Dental dam

What is a rubber dam?

Dental dam in place

A rubber dam or dental dam is a sheet of a rubber-like material that is clamped around teeth to keep them isolated.

This has several roles – firstly the dental dam helps to protect the cheek, tongue and soft tissues from dental instruments. It also helps to keep the teeth dry, which is very important for modern adhesive dentistry – even the water drops from breathing can have an impact on how strong the bond is.

And here’s the really important one – it helps to prevent fluids from either going into the mouth, or onto the tooth from the mouth. This is particularly important when doing root canal treatments – as saliva is absolutely packed full of the bacteria that can cause root treatments to fail. There is also evidence that composite restorations placed under rubber dam have a better lifespan than when done without a dam.

Rubber dams have been used in dentistry since 1864. This is not something new, but it is far from commonplace.

Why to use a rubber dam

With the advantages listed above, I guess a more pertinent question is “Why not?”

Generally it is down to the dentist.

Why dentists DON’T use the rubber dam

When I was doing my Vocational Training, I remember that one of my study group did an audit within practice to see the reasons behind not using one.

Perhaps most telling was the list that it generated –

  • Time-consuming – in reality, if you are using it every day, it actually saves time.
  • Fiddly – Sometimes it can be, but if you use it every day, day in day out, it becomes second nature.
  • Don’t need it – the evidence is that there are better outcomes, even with the same dentist doing the treatment, when the rubber dam is used
  • But perhaps the most telling response summarises it nicely- “Can’t be arsed

    I use it because it makes my work easier and less stressful, as well as giving better outcomes. Sure, I could work without it, but a small percentage of failures due to not using a dam is simply not worth the risk. We want you to have the best outcome.