Hi all, just a little apology blog that I am pretty bogged down with work at the moment so blog posts may be a little thin on the ground for the next few weeks. Luckily I have lined up a guest blogs and a new contributor to fill the void.
Today was just another regular day for me in practice except I’m now in week 3 of my rubber dam challenge to do every restoration under quadrant dam. So far I have had one failure but otherwise I’m doing OK, bit stressful at times but I’m amazingly keeping to appointment times. This picture is just a sample where I have placed the dam then prepped the 26 occlusal cavity for restoration. For those who haven’t tried it placing the dam before preparation is awesome, saves so much time and really improves your cavities!
It turned out I used composite to restore but I’m trying to do the amalgams the same way now too. It is a lot harder than doing things the way I know but there is a satisfying feeling that I am developing a skill that I can use whenever I want and should improve my work (I believe anyway). I’ve also had some really good feedback from patients about the technique which more than anything else spurs me on.
I’ll go through some tips on dam placing when I get a chance (and when I have some) but just thought it’d be cool to show my slow progress and hopefully show that it is possible to change the way you work even if it’s hard at first. See here for an audio blog on the subject last week.
In other news the inci-dental blog was voted in the 50 best blogs in Dental Sphere my nursing schools.net. See the link here it includes some other great blogs out there too. Thanks go to everyone who reads the blog and even more the people who contribute to the site!
That’s all for just the second
Hope everyone is enjoying the sun
Chris
#1 by Pete Buchan at April 14th, 2010
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I only use dam when I cannot get proper isolation with regular non dam techniques…
Upper six occlusal should be easy with no dam? I understand the pict is for illustration purposes.
There are drawbacks to dam… and dam is really good.
#2 by Toothhater at April 14th, 2010
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Great resource for an aspiring dentist like myself, much appreciated.
Toothhater´s last blog ..Toothless Twins
#3 by Jonathan Moulding at April 14th, 2010
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I use dam for endo and composite especially posterior composite, I think this affords a better access, better moisture control, improved patient comfort.
Just a question why quadrant isolation for a single occlusal composite, I would of done single or two tooth isolation, was this for practice only.
Regards Jon
http://www.spicerroaddentalpractice.com or my blog at http://jonathansbloglifeanddentistrycombined.blogspot.com/
#4 by ChrisO'C at April 14th, 2010
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Pete and Jon,
I can probably answer both of these at once.
I used to do single or two teeth isolation but I find that actually bringing the whole quadrant in takes about the same length of time but allows the dam to lie far flatter and makes securing it and inverting far easier (but yes I also want to be better at it for sectional matrix purposes etc).
Also the reason I’m using the dam more is not really for moisture control more patient comfort visablity and so that I don’t have to keep retracting tissues with my left hand. I think the retraction is probably the most important element hence full quadrant.
I find it more ergonomic, better for loupes, quicker and better for the patient. Yes I could hapily do this restoration without a dam but I would be uncomfortable and rushed. When the dam is on like this it just becomes a pleasure to do the work.
I’m finding a I get quicker at placing them that I like it more and more and can see me damming the quadrant for endo now too. Just so I can easily restore after obturation and also get that retracted comfortable environment to work in without the dam lifting up.
I’ll probably use dam more selectively once I’m up to speed with it but at the moment I’m really enjoying working with it and developing the skill.
I would give the quadrant a bash Jon and see if you prefer it! Let me know
Chris
#5 by Ben at April 15th, 2010
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Nice blog. Always good to see others perspectives on dentistry!
#6 by matt at April 15th, 2010
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Love the dam. Keep it up, you put me to shame!
#7 by Kent Howell at April 23rd, 2010
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Hello,
I stumbled across your blog from other dental technology blogs and would like to make you and your readers aware of a new resource on the web for identification of dental implants by radiograph. Dr. Lavine from the digitaldentist.com has recently blogged about our new website we created for identifying dental implants by radiograph for dentists all over the world. Currently we have almost 200 implants in our database and it is growing rapidly. Our site is FREE and we have been featured in numerous other blogs and forums all over the world. We would love for you to visit our site and if you like what you see, blog about us to your readers to help spread the word. You can go to whatimplantisthat.com and see what you think. We look forward to hearing from you.
Thanks!
Kent Howell DMD
#8 by implants at May 25th, 2010
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a great blog, you’ve inspired me to consider a blog for my practice.
#9 by Gary Grimm at June 11th, 2010
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I love the dental dam. I use it for everything, I would use it for prophys if I could.
#10 by Sahir Kara at June 24th, 2010
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Chris,
Keep up the good work! Am somewhat of a lurker but am always impressed with your conscientiousness in doing things “right” .. and by that I don’t just mean evidence-based, but for the benefit of us and our patients too. Ultimately I’m a total sad-o for reading a blog about rubber dam after a tiring day of nowt but teeth, but your work’s an inspiration to fellow young dentists, myself included.
With the vomit-inducing brown-nosing over, a couple of questions for you:
1. Let’s face it, the suggestion that “I’m going to clamp this enormous sheet of purple latex (or non-latex) over your half your mouth, Mrs. Jones” doesn’t always elicit the most enthused response.
Don’t get me wrong, I very VERY rarely have patients complain that they hate it (a lot of their opinion, I’ve come to realise, stems from your own attitude towards it), but how do you approach it in the first place? Am I right in saying that in the majority of cases, people have never seen or heard of the thing before?
2. I’m presuming you give LA, mark ICP and excursions before dam.. but do you have any tips occlusion-wise? Or do you just take the dam off and adjust as required?
Cheers, Sahir
#11 by Lucy Daniels at August 3rd, 2010
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I really love your blog! Dentist Office Blog is another great source!