FIELD ISOLATION

FIELD ISOLATION
Objectives
Criteria for isolation techniques
Methods of moisture control
Rubber dam components and its application
Common errors in rubber dam application

ISOLATION OF TEETH
Why to Isolate the field??
Fluids need to be removed from the mouth for the
patients comfort and to improve the dentists vision
Contamination by moisture has a detrimental effect on all
filling materials and it is essential that cavities are kept
dry to produce a good restoration
Saliva is not the only possible contaminating fluid;
crevicular exudate and bleeding from gingival margins
must also be considered

ISOLATION OF TEETH
Criteria for field isolation technique
Be easy to apply and not to injure soft and hard tissues
Be comfortable for the patient
Provide retraction for better visualization for the operator
Prevent moisture contamination
Isolate the area of concern

Methods of moisture
control
1. Direct methods
2. Indirect methods

Methods of moisture
control
1. Direct methods

Rubber dam
Oral Evacuation system
Absorbent materials
Air- water syringe
Gingival retraction cord
Electro-surgery

Methods of moisture
control
2. Indirect methods
a. Local Anesthetics
b. Pharmacological methods
Anti-sialogogues
Antianxiety drugs
Muscle relaxants

ORAL EVACUATION
SYSTEM
The process of removing excess fluids
and debris from the mouth
Two systems:
Saliva ejector
High-volume evacuator (HVE)

SALIVA EJECTOR
Small, straw-like oral evacuator used
during less invasive dental procedures

SALIVA EJECTOR
Indications for use
Helps control saliva and moisture
accumulation under the dental dam
For the cementation of crown or bridge
During an orthodontic bonding procedure
Preventive procedures such as a
prophylaxis or fluoride treatments

HIGH-VOLUME
EVACUATOR (HVE)
Used for most dental procedures,
especially when the dental handpiece is in
use

HIGH-VOLUME
EVACUATOR (HVE)
Oral evacuation tips
Operative suction tips
Designed with a straight or slight angle in the
middle
Beveled working end
Made of durable plastic or stainless steel

Surgical suction tips

Much smaller in circumference
Made of stainless steel

Grasping the HVE

Positioning the HVE

Absorbent Materials

COTTON ROLL &

CELLULOSE PADS
Pre-formed, pre-shaped
cotton positioned
close to the salivary
gland ducts
absorbs the flow of saliva
and excess water

COTTON ROLL
Advantages: ISOLATION
Easy application
No additional equipment is required
Flexible, so they can be adapted to fit areas of the mouth

COTTON ROLL
ISOLATION
Disadvantages:
Does not provide complete isolation
Does not protect the patient from aspiration
May stick to the oral mucosa and can injure it
It must be replaced frequently because of saturation
Limited retraction

DRY-ANGLES
A triangular absorbent pad
placed over the Stensen's
duct blocks the flow of
saliva and protects the
tissues in this area.

Dental Dam /
Rubber Dam

DENTAL DAM / RUBBER

DAM

RUBBER DAM
Indications for use
Infection control protective barrier
Safeguards the patient's mouth
Protects the patient from accidentally inhaling or
swallowing debris
Protects the tooth from contamination
Provides the moisture control needed
Improves access
Provides better visibility
Increases dental team efficiency

RUBBER DAM

Rubber dam Sheet

A thin stretchable latex material becomes a
barrier when appropriately applied to select teeth

RUBBER DAM
Rubber dam Sheet
Made of either latex or latexfree material.
Available in a continuous roll or in two precut sizes (6x6 or
5x5).
Available in a wide range of colors from light to dark.
Available in different scented flavors.
Dam thicknesses (gauges) are thin, medium, heavy, extra
heavy, special heavy.

RUBBER DAM
Rubber dam Frame
U-shaped frame / Youngs frame
Oval shape frame / Nygard Otsby frame
Plastic / Metal frame

RUBBER DAM

RUBBER DAM
Rubber dam napkin
Increases patient comfort by absorbing moisture
between the patient's face and the dam.

Rubber dam Lubricant

Watersoluble lubricant placed on the underside of the
dam to help the dam material slide over the teeth and
through the interproximal spaces.

RUBBER DAM

RUBBER DAM
Rubber dam punch
Creates the holes in the dental dam that are
needed to expose the teeth to be isolated.

RUBBER DAM

RUBBER DAM

RUBBER DAM
Rubber dam stamp
Ink pad and stamp used to mark the dental dam
with predetermined markings for average adult
and pediatric arches.

Rubber dam template

Stiff plastic template with holes indicating where the
teeth should be marked.

RUBBER DAM

Rubber dam Clamp forceps

Beaks of the forceps fit into holes on the jaws of the
clamp.
Sliding bar keeps the handles of the forceps in a fixed
position.
Handles are squeezed to release the clamp.

RUBBER DAM

RUBBER DAM

Rubber dam clamps

The primary means of anchoring and stabilizing
the dental dam.

RUBBER DAM
Parts of the clamp

Bow
Jaws
Prongs
Holes / Notch for theforcep

RUBBER DAM

RUBBER DAM

RUBBER DAM
Types of Clamps
Winged clamps / Wingless clamps
Posterior clamps / Anterior clamps

RUBBER DAM

RUBBER DAM
Ligature
An important safety step that makes it possible to
retrieve a clamp should it accidentally become
dislodged and then inhaled or swallowed by the
patient.

STEPS IN PREPARATION
AND PLACEMENT

Placement of Rubber Dam

Teeth must be cleaned

interdentally

Placement of Rubber Dam

Rubber dam sheet will be marked accordingly

Placement of Rubber Dam

Dam is punched

Placement of Rubber Dam

Dam is lubricated

 Rubber dam clamp is engaged into the

punched lubricated sheet area

Placement of Rubber Dam

Clamp selected, ligated, and positioned
on forceps

Placement of Rubber Dam

Placement of clamp

Placement of Rubber Dam

Placement of napkin

Placement of Rubber Dam

Placement of dam

Placement of Rubber Dam

Placement of frame

Placement of Rubber Dam

Dam secure and inverted

Placement of Rubber Dam

Fixation and tying of the rubber dam sheet

STEPS IN REMOVAL

Remove any ligatures that are stabilizing the dam.

Using crown and bridge scissors, cut each hole
creating one slit.
Position forceps in clamp.
Remove everything as one unit.
Evaluate patient.
Evaluate dam.