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Dental Isolation in the COVID-19 Era - Updated

 In their recent algorithm for treating emergency patients during the COVID-19 pandemic, the ADA has included rubber dam use, with a high-volume saliva ejector, “as a means to reduce the spread of the highly contagious virus”. There is now an obvious indication for rubber dam isolation in as many dental procedures as possible. 

"By utilizing a rubber dam, we can minimize the aerosolized particles produced during patient care."

This helps to keep our teams safe when providing emergency care to patients who may spread viruses and other infectious diseases through airborne particles”.  Isolation with rubber dam will significantly increase the efficiency of the suction, which is one important defense against the creation of airborne contaminants. When its use is presented to a patient as an added protocol to help prevent the spread of ALL viruses, including COVID-19, their trust in your care will undoubtedly increase. 

While rubber dam use is standard of care in endodontics, there are many advantages to their use in other procedures, besides preventing the spread of virus. For example, “Studies have shown that for successful long-term bonding in restorative dental treatment, a surface free of contaminates — such as crevicular fluid, saliva glycoproteins and blood — is necessary”.  IN AS MANY DENTAL PROCEDURES AS POSSIBLE is the operative phrase from the ADA. 

Rubber Dam and isolation techniques, once thought to be time consuming and awkward can now be made simple and seamless with the right products...

1. A good rubber dam is essential

As more patients now present with latex sensitivities or allergies, it is important to have a rubber dam on hand that will eliminate the potential for allergic reactions. True™ Dental Dam by Clinician’s Choice® has a latex-free option that provides exceptional strength and tear resistance, as well as optimal elasticity to provide a superb marginal seal. The purple colour is an excellent contrast to the dentition. True Dam is also available in a low-protein latex alternative.

2. Reliable clamp is also key

Black Oxide Rubber Dam Clamps (BMT) prevent the insidious glare from high intensity lights which can cause eye strain. They also provide excellent spring action, resistance to metal fatigue, and resistance to corrosion. 

3. A material to augment the seal for complete isolation should also be available

Compromised teeth or roots make an adequate seal difficult and rubber dams can still leak. OraSeal or OpalDam by Ultradent can effectively supplement the rubber dam by filling gaps or leaks easily. 

True Dental Dam glides smoothly through contacts and tucks into the sulcus allowing for true placement confidence.
Composite is placed onto a surface that is free of contaminates. Long-term studies show using a dental dam enhances bond strength.
Compromised teeth or roots make an adequate seal difficult and rubber dams can still leak. OraSeal or OpalDam by Ultradent can effectively supplement the rubber dam by filling gaps or leaks easily.

i Andy Janiga, D.M.D., Spear Digest, April 2020 

ii Decisions in Dentistry By Mario F. Romero, DDS, John F. Coleman, DMD, Michael Pruett, DMD and Courtney S. Babb, DMD 

Dentistry and photography courtesy of Bob Margeas, DDS 

About the Author

Mr Brian Bevan

Brian Bevan, Endodontic Product Manager

Over a lengthy career he has established excellent and enduring relationships with Key Opinion Leaders, Universities and Grad programs, and key dental industry contacts. Brian speaks to general dentists and specialists on an almost daily basis and is considered a valuable resource on the challenges and techniques essential to successful endodontics.

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This article was originally published in the Clinical Life™ magazine: Winter 2021 edition

Clinical Life™ magazine is a premier periodical publication by Clinical Research Dental Supplies & Services Inc. Discover compelling clinical cases from Canadian and US dental professionals, cutting-edge techniques, product insights, and continuing education events.

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