Dental dams have been used in the dentistry industry for hundreds of years and remain an important part of preventing the risk of bacteria when undergoing dental treatment.

What is a dental dam?

A dental dam (also known as a rubber dam) is a protective sheet with a hole in it. It is placed over the treatment area to isolate it and help prevent the spread of bacteria during procedures. Dental dams are typically made of latex but other materials can be used if the patient is allergic to latex.

What are dental dams used for?

Dental dams are used for a variety of procedures, specifically those that require isolation. They are typically used to isolate a tooth or a specific area of the mouth for a more visible treatment area and to stop excess fluids and bacteria from entering the treatment site.

What is used in conjunction with a dental dam?

A dental dam is not used in isolation, many elements and tools are used alongside it, including:

  • Clamps or hooks
  • A dam punch
  • Dental floss
  • A frame (to help keep the dam in place)
  • Dam sheets
  • Cotton roles (sometimes used to help isolate the treatment area and help absorb excess fluid)

The advantages of using a dental dam

Dental dams come with several benefits, the most important being they help prevent bacteria from entering the treatment area. Other advantages of dental dams include:

Targeting the problem area – dental sheets help to isolate the treatment area and provide a clean and clear space for treatment to take place.

Improved visibility of operating area – as well as helping to target the right areas, dams also enhances visibility over the operating area, allowing for a safer treatment.

Prevents fluids from entering the treatment area – dental dams help prevent saliva and blood from entering the treatment area.

Prevents patients from swallowing fluids – the dam will also help direct fluids away from the patientā€™s mouth, making the procedure more comfortable and hygienic.

The disadvantages of using a dental dam

Dental dams are not essential across all treatments, and arenā€™t viable for certain procedures. In fact, a study conducted by the NACBI discovered that dental dams were only used in 12% of treatments. Dental dam disadvantages include:

Time – dental dams can take time to apply and slow down the procedure process

Patients may not want to use a dental dam – patients can sometimes choose to reject the use of a dam if they deem them uncomfortable. Itā€™s also very difficult to speak

They cannot be used for malpositioned teeth – this type of procedure is not appropriate for a dental dam as itā€™s difficult to position the dam around the targeted tooth (or teeth) due to the awkward placement.

More recently, the use of dental dams has dropped, mainly due to the time it takes to apply the dam and the lack of training regarding its application. Additionally, patients have reported that the dam can be uncomfortable, especially for patients who suffer with claustrophobia.

Problems with positioning the dam around awkward treatment areas has lead to professionals becoming reluctant to use them.

What procedures require a dental dam?

Dental restorations – to restore parts of a broken tooth or teeth to their former shape, structure and functionality.

Endodontic treatments – these include root canal treatments, fissure sealants and dental crown implants

Application

Dam sheets are typically made from latex, but if a patient suffers from a latex allergy, other materials can be used. The application begins by anchoring the dam around the target area – a tooth for example – using a metal clamp, this helps secure the dam sheet to the treatment site. Once secured, your dentist may apply dental floss around the clamps to help prevent external fluids from entering the treatment site.

The dam is then ā€˜punchedā€™, which creates a hole (the hole can be any size) to isolate the treatment area. When treating a tooth (or teeth) the spacing must be taken into account. Additionally, if multiple teeth are being treated, the holes should align with the curve of the dental arch. The only time where this technique will not work is in the case of misaligned teeth due to the difficulty of positioning the dam around the affected tooth.

The rubber dam frame is an integral part of the application process because it helps keep the sheet secure around the target area. Small pins help keep the sheet secured to the frame to help stop other dental instruments from getting in the way. This also provides clearer visualisation over the treatment area.

Are there alternatives to dental dams?

There are many alternatives to dental dams, including suction tools, retraction devices, cotton rolls and gauze packs being the most common. This does not mean to say the dental dam has become obsolete, but it is making way for faster and more affordable alternatives. Today, less than 19% of dental practitioners routinely use the dams.

Want to learn more about the dental industry?

Did you know that we have a guide on how to clean your teeth before visiting the dentist? Alternatively, you can learn more about the world of dentistry and explore some top tips on oral healthcare on our blog.