A rubber dam is a thin sheet of latex that creates a barrier between the working field and the rest of the mouth. We punch holes in it for the teeth to slip through.
This has an incredible number of advantages to the dentist, the dental assistant, and most importantly, the patient. I will review some of these advantages here:
- Prevents contamination of the cavity with saliva or blood when bonding your filling. The number one cause of sensitivity after a white filling is contamination during the bonding. Not only does this make your tooth hurt for weeks, but it also decreases the longevity of the filling. Poorly bonded fillings break down at the margins, allowing them to leak. Plus, when this occurs, decay then has an easy path under the filling.
- Protects the lips, tongue, and cheek from harm from the drill. The rubber dam retracts and protects lips, cheeks, tongue, and even the gums.
- Retraction of soft tissue for better visibility. This also allows the dentist and assistant to focus more of their attention on your tooth and the procedure. The contrast in color from the rubber dam and the tooth also makes visibility better. Every step in a dental procedure requires a great level of attention to detail; the dam enables this.
- Protection of the gum tissue. With the dam in place, we usually place a wedge between the teeth. In combination with the dam, this prevents damage to the gums. It also allows a clean working field.
- Prevents swallowing foreign materials. We use a lot of small tools, which can be dropped. It is very comforting for patient and doctor to have the dam as a safety net.
- Keeps bad tastes out. Many dental products we use taste pretty bad, the dam will allow these products to be rinsed without touching any soft tissues.
- Keeps vapor from your breath out of the working field. Not only does this fog up our mirrors, making it hard to see, there is enough water in your breath to contaminate your filling.
- Catches amalgam scraps. While it is not as critical to have a dry field for a silver filling, we still use the rubber dam for the above reasons and also to catch any scraps that fall off as we carve your filling. The dam also catches any pieces of fillings or crowns that are removed when drilling.
- Keeps bacteria from saliva out of the tooth during root canals. Root canal is the procedure that has been most associated with rubber dams; in fact, many dentists will only use the rubber dam for this procedure. It is used for good reason, as we use small files and caustic irrigating solutions that we do not want in your mouth.
- Allows patients to relax. When first using the rubber dam, I anticipated a lot of negative reaction to it from patients. Surprisingly, the feedback I got was almost completely positive. Many patients found it comforting to have the protection in place and also not have to worry about what to do with their tongue.