RUBBER DAM ISOLATION- A BOON TO DENTISTS IN INFECTION CONTROL

The COVID- 19 pandemic forced the world to view infection control in a different light all together. Be it food industry, hospitality industry, personal home care or providing dental treatment to the patients, everyone had to review and re-access whether the infection control protocols being followed in their work zones were sufficient or not to be safe and keep others safe. Due to the high speed and magnitude of transmission of the novel coronavirus disease, our profession investigated and came up with guidelines to improve the infection control procedures. Products and gadgets ranging from HEPA filters to surface disinfectants, foggers to name a few, have been recommended by various dental associations and bodies across the globe, for better infection control in our practices.

A simple & efficient tool like rubber dam isolation, which is existing in the dental field since 1864, is a great isolation technique which is very helpful in infection control during dental procedures. It was first described by Dr. Barnum over 150 years ago, the rubber dam ought to have its place definitely within our restorative and endodontic armamentarium now more than ever before. [1]

There have been studies conducted on simulated patients and the preliminary results suggest that isolation and high-volume suction are effective to reduce ultrafine dental aerosol particles.[2]

But along with good infection control, which a rubber dam isolation provides with, it also has other benefits like the following-

1. Good moisture control, which is important in adhesive dentistry,
2. Retraction and protection of soft tissues.
3. Prevention of inhalation and ingestion of foreign bodies- thus making it a great safety tool during dental procedures.
4. Improvement of access and visibility by eliminating tongue, cheeks and saliva from the operating field.

Some dentists across the globe have been skeptical of using this technique, anticipating it to be cumbersome. But it has gained popularity since past few years much more than earlier decades.

Now with the ongoing COVID-19 pandemic, our fellow colleagues have shown more acceptance to this form of isolation for better safety of patients and the dental team. But it is also a fact that, along with infection control, a rubber dam provides us with many other benefits while performing various dental treatment procedures.

Also, in my experience, I have observed that every procedure has a learning curve and so does this technique of isolation. With some basic training and practice, usually this technique on a patient requires couple of minutes only. So, incorporating rubber dam in our dental practice is a great step from the point of view of asepsis, as well as for getting many other benefits while performing a dental procedure.

[1]Abrams R A, Drake C W, Segal H. Dr. Sanford C. Barnum and the invention of the rubber dam. Gen Dent 1982; 30: 320-322.

[2]Balanta-Melo, J.; Gutiérrez, A.; Sinisterra, G.; Díaz-Posso, M.d.M.; Gallego, D.; Villavicencio, J.; Contreras, A. Rubber Dam Isolation and High-Volume Suction Reduce Ultrafine Dental Aerosol Particles: An Experiment in a Simulated Patient. Appl. Sci.2020, 10, 6345. https://doi.org/10.3390/app10186345