2Environment of the Dental Operatory Microbial exposures in the dental operatory involve :1. Airborne contamination .2. Digital contamination of surfaces .(i.e., hands soiled with saliva that repeatedly contact operatory equipment and surfaces and return to the patient's mouth during treatments).
3Environment of the Dental Operatory Airborne ContaminationHigh-speed handpiece :Create airborne contaminants from :Bacterial residents in the dental unit water spray system .Microbial contaminants from saliva, tissues, blood, plaque, and fine debris cut from carious teeth .Airborne contaminants exist in the form of spatter, mists, and aerosols.AerosolsInvisible particles ranging from um that can remain suspended in the air and breathed for hours.
4Environment of the Dental Operatory MistsBecome visible in a beam of light,Consist of droplets estimated to approach or exceed 50 um.Heavy mists tend to gradually settle from the air after minutes.Both aerosols and mists produced by the cough of patient with unrecognized active pulmonary or pharyngeal tuberculosis (TB) are very likely to transmit the infection.
5Environment of the Dental Operatory SpatterConsists of particles generally larger than 50 um and are even visible splashes.Spatter has a distinct trajectory, usually falling within 3 feet of the patient's mouth .Spatter or splashing of mucosa is considered a potential route of infection for dental personnel by blood borne pathogens .
9Rubber Dam Advantages Disadvantages Dry clean operating field Better access and visibilityProtection of Patient and OperatorIncreased operating efficiencyImproves the properties of dental materials indirectly.DisadvantagesTime consumptionObjectionable to some patients
10Anisworth Design (Hygenic) Rubber dam punchFunctionsUsed to make holes of different sizes in the RD sheet .Punch stylus pierces a hole in the rubber dam sheet.Anisworth Design (Hygenic)Ivory Design
11Rubber Dam sheet MATERIAL Available in 5 different thickness : Sizes : 5X5 inch and 6X6 inch sheets.Available in 5 different thickness :Thin 0.15 mm (0.006 inch)Medium 0.20 mm (0.008 inch)Heavy 0.25 mm ( inch)Extra Heavy 0.30 mm (0.012 inch)Special Heavy 0.35 mm (0.014 inch)The rubber dam has shiny and dull side.
12Rubber Dam frame and clamp Rubber dam holder ( frame)is used to secure the borders of RD in stretched condition.Young´s rubber dam holder is U shaped metal frame with small projections to hold the dam.Rubber dam retainer or clampUsed to anchor the rubber dam to the most posterior tooth to be isolated.It consists of 4 prongs and 2 jaws connected by a bow.Prongs make four point contact with the tooth.
13Rubber dam retainer or clamp Appropriate TeethW56most molarsW4most premolarsW7mandibular molarsW2small premolarsW8maxillary molarsW-winglessW8A- AactiveW27distal extension-mandibular molars- Ddistal extensionHyg B-6anterior teeth
15Rubber dam clamp forceps Functions and features1.Used to place and remove rubber dam clamps on and from a toothWork with a spring action when handles are squeezed together2. Beaks fit into the holes of the rubber dam clamp for secure placement3. Sliding ring allows forceps to lock when placing the clamp and to be released when removing the clamp4. Handle shaped to allow a firm palm-grasp by the operatorIvory DesignStoke type
16Rubber Dam Unfavorable Conditions for Dam Placement Insufficiently erupted teethSome third molarsExtremely malpositioned teethAsthmatic patientsLatex allergy