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The Rubber Dam Equation—Why Cutting Corners Just Won’t Cut It

Published on: Jun 23, 2022
 By: The New Dentist
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Using the right kind of clamp during a dental procedure can mean the difference between an expert result and a patient returning to the chair, dissatisfied—or worse yet, in pain.

However, choosing the right clamp for your procedure is easier said than done. “You need to know the importance of your clamp selection,” explains Dr. Céline Higton, BDS Hons.

Higton, who recently presented at Seattle Study Club’s 2021 Symposium, says that when dentists get too comfortable using the same methods to isolate teeth for procedures, the results will often fall short of the patient’s standards.

“Good enough is never good enough. That’ll do? No, it won’t” says Higton. “This is my mantra, this is my philosophy, this is how I practice all my dentistry.”

To combat the potential for serious rubber dam placement issues, like slippage, during procedures, “It all hinges on the clamp selection,” says Higton. “Clamps, they are the star of the show.”

While there are a variety of factors that make a dental clamp effective, the jaws and the tips are the parts dentists should pay most attention to, “because those are the areas that engage the teeth in a really fundamental way.”

Higton explains that, in order to ensure that the clamp fits well and resists the dam’s tension, it should ideally have a wide A-P spread and four-point contact with the tooth.

“What we aim for is…four point contact evenly spread around the tooth, so that even under pressure, under tension, the clamp won’t go flying,” explains Higton.

After checking a patient’s tooth size and selecting and applying the appropriate clamp, Higton says that practitioners should press down on the clamp’s bow to ensure that it will maintain its tension during the procedure. “If the patient’s head bobs up and down, then you know it’s a good fit.”

While picking the correct retracting clamp is also of the essence, Higton says that ensuring the fit of the stabilizing clamp is paramount. “The most important thing here is that the dam is already stable,” explains Higton, noting that the placement of the rubber dam itself should be carefully attended to.

“Don’t cut corners,” she cautions.

Most importantly, it’s essential for dentists to know not only the how, but the why behind each step of the process. “You cannot just miss out on steps. You cannot just choose things for no reason,” says Higton. “You’ve got to have method behind the madness.”

Dr. Céline Higton is the leading associate dentist at Beverley Dental in London. Dr. Higton has worked hard to stay at the top of the profession. She frequently attends courses to further enhance her practical and theoretical skillset. Dr. Higton qualified with distinction and honours from King’s College London; this university is consistently ranked within the top five in the world for dentistry. During her time there she received a number of prizes and awards for excellence in clinical dentistry, academic theory and patient management.

She enjoys all aspects of general dentistry but has a particular interest in restorative and cosmetic dentistry. Throughout her life she has always been drawn to the artistic side of things and has drawn portraits since secondary school and takes great pride in creating precise and accurate work. She is trained in Facial Aesthetics and Invisalign clear aligners––both excellent additions to the ‘cosmetic dentist’ package. She has an eye for detail and proportion so whether patients are after a winning smile, a more youthful appearance or simply a small tweak here and there, she will be sure to address every need and concern whilst ensuring that the treatment experience is overwhelmingly positive.

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