Rubber dam isolation is generally considered to be the optimal method of moisture control in dentistry and is taught at the vast majority of dental schools worldwide. Unfortunately, undergraduate training does not always translate into use in dental practice, with the majority of clinicians never using a rubber dam, even for endodontic procedures, where its use is regarded as the standard of care nationally and internationally. The COVID-19 pandemic has increased interest in the use of rubber dam as a highly effective infection control barrier. As professional and patient experience of rubber dam isolation is extremely limited, this paper, and the preceding one, are designed to support the practical training of clinical teams in the confident, skilful use of rubber dam. Part two provides a practical guide to rubber dam isolation techniques for endodontic and operative/restorative procedures.
CPD/Clinical Relevance: Mastering rubber dam isolation will enhance patient care and be professionally rewarding for clinical teams.
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The wide range of rubber dam materials and equipment described in part one1 is accompanied by a range of placement techniques. However, there are only three principal options for rubber dam placement:
The authors recommend technique 1 for simplicity and practical convenience. Also, as an infection control barrier, this technique may be expected to be more user friendly for immediate, effective respiratory isolation of both mouth and nose (Figure 1).
With practice, it is possible to quickly isolate a complete dental arch using a rubber dam (Figure 2) and, although more challenging, to simultaneously isolate maxillary and mandibular teeth.
However, it is usually more practical and convenient to isolate specific teeth and, by minimizing the number of rubber dam holes, moisture and infection control are optimized.
The following clinical case examples are designed to provide practical guidance for the versatile and predictable isolation of single and multiple posterior and anterior teeth for endodontic and restorative treatment.
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