Rdam Uses/Indications
This is the main purpose of the rubber dam.
What is to provide moisture control?
A patient has told you they do not want a rubber dam placed. This is how you would handle the situation.
The retainer used for rubber dam has the following parts.
After properly placing the rubber dam retainer and (before or after) removing the retainer forceps you must do this.
This is the correct punch if a pt is coming in for tx on tooth #14, with #16 missing, & #11-13 fixed bridge.
What is key hole punch #15, remaining holes would be punched to #9, except #12, which would not be punched. The dam would be cut from 11-13 to slide over the bridge.
The rubber dam serves as an important _______ _______ barrier in the preparation of teeth.
This is how you would explain placing a rubber dam retainer to a patient.
What is to let the patient know they may feel pressure?
These are some reasons why a punch hole has ragged edges causing the rubber dam to tear easily.
debris stuck in punch stylus
punch table and stylus don't meet squarely
the stylus is bent
When punching for a mandibular arch you punch the key hole (first or last) for the anchor tooth.
On a partially 2/3 erupted tooth you (would or would not) punch the dam for it.
*Placing a rubber dam on 6-10 year olds saves time.
The rubber dam protects patients from accidentally _______ or swallowing debris, such as small fragments of a tooth or scraps of restorative material.
You can determine which teeth need to be included in the rubber dam isolation by doing these things.
Rubber dam forceps are positioned with the beaks facing (toward/in or away) to the arch that is being treated?
What is toward/in?
The steps when using a cervical retainer include these.
This is the purpose for using a cervical retainer.
What is to retract the gingiva and rubber dam for a Class V restoration?
The best way to remove compound from a 212 retainer is to do this.
A single hole punched rubber dam is indicated for this procedure.
You can also use a single hole punch for this type of restorative filling.
What is an occlusal restoration?
This is the armamentarium required for placing a rubber dam.
What is:
Rubber dam material
rubber dam punch
rubber dam retainer (with a ligature attached)
retainer forceps
frame or holder
dental floss (used to floss interproximal contacts prior to placement of rubber dam to smooth rough areas preventing possible tearing & also to seat the septums)
lubricant (to help the dam slip between the teeth)
blunt tucking instrument (plastic instrument works well to invert with)
scissors (to cut the septums prior to removal)
Napkin (for patient comfort & to avoid irritation)
To help punch the proper pattern it is best to do this.
What is divide the rubber dam material into sixths?
These are the steps to placing a two step rubber dam.
1. Check the pt record for contraindications and teeth to be isolated.
2. Inspect the pt mouth prior to placing Rdam.
3. Floss contacts to ensure there is no debris, plaque, or roughness
4. Apply lubricant (PRN-most offices don't use it)
5. Punch the rubber dam with holes 3.5mm apart to prevent leakage or bunching (if you haven't done so prior to pt arrival)
6. Choose & place retainer for 1-2 teeth distal of tooth to be worked on w/ ligature to prevent accidental aspiration (you may or may not pull the ligature through)
7. Check retainer stability prior to removing forceps
8. Stretch the key hole over the bow of the retainer followed by the lingual and buccal sides
9. Attach the frame
10. Attach the last hole of the dam over the last tooth to be exposed (most anterior tooth) Use floss or widget if needed to secure
11. Slide rubber dam holes over teeth to be isolated
12. Floss septums completely to seat rdam: slide floss through embrasure areas to remove. Do not pull back up through contact area.
13. Make sure rdam is attached tightly to frame
14. Invert rdam with plastic instrument/air/explorer creating a seal to prevent leakage
15. Offer pt saliva ejector (needs to be placed on opposite side of arch being worked on)
True or False: Retainer numbers are determined by tooth size. The smaller the number, the smaller the retainer to fit on a smaller tooth.
True or False: The 'W' on a retainer means it has wings.
What is true?
Examples:
*size 00, 0, 2=smaller jaws for bicuspids & incisors
*size 8, 26 = larger jaws for molars
What is false?
*The 'W' represents Wingless.
True or False: The dental dam decreases dental team efficiency by discouraging patient conversation and reducing the time required for treatment.
*The dental dam increases dental team efficiency.
An efficient dental team can place the dam in about ___ minutes.
The expanded-functions dental assistant working alone can complete this procedure within ___ to ___ minutes.
What is 3 to 5 minutes?
To determine the best retainer for the tooth to be anchored, you must determine the space between the jaws to be this.
These are the steps to removing a rubber dam.
1. Remove floss or wedjet (PRN)
2. Cut septums (away from tissue)
3. Use forceps to remove clamp/frame/material at once
4. rinse pt and use 2x2 to wipe their face
5. Inspect rdam for missing pieces
If your curve of the arch is too flat the rubber dam will _______.
If your curve of the arch is too curved the rubber dam will _______.
If your holes are punched too close together (less than 3.5mm) the rubber dam will ________.
If your holes are punched too far apart (more than 3.5mm) the rubber dam will _______.
What is bunch on the lingual?
What is bunch on the facial?
What is cause the rubber dam to be stretched and cause leakage?
What is appear bunched causing excess material getting in the operators way or covering a tooth?