The Rubber Dam

Photo of Gordon Laurie BDS
Written by the Dental Fear Central Web Team and reviewed by Gordon Laurie BDS
Last updated on January 17, 2021

What is a rubber dam?

A rubber dam or dental dam is a thin sheet of latex or latex-free material, with holes in it for one or more teeth to slip through. It isolates the tooth or teeth that need treatment from the rest of the mouth. This is what it looks like:

This is what a rubber dam looks like

Dental dams come in lots of different colours, such as green, blue, or purple.

If you are allergic to latex or if you the smell of latex reminds you of bad experiences, ask your dentist to use a non-latex version.

What do you use a dental dam for?

  • A dental dam should always be used for root canal treatment 12
  • Many other dental procedures, especially when materials are used that need a dry environment to bond properly

How is it put on?

Your dentist or their assistant uses a hole punch to make a hole in the sheet for the tooth (or teeth) they want to isolate.

Next, your dentist puts a small clamp around the tooth (of course, you are numbed up before the clamp goes on). Then, your dentist slips the sheet around the clamp. Lastly, they attach the sheet to a metal or plastic frame to keep it stretched. Now you’re all set – the rubber dam will shield your mouth from any water or instruments. Only the tooth or teeth that your dentist works on are visible.

Your dentist may use a different order or technique – depending on their personal preferences and the tooth (or teeth) in question.

Why use a rubber dam?

  • It stops bacteria in your saliva from splashing onto the tooth. This is important for successful root canal treatment because the bacteria in saliva can re-contaminate the tooth.
  • You can’t get water, debris, or anything else into your throat. Also, the tiny files used to clean out the tooth during root canal treatment can’t drop into your mouth.
  • It keeps the tooth dry. Many modern dental materials need a dry, clean environment to bond properly.
  • It protects the tongue, lips, cheeks by keeping them out of the way.
  • If you’re prone to gagging, it can protect your gag reflex area.
  • 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. – from our message boards

Like a raincoat, the rubber dam protects you from water and splashes.

Can I breathe through my mouth with the rubber dam on?

Many people worry that they won’t be able to breathe. With the usual dental dam design (a sheet on a frame), there tends to be lots of room around the sides. So you should be able to breathe through your mouth:

The dam doesn’t completely cover the mouth, there’s plenty of room around 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

If you have trouble breathing through your nose, a medication like Sudafed spray or BreatheRight spray may help.

Importantly, let your dentist know about your concerns. They can then place the dental dam in such a way that you can breathe comfortably.

Breathing with the Quick Dam

There is another type of dental dam (the OptraDam, or quick dam). This type of dental dam doesn’t have the metal frame and creates a seal around your lips.

The quick dam design may prove challenging when you can’t breathe through your nose.

Luckily, there is an easy solution. The dentist can cut a hole into the rubber dam in an out-of-the-way location. From OptraDam’s instruction manual: “In patients with impeded nose respiration or if suction is desired, a hole may be cut into the latex bag in the palatal region using scissors”.

Can I swallow with the rubber dam on?

Swallowing with your mouth open can be a bit tricky. Sometimes it’s easier just to prevent the need for swallowing. The rubber dam is actually great for this because it prevents water spray from going down your throat in the first place.

Some people on our forum have commented that they actually find swallowing easier with the rubber dam on.

Still, you may find that your own saliva is pooling in your throat and that you find it difficult to swallow. If that’s the case, ask your dentist for a little suction tube (called a saliva ejector) which you can hold yourself to suck up any saliva as it builds up.

What can I do if I feel very claustrophobic?

You could try practising with the rubber dam (see below) or look into sedation options. If you are claustrophobic of things that cover your mouth, you may also find it difficult to use the mask for laughing gas sedation. Having said that, some people dislike only one and not the other. Oral sedation and especially IV sedation can help.

Dental dam practice

You may want to practice breathing and swallowing with the dam on, before any actual treatment. There’s no need to use a clamp for practising, so you don’t need local anaesthetic for this.

You can also practise using the suction tube as part of the rehearsal if you’re concerned about swallowing. And some people like to use a handheld mirror during the rehearsal, to see what is happening.

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.

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.

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. If you have a nice dentist like mine, they 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 and breathing, but it honestly did not restrict my breathing at all. It was not at all claustrophobic.

The dentist may put a dental dam on your tooth as they did for 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 a little frame around it. It may look scary, but it really isn’t after it is put on your tooth.

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.

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Sources of Information

  1. European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of EndodontologyInt Endod J 2006; 39: 921–930.[]
  2. Dental Dams – American Association of Endodontists Position Statement, Reaffirmed as of 2017.[]