Hands OnUse the rubber dam
Section snippets
Background
The use of the rubber dam (RD) reduces contamination and the likelihood that patients may swallow or inhale irrigants, hand files, infected tooth debris, or other materials. Dental students are taught that the RD improves visibility, visual access to the canal(s), moisture control, and soft tissue retraction, which combine to make endodontic treatment more efficient. RD is considered the gold standard of care in endodontics, yet studies show that fewer than half of dentists use the RD for all
Methods
The data were collected through an electronic search of the PubMed database. The period of time covered was between January 1983 and April 2013. Data were analyzed in two groups: prevalence of RD use and attitude toward RD use. Ethical issues and other considerations were also evaluated.
Results
The prevalence of RD use varied widely between countries, ranging from a low of 11% to a high of over 90%. Nearly all undergraduate students believed that they would use RDs in endodontic treatment after they graduated, but the actual use figures showed a dramatic decline in use. Up to 90% of dentists had never used the RD or did not use it for more than 1 year.
Attitudes toward RD use also varied. Most undergraduate dental students were unsure that RD had a role in dental care other than
Dental-Legal Issues
Use of the RD in endodontic therapy is not only supported in the literature but is also part of the universally agreed-upon safety and clinical practice guidelines for ensuring a sterile, safe field for root canal treatment. Dentists should have on hand all the equipment needed to perform RD isolation even for challenging cases. This includes dental floss, Wedjets, stabilizing cords, and hydrophobic non-setting caulking pastes. A split-dam technique can be used when the tooth structure is
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Ahmen HMA, Cohen S, Lévy G, et al: Rubber dam application in endodontic practice: An update on critical educational and ethical dilemmas. Austral Dent J 59:457-463, 2014
Reprints available from S Cohen, The Arthur A Dogoni School of Dentistry, Univ of the Pacific, 2155 Webster St, San Francisco, CA 94115-2333; e-mail: [email protected]