Dental dam for fillings - general practice?

[The1701]

I'm based in the UK and am about to have a tooth re-filled. I've read about the use of a dental dam and am a little worried about it as I don't think I could do it. Just wondered if it is a "must" for fillings or would I be able to say "no way" without causing too much bother?

 

[carole]

It is unusual for dentists to use a dental dam when doing fillings. But you can refuse to allow them to use one for a filling. I would prefer that they did use one for fillings as you don't have to worry about bits in your mouth.

What is it you fear from a dental dam ?

 

[Spike 1969]

I agree with Carole

For Root Fillings its usual to use a Dental Dam but not for a Normal filling. I actually prefer a Dental Dam (now I've got used to one) as it separates the tooth being worked on from the rest of my mouth, it als stops stuff from going in your mouth as Carole says.

cheers

 

[gentledental]

I'm based in the UK and am about to have a tooth re-filled. I've read about the use of a dental dam and am a little worried about it as I don't think I could do it. Just wondered if it is a "must" for fillings or would I be able to say "no way" without causing too much bother?

Hello, any dentist who uses a dental dam during treatment is a sign of quality. You don't need it to do a filling but your dentist is going that extra mile to provide quality treatment and that is why it has been suggested to you. I would recommend that this is used because it would help protect you and the dentist. The dental dam keeps the tooth dry and that means you will have optimum bond strength which is extremely important for a long-term filling with a good life expectancy.

Once you are all numbed up, the dam is like a rubber glove and fits over the tooth. You can close and move your jaw whenever you want, breathe through it and swallow.
What other benefits is there to you:
1)Your cheeks and tongue or protected from the drill and chemicals. All soft tissues are retracted and that means the dentist won't be distracted by that nosey tongue of yours and can focus on doing a proper filling on that tooth.
2)Bits of tooth, water and chemicals do not fall into the back of your throat. Do you want to be bathed in bits of rotten tooth when the dentist is drilling?
3)Keeps the tooth dry and preventing saliva and blood from going on the tooth. Things don't stick when moist.
4)Your bacteria from aerosol does not go everywhere, which minimises contamination to your dentist.

www.kidsgrovedental.com

 

[Leftie]

Have to say I was dreading it for my RCT but now if I was given the choice I would have it all the time. Much better experience and by the comment above it improves it for the Dentist as well!

 

[JJones86]

Hi.

I've never had a dental dam for fillings before and I've had many over the years. Even my most recent filling a couple of weeks ago they didn't use one.

I'm aware that I may be common practice some places, but not all dentists use dental dams for fillings.

The only times I've had a dental dam is for root canal treatments. I don't like them due to past experience, but I'm aware that they have many benefits to using them. I don't prefer them because they make me feel claustrophobic, but that's just me.

Maybe your dentist will let you try it and if you don't like it they can take it off. It can't hurt to ask.

JJ

 

[The1701]

Thank you all for the really helpful answers, I must admit I am not sure if one will be required or not, I'm having a filling removed and replaced - there is an image of the tooth here http://www.dentalfearcentral.org/forum/showthread.php?28068-Hit-the-panic-button-and-there-s-still-a-week-to-go/page4 I think it is quite a deep filling, the tooth is dead.

In answer to Carole's query

What is it you fear from a dental dam ?

My main fear is the smell of it I notice it goes right under the nose. At the moment I hold my breath so as not to smell the latex gloves but if I've got that right under my nose I don't know what I would do in order to cope.

I've also read a number of posts from people with a similar history to mine in terms of the root cause of the dental phobia and they all mention having problems with the dam eg the post here http://www.dentalfearcentral.org/fears/abuse-survivors/

I don't honestly know how I would react to it. Perhaps if the dentist where to do as SSOCEA helpfully suggests and let me try it before deciding to continue I would be a bit easier about it. Would that be possible do you think?

 

[gentledental]

Thank you all for the really helpful answers, I must admit I am not sure if one will be required or not, I'm having a filling removed and replaced - there is an image of the tooth here http://www.dentalfearcentral.org/forum/showthread.php?28068-Hit-the-panic-button-and-there-s-still-a-week-to-go/page4 I think it is quite a deep filling, the tooth is dead.

In answer to Carole's query

My main fear is the smell of it I notice it goes right under the nose. At the moment I hold my breath so as not to smell the latex gloves but if I've got that right under my nose I don't know what I would do in order to cope.

I've also read a number of posts from people with a similar history to mine in terms of the root cause of the dental phobia and they all mention having problems with the dam eg the post here http://www.dentalfearcentral.org/fears/abuse-survivors/

I don't honestly know how I would react to it. Perhaps if the dentist where to do as SSOCEA helpfully suggests and let me try it before deciding to continue I would be a bit easier about it. Would that be possible do you think?

It doesn't go under the nose. It's supposed to fit over the tooth only. Rubber dam tends to be scented so they don't all smell like rubber gloves

 

[carole]

The rubber dams do go over the tooth but as a patient it feels like it is right under your nose. I couldn't smell the rubber when I had one on. They put it over my tooth on a frame then they cut the bit that goes over the top lip and it is that bit that feels like it is under your nose which it is really.

The1701 maybe when you had one on before they didn't cut it to fit under your nose enough. I don't see any reason why they need to use one for a filling. As you have to give your consent to have one put on then say you want the filling but you do not want the dam on and explain why. If they still would like you to give it a go then if you wish you can agree to try it on the condition that they will remove it if and as soon as you ask.

They can be removed in a second by flicking something on the frame, it will take a couple of seconds to then remove the rubber from around your tooth.

 

[The1701]

The rubber dams do go over the tooth but as a patient it feels like it is right under your nose. I couldn't smell the rubber when I had one on. They put it over my tooth on a frame then they cut the bit that goes over the top lip and it is that bit that feels like it is under your nose which it is really.

The1701 maybe when you had one on before they didn't cut it to fit under your nose enough. I don't see any reason why they need to use one for a filling. As you have to give your consent to have one put on then say you want the filling but you do not want the dam on and explain why. If they still would like you to give it a go then if you wish you can agree to try it on the condition that they will remove it if and as soon as you ask.

They can be removed in a second by flicking something on the frame, it will take a couple of seconds to then remove the rubber from around your tooth.

Thanks Gentle Dental & Carole, I haven't actually had one fitted before. I'm ashamed to say that I did the one thing you should never do and google image searched them when I read about them on the FAQ page. I took one look at them and felt very sick.

The problem for me is latex - I am not allergic to it but the smell/feel of it will cause me to feel nauseous. My brain thinks, "Oh no, I remember that smell/sensation, this is not good, this is very bad, I remember what used to happen next and I need to get myself out of here NOW".

At present I can cope with the gloves as long as I don't smell them. Having a piece of latex in my mouth for any length of time is going to be a huge issue. I am treading a fine line between trying to get on with a normal life and letting go of avoidance behaviours but at the same time not exposing myself to too many things that trigger bad memories. To be honest I am struggling as it is during dental appointments but that could be a bit of a tipping point.

Out of interest if a patient is allergic to latex is there an alternative fabric? And would they have that to hand?

 

[carole]

Yes and you dentist will probably have the alternative, some nurses are allergic to latex so they use gloves made from something else. I forget what the others are made of but I know you can easily get the other thing.

I still don't understand what your dentist wants to use a dental dam for to do just a filling.

You really need to have a word with them and explain that you really don't want the dam on

 

[JJones86]

Hi.

Yes, there are alternative materials to latex. It's become more common now for dentists and medical doctors to use non-latex materials, although not all do.

I know from personal experience as I'm allergic to latex that there are alternatives to it. I get a bad rash and get really warm, when I come in contact with latex.

I'm a medical assistant, so in both my personal and professional life I avoid latex at all costs. At work I use Nitrile gloves. I think many offices use this also. I'm not sure of the other alternatives off hand. I'd have to do some research, but I think there's at least one other material they can use.

You can ask the office what latex alternatives they have available, but the Nitrile is easy to spot because it's typically blue in color.

Just tell your doctor that you're not comfortable with latex and it should be no problem for them to change to something non-latex when they're working with you.

Nowadays with electronic medical records, the office will put you allergy into the computer and the computer will notify them when they open your chart, to remind them of the allergy.

JJ

 

[The1701]

Thank you, that's really helpful and good to know. It might be easier if it was made of something else. Now I just need to find the courage to put my hand up and say something.

 

[Spike 1969]

I found it a little weird to begin with, once I realised that I could breathe with it in place, it was fine; my dentist snipped it back a little so it didn't cover my nose. I was worried that he might snip a piece of my nose but it was perfect ( it's a big target to avoid )

to be honest I would be happy having one for fillings, it keeps debris out of the mouth and the tooth dry which is important for Composite fillings. it just made it feel. Like it was just that tooth that was being worked on.

 

[carole]

I would rather have a dam on for fillings too, I also like them. You can breath and swallow as normal

 

[The1701]

Thanks folks, I honestly think I could handle it as long as it isn't latex, I know I will totally freak out if I feel that stuff in my mouth. Still not sure about the breathing aspect, I know you can breathe but it's whether or not my panic stricken brain would know too that would be the problem.

Either way if the dentist suggests it I will give it a go as gentledental has pointed out good reasons for using it. I'm still apprehensive though knowing it has set off flashbacks for other people but I don't know their current situations, I haven't had one for about 18 years now after having trauma therapy. I still have anxiety and problems with hypervigilence in certain situations but no flashbacks.

Thank you for your input, only a few days to go now and although I'm still nervous I'm calmer than I was a week ago. Almost down to the "normal" level of nerves for me and my sleep has improved the last couple of nights too so big thank you to you all.