The rubber dam is a system that protects the teeth from disturbing influences during treatment. With the help of this system, individual teeth can be isolated for treatment.
What is rubber dam?
Rubber dam represents a tension rubber, which is stretched in front of the teeth that are not to be treated, while the teeth that are to be treated are isolated exposed through holes in the rubber. The rubber dam serves to shield the teeth to be treated from unwanted influences such as saliva or bacteria. It also protects the patient from swallowing and inhaling harmful residues during dental treatment. This includes amalgam residues, pathogens, crown residues, parts of the treatment tools (e.g. drill tips) and much more. The tooth being treated should be kept as dry as possible during treatment and, in the case of root canal treatment, the root canal should be protected from invading bacteria. Rubber dam represents a tension rubber, which is stretched in front of the teeth not to be treated, while the teeth to be treated are isolated by holes in the rubber. This protective method was introduced by the New York dentist Sanford Christie Barnum as early as 1864. After the introduction of suction systems in the sixties of the twentieth century, the rubber dam slowly lost its importance. Today, however, more and more dentists appreciate the advantages of rubber dams. According to the DGZMK (German Society for Dental, Oral and Maxillofacial Medicine), important dental treatments should be performed with the aid of rubber dams. However, there is no mandatory obligation to do so.
Forms, types and styles
The use of a rubber dam has proven effective for root canal treatments, placement of plastic or gold fillings, removal of amalgam residue, tooth whitening or adhesive fillings. Among other things, it prevents contact of the root canal with invading pathogens or contact of the gums with the corrosive substances of bleaching or adhesive fillings. The rubber dam consists of a latex tension rubber. A non-latex material has also been launched for allergy sufferers. Rubber dam clamps are used to secure the rubber dam to the teeth. In addition to the rubber dam clamps, threads, wetjets (dental floss) or interdental wedges can also be used. Clamp pliers and punch pliers for punching holes for the teeth to be treated are also required as accessories. Furthermore, a clamping frame for stretching the rubber in front of the mouth is also included. In addition to this basic equipment, however, newer developments are already on the market. For example, there are ergonomic rubber dams with a nubby design, where marking the hole positions and punching the holes is no longer necessary. Some new developments have integrated plastic rings that make fastening with staples superfluous. Other systems already feature a perforated clamping rubber. These further developments of rubber dam systems are intended to increase their acceptance, which is still quite low today due to the sometimes awkward handling.
Structure and mode of operation
The way rubber dam systems work is very simple. Since the tooth must be kept dry, for example, during a root canal treatment or the placement of a plastic filling, the rubber dam provides good protection against moisture from saliva or moist breath. There is no need for constant suctioning. The same applies to shielding the tooth from pathogens from the oral cavity. When treating isolated free-standing teeth, corrosive substances or medication solutions are often used, which cannot be swallowed due to the use of this system. Likewise, there is no risk of swallowing tooth residue or amalgam residue. For this purpose, the tensioning rubber is first stretched in front of the mouth by means of the tensioning frame. The rubber is then placed over the teeth that are not to be treated. There it is fixed with the rubber dam clamps. The teeth or groups of teeth to be treated then protrude from the previously punched holes in the rubber. When treating gingivitis, the gums can also be isolated from the tooth using a rubber dam. The mouth is kept open at all times with the rubber dam. This allows the dentist to calmly concentrate on treating the teeth while the patient swallows in peace.
Diseases and complaints
The use of rubber dam has many advantages.However, there are also disadvantages and contraindications. When the rubber dam is stretched, the dentist no longer has to worry about suctioning the teeth. In addition, tooth debris, components of old fillings or broken off parts of treatment tools become easier for him to see. His work is also made easier because the patient’s mouth remains open throughout the treatment. The benefit for the patient is that by keeping the tooth being treated dry, for example, a plastic filling can be partially seated more firmly or contamination of the root canal during root canal treatment with the bacteria of the oral mucosa is prevented. This greatly increases the chances of healing. Even severe gingivitis (inflammation of the gums) in part can be better treated because the isolation of the gums from the tooth makes the focus of inflammation visible. However, the compressive stress of the rubber dam clamps can cause pressure ulcers in the gums. Also, the displacement of the gum from the tooth, to treat previously invisible areas, can cause trauma to the gum. Contraindications to placing a rubber dam include epilepsy, allergies, asthma, respiratory disease, or anxiety disorders.
