Other texts give full details of the various application techniques of the rubber dam. It
must be remembered that good analgesia is very important, as placement of rubber
dam particularly when a clamp is used is painful. An infiltration backed up by intra-
papillary injections is usually needed.
428H
Fig. 9.10 Rubber dam in place protecting
gingivae and eliminating moisture.9.7 ANTERIOR CARIES
Caries of permanent anterior teeth in childhood and adolescence, is not that common
and usually occurs either where there is defect in the formation of the teeth, which
leads to plaque accumulation, or in children with rampant caries, where the sugar
intake is so high that the dentition is overwhelmed. The best material for restoring
anterior teeth is composite resin. The use of this material in the treatment of patients
affected by either trauma or as a solution for cosmetic problems is described in
429HChapters 10 and 430H 12.
In patients suffering 'normal' caries, with interproximal cavities, composite restoration
is the material of choice. In patients with rampant caries it may be preferable to use
glass ionomer to restore the lesions as an interim measure while the risk factors are
addressed.
9.8 OCCLUSAL CARIES
9.8.0 Introduction
Where the dentist has established a diagnosis that a stained fissure is a carious lesion
into dentine, restorative treatment is indicated. If the lesion is limited to areas of the
tooth not bearing occlusal loads then a PRR is appropriate (Smallridge et al., 2000). If
the lesion is more extensive, then the clinician should consider a composite or an
amalgam restoration.
9.8.1 The preventive resin restoration
Clinical technique