Rubber Dam Isolation, Part 4: Basic Technique for Rubber Dam Application

[@uppingham1966]

Hi Dr Stevenson, I am presently a clinical dental supervisor at Griffith University on the Gold Coast in Queensland, Australia. and I enjoy watching your instructional videos. I have used rubber dam for all restorative procedures for the last 38 years or so and there is not a mistake to make with rubber dam that I haven't made dozen times. "Ballistic Dysclampsia" was a common issue in my early rubber dam days!!! I cannot tell you how pleased I am to see your technique of placing the rubber dam clamp on tooth and then stretching the dam over the clamped tooth ...... this is the exact same technique I have used for my career; having tried all the others I find this the most predictable and therefore the quickest. My students ( almost all of them....not all!) say they find this technique easier than placing the clamp in the dam and then "carrying" it to the tooth and trying to see where to place it whilst trying to see the buccal and lingual soft tissues. Accordingly I heartily endorse your technique to your many viewers. In my university in London we were not taught to regularly use rubber dam other than for endodontics and I was about to give up dentistry in 1979 after a year of frustration at having my fingers and hands covered in saliva and blood, and therefore slippery all the time ( remember that these days were before the general use of gloves in dentistry....gloves only became routine after the HIV/AIDS scare of the early 1980's). Fortunately a young dentist working with me offered to help me learn how to use rubber dam properly and he stayed back every night for a week to teach me.....thank you Dr Choon Kow, Adelaide University graduate!!! Students watching this presentation....I encourage you to learn how to use rubber dam routinely. My own students ALL love to watch the numerous KZbin presentations of beautiful composite, ceramic, amalgam and gold work......almost without exception, rubber dam is being used by these operators. I also encourage you to keep watching Dr Stevenson's instructional videos.....it's all really good stuff. Enjoy your careers. Jamie Arthur BDS London 1978

[@StevensonDentalSolutions]

Dear Dr. Arthur, what a beautifully written commentary - we are cut from the same cloth no doubt and I applaud your efforts in education! All the best, Rich

[@dr.anujmewada4749]

This is one of the better videos out there, good focus, light and no jarring music. i am not gonna even comment on rubber dam application. Subscribed..

[@StevensonDentalSolutions]

Thank you.

[@candicetrixiatan7952]

I agree about the no jarring music. Voice isn also very clear. Keep it up Dr. Stevenson! 😊

[@Stokogu]

As a dental student, I love everything about this channel. It'd be really nice to see local anesthesia injection technique if that isn't too much to ask for.

[@StevensonDentalSolutions]

I've got this in the queue - thank you!

[@judybooty9766]

@@StevensonDentalSolutions I second this!! I'm a huge fan of your channel and it would help us so much if you could make anesthesia injection videos, especially those preparing to enter clinic!

[@StevensonDentalSolutions]

Will do Doc! Thank you

[@drgunjan3540]

Second that

[@WhasianDDS]

First year dental student here! Thank you for the video! You teach better than a lot of professors at my dental school. I look forward to watching more!

[@StevensonDentalSolutions]

Thank you!

[@buddyweiser8508]

Had a root canal yesterday, and all day I couldn’t figure out why my gum margin was sore. Never had a dental dam used on me before, so I figured that be the logical thing to look up. That clamp/clip looks like it makes total sense, why my gums are sore. Oh well, so far that has been the worst part of getting a root canal, and it’ll probably be better in 2-3 days.

[@StevensonDentalSolutions]

Yes, and the type of clamp makes a big difference - if the dentist uses conservative clamps, no pain or soreness after...

[@acash93]

Lubricant makes a huge difference when it comes to passing through the dam through the contact points.

[@StevensonDentalSolutions]

So true Doc - thank you for your comment!

[@waelelsebaey]

Thank you dr Stevenson As always it’s great to watch your videos Waiting for the next one Take care

[@StevensonDentalSolutions]

Thank you Doc.

[@ayahere5105]

بعد إذنك ، ممكن تشرحلي ليه حط الclamp التاني في آخر الفيديو؟

[@mariajosefarinacotelo7325]

Many thanks from Spain!! You are a wonderful Discovery for me. I'm 60 years old but I still enjoy learning as much as I can! I sometimes have some trouble with lower lip, because It remains covering the teeth...and makes difficult to work on them. How can I solve this problem? Thanks

[@StevensonDentalSolutions]

Hi doctor, good to hear this! Rubber dam extending to the opposite premolar usually solves this issue.

[@eb4634]

Thank you so much for this video. It will definitely help me be more efficient assisting my Doctor.

[@StevensonDentalSolutions]

Awesome! Our Dental Assistants are the quiet champions of the profession - keep up the good work!

[@AbhishekMishra-fc6ev]

Really helpful, and coming across some new innovative technique that I have never ever heard and seen... Thank u doc.. I hope this may continue...

[@StevensonDentalSolutions]

Great - thank you for your support!

[@yanoevy1634]

Iam so glad I found your channel .. your videos are so informative thank you so much sir .. looking forward for more of your amazingly done videos👌🏻

[@StevensonDentalSolutions]

Awesome - welcome to the channel. Feel free to request topics!

[@emmac687]

Thank you for the great video! Subscribed!!! 🦷

[@StevensonDentalSolutions]

Thank you!

[@saiedmostafamoazzami7408]

Thank you very much. It was really informative for me.

[@StevensonDentalSolutions]

Thank you

[@ibriarmiroi]

Could you please make a video( or videos) about access cavity preparation? (it would be ideal if you could talk about each tooth), Thanks

[@StevensonDentalSolutions]

We are filming this in April and these ends access videos will be covering the following: Maxillary incisor, Maxillary Molar and Mandibular Molar. If requested we will provide others. Thank you!

[@yesidramirez8635]

Thank You doctor

[@StevensonDentalSolutions]

My pleasure!

[@tanjakat1977]

Best channel ever !

[@StevensonDentalSolutions]

Thank you!!!

[@georgemoussa9905]

Hi Dr Stevenson, thank you for the valuable illustration..would you be able to provide a video for punching holes and application for maxillary teeth specially molars and premolars? Thank you

[@StevensonDentalSolutions]

Here you go Doc! kzbin.info/www/bejne/q2qQiGtoms-IjJI

[@lcastill2013]

Is the application of the second clamp simply to hold the rubber dam on tooth #19? I’m curious what could possibly happen if you didn’t place the second clamp? Thanks 🙏

[@StevensonDentalSolutions]

Hi, the 27 clamp is to further retract the rubber dam to gain access to the buccal surface. Thank you for asking the question!

[@ledamorales5079]

I really enjoy this videos! Thank you.

[@StevensonDentalSolutions]

Thank you!

[@alialkhaqani7210]

Thanks sir , really appreciate ur efforts

[@StevensonDentalSolutions]

Thank you!

[@MrBaladaum]

Hi there doc! Could you please explain what are the criteria to deciding wich teeth to clamp and isolate if we are restoring a particular tooth? Lets say we want tp restore tooth 20 and 22, from where to where should I isolate and where should I put the clamp? What exactly is the criteria? Thanks a lot

[@StevensonDentalSolutions]

Hi, typically 1-2 teeth distal to the tooth being restored all the way to the midline or contralateral 1st premolar. If we are working on #22, the clamp W2 would be placed on tooth #20 and extends to tooth #28.

[@zerposh]

thank youuuuu thank you thank you!from sweden

[@StevensonDentalSolutions]

Thank you! I wan't to visit soon!

[@Dr.pujasingh]

Its really awesome sir..u r doing a god job👌👍

[@StevensonDentalSolutions]

Happy to share my thoughts.

[@rahulkore243]

Hello sir Sir, you are an amazing artist. Can you do videos on full mouth rehabilitation? Ways of Increasing VDO, wax up, developing anterior guidance, etc

[@StevensonDentalSolutions]

Great ideas - on the list for 2020

[@rahulkore243]

@@StevensonDentalSolutions thanks sir for your valuable reply. Waiting for it

[@StevensonDentalSolutions]

You got it!

[@cdfgdght3559]

❤❤❤🎉🎉🎉excellent

[@gozdeyildiz5965]

Thank you Dr Stevenson, these videos are very helpful. Can we stabilizied the dam without clemps ? Colten rubber dam kit has a latex stabilizing cord. How can we use it practically ? Thanks a lot

[@StevensonDentalSolutions]

The cord (Wedjets, etc) work best with anterior isolations/ Place the dam, then insert the elastic pieces between the last tooth isolated and the tooth covered by the dam.

[@delishapinto4648]

Hello sir. Can you please make videos for preps required for bench test? Thank you for explaining everything so well. Appreciate it.

[@yahyasaad6199]

❤❤

[@StevensonDentalSolutions]

Check out my video library - I have dozens of them for the Bench Exam. Thank you

[@kevinpham3087]

Could you make a video on ways to hold your handpieces?

[@StevensonDentalSolutions]

Coming soon - ergonomics, etc.

[@tsaidoo]

Thank you . This vedio really does great help

[@StevensonDentalSolutions]

My pleasure Doc

[@pl1347]

I feel like securing the clamp and rubber dam together first outside patient's mouth is more efficient

[@StevensonDentalSolutions]

More efficient but it leads to more issues with proper clamp positioning. (you simply cannot see the entire clamp features with a dam draped over it. Often grabbing too much tissue, etc. Both work well after practice.

[@kunalforualwz]

Thankyou so much!

[@StevensonDentalSolutions]

You're welcome!

[@dongdongdong8413]

thank you

[@StevensonDentalSolutions]

My pleasure!

[@farshadbajoghli1606]

Dear dr Stevenson: Thanks for your nice video, very helpful as always. What if you have to do a Do composite on the last distal tooth i.e tooth no.7, how would you manage the clamp and the matrix band without interfering with each other?

[@StevensonDentalSolutions]

I'd use an RGS M17D clamp and then use a Tofflemire retainer and band for the distal - squeeze the clamp open SLIGHTLY after prepping, then insert the assembled matrix and then allow the clamp to squeeze against the matrix...stevensondentalsolutions.com/shop/molar-distal-access-rubber-dam-clamp-rgs-m17d/

[@mansoorkhan8272]

Dr stevenson i mostly have problems with my rubber dam sheet as it bunches up together when i apply the frame over the sheet like making folds in the dam ..how can we avoid that

[@StevensonDentalSolutions]

Send me a photo to my inbox: [e-mail] and I'll take a look.

[@AbhishekMishra-fc6ev]

Subscribed ur channel, and I press like button on each f ur video tht I go through..

[@2kidsnosleep]

We had a situation today working on a premolar. The molars behind are both implant teeth. Can you clamp an implant? Should you??

[@StevensonDentalSolutions]

Probably not a good idea. I never have placed a clamp on an implant restoration.

[@RR-dz6yy]

Dr, could you please do a video on mistakes during osec RD technic by students

[@StevensonDentalSolutions]

Great Idea! Will do.

[@stoma-k5297]

Doctor Stevenson, can you make video about Clarks preparation technique?

[@StevensonDentalSolutions]

Yes, David Clark has developed a wonderful technique! Will do...

[@DrShahid-Shafi]

Thank you Sir for sharing this. I've seen your videos on the Rubber dam and believe me it has helped me immensely. Thank you again Sir Just a confusion sir , asked many practitioners this question but no one gave a satisfactory answer to my query. Sir , is the largest hole punched for any tooth which receives the clamp irrespective of the type of the tooth or we need to select the hole according to the size of the tooth but as a beginner how do you we get the idea that this particular tooth needs this particular hole? For example, Sir , if we're isolating a mandibular incisor, do I need to punch the smallest hole? And for maxillary incisor the second smallest hole and so on? And does this change when they are isolated but not as anchor tooth? Hope you get my question Sir. Sir I often end up imbalance of the sheet and frame on the patient. It goes more towards on side and I end up with no so good isolation? What could you be the reason Sir . Hope you get time to answer Sir Thank you

[@StevensonDentalSolutions]

Great questions! 1. The size of the hole should always try to match the tooth first and then one size larger to facilitate placing the dam over the bows. Helpful hint: For class V lesions, we also punch one size larger than normal and about 3 mm towards the facial, and with about 2 mm more space mesial and distal - This allows the hole to be shifted facially and secured with a 212 retractor. 2. Use a "top clamp" on the opposite side to keep the assembly from rotating. Procedure: Once the dam is on, use a W2 for premolars or a W3 for molars and clamp the side which has no holes on the tooth of your choosing - it won't be painful as the dam is cushioning the gingiva and it will keep the dam straight on the face. Best! Dr. S

[@DrShahid-Shafi]

@@StevensonDentalSolutions Thank you very much sir. Pretty much satisfied with the answers. Thank you again Sir.

[@Jabinsurriya]

Thanks alot....i ll be your student oneday....

[@StevensonDentalSolutions]

Okay - I'm counting on it!

[@Jabinsurriya]

@@StevensonDentalSolutions ...doc you are wonderful teacher but a kind heart too.im so much happy that you ve answered my query.i watch your videos without count on them.i am determined to be your student once i managed my budget .you are a blessing for millions of learners who cnt afford to fly all the way to usa .plz keep doing this phenomenal work . Million thanks

[@StevensonDentalSolutions]

I'm glad I can be of some help - wishing you the best!

[@sameer7420]

What should we do when there is bridge in the area of isolation?

[@StevensonDentalSolutions]

I usually ignore the bridge (no holes) and allow the dam to cover it like an edentulous area. There are more advanced techniques but they require lots of time and practice. Thank you!

[@sameer7420]

@@StevensonDentalSolutions thanks!

[@lannyrubin2600]

Great video What was the lubricant you used to slide the dam into place that you said was better than vasoline. you called it brushless soap?

[@StevensonDentalSolutions]

Barbasol shave cream - I keep it in a Monject Syringe: www.amazon.com/Barbasol-Moisturizing-Shave-Cream-Sensitive/dp/B000WXG5EU/ref=sr_1_9?dchild=1&keywords=Barbasol+cream&qid=1591228559&sr=8-9

[@julieo3860]

Thanks Dr. Stevenson. Do you anesthetize the tooth to be clamped?

[@StevensonDentalSolutions]

Yes, but for maxillary teeth I don not usually need to give a palatal injection.

[@siddharthshah8228]

Thank u ......

[@StevensonDentalSolutions]

My pleasure Doc!

[@computerninja5552]

Really good vid. If the technique you showed at 6:00 has no downsides, is it possible to place the rubber dam sheet before even placing the clamp? are there any disadvantages apart from what you pointed out ( having to adjust the clamp so it sits on tooth structure)?

[@StevensonDentalSolutions]

It's done all the time, especially for anterior only isolations, like from premolar to premolar. The area adjacent to the retainer (clamp) need not receive anesthetic with this technique, as the rubber dam cushions the tissue...

[@computerninja5552]

@@StevensonDentalSolutions ah ok thanks for the reply. Why do you think this method isnt shown more often (posteriorly), as i find it to be the simplest and quickest to an extent, yet cant find any videos on it?

[@imranchowdhury5550]

What's the pupose of bow-tie in rubber dam?

[@StevensonDentalSolutions]

secure it without placing another clamp

[@imranchowdhury5550]

@@StevensonDentalSolutions Thanks.

[@newworld9338]

Helle Good job ,,Whats name material in 3:21 ?

[@StevensonDentalSolutions]

www.amazon.com/Barbasol-1919-Classic-Shaving-Cream/dp/B08KGX43VL/ref=sr_1_23?crid=1KLMTOC6FWUW4&dchild=1&keywords=barbasol+shave+cream&qid=1608265267&sprefix=Barbasol+%2Caps%2C242&sr=8-23

[@newworld9338]

Stevenson Dental Solutions I thank you

[@StevensonDentalSolutions]

@@newworld9338 My pleasure!

[@Alhussiuny]

Vey very beautiful thanks dr

[@StevensonDentalSolutions]

Thank you Doctor!