Rubber Dam Flashcards

1
Q

what is a rubber dam?

A

it is a means of isolating teeth during restorative and endodontic procedures

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2
Q

what type of restorative procedures require rubber dam?

A
  • composite fillings (especially molar teeth)
- bonded restorations:
cores
veneers
quartz fibre posts
ceramic crowns
resin retained bridges
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3
Q

what type of endodontic procedures require rubber dam? x3

A
  • direct pulp capping
  • emergency treatment that involves opening into the pulp chamber
  • ALL root canal treatment
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4
Q

why is rubber dam mandatory for root canal treatments?

A
  • eliminate salivary contamination
  • reduces risk of cross-infection
  • protects oropharynx from aspiration or swallowing of instruments, irrigants, tooth, material debris
  • improves access to operational area:
    retracts and protects soft tissues
    improves visibility, dry field, less mirror fogging
  • relaxes patient
  • reduces chairside time
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5
Q

why should a rubber dam be used?

A
  • medically and legally mandatory for all endodontic procedures
  • essential for effective infection control: pulpal and periradicular disease
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6
Q

what are the legal implications of not using rubber dam?

A
  • instruments can be inhaled/swallowed -> negligence

- disregarding legal standard of care

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7
Q

what are the materials and equipment required for rubber dam placement?

A
  • rubber dam sheets: nitrile/latex
  • punch
  • clamps
  • frames
  • ancillary items: napkins, floss, wedjets, OraSeal
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8
Q

reactions to materials: which 2 types are there?

A
  • irritant contact dermatitis
  • allergic contact dermatitis
  • each can be acute or chronic
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9
Q

true latex allergy: what type of hypersensitivity?

mediated by? what happens with successive exposures?

A
  • type I hypersensitivity
  • IgE
  • becomes more severe
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10
Q

latex allergy:

  • risk factors?
  • symptoms?
  • treatment?
A
  • eczema of hands, food allergies, prolonged exposure
  • swelling, lightheadedness, oedema, itching, difficulty breathing
  • assess and call patient ambulance, epinephrine, 100% oxygen (10 l/min)
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11
Q

what are the 5 different types of clamp designs?

A
  • winged
  • wingless
  • passive clamp
  • active clamp
  • anterior clamp
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12
Q

winged clamps:

how are they placed?

A

placed with rubber dam attached to the clamp

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13
Q

wingless clamps: how are they placed?

A

clamp has to be placed on tooth before applying rubber dam

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14
Q

passive clamp: suits which teeth?

A

most molars with an intact crown

- not aggressive

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15
Q

active clamp:
good choice for?
can traumatise which tissues?

A
  • for tooth that is badly broken down, partially erupted or has no undercut
  • aggressive clamp, do not use on porcelain crowns
  • may traumatise gingival tissues
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16
Q

anterior clamp:
particular feature?
what are its uses?

A
  • very aggressive
  • for teeth with minimal coronal tooth structure
  • retraction of gingival tissues for placement of composite/GI cervically
17
Q

rubber dam frames: what are the 2 types?

A
  • plastic nygaard-ostby

- metal frame

18
Q

why must dental floss/tape be tied around clamp?

A

to prevent clamp from falling into oral cavity in the event of accidental breakage
allows retrieval if it flies off or breaks

19
Q

what is oraseal caulk putty used for?

A

it prevents the seepage of saliva or irrigant through rubber dam

20
Q

location of hole in rubber dam?

A

hole should be made in a way where the rubber dam should protect the oropharynx by sitting above the patient’s upper lip
* however, it should not cover the patient’s nose

21
Q

factors in the choice of clamp?

A
  • size of tooth (tooth type)
  • active/passive clamp (tooth structure)
  • winged/wingless (depends on technique of application)
22
Q

what could cause clamps to break?

how is dental floss threaded into the clamp?

A
  • effect of sodium hypochlorite or autoclaving

- length of floss threaded through one hole, around the bow, and threaded through the other hole

23
Q

what are the 3 main methods of rubber dam application?

A
  1. rubber dam attached to the clamp (winged), with or without frame
  2. (winged or wingless) clamp is placed directly on the tooth, dam is then stretched over
  3. dam stretched over tooth, then clamp is placed over
24
Q

broken down teeth/bridgework?

A
  • cement orthodontic/copper band around tooth
  • split-dam technique: clamps are placed on teeth mesial and distal to broken tooth
    dam stretched over 3 teeth
    requires extra protection from salivary contamination/leakage by using cotton wool rolls in the sulcus and salivary ejectors
25
Q

anterior isolation: how to carry out?

A
  • punch a series of 8 holes,
  • place topical anaesthetic over teeth being clamped.
  • seat clamp on premolar tooth to ensure stability
  • place dam over premolara-premolar
26
Q

advantages of anterior isolation?

A

clamps are placed well away from tooth being treated - will not obscure apex while taking radiographs
- dam can be placed prior to cutting access cavity: easier to follow long axis of tooth

27
Q

what type of radiographs are required during root canal treatment?
what equipment must be used?

A
  • working length radiograph
  • trial point radiograph
  • endodontic film holder