1. Isolation techniques
Dr Heba Mohd Elkhodary

2. Objectives List the advantages and indications for use of rubber dam.
Use the appropriate rubber dam instrumentation
and application for the child patient.

3. The objective of isolation is to provide
A dry, clean operating
field.
Access and visibility
Improved properties
of dental materials
Protection of the
patient and operator
Improved operating
efficiently.

4. Different methods of isolation:
Rubber dam
High volume evacuator
Absorbents
Retraction cord

5. Mouth prop
Cotton rolls and holders
+ saliva ejector

6. RUBBER DAM
It is used to define the operating field by isolating one or more teeth from the oral environment. The dam eliminates saliva from the operating site and retracts the soft tissue.

7. Advantages of Rubber dam
Clean, dry operating field. Clear access and visibility. Improves properties of dental materials. Protection of the patient and operator. Improves operating efficiency. Prevents aspiration of fluids used. Prevents accidental ingestion of files/reamers. Prevents injury to soft tissue such as tongue, cheek, gingival. Reduced patients conversation.

8. Disadvantages of Rubber dam
- Time consumption
- Patient objection
Certain conditions may preclude the use of rubber dam:
- Incompletely erupted teeth.
-Third molar isolation
-Extremely mal-positioned teeth.
-People suffering from asthma, mouth breathers.

9. Precautions to be taken with using Rubber Dam:
Patient must not be a mouth breather.
Clamps used must be tightly
secured in place and a floss
thread must be tied to retrieve
the clamp if ingested or aspirated.
The dam should be checked not to cover the nostril.
Lips should be lubricated to provide drying.
The clamp must not impinge on the gingival nor traumatize the adjacent teeth.

10. Armamentarium Rubber dam sheet clamps Rubber dam forceps
Rubber dam punch
Rubber dam template
Rubber dam holder frame
Scissor

11. made of latex material : Size – 5 x 5 inches (Pediatric purpose)
Rubber dam material
made of latex material :
Size – 5 x 5 inches (Pediatric purpose)
6 x 6 inches (Adult size)
Thickness – Thin (0.006”)
Medium (0.008”)
Heavy (0.010”)
Extra-heavy (0.012”)
Special heavy (0.014”)
Color – green, blue, black, brown.
It has a dull and bright surface ??
The dull surface should face the occlusal aspect as it reflects less light.
Thicker material resists tear
The thinner ones pass through the tight proximal contact easily.

12. Clamps: 
used to anchor the dam
to the posterior tooth to
be isolated.
Different sizes are available for different teeth. 

13. Rubber dam forceps
Rubber dam punch

14. Rubber dam template
Rubber dam holder/frame

15. Placement of rubber dam
Steps involved are:
Obtaining anesthesia.
Mark the punch holes – using
the template.
Make punch holes using rubber dam punch.
Selection of the correct clamp.
Rubber dam placement (one of the 3 methods):
- Clamp is placed first on the tooth followed by the sheet
- The sheet is placed first followed by the clamp
- Both the clamp and the sheet are placed simultaneously;
this is possible when winged clamp is being used. 

16. Thank you