Do all schools require rubber dams?

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UNR.Grad

UNR.Grad

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The only school I remember mentioning this was UOP, but I assume all schools instruct and require their students to use them, right?
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Pacific is doing a pilot program for integrating Isolites onto the clinic floor. THere are currently 4-5 chairs set up with the system and from what I hear, things are looking good.
 
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armorshell said:
Pacific is doing a pilot program for integrating Isolites onto the clinic floor. THere are currently 4-5 chairs set up with the system and from what I hear, things are looking good.
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That would be awesome. An Isolite is going to be one of the first things I buy in practice.
 
we are taught to for every endo, and pedo. We should do it for operative as well, but I havent seen anyone place one yet. Only in endo and one in pedo.

I like em personally
 
Always have to have rubber dam at UCSF. Not only isolation problem, but also safety (so you don't cut tongue, cheek & lips) and practice for the boards as well. I'm surprised to hear many schools do not enforce rubber dam. I remember when I took the wreb, a guy sitting across from me (don't know what school he is from), did not know how to put on rubber dam. Keep on running to my cubicle to see how I ligate & invert the dam. He has to pay another assistant specially to come in when he needs to place the dam because his assistant does not know how by herself. I could not believe graduating from a dental school and can't place a rubber dam. It's such a basic skill.
 
From what I've heard, a lot of patients hate them. I've never seen dentists using them. However, I'm also under the impression that by placing them your restorations will tend to go a bit faster - patient doesn't really have the opportunity to talk to you.
 
KOM said:
From what I've heard, a lot of patients hate them. I've never seen dentists using them. However, I'm also under the impression that by placing them your restorations will tend to go a bit faster - patient doesn't really have the opportunity to talk to you.
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Here at BU, it's mandatory. But all the dentists I came across rarely used a rubber dam!

I think the Isolite system looks great, I need to look into it more to consider having one in the future.
 
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At Marquette just this year they started having us do all are preclinical work with rubber dams, I guess they want us to be proficient. After a year I can place one in a couple or minutes, (in a dummy...big deal). I have heard some stories from my classmates that they actually placed the rubber dam on patients while assisting because the jr/sr. was having to much difficulty.
 
RD isolation is standard of care for endo and pedo. For operative at UNC, it depends on the faculty in clinic and what type of restoration. An occlusal amalgam probably doesn't have to have one while if you're doing composites, you probably should.
 
Cold Front said:
Here at BU, it's mandatory. But all the dentists I came across rarely used a rubber dam!

I think the Isolite system looks great, I need to look into it more to consider having one in the future.
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Im sure isolite is great, if you are not using isolite there are procedures that demand isolation. I use a dam all the time. It is easy to put on after repitition, and it makes most procedures much easier and predictible. It is NOT standard of care to perform endo without a dam. If Im doing quadrant dentistry that includes resin restorations, Im using a dam. What causes these things to fail? ...inadequate moisture control. Thats what a dam does. If all the dentists you come across rarely use a dam, I would be concerned about the predictibility of some of their restorations/procedures. Sure you can isolate with cotton rolls, but not like you can with a dam. The best clinicians out there, those that are known for their clinical skills, like a Ron Jackson, are using rubber dams.
One downside to the isolite is the expense.
 
OceanDMD said:
Sure you can isolate with cotton rolls, but not like you can with a dam. The best clinicians out there, those that are known for their clinical skills, like a Ron Jackson, are using rubber dams.
One downside to the isolite is the expense.
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Average bond strength with cotton roll isolation is 4 MPA less than with rubber dam isolation, so there's that.
 
USC also requires. We are also trying to introduce Isolite
 
crazy_sherm said:
1) source?
2) how did they measure this?
3) in vivo or in vitro?
4) are we talking enamel or dentin bond?
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Source = Dr. Kachalia's voicebox. I'm just a dentist wannabe and not an R.D. so I don't feel the need to check up on research.

JK of course. He said it was a older study though, and the numbers quoted (~14-18 MPA) suggest dentin bonding.
 
Anybody know about UCLA?
 
Kentucky required it while I was there. You could get by without it with some faculty, but for the most part it was a must. There was one faculty in particular who checked your placement to the extreme. Even if you were working on #18, he wanted you to isolate the whole damn quadrant. If it didn't look right (to him), he would waste your time by taking it off and making you do it again. Funny in retrospect, but a real pain in the a$$ at the time...

I guess looking at a shot glass half-full, it made me very efficient when boards rolled around...:thumbup:
 
Wayne Coronado said:
Kentucky required it while I was there. You could get by without it with some faculty, but for the most part it was a must. There was one faculty in particular who checked your placement to the extreme. Even if you were working on #18, he wanted you to isolate the whole damn quadrant.
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:laugh: The baseline Pacific isolation is 1 tooth posterior to the one you're working on to the opposite canine :(
 
Wayne Coronado said:
Kentucky required it while I was there. You could get by without it with some faculty, but for the most part it was a must. There was one faculty in particular who checked your placement to the extreme. Even if you were working on #18, he wanted you to isolate the whole damn quadrant. If it didn't look right (to him), he would waste your time by taking it off and making you do it again. Funny in retrospect, but a real pain in the a$$ at the time...

I guess looking at a shot glass half-full, it made me very efficient when boards rolled around...:thumbup:
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Isn't that pretty standard? In pre-clinic, we isolate from 1 tooth distal to the tooth were treating to 1 tooth past the midline.

jb!:)
 
UNR.Grad said:
Anybody know about UCLA?
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UCLA required rubber dam in both pre-clinical and clinical settings when I was there. For pre-clinical exams, you have to invert the rubber dam material around each tooth and it has to pass the midline. And you cannot use Young’s frame….you have to use the ugly head strap to hold the rubber dam in place.
 
jackbauer! said:
Isn't that pretty standard? In pre-clinic, we isolate from 1 tooth distal to the tooth were treating to 1 tooth past the midline.

jb!:)
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I'd say based on you, me, and armorshell, I don't think we have a standard. ;)
 
charlestweed said:
UCLA required rubber dam in both pre-clinical and clinical settings when I was there. For pre-clinical exams, you have to invert the rubber dam material around each tooth and it has to pass the midline. And you cannot use Young’s frame….you have to use the ugly head strap to hold the rubber dam in place.
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Thanks for the info!
 
Required at Baylor for operative(unless it's totally out of the question) and endo(obviously), I actually like using it now because it shuts the patient up and allows you to work in a dry field w/o an assistant. It's just a bitch learning to put one on, however I think it does save time in the long run.
 
i am a little lost here... what is the rubber dam used for?
i worked for a fairly long time at a an implant/prosthodontics practice and i never came across a rubber dam...

this is probably daft, but i can't even visualize what people are talking about... will someone explain it to me? :D
 
moxn said:
i am a little lost here... what is the rubber dam used for?
i worked for a fairly long time at a an implant/prosthodontics practice and i never came across a rubber dam...

this is probably daft, but i can't even visualize what people are talking about... will someone explain it to me? :D
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http://www.allsmilesdentalcare.com/Rubber_Dam.jpg

It isolates the teeth from the rest of the mouth. Its not used with crown/bridge or implants really.
 
At Case it depends on the faculty/group that you are working in. My group requires them for all procedures. Placing them is a bit of a pain at first but once you get the hang of it it's really not that bad.

IMO the little bit of time it takes to place one is well worth it. Since we are working without assitants I spend less time trying to suction and worrying about the patient choking on a mouth-full of water/debris when I can't retract and suction at the same time. Also as someone previously mentioned it keeps the patients fat wandering tongue out of the way. I even use them for the bulk of crown preps and then just remove the dam to finish the margin. I personally love them. Once you get it in place it's just like working on a typodont. :D
 
At UCLA, RD is required for for all endo, all operative, buildups, inlay preps, and removing old amalgam restorations.
 
Required for every last thing we've done in operative so far (preclinical). I'm at Stony Brook. They make sure we know how to do it. I'm not sure if there is a procedure where they are not required/recommended. We haven't gotten to that yet. :)
 
UNR.Grad said:
Anybody know about UCLA?
Click to expand...

Instructors at UCLA like to see you use water-based lubricant. Fill up your empty Monoject plastic syringe with the shaving cream. Take the rest of the shaving cream home for your beard or legs. After you punch the holes, apply a small dab to a clean surface or the RD itself and smear it across all the holes with an index finger. Be sure that you apply the shaving cream to the underside/apical side of the rubber dam.

Also, you can cut your templates to size so that you can store them in your box of rubber dams. Many people lose them. Or you can practice to punch your holes freehand.
 
required at vcu
 
They are almost always required at Baylor.
 
Required at NYU and I've been told the clinical director, Dr. Wolfe, is pretty strict about complying.

I went in for some work and had the rubber dam installed on my face for the first time ever. It was sort of tilted to the side so one side of my mouth was open to the air and I couldn't keep my tongue from feeling around it. There was this attractive D2 shadowing the third year and I'm just rolling around in the chair gagging with my tongue flickering all around. Then this faculty comes over and decides to check my muscles of mastication for some reason and he is wiping my own saliva all over my face as he palpates my ptergyoids, etc.
 
OceanDMD said:
Im sure isolite is great, if you are not using isolite there are procedures that demand isolation. I use a dam all the time. It is easy to put on after repitition, and it makes most procedures much easier and predictible. It is NOT standard of care to perform endo without a dam. If Im doing quadrant dentistry that includes resin restorations, Im using a dam. What causes these things to fail? ...inadequate moisture control. Thats what a dam does. If all the dentists you come across rarely use a dam, I would be concerned about the predictibility of some of their restorations/procedures. Sure you can isolate with cotton rolls, but not like you can with a dam. The best clinicians out there, those that are known for their clinical skills, like a Ron Jackson, are using rubber dams.
One downside to the isolite is the expense.
Click to expand...

The other option is the Kona Adapter ($89) with Isolite mouthpieces. It's especially ideal for students because there's nothing to install. It simply inserts into your HVE valve just like a regular HVE tip. http://konaadapter.wordpress.com/2011/08/21/special-deal-for-dental-students/
 
At UT Houston, we have to use one for operative, endo and pedo. Realistically, some patients can't tolerate it or it can't be placed, like distal preps on second molars, but I actually like it.

If you don't have an assistant, I don't know how you would ever keep composite restorations dry for bonding- it's WAY too moist from breathing and adjacent moisture to bond composites acceptably. I place amalgam when I can as well with it just because It keeps all the little pieces from falling back into their throat, and although it does take a few minutes to apply (from 3-5) by yourself, I think it saves time in the long run.
 
At Colorado required for Pedo/Endo every time. Operative almost every time, but like many have said before 2nd molars, small occlusal amalgams, small class 3s etc....

It's pretty faculty dependent for clinic, some prefer it for crown preps (insanity).
 
jay47 said:
At UT Houston, we have to use one for operative, endo and pedo. Realistically, some patients can't tolerate it or it can't be placed, like distal preps on second molars, but I actually like it.

If you don't have an assistant, I don't know how you would ever keep composite restorations dry for bonding- it's WAY too moist from breathing and adjacent moisture to bond composites acceptably. I place amalgam when I can as well with it just because It keeps all the little pieces from falling back into their throat, and although it does take a few minutes to apply (from 3-5) by yourself, I think it saves time in the long run.
Click to expand...

Even with an assistant I would still recommend a rubber dam or Isolite for composites. Proper isolation is critical.
 
Streetwolf said:
Required for every last thing we've done in operative so far (preclinical). I'm at Stony Brook. They make sure we know how to do it. I'm not sure if there is a procedure where they are not required/recommended. We haven't gotten to that yet. :)
Click to expand...

It seems like more and more dental schools are allowing rubber dam alternatives (Kona Adapter, Isolite, Izolation, etc.) for at least some procedures.
 
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