Written by Dr. Dominique Laatz MSc. MSc. (German Dental & Dermatology Center Doha, Qatar)
Within the Dental profession, few things are perceived as Must-have’s for better outcomes. As everywhere else, opinions tend to defer. But among the specialists in Endodontics – a sub-specialty concerned with Root Canal Treatment – an overwhelming majority of practitioners recommend the utilization of so-called “rubber-dams” (also frequently referred to as “dental dams”). This device can best be described as a quadrangular, 6 square inch sized rubber sheet, which is used to isolate the tooth from the rest of the oral cavity and from saliva. It therefore primarily serves the purpose of contamination control. The logic behind this, is that the opened root canal system should not be flushed with potentially harmful bacteria present within the oral cavity.
This is not only common sense. Latest scientific evidence points quite strongly to improved outcomes of root canal procedures, which were performed under rubber-dam, when compared to those who weren’t. The leading societies, like the European Society for Endodontology and the American Association of Endodontists also gave clear recommendations in favor of rubber dam utilization during Root Canal Treatment.
Which leads to the question why – according to findings reported in the British Medical Journal – more than 50% of general dental practitioners don’t apply the rubber dam technique during Root Canal Therapy on a regular basis.
Even though, the utilization of rubber dam is recommended by the respective societies, this doesn’t constitute an obligation on the side of the dental practitioner.
Some dentists may shy away from the additional time for the treatment or other factors such as convenience and costs (although the additional investment is rather low). Others may not be aware of or even doubt the benefits of this technique.
In sharp contrast to this, the overwhelming majority of endodontic specialists apply rubber dam in almost every root canal procedure. For sure, this can be explained with the higher fees and more time dedicated for each root canal treatment, when compared to most general practitioners, who tend to treat more patients per day with a more diverse spectrum of treatment options.
But in light of the scientifically proven benefits, it is important for the patient to be properly informed about what is the current best practice protocol. And the rubber dam technique surely is one of the important factors for successful root canal procedures.