Online Questionnaire-Based Study to Evaluate the Attitudes and Use of Rubber Dental Dams by Saudi Dental Practitioners

BACKGROUND A dental dam is a protective sheet with an aperture and is used to prevent the spread of infection during dental procedures. This study aimed to use a 2-part online questionnaire to evaluate the attitudes and use of rubber dental dams by 300 Saudi dental interns, general dental practitioners, residents, specialists, and consultants in prosthodontics, endodontics, and restorative dentistry. MATERIAL AND METHODS The 17-item validated questionnaire consisted of 5 questions on demographics, 2 on knowledge, 6 on attitudes, and 4 on perceptions. It was distributed through Google Forms. The chi-square test was used to determine the associations between the study variables and perception questions. RESULTS A total of 41.67% participants were specialists/consultants, among which 59.2% were in the prosthodontics specialty, 12.8% in endodontics, and 28% in restorative dentistry. Most participants (84.67%) stated the necessity of using rubber dams during post and core procedures. A total of 53.67% had received enough training for using rubber dams during their undergraduate/residency education. The majority of participants (41%) also preferred using rubber dams during the prefabricated post and core procedures, and 28.33% stated that the remaining tooth structure was one of the major reasons for not using rubber dams during the post and core procedures. CONCLUSIONS Workshops and hands-on training should be conducted among dental graduates to instill a positive attitude regarding the use of rubber dams.

Evaluation of pain response in children to the SoftClamp™ as an alternative to the metal rubber dam clamp: A randomized clinical trial

Background

The use of a rubber dam is more important than ever in today's COVID-19 era to limit cross infections. In children, the placement of the metal clamp to retain the rubber dam is perceived to be painful and often requiring a local anesthetic injection. This dissuades many clinicians from placing the rubber dam. Hence, this study evaluated the pain response of children to a SoftClamp™ compared to the conventional metal clamp.

Materials and Methods

This was a randomized controlled, equal allocation ratio, split-mouth clinical trial. Forty-two children aged between 8 and 12 years, having two permanent mandibular molars in need of sealants, were divided into Groups A and B (metal clamp and SoftClamp™, respectively). The pain response was recorded using both an objective and a subjective scale i.e., the Faces Legs Activity Cry Consolability (FLACC) scale and the Wong Baker Faces Pain Rating Scale (WBFPRS). The level of significance was set at 5% (P < 0.05). The pain response recorded from the WBFPRS and the FLACC scale for the metal and the SoftClamp™ were analyzed using the Wilcoxon signed rank test. The difference in pain response between genders and between two age groups (below and above 10 years of age) was analyzed using the Mann-Whitney U-test.

Results

The children reported mild discomfort to clamp placement in both the scales. The P values for the FLACC and WBFPRS scores comparing the pain response to the metal and SoftClamp™ were 0.311 and 0.149, respectively.

Conclusion

There was no significant difference in the pain response of children to both the clamps. Good rubber dam application practices in children through the use of behavior guidance and a proper topical anesthesia technique may play a far more important role regardless of the clamp used. But the SoftClamp™, with its more child friendly appearance could be a viable alternative to the metal clamp in children.

Minimally invasive technique for non-vital tooth bleaching using traditional Japanese paper

The purpose of this case report is to describe a minimally invasive technique for non-vital tooth bleaching using traditional Japanese paper, known as washi. Non-vital tooth bleaching with a mixture of sodium perborate and 30% hydrogen peroxide rolled in Japanese paper for a traumatically injured tooth, and in-office vital-tooth bleaching for the upper front six teeth and first premolars, were performed. Five-year follow-up showed satisfactory stability in the bleaching effects and did not show any problems in the traumatically injured tooth. The use of Japanese paper for non-vital tooth bleaching may minimize damage to discolored non-vital teeth.

The Use of a Dental Dam during Implant Placement and Pertinent Literature Review

In some regions, endodontists are increasingly placing implants in their daily practice. Endodontists have been proponents of the use of a dental dam during root canal treatment. It is beneficial to reduce the ingestion/aspiration of dental instruments during implant placement. It may be beneficial to reduce the bacterial load during implant placement procedures because biofilm formation on implants can lead to failure. A dental dam may help reduce the ingress of oral bacteria during implant placement. This case report demonstrates the use of a dental dam during the surgical placement of a dental implant. A literature review is presented that includes the history and rationale for the use of dental dams during various dental procedures. It also reviews the risks of aspirating/ingesting implant instruments. The use of a dental dam during implant placement offers certain operator conveniences, while also providing a safer field with less chance of instrument swallowing. It is expected that the technique offers a less bacteria-laden operating field due to the reduction in salivary ingress into the surgical site.