What is a cofferdam? Application in dentistry.

Today, the obvious fact is that the level of quality of dental treatment has increased significantly. What affects the quality and long-term treatment is sometimes hidden from the patient’s eyes or he does not attach importance to it. For example, in this article we want to talk about the use of such an auxiliary element in treatment as a rubber dam. It also has other names used: optidam or rubberdam.

Sometimes it may seem to the patient that the dental clinic uses such “add-ons” in order to make the treatment procedure more expensive. Believe me, this is absolutely not true. Below we will tell you why the use of a rubber dam in treatment is indispensable if you want to receive high-quality treatment with long-term results.

Scope of application of rubber dam.

Endodontic dental treatment . When treating root canals, it is extremely important not only to maintain ideal sterility for the tooth, but also to prevent accidental contact with the oral mucosa of medications that can cause an allergic reaction.
Restoration of teeth with light-curing fillings and artistic restorations. In order to achieve reliable adhesion of the filling material to the tooth surface, the conditions of absolute dryness of the treated surface must be met, which the rubber dam invariably helps with.
Teeth whitening. To ensure that the whitening composition, which affects the enamel, does not injure the mucous membrane, the gums must be isolated using a liquid rubber dam. Professional teeth whitening is not complete without the use of a rubber dam.
Fissure sealing. For high-quality fissure sealing (coating the chewing surface of the tooth with a special composition in order to protect the enamel from destruction by caries), a perfectly dry tooth surface is necessary.
Splinting of teeth. When splinting, the adhesive material adheres better to the enamel surface when the risk of accidental saliva ingress is eliminated.

What is hidden behind complex names and when to use these tools

Today it is difficult to argue with the fact that in dentistry the level of development of advanced technologies has made it possible to significantly improve the quality of services and bring them to a fundamentally new level. But not all patients clearly understand that dental treatment or restoration largely consists of many little details that are invisible to the average person, each of which is individually important and irreplaceable.

For example, a rubber dam in dentistry. Having heard about it, many believe that this is just another way to extract money from a patient, and do not even suspect that the product can bring significant benefits and contribute to achieving the most positive result. How? Read about this in the material prepared below.

Why rubber dam has positive aspects for the doctor and for the patient.

Doctor. The specialist can focus on the treatment process, having the most convenient access to the tooth. The working field is visible much better due to achieving optimal cleanliness and dryness through insulation. The treatment process is monitored more efficiently and time is used rationally.
Patient . Additional protection from accidental injury to the mucous membranes, gums, and lips. Saliva can be safely swallowed; medications used in treatment and elements from dental treatment do not get into it. The muscles and jaw joints experience less stress and are less tired because treatment time is reduced. All this creates greater comfort.

An undeniable advantage is that the installed filling or restoration will last much longer than during treatment without the use of a rubber dam. The main goal is to improve the quality of treatment. The cost to the patient during treatment of using a rubber dam is negligible, and in the long term, it definitely leads to cost savings.

Tatyana Borisovna Sitenkova

Dentist, therapist

years of experience

All types of therapeutic treatment, artistic restoration, hygiene procedures of any degree of complexity.

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What is a rubber dam?

So, rubber dam in dentistry - what is it? Take a look at the photo. This is a latex plastic material. The doctor first places it on the patient’s oral cavity before starting treatment, after which he makes the necessary hole to isolate the working area under one, sometimes several teeth. That is, in essence, it allows you to isolate the working field, remove all unnecessary things that may interfere.

The specialist fixes the device using a special frame or clamps, ensures the required level of lip tension and gets to work.

On a note! Have you heard about optidam in dentistry, but have no idea what rubberdam and rubber dam are? It will be useful for you to know that these are the same thing, the only differences are in the names and their translation from English. But the essence of these devices is the same - to ensure sterility and isolation of the working field.

Contraindications and disadvantages.

If a person has impaired nasal breathing, the use of a rubber dam is contraindicated, since the patient will not be able to breathe normally. Also, the use of rubber dam is not applicable for people with Alzheimer's disease, with epileptic seizures, provided that there is an allergy to talc, rubber or latex. In case of allergic reactions, special sponges and rollers are used to absorb moisture; a saliva ejector also helps to cope with the secretion of saliva. But these measures do not provide such high-quality isolation of the tooth being treated and the service life of the filling is significantly reduced.
If the doctor is not highly qualified, then when using a rubber dam there is a risk of damage to the interdental papillae.
To install a rubber dam, it is necessary to work “with 4 hands”, that is, the doctor works in tandem with an assistant.
Relative disadvantages also include a slight increase in the cost of the treatment procedure. But, taking into account the prospect of a long service life of the filling and high-quality canal filling, the use of a rubber dam makes treatment cheaper.
The process of installing a rubber dam is often not a very pleasant procedure. But, taking into account further greater comfort during the treatment process: shorter time, less tired facial muscles, no penetration of medications and tissues of the treated tooth into the oral cavity, the discomfort from the installation can be considered minimal.

Yana Dmitrievna Mitskevich

Dentist, therapist

years of experience

All types of therapeutic treatment, including endodontic treatment using a microscope, microprosthetics, hygienic procedures of any degree of complexity.

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Overlay Techniques

When applying a rubber dam, you need to know that it should be placed with the smooth side facing the patient's mouth and the powdered side facing the dentist. A clamp is required to install the system.

Installation of a rubber dam is carried out using one of four techniques:

The "wing" technique is used to place a latex curtain on the molars and premolars. Here you need a frame onto which a latex napkin is stretched. A clamp is placed in the cavity and the forceps are secured. To prevent the scarf from touching the person’s skin, the face is covered with a napkin. Next, the clamp is fixed on the tooth slightly lower than the equator. The final touch is to remove the rubber dam from the wings using a trowel.
"Rubber dam first" ideally requires the assistance of an assistant. This method is convenient for applying material to any teeth. It is necessary to install the optidam on the frame in advance, then the assistant takes it with both hands between the index and thumb and pulls the tooth through the hole. The final step is for the doctor to thread a latex rubber band through the proximal contacts using dental floss. The essence of the work is that the assistant holds the system, and the doctor secures the clamp.
“Clamp first” is a method suitable for the first molar and premolar. Here the valves are needed without wings. First, they are attached to the tooth, and then the latex scarf is pulled over the clamp and fixed to the frame. Before fastening, you need to fix the dental floss for easier removal.
The arch technique is necessary if lower molars are to be treated. It is better to use clamps without wings. At the first stage, you need to insert a clamp arc into the hole of the latex napkin. Next, you need to secure the tongs and collect the scarf into a bun. Then the clamp must be placed on the tooth, holding a scarf to control the fit. After this, pass the scarf through the clamp and secure it to the frame. If it needs to be installed on a vital tooth, then anesthesia is performed, because this is a slightly painful procedure.

Visual application of rubber dam stage by stage with photo and video explanations in three techniques. The first method “Wings”:

Second way:

And the third way:

In many countries, endodontic treatment without the use of a latex curtain is prohibited.

Types of rubber dam.

Classic rubber dam.

This is a latex napkin, which in turn varies in density and thickness. Depending on the purpose, a certain type is used. There are also differences in colors that determine the scope of application. The colors are: light beige, blue, pink, green, gray, blue.

Liquid rubber dam.

Made on a gel basis, when used it tends to be distributed evenly and is fixed when exposed to special light. This type of rubber dam is used for teeth whitening, sometimes in combination with endodontics (canal treatment).

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AT THE GERMAN AESTHETIC DENTISTRY CENTER ES-DENT, specialists provide a guarantee for dental treatment and are responsible for the long-term quality result, ensuring the most comfortable condition of the patient during the treatment procedures. That is why the use of a rubber dam has positive aspects for both the patient and the doctor.

Alternative solutions

If there are certain contraindications or reluctance to apply Optidam, then you can use alternative methods:

saliva ejector or dust ejector;
tips - specialized plates inserted onto the salivary duct to absorb liquid;
cotton wool rolls.

These methods also help create dryness, but they do not guarantee 100% control of pathogenic microorganisms.

As a result, the use of latex scarves in dental practice ensures safety and saves time for the doctor and the patient, making the treatment process easier and better. Installation of such a system will be convenient for the dentist and his patient.

Alternatives

The main role of the rubber dam is to ensure the isolation of the tooth from possible moisture. Traditionally, this is solved using cotton rolls that are placed around the tooth. But they have to be changed frequently, they interfere with the dentist’s view and cause discomfort to the patient.

A more modern option is saliva absorbent pads (Dry Tips) . They have greater absorbency and fit more comfortably in the mouth. But their insulating characteristics are still inferior to rubber dam.

For timely removal, a saliva ejector is used . But its use requires the constant presence of an assistant. This device takes up a certain place in the mouth and can interfere with the dentist’s work.

The following isolation methods are less often practiced:

retraction thread;
fum tape;
liquid rubber dam;
Tofflmayr matrix holder with metal matrices;
sectional matrices and wooden wedges.

Learn about the advantages of the device and one of the application methods from the video.

Liquid material

Rubber dam in the form of methacrylate gel is a good solution for many dental procedures.

First of all, it is easy to apply, effectively isolates the gums, penetrating into the most difficult interdental areas.

The method of applying it is as follows: retractors are placed in the oral cavity to move the cheeks and tongue, a saliva ejector is inserted and the working surface is dried using cotton rolls.

Then the periodontal tissues are covered with a gel, which polymerizes in 20 seconds. The patient is ready for further manipulations. The protective material is removed with careful movements using a special trowel.

Since the liquid version does not protect the entire oral cavity, its main areas of application are:

professional enamel whitening;
microabrasion.

Liquid rubber dam is used when additional protection is needed for gums covered with a classic latex curtain.

How to prevent side effects?

Latex is a synthetic material that is not always well tolerated by the body. In some cases, it can cause an allergic reaction. Sometimes negative consequences are caused not by the rubber itself, but by the talc with which it is sprinkled for storage.

Recently, manufacturers have taken into account the wishes of specialists and began to produce material without this powder. That is, latex is repeatedly treated with liquid. In addition, modern silicone-based dental materials are now available.

Their only drawback is that they are slightly less elastic than latex. However, in other respects silicone is in no way inferior.

Cofferdam: long-forgotten old or new in dentistry

A rubber dam or dental rubber dam allows dental treatment to be performed quickly, reliably, and conveniently. But not everyone knows that this device is not a trend of progress at all, but a long-forgotten old one. Thus, the product was first presented to the public more than 100 years ago. It was invented by an American dentist: in those days the system was successful, but was gradually forgotten by doctors. This happened because it did not directly affect the outcome of treatment, plus it increased material costs. Therefore, only a small part of doctors were ultimately inclined to use it, and then it was used only for endodontic treatment.

Today, increased demands are placed on sterility and quality of work performed. Plus, innovations have appeared - restorations using modern materials, whose quality and perfection are steadily growing - which was not the case before. All this requires a high degree of preparation, which is why the rubber dam in dentistry has again gained popularity.

Reviews

Over its long history, cofferdam has earned many positive ratings, both among professional doctors and patients.

Do you have experience with latex curtain? What do you think about her? You can leave your comment here.

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General overview

A rubber dam is a material with which the dentist isolates a diseased tooth during treatment.

Most often this term refers to a piece of latex with a hole. In fact, this is a broader concept, since in addition to standard 15x15 cm flaps, there are also rolled forms of rubber dam, three-dimensional latex plates, as well as its liquid version.

The invention is not new at all. Dental treatment using this technology was first performed in the mid-19th century. Who owned the original idea is a moot point, since both the Frenchman La Roche and the American Sanford Christie Burnim claimed authorship.

One way or another, but since 1867, rubber dam (from the German Kofferdam) or rubber dam (English version Rubberdam) have entered the practice of dentists everywhere.

The traditional material for rubber dam is cis-1,4-polyisoprene, obtained from the sap of a tropical plant - Hevea brasiliensis.

Nowadays, International Rules for performing a number of dental procedures require the mandatory use of a rubber dam.

Write a comment

Zulfiya
April 16, 2021 at 02:59 pm
We came with the child for a consultation, the doctor persuaded her, looked at her teeth, persuaded her for about 10 minutes, but seemed to have found a contact. I was already happy, I thought we would get my teeth fixed by this aunt. This aunt counted us as much as 18,000 rubles. for 4 teeth! I made an approximate calculation, I read it at home, I found this rubber dam there as many as 4 times for 850 rubles! And why such expenses? I called them and asked why we needed this, since our whole life we had been treating our teeth without it. To which I was told that according to some international standards, children’s teeth are supposed to be treated only with this gasket. It’s terrible, now I’m thinking about looking for a new clinic and trying to persuade the child to try a new one.
Renat
April 16, 2021 at 09:21 pm
It's good that they invented this latex napkin. However, the method only recently reached our city. Convenient, just beyond words. You can swallow normally, nothing runs into your mouth. True, your mouth gets extremely dry and you only need to breathe through your nose, since your mouth turns out to be blocked and you can’t breathe through a napkin.
Anton
April 18, 2021 at 02:44 pm
This may be a cool thing, but not all doctors know how to use it. I went to read how they put it on and realized that not everyone can do it. Despite the fact that all my teeth are in place and not destroyed, my dentist tried to pull this scarf on for about 15 minutes, together with the nurse. They calculated something, adjusted things, and in the end they almost gouged out my eye with some piece of iron that flew out of their hands. In short, no thanks, I’d rather sit with cotton balls behind my cheeks. I want to warn everyone, before agreeing, first ask the doctor how many of these scarves she has already worn during her work
Mark Alexandrovich
July 22, 2021 at 12:39 pm
This may be a cool thing, but not all doctors know how to use it. I went to read how they put it on and realized that not everyone can do it. Despite the fact that all my teeth are in place and not destroyed, my dentist tried to pull this scarf on for about 15 minutes, together with the nurse. They calculated something, adjusted things, and in the end they almost gouged out my eye with some piece of iron that flew out of their hands. In short, no thanks, I’d rather sit with cotton balls behind my cheeks. I want to warn everyone, before agreeing, first ask the doctor how many of these scarves she has already worn during her work
Valentina
July 22, 2021 at 21:00
We came with the child for a consultation, the doctor persuaded her, looked at her teeth, persuaded her for about 10 minutes, but seemed to have found a contact. I was already happy, I thought we would get my teeth fixed by this aunt. This aunt counted us as much as 18,000 rubles. for 4 teeth! I made an approximate calculation, I read it at home, I found this rubber dam there as many as 4 times for 850 rubles! And why such expenses? I called them and asked why we needed this, since our whole life we had been treating our teeth without it. To which I was told that according to some international standards, children’s teeth are supposed to be treated only with this gasket. It’s terrible, now I’m thinking about looking for a new clinic and trying to persuade the child to try a new one.
Stas
July 24, 2021 at 10:18 am
It's good that they invented this latex napkin. However, the method only recently reached our city. Convenient, just beyond words. You can swallow normally, nothing runs into your mouth. True, your mouth gets extremely dry and you only need to breathe through your nose, since your mouth turns out to be blocked and you can’t breathe through a napkin.