Do Dental Educators Need to Improve Their Approach to Teaching Rubber Dam Use?

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,

Influence of Isolation Method of the Operative Field on Gingival Damage, Patients' Preference, and Restoration Retention in Noncarious Cervical Lesions

“…Rubber dam isolation prevents moisture contamination during the placement of direct restorations and endodontic treatments, 2,3,6 and most dental schools regularly teach this method. 7 Many faculty members consider rubber dams to be an essential component of modern adhesive dentistry, 8,9 and many advantages have been listed elsewhere. 2,3 However, the use of a rubber dam during operative dentistry procedures in a private practice is not common.…”

The attitude of Czech dental patients to the use of rubber dam

“…Rubber dam, however, is quite rarely used in general practice, both in the Czech Republic and in many other countries . The most common arguments mentioned by general dental practitioners against rubber dam are as follows: …”

Resistencia microtraccional de capa de adhesivo contaminada con sangre

“…Cuando ocurre una contaminación, la menor resistencia adhesiva lograda llevará a infiltración marginal, formación de caries secundaria y tinción de los márgenes de la restauración (19) . La mayoría de las veces, esta contaminación puede evitarse mediante el uso de goma dique, sin embargo, recientes publicaciones indican que la mayoría de los clínicos no suele utilizarla (2) .…”

“…A pesar de la importancia del uso de la goma dique, una publicación basada en cuestionario del año 2008 muestra que un 45% de los dentistas generales en EE.UU. nunca ha utilizado la goma dique para restauraciones directas en dientes anteriores y un 39% para restauraciones de dientes posteriores (2) . Un estudio más reciente observó una baja utilización de la goma dique durante procedimientos restauradores, sin embargo, su uso varía significativamente dependiendo del dentista, tipo de restauración y características del paciente (3) .…”