RETRACT THE GINGIVAL TISSUES.
• IT HAS 2 JAWS CONNECTED BY A BOW. ON EACH JAW ARE PRESENT 2 PRONGS WHICH MEANS THAT
THERE ARE 4 PRONGS IN A CLAMP AND EACH PRONG RESTS ON THE MESIAL OR DISTAL LINE ANGLE OF
THE TOOTH TO BE CLAMPED.
• TWO TYPES OF RETAINERS ARE:
1. WINGED RETAINERS: THESE HAVE WING LIKE PROJECTIONS ON THE OUTER ASPECT OF THE JAW.
HENCE THEY PROVIDE EXTRA RETRACTION OF THE RUBBER DAM FROM THE FIELD OF OPERATION.
2. WINGLESS RETAINERS: THESE HAVE NO WINGS ON THEIR OUTER JAWS I.E., THEY ARE SMOOTH ON
THEIR OUTER ASPECT.
 .

…
3. RUBBER DAM FRAME / HOLDER:

• IT HOLDS THE BORDERS OF THE DAM AND POSITIONS IT.

• THE FRAME IS U-SHAPED AND COULD BE OF ADULT AND PEDODONTICS ONE
MADE OF METAL OR PLASTIC. THE METAL ONE IS KNOWN AS THE YOUNG’S
FRAME.
• PLASTIC FRAME IS USEFUL WHEN A RADIOGRAPH IS TO BE TAKEN WITHOUT
REMOVING THE FRAME.
• THE FRAME HAS MINUTE PROJECTIONS ON ITS OUTER SURFACE WHERE THE DAM
IS SECURED.
• THE FRAME IS PREFERABLY PLACED BENEATH THE DAM RATHER THAN ABOVE IT.
 4. RUBBER DAM RETAINER FORCEPS:

• IT IS FORCEP THAT HOLDS THE RETAINER AND FACILITATES ITS PLACEMENT

AND REMOVAL FROM THE TOOTH.
 5. RUBBER DAM TEMPLATE/ STAMP:
• BOTH HAVE POSITIONS OF THE TEETH MARKED ON THEM AND ARE USED TO
.
TRANSFER THEM TO THE RUBBER DAM SHEET FOR THE HOLES TO BE
PUNCHED.

.
 6. RUBBER DAM PUNCH:
• IT IS A PUNCH FOR MAKING HOLES IN THE DAM HAVING ROTATING METAL
DISC WHICH BEARS 5 OR 6 HOLES OF DIFFERENT SIZES AND A SHARP POINTED
PLUNGER.
• WHEN THE HANDLES OF THE PUNCH ARE PRESSED, THE PLUNGER SHOULD
REST IN THE CENTER OF THE HOLE.
• IF NOT, THE PLUNGER TIP WOULD GET DAMAGED AND ITS CUTTING ABILITY
IS RUINED.
• USE OF THE PARTICULAR HOLE SUGGESTED FOR THAT PARTICULAR TOOTH,
OTHERWISE A TIGHT SEAL WILL NOT BE POSSIBLE OR THE DAM MAY TEAR
DURING ITS PLACEMENT.
 7. DENTAL FLOSS:
• IT SHOULD BE TIED AROUND THE RETAINER BEFORE IT IS CARRIED INTO THE
ORAL CAVITY.
• THIS A SAFETY MEASURE TO PREVENT ACCIDENTAL ASPIRATION OF THE
CLAMP SHOULD IT SLIP.
• FLOSS SHOULD BE PASSED THROUGH BOTH THE HOLES IN THE JAWS AROUND
THE BOW OF THE CLAMP.
• THE FLOSS SHOULD BE ADEQUATELY LONG SO THAT THE STRAND HANGS
OUT OF THE MOUTH FOR A SUFFICIENT DISTANCE.
 8. WEDJET:
• THIS IS AN ELASTIC CORD GENERALLY USED TO SECURE THE DAM
AROUND THE TEETH FARTHEST AWAY FROM THE CLAMP.
• IT CAN ALSO BE USED TO PUSH THE DAM THROUGH THE
INTERPROXIMAL CONTACT.
9. LUBRICANT:
• IT AIDS IN PASSING THE DAM OVER THE TOOTH.
• IT IS APPLIED ON BOTH SIDES OF THE DAM IN THE AREA OF PUNCHED HOLES.
• WATER SOLUBLE LUBRICANT MUST BE USED.
• RUBBER DAM LUBRICANT IS COMMERCIALLY AVAILABLE OR ONE CAN ALSO USE
SHAVING FOAM OR SOAP SLURRY.
• VASELINE IS NOT USED AS LUBRICANT AS IT CANNOT BE RINSED EASILY AFTER
RUBBER DAM PLACEMENT RATHER IT CAN BE USED TO APPLY AS A NON-IRRITANT
AT CORNERS OF THE MOUTH.
 10. RUBBER DAM NAPKIN:

• IT IS PLACED BETWEEN THE RUBBER DAM AND THE PATIENT’S SKIN, WHICH
HAS THE FOLLOWING BENEFITS.
1. IMPROVEMENT OF PATIENT’S COMFORT BY REDUCING DIRECT CONTACT OF
THE RUBBER MATERIAL WITH THE SKIN.
2. ABSORPTION OF THE SALIVA SEEPING AT THE CORNERS OF THE MOUTH.
3. SERVES AS A CUSHION FOR THE RUBBER MATERIAL.
.
RECENT ADVANCES
1.INSTIDAM: COMPACT DESIGN FITS OUTSIDE THE PATIENT’S MOUTH. IT IS
NON-THREATENING AND COMFORTABLE TO PATIENT.

2.HANDIDAM: IT IS PRE-FRAMED RUBBER DAM AND IT IS EASY TO PLACE ON

THE PATIENT AND SAVES TIME.
.

3.OPTRA DAM: ANATOMICAL SHAPE AND INTEGRATED FRAME MAKE PLACEMENT FAST AND EASY BY ONE
PERSON.
FLEXIBLE IN ALL DIRECTIONS, HENCE COMFORTABLE TO THE PATIENT FOR LONG PERIODS.
NO METAL CLAMPS ARE REQUIRED.

4. OPTIDAM: 3-D ANATOMICALLY CONTOURED FRAME AND DAM DESIGN, ALLOWS EASY
4

PLACEMENT AND ACCOMMODATES ANATOMICAL VARIATIONS IN THE MOUTH, REDUCING

HAND FATIGUE AND IMPROVING PATIENT COMFORT.
 5.LIQUID DAM: IT IS A RESINOUS MATERIAL APPLIED ON THE GINGIVAL ASPECT
. OF THE TOOTH SURFACE PRIOR TO PROCEDURE.
.

THANK YOU🙏🏻

REFERENCES:
STURDEVANT
VIMAL SIKRI