Dental dam

In dentistry, a rubber dam is used (from English to coffer, include ' and dam, dam '), often called Kofferdamtuch or a rubber band, to shield the tooth to be treated from the rest of the oral cavity, especially in root canal therapy, a plastic filling, a ceramic inlay filling or an amalgam removal. Thus, the flow of saliva is prevented. The rubber dam is usually made ​​of flexible plastic or rubber. In addition to the screening of the oral cavity for easier saliva- free treatment of the tooth is opened also prevents foreign objects such as amalgam residues, crown residues, pathogens, liquids, or root canal instruments can be swallowed or inhaled.

History

The rubber dam was introduced in 1864 by New York dentist Sanford Christie Barnum in dentistry. Originally it was used to keep the work area dry because at the time there were no dental suction systems. With the proliferation of these intake systems in the 20th century, the acceptance of the rubber dam with dentists decreased markedly, and its advantages in infection control (eg, root canal treatments ) were forgotten.

Pros and Cons

The disadvantages of the rubber dam are an uncomfortable feeling by the compressive stress of the metal brackets on the tooth and a risk of trauma to the gums through it. As long as the rubber dam is placed, the patient may also at any time close the mouth. Furthermore, it must be a full nasal breathing possible.

A great advantage of rubber dam is the absolute drying lying under the gum line areas. This is achieved by consuming adjusting the cofferdam at the individual root cross-section and enabled by displacement of the gums the treatment of areas that are without rubber dam in the invisible range below the gum line. However, this procedure is not always possible and has a high Traumatisierungspotenzial for the gums. This fact is important when applying the adhesive technique, in which a main quality criterion for the permanent bonding of tooth structure and restorative material is the absolutely dry.

Various Publications criticize for quite some time that a rubber dam is used only by comparatively few German dentists. The argument / to work even without the rubber dam and the " relative isolation " saliva- free dry is so far to assess critically, as the rubber dam holds back even the condensation of the air we breathe. In a scrupulously executed plastic filling the Kofferdameinsatz is mandatory. In addition, a rubber dam also protects the patient from contact with irritating or sensitizing chemicals, such as those used in the root canal or the adhesive technique. In a recent opinion DGZMK for root canal treatment it is said: " A rubber dam is to be at every meeting of a root canal treatment, if not overriding medical reasons ( eg allergies, asthma, airway obstruction, epilepsy ) forbid this. "