Quiz 1 Exam 1 Flashcards by Austin Mahlik

Main Goals of Isolation of operating field (3)

Moisture control
Retraction
Harm prevention

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Goal of retraction and acess

provide maximum exposure of the operating site

keeps mouth open (i.e. bite blocks)

Depress tissue

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Harm Prevention -to the patient-provided by rubber dam includes (3)

Excessive saliva pooling can startle patients

Fluids and or small instruments can be swallowed or aspirated

Soft tissue can be damaged

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____ is critical in moisture control

isolation

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a clean, dry field affords ____ (3)

better visibility
cleaner prep walls
improved restoration success

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Methods of isolation and moisture control (6)

Some drugs used
-antiosialagogues w/ anesthetics
High V evacuation (HVE)
Saliva ejector
Cotton rolls/gauze
Iso-dry/Iso-lite
Rubber dam

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use of atropine sulfate

reduce salivary flow-RARE

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Pharmocological basis of anesthetics reducing salivary fluid

none- it may work

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HVE uses

who, what, when

High V Evac: removes moisture and debris by dental assistant

often used for fixed prosthodontics (crowns and bridges)

Excellent for debris removal

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Saliva ejector

use

can be used without an assistant (bend and hang)

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Leaving a saliva ejector unattenuated at the floor of the mouth

may harm tissue

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alternative of saliva ejector

svedopter: connects to the saliva ejector

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Cotton rolls and gauze (use and cons)

acceptable for some quick procedures-become saturated fast and must be replaced-may get in the way

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Placement of cotton rolls or gauze (where)

in vestibule, floor of mouth, or over salivary gland orifices

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What cotton rolls do for visibility

Do NOT increase, may obstruct

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Iso dry and Iso lite

connect to the HVE

-built in bite block

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Rubber Dam Isolation first use

NYC Dentist S.C. Barnum 1864

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Effectiveness of Rubber Dams

Most effective and can be effective over long appointment times

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More advantages of Rubber Dams (6)

dry, clean field (isolates operating field)

improve visibility and access

Maximizes patient safety

enhances patient comfort (debris do not accumulate in mouth)

Maximizes operator safety and efficiency (reduces aersols)

Improved properties of dental restorative materials (bonding, composite resin)

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Rubber dams maximize patient safety by preventing

lacerations, chemicals, prevents swallowing

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Disadvantages of Rubber dam (3)

time consumption

Patient objection (psychological)

Cannot be used for all patients (see other card)

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Cases in which a rubber dam cannot be used (5)

partial eruption (unable to hold a retainer)

malpositioned teeth

3rd molars

Patients with impaired nasal breathing

lesion position/location

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Average placement time of rubber dam

3-5 min

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Thin rubber dam pros

easy to apply, comfy

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Heavy rubber dam pros

improved resistance to tearing, improved retraction

Adult size Rubber dam

6"x6"

child size rubber dam

5"x5"

Color of rubber dam

provides contrast for improved visibility

New in rubber dams

improved elasticity and storage recommendations (cool, dry)

Retainer (clamps) function

provide a stable anchor for the system at the most distal aspect

Components of retainers

``` Prongs (4) Holes (2 usually) Bow Jaw Wings (not on all) ```

Tooth retainer goes on

most distal tooth that is in operating window

Function of wings on retainers

hold the RD out of the way during placement and operation, but can restrict restorative access

Number of prongs engaged with tooth?

4 prong-helps pick the retainer

Function of the frame of a retainer

to hold and stretch the RD material to improve visibility and help create a space for access

Engage the retainer where on the tooth?

below the height of contour-around the neck of the tooth is best

Punch funtion (RD)

Place holes in the RD material

Considerations when punching

conform to patients arch

punch holes too close together

RD will stretch and result in gaps (leaking)

Holes too far apart

RD will be bunched up and result in poor sealing (leaking)

Autoclave RD Punch?

NO- will dull it

Forcep function

utilize to place the retainer in position on the tooth and to remove the retainer after completion

Lubricant function in RD

may be placed on the underside of the rubber dam to aid in placement-usually in difficult spors in interproximal

Lubricant may be applied .... (2 scenarios) What should not be used?

on underside of dam to aid in placement (for hard interproximals) to a patients lips to aid in comfort-not vaseline

Napkin function-I wish this was a joke

absorbs excess saliva, aids in patient comfort, some dams have a built in patient side

alternative to vaseline that should be used

gel toothpaste

a poor rubber dam may be ______ effective and, therefore, a ________ isolation method

less effective less valuable

Achieving adequate and effective _____ is of primary importance

Isolation

Five Steps of Rubber Dam Usage

Determine the operating field Prepare the RD Select proper retainer Place the RD Remove the RD

Aramentarium of dental dam (~9)

``` dam and frame Rubber dam Dental floss Scisors Dam templates Forceps Retainers Punch ```

determining operating filed for post teeth

place a retainer (at least) one tooth distal to tooth you are working on and cross the midline with the holes (ex restore tooth 29 and place on 31 to 21)

Ant tooth RD placement

place from 1st bicuspid to 1st bicuspid

Number of retainers used in RD placement for ant

One must be used | Two may be used

Why might canines be a poor tooth to terminate on?

morphology

Anchor with retainer or

floss

Use a powdered dam powder goes which way

Down towards patient

Attach floss to _____

retainer bridge-Always

winged retainer place on dam in hole for ______

most distal tooth

________ to bring dam between contacts

floss

Place dam frame _____ | how is it orientated

tips up/convex surface out (mimic convexity of the face)

Convexity of frame

mimics convexity of face

Inverting the dam

tuck damn around necks of optimizes isolation

Rubber dam removal | what should you not do?

Stretch dam, pull buccally or lingually (lateral not occlusal), cut it, pull out, double check for things left in mouth (sulcus)

Ligatures (how and where) Where is the floss placed into?

place ligature on tooth to be restored and on tooth each side-floss is placed into sulcus; on working tooth and those around it

Dam on the wing, good or not?

BAD

Rubber dam material _____ the neck of the tooth

hugs/is tight to

What is critical in moisture control of a rubber dam

isolation | -from gingival fluid, saliva, bleeding

With clean preparation walls, improved likelihood of

restoration success

The HVE is excellent for what

debris removal in pros

Most effective isolation method

Rubber dams

Do rubber dams enhance restorative material outcome?

Yes!

Possible con of wings on retainers?

Can restrict restorative dentistry

When placing a retainer on a tooth, Engage ____ or ____ Tines Then Set Opposite Side of Retainer

Buccal or lingual