No abstract

Most dentists are educated in rubber dam use in dental school, but there is often disparity between what is taught for various restorative procedures and what is practiced in the private sector. It is a common, although undocumented, belief that few practicing dentists routinely use rubber dam isolation. This study repeated a survey conducted in 1985 evaluating U.S. general dentists' attitudes toward rubber dam usage to see if improvement is needed in current dental educators' approach to this topic. Four hundred dentists were selected randomly from ten major geographically diverse cities using the website YellowPages.com. Each was mailed a letter requesting survey participation, which included a pre-stamped, pre-addressed postcard with the survey printed on the back. The target population, general dentists, returned 164 surveys (41 percent). Their responses can be summarized as follows: 71 percent do amalgams-of those, 53 percent never use a rubber dam whereas 12 percent always use a rubber dam; 100 percent do anterior direct resin composites-of those, 45 percent never use a rubber dam whereas 17 percent always use a rubber dam; 98 percent do posterior direct resin composites-of those, 39 percent never use a rubber dam and 18 percent always use a rubber dam; and 78 percent do endodontic procedures-of those, 11 percent never use a rubber dam whereas 58 percent always use a rubber dam. Most (74 percent) felt that their dental school rubber dam training was adequate; 42 percent felt that its use has an effect on the quality of restorative dentistry. Their most common reasons for not using a dam were the following: inconvenience (40 percent); unnecessary (28 percent); other (12 percent); patient refusal (11 percent); and time (9 percent). No respondent indicated that "cost" was a reason for not using rubber dams. This study indicates that many general dentists in this country continue to ignore the rubber dam for many restorative and some endodontic procedures. It indicates that predoctoral dental educators need to look for opportunities for improvement to reduce the discrepancy between what is taught and the general practice of dentistry.Dr. Hill and Dr. Rubel are both Associate Professors,

For various reasons, dentists may be tempted to definitively tighten implant abutment screws using only handheld screwdrivers. The purpose of this study was to test the ability of general dentists to generate implant abutment screw preload using a simple screwdriver in a limited-access space simulating the mouth. Results indicated that mechanical torque wrenches must be used in posterior areas of the mouth to establish sufficient preload, and dental experience is not a major factor in the ability to tighten an implant abutment screw.

This study indicated that only a few schools are fortunate enough to have sufficient full-time, specialty-trained faculty available for complete coverage of all undergraduate prosthodontic courses and clinics. The information presented serves as a baseline for future comparison to see if the percentage of full-time and/or specialty-certified prosthodontic faculty changes.