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Module 5 - Endodontics > Rubber Dam > Flashcards

Rubber Dam Flashcards

1
Q

What is Type 1 latex allergy? Symptoms and treatment?

A
  • Type 1: anaphylaxis
  • Symptoms: swelling, light-headedness, dizziness oedema, erythema, itching, difficulty breathing.
  • Treatment: call ambulance, 0.5mL (1:1000) epinephrine IM - repeat after 5 mins if needed. 100% oxygen - 10 liters/min.
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2
Q

What are wedjet cords and when are they used (2)?

A
  • Small elastic cords.

Uses:
- When placing rubber dam as an EMERGENCY and are not placing a clamp
- When placing a clamp on one side of the arch and want to stabilize the other.

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3
Q

What two chemicals can be used to disinfect teeth when placing rubber dam?

A
  • 1% hydrogen peroxide.
  • 0.2% iodopovidone.
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4
Q

By what % does rubber dam reduce the spread of microorganisms into the atmosphere?

A

90%

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5
Q

What is the treatment for anaphylaxis?

A
  • call ambulance
  • 0.5mL (1:1000) epinephrine IM - repeat after 5 mins if needed
  • 100% oxygen - 10 liters/min.
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6
Q

What type of clamp would you use in a partially erupted tooth?

A

Active clamp

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7
Q

What are the steps to placing rubber dam (ignore clamp and frame).

A
  1. Mouthwash for 30 seconds with 1% hydrogen peroxide or 0.2% iodopovidone, spit into disposable cup.
  2. Disinfect rubber dam before use.
  3. Place rubber dam.
  4. ensure adequate seal around the tooth.
  5. disinfect tooth with hydrogen peroxide on cotton wool.
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8
Q

How many species of microbes exist in the mouth? How many bacterial cells?

A
  • 700 oral species.
  • 10 billion bacterial cells.
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9
Q

would you use rubber dam for an emergency access?

A

YES

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10
Q

What are 7 uses of rubber dam?

A
  • Protection from ingestion/ aspiration (ex. of small files used in endodontics).
  • Retract/ protection of soft tissues.
  • Better visibility.
  • Reduction of delays during treatment (patient cannot get up to spit and rinse etc).
  • Patient and dentists more relaxed.
  • Dentists and nurses are protected against infections which can be transmitted by patient’s saliva.
    o Reduces the spread/ atmospheric contamination by microorganisms by more than 90%.
  • Prevents the root canal system from being contaminated with the patient’s saliva.
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11
Q

What restorative procedures is rubber dam used for?

A
  • composite fillings (especially in molars).
  • bonded restorations (crowns, cores, veneers, posts)
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12
Q

What are the 4 types of rubber dam clamps?

A
  • Winged/ wingless.
  • Passive/ active.
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13
Q

Describe a method of clamping anterior teeth without the use of an anterior clasp.

A
  • Punch 8 holes
  • Place topical around tooth being clamped.
  • Seat clamp on premolar tooth.
  • Place dam over premolar- premolar, ensure fluid tight seal using floss ligatures.
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14
Q

what does the choice of clamp depend on? (size, active/passive, winged/ wingless).

A
  • Size: tooth size/type.
  • Active/passive: tooth structure.
  • Winged/ wingless: technique.
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15
Q

What MUST be done when placing a clamp on a tooth?

A

MUST floss clamp to allow retrieval if it breaks.

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16
Q

When can a rubber dam be removed during endodontic treatment?

A

When the temporary dressing is placed.

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17
Q

How is a wingless clamp applied to a tooth?

A

placed on tooth before applying the rubber dam

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18
Q

When is an active clamp best suited (3)? When should it not be used? What is a “drawback”

A
  • good for badly broken down teeth, partially erupted or no undercut.
  • do not use on a ceramic crown
  • may traumatize gingival tissues, give LA.
19
Q

How is a liquid dam used?

A

Place around tooth and cure with light.

20
Q

What type of clamp would you use in a tooth with a ceramic crown?

A

PASSIVE clamp, active clamp could damage crown

21
Q

What is rubber dam?

A

A means of isolating teeth during restorative and ALL endodontic procedures.

22
Q

What clamp would you use for the placement of a cervical composite on tooth 22?

A

Anterior clamp.

23
Q

What two materials can rubber dams be made of?

A

nitrile or latex

24
Q

What is a passive clamp? What are they best suited for?

A
  • 4 points of contact have a flat approach to the crown of the tooth.
  • Not agressive.
  • Suit most molars/ premolars with an intact crown.
25
Q

How is a winged clamp applied to a tooth?

A

placed with rubber attached to clamp.

26
Q

What is a rubber dam technique that can be used to isolate broken down teeth/ bridgework?

A
  • Split-dam technique:
    1. clamps placed on teeth mesial/ distal to broken tooth.
    2. 3 holes made in dam and joined using scissors.
    3. dam is stretched over the 3 teeth.
    4. use of salivary ejectors, cotton wool rolls in sulcus (+ liquid dam) to prevent salivary contamination.
27
Q

What % surface area do teeth make up in the oral cavity?

A

20%

28
Q

What are 4 methods to achieve a fluid tight seal when placing rubber dam?

A
  1. caulking material.
  2. liquid dam.
  3. invert dam with flat plastic or 3 in 1.
  4. floss ligatures
29
Q

How is a wingless clamp prepared for placement in a lower tooth?

A
  • Lower tooth: place the clamp on the dam with the bow pointing UP.
    1. Place clamp in the punched hole in the rubber dam.
    2. Bring the holders (forceps) towards the clamp with the tips of the holders pointing DOWN.
    3. Stretch the tips of the holders to engage the clamp holes.
    4. Slide up the metal bar on the forceps, locking them in place.
30
Q

What is a word used to describe oral pathogens?

A

opportunistic

31
Q

What must the dam cover and what must it not cover?

A

Must cover the oropharynx, must NOT cover the nose.

32
Q

What is an ora-shield?

A
  • Rubber dam napkin, used between the patient’s skin and the dam for comfort.
33
Q

What endodontic procedures require rubber dam?

A
  • Indirect AND direct pulp capping.
  • Emergency treatment that involves opening into the pulp chamber.
  • Pulpotomy
  • ALL root canal treatment procedures (including emergency access/ pulp extirpation).
34
Q

What are 2 uses of anterior clamps?

A
  • very agressive.
  • teeth with minimal coronal tooth structure.
  • retraction of gingival tissues for placement of composite/ GI CERVICALLY.
35
Q

Why may a clamp break?

A
  • Due to the effect of sodium hypochlorite or the autoclave.
36
Q

What are pre-framed rubber dams useful for?

A

emergencies and children’s dentistry

37
Q

What percent of healthcare workers and the general public have a latex allergy?

A
  • Healthcare: 8-12%
  • General public: 1-6%.
38
Q

How is a wingless clamp prepared for placement in an upper tooth?

A
  • Upper tooth: place the clamp on the dam with the bow pointing DOWN.
    1. Place clamp in the punched hole in the rubber dam.
    2. Bring the holders (forceps) towards the clamp with the tips of the holders pointing UP.
    3. Stretch the tips of the holders to engage the clamp holes.
    4. Slide up the metal bar on the forceps, locking them in place.
39
Q
A
40
Q

You want additional soft tissue retraction. Would you use a winged or wingless clamp?

A

Winged clamp.

41
Q

What is done to the rubber dam when working length and trial point radiographs are taken?

A
  • MUST use endodontic film holder.
  • Rubber dam DOES NOT COME OFF.
42
Q

would you use rubber dam for an emergency pulp extirpation?

A

yes

43
Q

Is use of rubber dam for endodontic procedures a medico-legal requirement?

A

YES - use of rubber dam is the LEGAL STANDARD OF CARE. Instrument inhalation/ aspiration is considered NEGLIGENT.

Module 5 - Endodontics (11 decks)

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