350H
Fig. 8.10 Shows rubber dam placed in
the a child and with the comfort it
provides it is not unusual for children to
fall asleep in the dental chair during
treatment under rubber dam.8.6.3 Benefits to the dentist
Reduced stress
As noted above, once rubber dam has been placed the child will be at less risk from
the procedures that will be used to restore their teeth. This reduces the effort required
by the operator to protect the soft tissues of the mouth and the airways. Treatment can
be carried out in a more relaxed and controlled manner, therefore lessening the stress
of the procedure on the dental team.
Retraction of tongue and cheeks
Correctly placed rubber dam will gently pull the cheeks and tongue away from the
operative area allowing the operator a better view of the area to be treated.
Retraction of gingival tissue
Rubber dam will gently pull the gingival tissues away from the cervical margin of the
tooth, making it much easier to see the extent of any caries close to the margin and
often bringing the cervical margin of a prepared cavity above the level of the gingival
margin thus making restoration considerably easier. Interdentally, this retraction
should be assisted by placing a wedge firmly between the adjacent teeth as soon as the
dam has been placed. This wedge is placed horizontally below the contact area and
above the dam, thus compressing the interdental gingivae against the underlying bone.
Approximal cavities can then be prepared, any damage from rotary instruments being
inflicted on the wedge rather than the child's gingival tissue.
Quite often it can be difficult and time consuming to take the rubber dam between the
contacts because of dental caries or broken restorations. It is possible to make life
easier by using a 'trough technique', which involves snipping the rubber dam between
the punched holes. All the benefits of rubber dam are retained except for the retraction
and protection of the gingival tissues (351HFig. 8.11).
Moisture control
As mentioned previously, silver amalgam is probably the only restorative material
that has any tolerance to being placed in a damp environment, and there is no doubt
that it and all other materials will perform much more satisfactorily if placed in a dry
field. Rubber dam is the only technique that readily ensures a dry field.