Rubber Dams and Pit/Fissure Sealant

Question 1

What are the three main reasons for use of rubber dams?

Answer 1

1. Moisture control
2. Protects and retracts soft tissue
3. Improves vision for operative site
4. Protects airway

Question 2

When are rubber dams mandatory?

Answer 2

During endodontic procedures

Question 3

What are some reasons for not using rubber dam?

Answer 3

1. Time
2. Patient doesn’t like
3. Allergy

Question 4

What is an alternative method of anchoring rubber dam?

Answer 4

With Wedjet and ligature

Question 5

What instrument do you use to invert the dam around necks of teeth to complete isolation?

Answer 5

Flat plastic

Question 6

What is ligaturing?

Answer 6

Passing floss through mesial and distal contacts, looping around lingual surface at gingival margin

Question 7

What types of clamps are used for posterior teeth and what is the purpose of clamps?

Answer 7

Premolar clamp 1, 2 and molar clamp 56

Used for retention of rubber dam -construct the cervical area of the dental crown to hold the rubber dam

Question 8

What are some advantages and disadvantages of winged clamps?

Answer 8

Advantages:

• More rapid placement of dam
• less chance of tear dam when stretching over clamp
• less chance of popping of the tooth

Disadvantages:

• Can obscure teeth- hard to identify tooth
• Must stretch dam
• Clamp can slip off

Question 9

What are some advantages and disadvantages of wingless clamps?

Answer 9

• Clamp can be placed rapid, accurately not obscured vision
• less projection on clamp- better access to tooth

Disadvantages:

• Stretching dam over clamp
• Clamp must be secured by floss
• Difficulty access mouth by dam and fingers

Question 10

What type of clamp is this?

Answer 10

Wingless

Question 11

What type of clamps are these?

Answer 11

Hu-friendly pattern clamps-winged

Question 12

What are the basic instruments required for rubber dam set up use?

Answer 12

Artery forceps, hole punch, supporting frame, clamps x3 minimum, rubber dam forceps, scissors, dam, template, floss, interproximal carver or flat plastic

Question 13

What is this wedge used for?

Answer 13

To tie down anterior dam

Question 14

What are the basic steps in applying the rubber dam?

Answer 14

1. Hole punch appropriate teeth in dam using template
2. Choose appropriate sized clamp- attach floss to clamp- at least 15cm of floss
3. Deliver assembled dam and clamp the tooth
4. Use flat plastic to flip dam off wings- ensure sealed
5. Position most anterior hole over tooth and lock down with floss
6. Ligaturing- floss through mesial and distal contacts looping around lingual surface at gingival margin
7. Make a slip knot with floss- pull tight
8. Use flat plastic to invert the dam around necks of teeth to complete and seal for isolation

Question 15

For a pit and fissure sealant of buccal pit, what handpiece tip do you need?

Answer 15

Low speed with bristle brush

Question 16

What sealant do use for a pit and fissure sealant, and tip?

Answer 16

Helioseal fissure sealant and fine black cannula

Question 17

Before you begin sealing, you are required to clean the pit and fissure with a paste. What paste and describe the process?

Answer 17

Pumice- make a slurry paste.

Using a mixing spatula, add 2 drops of water, scoop powder over with spatula to make slurry.

Helps the pumice stick to the brush better.

Question 18

How do you ensure you add the paste to tooth without it spinning off the brush?

Answer 18

Turn off water supply

Foot pedal on minimum speed (to the left)

Question 19

What instrument do you use to check the margins of fissure sealant?

Answer 19

Sickle probe

Question 20

Describe the process of pit and fissure sealant

Answer 20

1. No tooth prep with burs
2. Clean pit and fissures with bristle brush and slurry pumice paste on low speed
3. Wash off paste and dry
4. Acid etch for 15 secs- wash and dry
5. Bleed off 1-2 mm of sealant onto tissue, and place sealant into the fissure (release air bubbles)
6. Remove excess with mycrobrush or air from triplex
7. Light cure for 20 secs