Isolation Flashcards by Nicky Tahpee

Main benefit of tooth isolation? (2)

higher speed during treatments
moisture free area
more secure operating field

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How many types of isolation are there?

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What are the types of isolation? (2)

rubberdam (total)

- relative isolation

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Who invented rubber dam isolation? when? (2)

Dr. Barnum in 1864

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Since when has rubber dam isolation been introduced in all dentistry universities ?

1864 by dr. barnum

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What did Prime do? when? (2)

•In 1937 compiled 57 reasons why to use the rubber dam

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Rubber dam isolation advantages? (9)

❖ Moisture free operating field.
❖ Isolation from salivary contamination.
❖ Protection and retraction of soft tissues.
❖ Improved access.
❖ Improved patient comfort.
❖ Minimized procedural time.
❖ Minimized mouth breathing (specially useful when inhaled sedation is being administered).
❖ Reduced risk of inhalation or ingestion of small instruments or debris.
❖ Cross-infection control is achieved by minimization of aerosol spread of microorganisms.

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Rubber dam isolation disadvantages? (2)

❖ The patient can no longer speak easily.
Conversations become one-sided.
❖ A few patients dislike the rubber dam, it makes
them feel claustrophobic.

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The rubber damn is held by…? what happens with this? (@)

The rubber dam is held by a clamp on a tooth.

-This tooth may be sensible for several hours after the
removal of the clamp

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Indictions for rubber dam isolation?

All situations where a moisture free operating field is required

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Counter-indications of rubber dam isolation? (5)

➢ Allergic to latex patient.
➢ Patient with nasal obstruction, airways infection.
➢ Epileptic patient (Hard to remove during a crisis)
➢ Tooth with little retention:
• Erupting tooth
• Very destroyed tooth.
➢ Caries of difficult access:
• Gingival caries. (Once the clamp and the rubber dam
are correctly positioned, the access may be even better
than without isolation)
• Distal caries of the last tooth in the arch

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Rubber dam isolation equipment? (7)

Rubber dam.
Rubber dam punch.
Clamps.
Dental floss.
Rubber dam clamp forceps.
Rubber dam frame/holder/arc
Additional retention

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What are rubber dams made of? (2)

latex

- no latex

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Size of rubber dam ? thickness?

15x15 cm

- thick or extra thick

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What size holes are used for each tooth?

smaller holes are used for incisors, canines and
premolars.
Larger ones are reserved for the molars

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What are clamps used for? (2)

Supporting the rubber dam around the tooth

- provide gingival retraction

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What are wings on the clamp for? (2)

More stability and bigger working field

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Clamp jaw types? (2)

-Subgingival: More retentive. More indicated in molars that are still
erupting
-Supragingival: Flat jaws. To use them we only need to put topical anesthesia on our patient

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What must you always use with isolation? why? (2)

Dental floss

-avoid aspirating or swallowing the rubber dam clamp

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What are rubber dam clamp forceps used for? (3)

place the clamp
adjust clamp
remove clamp

What is the rubber dam frame used for? (2)

to stretch the dam and keep away from teeth

What types of rubber dam frames are there? (5)

•A. Plastic: They are radio lucid
•B. Metallic: They are radiopaque and may have different shapes:
- Closed or hexagonal (Nygard-Ostby arch)
- Oval with a hinge (Saveur arch)
-With U shape (Young arch). This are the most commonly used in children

How do you place the rubber dam frame?

Open part towards the nose and concavity towards the chin

What do we use for additional retention for rubber dam isolation? (2)

Wooden wedges

Rubber wedjets

When should we place the rubber dam?

Preferably before starting the cavity

What must you do before placing the rubber dam? (3)

- Decide which teeth we have to isolate - Perforate the rubber dam. - Select the clamp

How many teeth do we need to isolate with rubber dam isolation? (3)

- We usually isolate 3 teeth: - The tooth we want to treat - The two adjacent teeth

How do we isolate if the caries only affects the occlusal surface?

only isolate that specific tooth

How do we isolate if the tooth we want to treat is the last on in the arch?

Only isolate two teeth

What do we use for rubber dam perforation?

Rubber dam stamp

How can we divide the rubber dam? (2)

- four parts | - 9 parts

What is the slit technique? (2)

Rubber dam isolation: We cut together the perforations of the teeth where we are going to work.

What do you have to do for clamp selection?

- try the clamp without the rubber dam - check four point contact - check stability by putting slight pressure with finger at the clamp arch

How many different techniques are there for rubber dam isolation?

Name the techniques for rubberdam isolation

▪ Consecutive technique in 2 steps(clamp first) ▪ Consecutive technique in 3 steps ▪ Simultaneous technique in 2 steps (clamp + rubber dam technique) ▪ Modified Simultaneous technique

How do you preform the consecutive technique (2 step) for rubber dam isolation?

1. Select the clamp 2. We place and adjust the on tooth. 3. Stretch rubber dam on the frame 4. Put frame on mouth and attach the rubber dam to the clamp 5. Place additional retention

How do you preform the consecutive technique (3 step) for rubber dam isolation?

1. Select the clamp 2. We place and adjust the on tooth 3. Then we take the rubber dam and pass the clamp through the perforation 4. We place the additional retention, and the rubber dam frames`

How do you preform the simultaneous technique (clamp + dam technique)? (5)

1. Select the clamp 2. We place the clamp at the rubber dam. 3. Then we take clamp + the rubber dam with the forceps 4. Place and adjust the clamp 5. Place additional retention, and the rubber dam frames *Some dentists do the simultaneous technique taking at one time rubber dam+ clamp+ frame

How do you preform the modified simultaneous technique? (4)

1. Select the clamp 2. Pass the clamp bow through the rubber dam 3. Place the clamp on the tooth and pass the rubber dam under the clamps jaws 4. Place the additional retention.

How do you isolate the upper anterior sector? (4)

* Clamp on both canines * Wooden wedges to keep the rubber dam in place * Dental floss at the dental cervix * Any method that keeps the rubber dam in place

How do you remove the rubber dam? (3)

1. We will stretch the dam and cut the interdental septas of the rubber dam with a scissor 2. Remove the additional retaining elements 3. Remove the clamp with the clamp forceps

What are common errors that occur with rubber dam isolation? (5)

- Off centre arch form. - Inappropriate distance between holes. - Incorrect arch form of holes. - Inappropriate clamp selection. - Inappropriate additional retainers.

When do we use relative isolation?

When the placement of the | rubber dam is not possible.

Difference between relative isolation and rubberdam isolation? (2)

- Only provides a control over the moisture | - It does not retract the soft tissues or provides a cross infection control

What material do we use in relative isolation that we dont use in rubber dam isolation?

cotton balls

Why are cotton balls used in relative isolation?

- to provide moisture | control with the help of the saliva ejector

Where do you place the cotton ball in the maxillary teeth?

in the facial vestibule

Where do you place the cotton ball in mandibular teeth?

- in the facial vestibule | - between tongue and teeth

What accessories can be used to keep cotton rolls in place? (3)

* Wooden wedges * Clamps * Nola dry field