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Rubber Dental Dams: What They Are and Why Dentists Use Them
Have you ever gone to the dentist and had them put a big rubber blanket over your mouth?
In 1864 (nearly 150 years ago), a New York City dentist by the name of S.C. Barnum invented the rubber dam for use in dentistry. He was looking for an easy way to isolate the particular teeth that he wanted to work on during procedures.
The rubber dam is simply a thin sheet of rubber that is clamped around the tooth or teeth that will be worked on. There are many advantages to using a rubber dam, some of which are listed below.
9 Advantages of Dental Rubber Dams
1 - The dentist is better able to visualize the tooth or teeth that he is repairing. By providing a contrasting background, the rubber dam makes the tooth easier to visualize. If the dentist can see better, chances are you'll get a better filling.
2 - It helps keep the tooth dry. Amalgam fillings aren't as good if they are used in a wet tooth. Bonding composite fillings to the tooth also doesn't work very well if it is wet. So rubber dams lend to the success of such procedures by keeping teeth dry.
3 - It protects the patient in several ways:
- It prevents the patient from breathing in the debris associated with drilling teeth.
- It protects the patient from irritating chemicals used in dentistry such as those used to disinfect a root canal or the acids used to etch teeth to prepare them to be filled with a composite resin filling
- It protects the patient's tongue and cheek from the dental drill
4 - It helps isolate the tooth from the bacteria in the mouth - this is especially important in a root canal treatment and when restoring very large cavities that are close to the pulp. It is important to keep the pulp shielded away from the many bacteria that live in your mouth.
5 - It can shorten the duration of a procedure. When using a rubber dam, there isn't a tongue constantly in the way and it is easier for the dentist to drill with no other distractions in the mouth visible. This increases the dentist's efficiency, which means you can leave the dental office sooner!
An interesting side effect of rubber dam is that they discourage the patient from talking. If the dentist wants to get a rubber dam on you as soon as you walk into the office, it could be a sign that you're pretty talkative!
6 - It can calm down a patient. With the rubber dam on, it may not feel like the dentist is really inside your mouth. It kind of adds a layer of separation between your body and the dentist. This is helpful for patients who become anxious during procedures.
7 - It can help in the administration of nitrous oxide (this is especially true with children ) since it forces the patient to primarily breathe through their nose.
8 - It protects the dentist and dental assistants from any diseases that the patient may have. Did you know that if a dentist drills on one of your teeth for 30 seconds, the dentist is exposed to as much bacteria as he or she would be if you sneezed right in their face? Here's the source for that fact. For more on how dental dams prevent the spread of infection from the dental patient to others, here's a study, another one, and yet another one.
9 - Rubber dams give you a higher quality tooth restoration. A study by Dr. Gordon Christsenen concluded that rubber dams allow the dentist to perform better, thus creating a higher-quality restored tooth in the end.
Why Some Dentists Don't Use Rubber Dams
Rubber dam clamps that can be used to anchor the dam around various teeth.
Some dentists think that rubber dams take too much time to place or that the patients dislike them. To be honest, it does take some time to put a rubber dam on a patient. You have to punch a few holes in the rubber dam for each tooth and put a clamp around the tooth to stabilize the dam. To make sure that the clamp doesn't fall down the patient's throat when you put it in, you have to wrap floss around it. Finally, you have to stretch the rubber dam around the clamp and floss it between all of the teeth that you want to be visible through the rubber dam.
At my dental school, they usually require us to put a rubber dam on our patients when we are doing fillings. After doing this so often, it has become easy to put a rubber dam on a patient. Plus, there is usually a period of a few minutes that the dentist has to wait for the anesthesia to begin working. Those few minutes are the perfect opportunity to put a rubber dam on, and as I mentioned above, using a rubber dam can shorten the duration of a procedure overall.
Do You Like Rubber Dams?
Have you ever had a rubber dam? Was it a good experience? Some patients I've talked to say they like it, and others find it uncomfortable.
If you have any questions or comments about rubber dams, please leave them below in the comments section.
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Hi, I'm Tom. I'm currently a 4th year dental student in the USA. I started this blog to help people take better care of their teeth. You can 
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I can't have a rubber dam in my mouth because they make me gag. I need a root canal but my dentist says that he has to put the rubber dam on my mouth. Is there a way to find a more relaxed dentist who would be willing to not use a rubber dam just this one time?
Hi Donovan - I've been getting this question a lot. The dentist does have an obligation to put the rubber dam on because it helps prevent contamination of the root canal with bacteria from your saliva.
The book we use at my school, Endodontics, Principles and Practice says "The use of the rubber dam in the United States is considered the standard of care. It is mandatory for legal considerations." Also, you don't want your dentist to drop some of the small tools they use for root canals down your throat. The rubber dam ensures your safety and ensures that the inside of the tooth doesn't get infected with bacteria from your mouth.
I would say that your best bet would be to get put under one of the many varying levels of sedation. Talk with your dentist to see what drug might work best for you. I hope that helps. Good luck with your root canal!
I had a root canal treatment done with a rubber dam. It wasn't by choice. It was never offered. I later had a cavity filled by a different dentist who used a dam, which I found to be more comfortable since it allowed me to swallow whenever I needed to without swallowing chemicals. However, I can understand that it may be uncomfortable for some.
It's not mandatory to use a dental dam or illegal to do it without. Plus, you must realize that patients may be allergic to the rubber so exceptions must be made.
Hi Cindy - That's too bad that they didn't use a rubber dam when doing your root canal. In the above comment, I didn't mean to say that it is illegal to not use the rubber dam when doing a root canal. What I meant is that if the dentist doesn't use a rubber dam when doing a root canal, then the dentist can be liable for anything bad that happens (for example, if the root canal fails or in more extreme cases if a root canal file gets dropped down the patient's throat!)
At my dental school, we always use some form of good isolation when doing root canals. We also have latex-free rubber dams available for those patients with allergies. Thanks for your insightful comments, Cindy!
My seven year old daughter just came back from an appointment with two dental students at our local dental school. She needed one filling and the student dentists were fumbling and fiddling so long with the dental dam that it was causing my daughter unnecessary discomfort. She started crying. They just told her, "You are doing great," but kept on trying to put on the damn dam. I told them to stop, that I did not want them to continue, and that I had would go to a dentist that either didn't use a dental dam or one that had more experience putting them on patients. My daughter says, "I couldn't breathe or swallow. It was very uncomfortable."
Hi Beatríz - Dental dams can be really awkward to put on, especially when you're just learning as a dental student! It's probably best that we get our practice on adults. Hopefully your daughter isn't too traumatized from that experience. I hope everything works out at her next appointment.
Thanks for your comment and for sharing your experience, Beatríz.
Is it possible that the clamp from the rubber dam can cause damage? One year ago I had an old filling replaced on the very last bottom tooth on the left side of my mouth. The clamp was attached to the bone at the back. It was incredibly painful. I have had nothing but problems since. The new filling had to be removed and a root canal performed. I have had ear pain which travels to the back of my neck as well as problems with my salivary gland. I am currently awaiting an ultrasound on my neck/ear area and an appointment with a specialist. The sad thing is that until this filling was replaced, I didn't have a single problem with my teeth.
Hi Vicki - I have heard of the rubber dam clamp causing damage to the gums around the tooth, but I don't know of any evidence linking it to ear pain. I'm sorry for the difficulty you've had. Hopefully you can get it figured out with the ultrasound.
I hope that helps. Let me know if you have any other questions, Vicki. Thanks for your comment!
I have had the dams 3times. I prefer them over not...feel much safer. Is it reasonable to have it for all dental work?
Also, I had RT done 7 years ago with retreatment 3 years ago. no. 30 had crown put on. No. 29 did not. Now it has cracked in the side almost to the middle with pain. Why would I have pain when it has been cleaned out? They say it needs crowned...would there be enough left to crown?
Is there also a sort of block they can put in your mouth to keep it open? I have TMD, and My chin quivers after about 10 minutes...like muscle spasms
Hi Cris -
Most fillings and root canals can be done with a dental dam in place.
You can still get pain on a tooth with a root canal because the ligament around the tooth is still alive. If the tooth is cracked, the ligament could be sensing the crack as pain.
Whether or not there is enough tooth left to crown would depend on how deep the crack is.
There are a few different varieties of mouth props that we can put in your mouth to keep you open. Ask your dentist about them, as I'm sure they have some on hand.
I hope that helps. Let me know if you have any other questions. Thanks for your comment, Cris!
Dear Vicki and Tom,
I recently had a cavity filled and a rubber dam was used. I had a lot of pain after that procedure and the same symptoms that Vicki describes in her post. My dentist referred me to an endodonist as he thought I might need a root canal. However, all the tests with the endodonist did not indicate a need for a root canal. The endodonist prescribed antibiotics to be taken for a week. I had immediate relief on taking the antibiotics. Now I have completed the prescribed week of antibiotics and I feel the pain gradually returning to my jaw, salviary gland and ear. I am wondering if Vicki would update us on her situation to see if she was able to find any relief to her situation or if you have any additional information regarding others who may have the same or similar symptoms. Thank you.
Hi there. I had a fissure sealant placed in my lower left 1st molar today. It was definitely an uncomfortable moment for me when the dentist placed the rubber dam clamp on my 2nd molar. The pressure exerted from the clamp which impinges the gingiva cervical to the tooth is still lingering. Yes, the rubber dam isolation sure has its benefits but as a patient, I sure as hell would not want to go through it again.
If there is anybody out there who can invent a rubber dam clamp that doesn't cause or reduce the pain and pressure, I hope you can market your product as soon as possible in the future!