Biomimetic Dental Course| Lesson 4: The Rubber Dam & Isolation

Lesson 4 of Biomimetic Dental Course covers the importance of isolation and the Rubber Dam.

WHAT IS ISOLATION IN DENTISTRY? Isolation refers to keeping the tooth free from saliva, moisture, blood, and debris while it is being worked on. It is similar to having a clean surgical field during an operation.

TYPES OF ISOLATION There are many methods used for isolation, but most do not adequately keep the tooth free from saliva, moisture, blood, and debris. The absolute best method of isolation is the Rubber Dam. Another method that works well is an Isolite or similar device described below.

RUBBER DAM The Rubber Dam consists of a square piece of latex or nitrile material that gets holes punched into it to fit around the teeth and form a good seal. The seal prevents moisture, saliva, and blood from contacting the tooth surface and also prevents materials used during the procedure from coming in contact with your soft tissue and mouth.

ISOLITEAn Isolite (brand name) or other similar products provide intra-oral suction combined with retraction of the cheeks and tongue. Keeping the tongue and cheeks away from the teeth helps maintain adequate isolation, however, the gum area around the teeth still results in some moisture and contamination. This is important when procedures are performed near the gum line, where isolation is most difficult. One strategy is to combine Isolite or similar device with a piece of cord/string around the gum to absorb moisture, but using the Rubber dam is most effective when possible.

WHY IS ISOLATION SO IMPORTANT? Adhesive dentistry and biomimetic dentistry require a strong adhesion or "gluing" of restorations to teeth. Any moisture or contamination on the tooth surface (saliva, moisture, blood, debris) will reduce the strength of the adhesion very significantly and make restorations fail by fracture, coming off, sensitivity, pain, and recurrent decay or cavities. Adhesion is such an important part of minimally invasive, biomimetic dentistry and therefore isolation is critical.

ADVANTAGES OF ISOLATION - Keeps tooth dry - Prevents contamination (saliva, blood, moisture, debris) - Protects gum and tissue from drilling, materials, and instruments used during the procedures. - Prevents exposure (inhaling, swallowing/ingestion, and absorption) of materials used during the procedure - Prevents exposure of materials removed during the procedure such as amalgam silver mercury fillings.