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Original poster

Root canal without rubber dam?

60 replies

Hetty241 · 18/12/2013 23:23

I have to have a root filling done on back upper molar. Asked my new dentist if she would be using a rubber dam and she said no. I thought a rubber dam should always be used for RCT to reduce chance of infection. Can anyone advise?

OP posts:
4nomore · 19/12/2013 08:43

Don't seem to use them anymore (thank goodness!). And no subsequent infection here either

differentnameforthis · 19/12/2013 08:45

Entirely possible

differentnameforthis · 19/12/2013 08:47

posted too soon, but use of rubber dam isnt to prevent infection, but to keep the area dry and prevent small tools being dropped into your mouth. You already have an infection on that tooth, hence need for RCT

Original poster
Hetty241 · 19/12/2013 12:17

Thanks for replies. Have moved area, hence new dentist. Had a couple of RCTs before and previous dentist used dams (and prescribed me Valium to cope). New dentist said she wouldn't be using a dam and from my hypochondriac induced googling it seems overwhelmingly to recommend dams for RCTs?

OP posts:
Mrsmorton · 19/12/2013 21:09

Rubber dam is definitely still being used and it's lazy and dangerous to do so without it. It's compulsory in some countries and bordering on negligence to not use it. I would have to have an extremely good reason to not use it for RCT appointments. Different, do you not use it?? Shock

NoArmaniNoPunani · 19/12/2013 21:19

I always use rubber dam for RCT. I didn't know it was compulsory in some countries. I'm surprised it isn't in the uk really as our dentistry standards are high

bonzo77 · 19/12/2013 21:23

No rubber dam: no rct. No excuses. If you're competent to do rct, you're competent to apply rubber dam. If there's enough tooth to restore after, there's enough for the clamp to grip. Even on the NHS.

flow4 · 19/12/2013 22:13

You have just brought back a terrible memory. I went to a teaching hospital for a filling in the early 90s, when I was very young. They were using dental dams. Fair enough. But while the student dentist was fitting it, I started to have a panic attack. He stopped, and called his supervisor, exactly as he should have done. The prof came over, and I told him I was declining the dam, and was willing to trust the student (all his tools were on little chains attached to his finger)... The prof said I wasn't allowed to decline, and proceeded to hold me down while he tried to force a dam into my mouth. I started to hyperventilate, then literally screamed "stop stop stop stop STOP!" and fought him off. Shock

With hindsight, he actually assaulted me, and I wish I'd reported him to the police.

Valium and panic attacks. People hate them. That is why many dentists have stopped using dental dams. They're horrible, horrible things.

Original poster
Hetty241 · 19/12/2013 22:44

OK, I'm getting worried now. My RCT is due on Monday; do I refuse the treatment if dentist doesn't intend to use dam? I can cope with the dam if it's essential. I'll just pop a couple of Valium (friend is driving me to and from appt) and put my iPod on. The dentist is going to restore the tooth with a ceramic inlay.

Dentists - advice much appreciated, please!

OP posts:
differentnameforthis · 20/12/2013 05:18

Please don't be shocked, Mrsmorton, I am a dental nurse (but have been a SAHM for 10yrs), and yes, we did use it. I said it was possible to do the procedure without it because when I started dental nursing (26yrs ago) it wasn't commonly used. Infact, it was hardly used at all & the procedure went fine with it's use.

differentnameforthis · 20/12/2013 05:18

the procedure went fine without it's use.

Backonthefence · 20/12/2013 06:18

I had a RCT last week with a rubber dam personally I think it is negligent to not use from what I have read about the procedure.

mummytime · 20/12/2013 06:41

Well as I have had a few RCT and hadn't even heard of a rubber dam before; and my dentist is very good.
So I googled and found this drawbacks of a rubber dam ; which probably explains the reason my dentist wouldn't use one (on me).

flow4 · 20/12/2013 08:03

The one time I went to that dental hospital is the only time anyone has ever tried to use a dental dam with me. In 40+ years of dental work, including RCT, no other dentist has ever even suggested it. So don't worry Hetty, it is perfectly fine to do without.

Mrsmorton · 20/12/2013 10:44

That link is complete bollocks.

Mrsmorton · 20/12/2013 10:45

And it really is unacceptable to do root canal treatments without one.

bonzo77 · 20/12/2013 12:33

Rubber dam, in many ways, is like a seat belt. No use at all until you need it. Then it's essential. And just like seat belts, unless you're used to them they're a pain. And just like seat belts they can become second nature, you feel wierd without one.

I worked in Australia. Rubber dam was de rigeur for rct, all fillings, fitting crowns and veneers. When I came back to the uk and nhs dentistry I carried on with the rubber dam for most of these procedures. It actually saved time. The only downside was that I had to purchase extra kits as the 6 surgery practice I was working in only had one kit so sterilising it between patients was a problem.

NoArmaniNoPunani · 20/12/2013 13:43

Three dentists on this thread are saying rubber dam is essential. I think that tells you all you need to know

flow4 · 20/12/2013 14:45

Only that they use them themselves and like them.

In the UK, only 20% of dentists use them, and 60% have never used them. So they might be recommended, but they certainly aren't essential.

ref

Mrsmorton · 20/12/2013 15:09

flow did you read the first sentence of the conclusion?

Do you use them in practice? How would you explain to a GDC hearing that you didn't think they were necessary if a patient of yours had to have a lobectomy because they inhaled a fractured file or some sodium hypochlorite. There is a case before the GDC right now where a charge is failing to protect the patient's airway.

NoArmaniNoPunani · 20/12/2013 20:10

Flow4 the conclusion of the link you posted reads:

The use of rubber dam is mandatory during endodon-
tic treatment. Current guidelines have re-emphasised that rubber dam should be universally employed for all endodontic treatment. Endodontic treatment carried out without the use of rubber dam has implications both from a safety and medico-legal standpoint

So it doesn't really back up your argument against rubber dam.

flow4 · 21/12/2013 00:44

My 'argument' is really simple: most UK dentists don't use dams; most UK dentists have never used them. Those of you here who believe in their use are in a minority.

If dams are really 'essential', then their manufacturers are doing a really bad job of convincing people.

Vajazzler · 21/12/2013 01:02

I've had 4 root canals and have never seen or heard of a dental dam. Used a fair few different dental practices in my time too.

Mrsmorton · 21/12/2013 08:48

flow you didn't answer any of the questions in my post..?

flow4 · 21/12/2013 10:59

They were clearly rhetorical, MrsM. :)

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