TIPS AND TRICKS
HOW TO USE RUBBER DAM CORRECTLY
You can put the latex first, first the clamp or rubber dam and clamp at the same time. The successful placement, in the last case, depends mainly on how handy the operator is. In this case the use of winged clamps is recommended.
Rubber gets nipped with the clamp, or it is not adequately adapted in the sulcus, or even rubber tears alongside the perforation. If the failure cannot be corrected, placement of a new rubber means the solution.
HOW SHOULD ISOLATION BE DONE?
As far as possible the teeth holding the clamps should be anesthetized, the the amalgam fillings should always be removed in isolation and it is useful the application of anesthetic gel on the rest of the teeth because of the invagination (adaptation into sulcus) – Active orthodontic is not a real contraindication.
– FRONT teeth the isolation of the entire frontal area is recommended, in most of the case (from 4 to 4).
– PREMOLAR teeth isolation of only 2 teeth is rare when treating MO or OD cavities. Basically, I prefer to work in quadrant isolation.
– MOLARS, the isolation of the entire molar area is the minimum isolation requirement!
”Starting the daily use of the rubber dam is the beginning of wisdom. When the rubber dam comes through the door, slipshod methods go out of the window. It marks the beginning of better dentistry.
FOUR LEVEL OF INVERSION
A GOOD ISOLATION: WHAT DOES IT MEAN?
Level 1 – AIR INVERSION
The easiest way of getting inversion is by blowing air around the cervical area and, at the same time, delicately pushing the rubber into the sulcus with a spatula.
Level 2 – INVERSION WITH DENTAL FLOSS
When air inversion just doesn’t work at all, a strategy to invert the rubber dam in the sulcus is to use a dental floss placed around the tooth; with apical pressure and slow movements the rubber dam should roll and be inverted.
Level 3 – INVERSION WITH KNOT LIGATURES
This technique provides two main advantages: one is that the floss pushes the rubber deep in the sulcus, close to the epithelial insertion, and second, the floss tightens around the tooth and holds the rubber dam in place during the restorative procedure. This option of isolation can only work if the destruction limit doesn’t affect the epithelial attachment.
Level 4 – INVERSION USING TEFLON TAPE
When we use this technique for inversion, it means that we have some problems with isolation. By using teflon tape, we can place the rubber deep subgingivally in the sulcus and place it under the limit of our preparation.
Illustrating the benefits of using a dental dam creates empathy and helps the patient accept the practice and reduces the perception of discomfort.
Accurate analysis and planning, including the choice of the teeth to be isolated, the clamp to be used and the dam application technique, leads to reduced intervention time and improved safety for both the patient and the professional.
The choice of the clamp requires assessment: after securing the clamp with dental floss to prevent the patient from swallowing it, the clamp is positioned and mechanically tested for anchorage.
Time to use the marker, the dam template, the rubber dam and the forceps to punch the latter according to the isolation plan.
Apply the dental dam using the clamp-engaging forceps and the dam frame. If necessary, use dental floss for interproximal placement and a blunt instrument to tuck the edges of the rubber dam into the gingival sulcus.
Carefully stretch the rubber dam and, if necessary, cut interdental septa. Once the clamp is disengaged and the procedure is over, the golden rule suggests asking the patient about the overall experience.
WHAT ARE THE DIFFERENCES?
ADVANTAGES USING VISION DAM
16:9 WIDER AND RECTANGULAR DAM (NOT SQUARE) MAKES ASSEMBLY EASIER, INCREASES PROTECTION AND COMFORT
BLACK COLOUR MAKES THE DETAILS OF THE INTERVENTION AREA STAND OUT. PERFECT TO TAKE PHOTOS OF YOUR CLINICAL CASE
A THICKER AND MORE ELASTIC DAM MAKES ASSEMBLY AND REMOVAL EASIER (STRETCHING CAN REACH 700%)
CLAMPS WITH XLAYER COATING FOR EASY REMOVAL OF RESINS
A STAINLESS STEEL MAGNETIC TRAY FOR EASY STERILIZATION AND LOCKING
A REUSABLE DAM TEMPLATE AND A FOOD GRADE MARKER TO PINCH THE DAM WITH MORE PRECISION
TRADITIONAL SQUARE DAM ARE SMALLER AND NOT SO COMFORTABLE FOR PATIENTS AND DENTISTS
BRIGHT COLORS DAM DO NOT ENHANCES CONTRAST AND CREATE DISTRACTION FROM THE FIELD OF WORK
LESS ELASTIC DAM COULD BE EASIER DAMAGED AND STILL DIFFICULT TO ASSEMBLE AND REMOVE
WITH TRADITIONAL CLAMPS RESINS IS ALWAYS DIFFICULT TO REMOVE
WITHOUT A KIT, CLAMPS AND TOOLS ARE LOOSE AND NOT EASY TO LOCK
NO READY DAM TEMPLATE. YOU HAVE TO CREATE IT BY YOURSELF, LOOSING TIME
INSIDE YOUR KIT…
YOU WILL FIND:
Inside a complete Vision Dam Kit you can find a 16:9 black rubber dam (60 pcs.), 6 clamps with xlayer coating for easy removal of resins, a stainless steel magnetic tray for easy sterilization and locking, a new larger dam frame for patient comfort and dentist convenience, a stainless steel reusable dam template, 1 food grade marker with double tips with different size, 1 high precision Ivory punch forceps and 1 ergonomic Ivory clamp forceps.