Rubber Dams: Why So Rare In Private Practice

[DrTacoElf]

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I was wondering why so many dentists in private practice only use rubber dams for endo. Is cost a major factor and even so isn't there a relatively high risk of aspiration of any substance? We just learned how to put them on in operative and it seems to make anything you would be doing so much easier.

 

[Jediwendell]

I was wondering why so many dentists in private practice only use rubber dams for endo. Is cost a major factor and even so isn't there a relatively high risk of aspiration of any substance? We just learned how to put them on in operative and it seems to make anything you would be doing so much easier.

Have you ever had one on? They aren't terribly comfortable.

 

[12YearOldKid]

I was wondering why so many dentists in private practice only use rubber dams for endo. Is cost a major factor and even so isn't there a relatively high risk of aspiration of any substance? We just learned how to put them on in operative and it seems to make anything you would be doing so much easier.

Not the cost of the dam itself, but the cost of the time to place it. It takes about 30 seconds to snap it on your perfect dentiform, but it can be a real hassle with crowded teeth, tight contacts, loose contacts, teeth with no height of contour, etc... In private practice those are precious minutes wasted if you are only doing a couple of amalgams that could easily be isolated with a few cotton rolls and a good assistant.

Oh, and most patients hate it.

 

[DcS]

Not the cost of the dam itself, but the cost of the time to place it. It takes about 30 seconds to snap it on your perfect dentiform, but it can be a real hassle with crowded teeth, tight contacts, loose contacts, teeth with no height of contour, etc... In private practice those are precious minutes wasted if you are only doing a couple of amalgams that could easily be isolated with a few cotton rolls and a good assistant.

Oh, and most patients hate it.

While I do agree that time (and therefore money) is the main reason, I don't agree that rubber dams are hard to put on. In most cases it can be done in 30 seconds. It might seem tough at first in clinic but most times a dentist can drop the anesthesia and go to another patient while an assistant puts in on. I think it's sheer laziness but perhaps dr. jeff can enlighten us all.

 

[DrTacoElf]

Have you ever had one on? They aren't terribly comfortable.

I've had 2 on and honestly it wasn't a big deal for me. I like the fact that I could swallow and not worry about ingesting chunks of debris.

 

[12YearOldKid]

... and the MDs also find the occasional weirdo who enjoys a colonoscopy. But I promise you, you are in the minority TacoElf. Many of my patients hate the rubber dam more than the shots.

 

[DcS]

In my 3 years of clinic most of my patients prefer it. As telf said they like the separation b/w the working field and their throat, etc.

 

[psiyung]

I've had 2 on and honestly it wasn't a big deal for me. I like the fact that I could swallow and not worry about ingesting chunks of debris.

you're a real rarity. Most people, including myself, hate having them on and putting them on

 

[Sprgrover]

I've had 2 on and honestly it wasn't a big deal for me. I like the fact that I could swallow and not worry about ingesting chunks of debris.

I've had them on before as well and didn't mind for the same reasons. My dentist, and as well as the other ones I've shadowed, used them rather frequently and could pop 'em on and off rather quickly. This is probably due to lot's of experience, and I guess I'll have to see what kind of a relationship I'll have with them come clinic time.

 

[kerrydds06]

next time you cut a crown prep (YES i said CROWN prep) on a mandibular tooth that is not the distal tooth in the arch, put the dam dam on. Then tell me how much time (aka $) you save.

I love using the dam dam whenever i can. Preventing an aspiration ia worth the "hassle". Pts will understand and even prefer it if you explain.

 

[12YearOldKid]

I've had them on before as well and didn't mind for the same reasons. My dentist, and as well as the other ones I've shadowed, used them rather frequently and could pop 'em on and off rather quickly. This is probably due to lot's of experience, and I guess I'll have to see what kind of a relationship I'll have with them come clinic time.

Oh, in the school clinic it is a no-brainer. Those couple of minutes putting it on will save you a good hour you would otherwise spend fighting the tongue, cheeks, blood, saliva --- but these are all things a good assistant takes care of in private practice.

Anyone have access to Isolite at their school? That is something that I would really like to try.

 

[grmaster1]

I was wondering why so many dentists in private practice only use rubber dams for endo. Is cost a major factor and even so isn't there a relatively high risk of aspiration of any substance? We just learned how to put them on in operative and it seems to make anything you would be doing so much easier.

A majority of civilian dentists don't use rubber dams because it saves them money, not because it's not comfortable for patients.

In the military general dentistry, rubber dams are used almost every time, even during sealant applications. Keeping the playing field dry is critical for restoration placements, especially, composites; plus, you don't want your patients swallowing all the junk--tooth structure, amalgam, etch, bleach, etc.

And, yes, you could prep a crown with the dam on...


Dam if you do, and damned if you don't... 😀