What is a rubber dam and why would your dentist want to use one?

What is a rubber dam?

A rubber dam or dental dam is a rectangular sheet of latex used by dentists, especially for root canal treatment, but also for things like tooth-coloured fillings. If you are allergic to latex, there are non-latex versions available. In dentist-speak, the rubber dam is also referred to as “a special raincoat for teeth”. This is what it looks like (the bit on the right is just packaging to make it look like you get loads):

Dental dams come in lots of different colours (green and blue are very popular options). Your dentist uses a hole puncher (similar to the one you use for paper) to make a hole in the sheet for the tooth to be treated. Most commonly, the rubber dam is used for root canal treatment, and only one hole is punched. The sheet may be marked with dots (with each dot representing a tooth) which make it easier to punch the hole in the right place.

Your dentist then puts the sheet onto a metal frame to make it easier to place it. A tiny clamp is placed around the tooth itself to prevent the rubber dam from slipping, and then the sheet with the hole in it is slipped around the clamp.

Why use a raincoat for your teeth?

  • To make a fashion statement
  • It stops bacteria in your saliva (spit) from splashing onto the tooth. This is very important for successful root canal treatment, because the bacteria in saliva can re-contaminate the tooth.
  • You don’t have to worry about your tongue getting in the way
  • You don’t get water (or, during root canal treatment, bleach) into your throat
  • It protects your throat from little bits of tooth debris
  • If you are prone to gagging, it helps to protect your gag reflex area from being triggered
  • It protects the lips and cheeks by keeping them out of the way
  • It keeps the tooth dry – very important nowadays because many materials need a dry clean environment for tooth-coloured fillings to bond properly
  • It gives you peace of mind that the dentist cannot accidentally drop the tiny files used to clean out the tooth (during root canal treatment) into your mouth
  • It can create a distance between yourself and the treatment: “Think of it as a ‘raincoat’ which you hide under while ‘your tooth’ not ‘you’ is being treated.”

Can I breathe through my mouth and swallow with the dental dam on?

Many people have a fear of the rubber dam because they are worried that they won’t be able to breathe and/or swallow. In the normal way (with the usual rubber dam design, where the sheet is put on a frame), there is lots of room around the sides, so you will be able to breathe through your mouth:

“The dam doesn’t completely cover the mouth, there’s plenty of room round the sides for air.

As for swallowing, I normally put in a little plastic suction tube below the dam that the patient can hold and move around to catch any saliva as it builds up.

I’ve had rubber dam used on me loads of times, it’s not as bad as you’d think, in fact I rather prefer having it on for fillings, there’s a lot less rubbish flying about in your mouth and you don’t have to worry about your tongue going into the cavity and stuff.” (Gordon Laurie, BDS)

There is another kind of dental dam called a quickdam. This design doesn’t have the metal frame, and it’s not so easy to breathe with that in place. However, the quickdam design is far less common.

With both designs, you can breathe through your nose. But if you have trouble breathing through your nose for any reason (e. g. having a cold, allergies, generally being a mouth breather, or feeling claustrophobic when breathing through your nose only), the quickdam design is not a great idea!

If your nose is blocked due to a cold or allergies, a medication like Sudafed spray, BreatheRight spray or an antihistamine may help. Ask your doctor or pharmacist.

 

What people on our forum have said about the rubber dam:

“Rack me up as someone who thinks that dams are great. I can swallow behind it, never had an issue breathing, and LOVE the fact that nothing hits the back of my mouth/throat — not water or toothy bits or filling stuff. I like not having to worry about if my tongue is getting in the way.”

“I did not find it suffocating at all, it is a bit fiddly for the dentist, she has to slide it between teeth either side, bit like sliding floss between the teeth, but it has to hold in there while r/c is done.If you have a nice dentist like mine she/he will be talking to you & distracting you while it is done, but once on, it did not feel stifling at all, it is just like putting a dust sheet down , before decorating, it is only there to collect any debris, and protect your other teeth. I sometimes suffer with anxiety & breathing but it honestly did not restrict my breathing at all :grin:. It was not at all claustrophobic.”

“The rubber dam is very helpful for my root canals. I have a problem where I gag really easily especially if my mouth gets dry/they keep the suction in there for too long. The dam pretty much isolated the problem teeth where they could do whatever they wanted to them and the entire rest of my mouth got left alone. It was very nice and I kind of forgot it was there. It wasn’t constricting at all for me. What they do is punch a hole in the rubber sheet and basically push that tooth through the rubber. Then they take some sort of frame thing that stretches out the rubber so that it’s not flopping around near your nose and mouth, which would be dangerous. I’m sure when you look at someone with a rubber dam it looks like it’s obstructing something but really it’s not at all. :)”

“he used a rubber dam (think that’s what its called) – it really helped me relax as it made it much easier to swallow and just “separate” myself from what was going on.”

“The dentist may put a dental dam on your tooth like they did me. All that is something to isolate the tooth that is being worked on from the rest of your teeth and it keeps dental instruments from going down your throat. It is kind of like a latex glove with little frame around it. It is nothing to be scared of. It may look scary, but it really isn’t after it is put on your tooth.”

“Last few months I have had 3 root canals done, I had no problem at all breathing through the rubber dam.”

“Here is a practical tip, you mentioned fear of suffocation. There is a very useful dental device called “rubber dam”. It isolates the treated tooth from the rest of the mouth, so no water nor instruments are touching you. In addition, it gives a feeling of distance between yourself and treatment.”

What can I do if I’m worried about not being able to breathe or swallow, or about gagging?

  • Let your dentist know about your concern. S/he can then make sure that the dental dam is set up in such a way that you can breathe comfortably.
  • Use a little suction tube which you can hold yourself to suck up any saliva as it builds up. You won’t feel as if you’re constantly having to swallow because you’re drowning in your saliva.
  • You may also want to practice breathing and swallowing with the dam on first, before any actual treatment. This practice can be done without using the little clamp, so you don’t need local anaesthetic first.
  • You can practice using the little suction tube during this rehearsal.
  • It can also help if you use a handheld mirror during the rehearsal (to see what is going on), while taking some deep breaths.

The following video shows how to do a rubber dam rehearsal – unfortunately, it is rather old and somewhat authoritarian – not as warm and empathetic as we have come to expect. But it does show the basic technique:

Rubber Dam Rehearsal (WMV file)

What can I do if I feel very claustrophobic when a dental dam is used?

You could try practicing with it (see above), or look into sedation options. If you are claustrophobic of the dental dam, you may also find it difficult to use the nitrous oxide mask for laughing gas (although some people dislike only one and not the other). Oral sedation and especially IV sedation can help.