Infection control Accidental aspiration Moisture control Visibility Efficiency Retract lips, tongue, and tissue Protects tooth from contamination (Saliva)
Asthma Respiratory congestion Allergies to latex Herpetic Lesions Lesions of the commissures Claustrophobic Bad experience
Explain procedure to patient Check medical history for latex allergy Tooth should be free of plaque and debris
Made of latex or latex free materials Sizes, Thickness, Color, and Scents Adult 6x6 Children's 5x5 Thin is usually for RCT. Medium is used for restorations. Thick is used as needed for stronger tissue retraction.
Dental Dam Napkins A disposable napkin is placed between the patients face and the dam. Helps to absorb moisture and increase the patients comfort. Protects the patients face from direct contact with the dental dam to decrease latex sensitivity.
A stamp is can be used to mark the dental dam with predetermined markings to be punched out by the assistant.
Template A template has holes where the teeth should be marked. It’s placed on the dental dam and a pen is used to mark through the template to indicate the location where to punch the hole.
IF holes are: Too big – Dam will not fit tight Too small – Dam will tear when going over teeth Too close – Dam will stretch to far – leakage Too Far apart – too much material between teeth – will bunch
Clamps to the Anchor tooth Stabilizes the dental dam Opposite end of the dental dam must be stabilized (also called ligating the dam) a. Can use another clamp. b. Can use a stabilizing cord-Wedget. c. Can use dental floss or tape.
Clamps are available in many sizes. Winged clamp Extra extensions for better retraction and retention Help retain the dental dam in place because the wings are angled toward the gingival. Used during the one-step dental dam placement method.
Wingless Clamps Do not have any projections. Names usually begin with a W (ex. W7) Used during the two-step dental dam placement method. Clamps that begin with “A” have jaws that bend sharply downward toward the gingiva. Clamps without the “A” have jaws that are on a flat plane
Universal means that the same clamp may be placed on the same type of a tooth in the opposite quadrant.
Also called Cervical clamps or 9 and 9W. Designed to: Retract gingiva or facial surface gum tissue. Improves visibility for the restoration of a cervical class V cavity. Isolates anterior tooth during RCT procedures.
Bow Arched metal Jaw Expanding Forceps hole Forceps attach Jaw point s Contact tooth
Beaks Lock – sliding bar Never leave in locked position
Lubricate the patients lips. Inversion- tuck the dental dam around the tooth. Stabilizing cord- Wedgets Ligatures- Means to tie down, can use floss or tape. Single tooth isolation- A one hole punch.
Multiple tooth isolation 6 to 8 isolated teeth provides the most stability. Remember to include 1-2 teeth posterior to the tooth being treated.
Missing fragments Tears in the material Cut or ripped septa Always check the interproximals of all the teeth involved, and if you should discover cut or ripped septa in between the teeth, gently floss it out.
Tell the Patient what you’re about to do, and explain the steps. Select the proper clamp for the tooth that you’re going to anchor. Punch the desired holes for the arch that you are working on. Decide whether you’ll use a one step or two step procedure in placing your rubber and clamp. Using the forceps, place the clamp on the tooth. Then your frame. Then stretch your holes over the teeth and use a wedget to secure it. Floss the dental dam down in between the teeth, and use your greg 4/5 to invert the material. Dry the surface of the dental dam and prepare to begin procedure.
When preparing a tooth for a restoration often there are times we will need to have an artificial wall in place of the missing wall of surface.
Replaces the missing walls of the tooth. Restores natural contours to the tooth structure. Prevents excess materials from getting near the gum tissues (gingiva).
Tofflemire matrix- Used with a tofflemire retainer, to replace the walls of the prep. Automatrix- A preformed band that is placed around the tooth, and tightened with a tightening device. Clear Mylar strips- A clear strip that placed around the anterior teeth to hold and form the composite in the prep. Shell matrix- Premolar and molar size.
Tofflemire retainers are most commonly used when the posterior amalgams are placed ex. (Class ll) The larger circumference is the occlusal edge. The smaller circumference is the gingival edge. The center of the matrix band must be shaped in the proximal contact area so it will make contact with the tooth next to it.
Triangular or round wedges. Made of plastic or wood. Placed into the embrasure to position matrix band firmly against gingival margins of the preparation of the surface to be restored. They also slightly separate the teeth when necessary.
Placed with Hemostat Cotton Pliers Howe Pliers Placed from the lingual surface
The results of an improperly placed wedge and band- a. Overhang- excess restoration material extending beyond the preparation. b. Cupping- a gap of indention in the restoration.