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Rubber dam isolation is generally considered to be the optimal method of moisture control in dentistry and is taught at the 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 best practice in the United Kingdom (UK) and elsewhere. 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, these two papers are designed to support the practical training of clinical teams in the confident, skilful use of rubber dam, to outline its advantages and to help overcome barriers to its routine use. Part one provides an update of the latest equipment and materials for rubber dam isolation and 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.
Article
Timing of the introduction of rubber dam to dentistry is famously precise; the first reported use was by Dr Sanford C Barnum on 15 March 1864.1 Since then, rubber dam teaching has been progressively introduced at the vast majority of dental schools worldwide. In the UK, rubber dam placement is also within the scope of practice of dental therapists and dental nurses who have received appropriate training.
Rubber dam is universally recognized as the optimal method of moisture control, and its use is considered to be best practice in the UK and internationally during endodontic treatment.2 However, the majority of clinicians never use it or use it rarely.3 Explanations for the pervasive professional reluctance to adopt the use of rubber dam are well established:
‘Probably no other technique, instrument or treatment in dentistry has been more universally accepted and advocated, and yet is so universally ignored by practising dentists. Many reasons can be given, but in most cases the fundamental cause is inadequate explanation and training in the dental schools. If any operative technique is not clearly taught and seen to be efficiently executed by the teachers, the new members of the dental profession will not use it willingly.’4
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