Dentaltown June 2017 - 30

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Rubber Dam Frustrations? Tips and Tricks?
Townie dentists share their preferred techniques for working with rubber dams.

keep smiling
Member Since: 06/09/15
Post: 1 of 98

Inspired by the thread "Considering Quitting Rubber Dam Use," I thought it might be
helpful to discuss some of the challenges, tips and tricks for using the rubber dam.
For me, with the exception of endo-where I use it 100 percent, even for pulpotomies and
pulpectomies-I use the dam only if it's easy for most other procedures. If the clamp pops off
the tooth, it's gone. If it digs into the gums and patient complains, it's gone. If it fits the tooth
too loose, it's gone. I can't be bothered to play around with different clamps. I would like to use
the dam more, though. It's easier on my back and I like the retraction of tissues. It would also
save a lot of cotton rolls and dry angles.
My questions to those who use rubber dams religiously:
How do you ensure retention of the clamp? Large variety of clamps? Wedges?
How do you ensure patient comfort (on buccal of lowers and palatal of uppers)? Use topical?
Second LA injection? Thanks. ■
4/1/2017

helpmedoc
Member Since: 11/01/11
Post: 3 of 98

I'm particularly curious to know how you choose the right clamp. I feel like the majority of
issues has to do with proper clamp selection. We have a box of a bunch of clamps that are very
poorly organized. If I knew how to select, it would help me organize them properly. ■
4/1/2017

Connor Jones
Member Since: 05/13/15
Post: 5 of 98

I've also got a lot of issues that can use help with my dam usage. It's a love/hate relationship.
I'd like to know how to invert the dam and keep it that way. I find it works well with floss ties,
but doing seven floss ties takes very long when you have 40 minutes to do two or three fillings.
My bur always cuts the dam and it looks like my dam went to war with all the blood and tears.
Also, I started using the thick purple Flexi Dam, which I like a lot for endo because it is
stretchy and eases the placement of files and hand filing. But do you guys think it's too thick
for fillings? What brand do you recommend? I can't seem to order the light blue Nic Tone in
Canada. Any other brand? ■
The rubber dam always look pretty on Instagram, but I've never been able to achieve that
personally. It ends up being a bloodbath regardless. Any help would be appreciated. ■
4/1/2017

jrmacdds
Member Since: 05/27/07
Post: 10 of 98

I use the rubber dam pretty religiously. I prefer heavy-gauge thickness and always use K-Y
liquid on the underside to make flossing through contacts easier. My absolute favorite molar
clamp is a #201. It allows me to prep the distal surface of the terminal molar if I am doing
a crown prep. For premolars, I often use a #206. Another go-to clamp for molars is a W8A,
although one must be careful because this one can gouge the gingiva if not placed carefully.
Any procedure with the rubber dam is always easier if it can be used. And for small teeth
such as premolars and incisors I would use a 00 clamp or consider a #212 clamp as well. For
putting the rubber dam on, I prefer to stretch the rubber while my assistant flosses with waxed
floss. and the closer her fingers are to each other, the easier it goes. ■
4/1/2017

Continued on p. 32

JUNE 2017 // dentaltown.com

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