random curiosity

[ratcreature]

When I had some dental work not too long ago (still awaiting the bill for my copayment for the new crown :( ), I noticed once again that my dentist does not use "dental dams". In fact despite having had fillings (both amalgam back in the day and composite fillings once they became available), root canals, and surgery for root tip resections with two dentists and two different dental surgeons (granted not a large sample), I've never experienced anyone using a dental dam for anything.

In fact though I have seen pictures of them online, I can't quite imagine them how they would work in practice. I read that they are supposed to keep the work area clean and dry, especially for the composite fillings, but my dentist does that with cotton wads and suction, and I've never had a composite filling fall out or anything like that, and while once or twice I've had a fixed tooth rot again, many of my composite fillings are by now lasting longer than the "average" lifetime they are said to have, so I don't think my dentist's work is particularly shoddy (though I do sometimes wonder about his approach to hygiene, because while he does wear gloves for drilling and such, he doesn't always for just checking, even though his hand is in my mouth then too).

Anyway, I have been wondering how common the use of dental dams in dental work really is, hence this poll.

Poll #13275 dental dams?

Open to: Registered Users, detailed results viewable to: All, participants: 30

View Respondents

Have you had dentists use dental dams while working on your teeth?

View Answers

Regularly.
5 (16.7%)

Occasionally.
8 (26.7%)

Never.
17 (56.7%)

Comments

[lilacsigil]

I say "regularly" but that's in the last 3-4 years, and I don't know whether it's because this is a new method or because I'd never had anything complex done before that, just a few basic fillings. Thyroid hormone management can be bad for your teeth, it turns out!

[ratcreature]

I don't think it is new, but maybe they adjusted the recommendations for best practice or something like that more recently?

[mllesatine]

Never seen them. I checked Wiki for a pic and I would probably forbid my dentist from using them since they look like you can choke with them. If nobody is sucking out the saliva when you get a filling how are you supposed to keep your head still?

[ratcreature]

I don't know. Like I said, I can't quite imagine how they work in practice either. I guess people must somehow swallow the saliva? Or maybe the suction thing is put under it in a fixed place? I have no idea. And obviously you need a clear nose for this kind of contraption to be viable. With my last dentist visits it would have been impossible, what with me having constant respiratory infections pretty much all winter, including during dentist visits.

[krait]

THe only time a dentist used one on me, I don't remember having any difficulty with swallowing (I even did a fair amount of talking, enough for the dentist to have made a wry comment), so I don't think they're that difficult to work one's tongue around?

[ratcreature]

I guess it must depend also on how far back the tooth is they are working on. I mean, if they worked on a front tooth, the latex would leave pretty much all your mouth free I imagine, but if it was the last back tooth, it would stretch far into your mouth.

[gnatkip]

Oh I forgot! I had some dental work just after you posted this, and they used a dam for the first time ever. It was on a back tooth, and I didn't have trouble breathing or swallowing, but then there was a period of time in the middle, when they removed the frame and left to do whatever mystical thing dentists do in the back room, and that part was pretty uncomfortable, with it hanging out of my mouth like I'd been trying to eat a deflated balloon. Anyway, all I could think was, I cannot believe this; I have got to tell ratcreature.

[ratcreature]

Heh. And I'm glad to hear about it for broader impressions of this practice. Well at least you had thoughts of posting about your dentist adventures to distract you from the rubber in your mouth!

[acari]

I had to google to figure out what dental dams are and I have experience with normal fillings, crowns and oral surgery.

[ratcreature]

I first encountered them in English-language books about lesbian sex (as a teenager pre-internet) and hence I long knew that they were these latex squares, but I just couldn't imagine what they could possibly be used for in dental practice, but never wondered enough to tediously research dental stuff. Then post-internet I eventually looked up pictures, but I still can't quite envision how it this all works in practice.

I suspect they are just not often used in Germany, because I'd never heard of them from others either (in the context of dentists), even though the German wikipedia page claims they are supposed to be in the best practice guidelines here too for certain things.

[acari]

Yeah, the first goggle hits were sex related.

[reginagiraffe]

Now that you mention it, the dentists I had as a kid/young adult used them frequently while my current dentist doesn't use them at all. It might just be a "what works best for them" sort of thing.

[ratcreature]

Could be. I suspect there are regional differences as well, because I think they are more common in the US than in Germany, but I'm not sure.

[sholio]

I had figured they'd simply become more common over the last ten years or so -- I never remember encountering them in the 80s or early 90s, but I have always had dams used in the last few years. However, I've had a number of different dentists over the years and my current dental office is very "up to date" with everything (it seems like every time I have a cleaning, they have new hygiene recommendations based on the most recent dental conference they went to) so that might have something to do with it too.

The good thing about the dam (for me as a patient) is that it keeps all of the chemicals from coming into contact with my mouth, but the bad thing is that sometimes I kind of feel like I'm drowning. Usually when the dam is in, they either have the suction thing left permanently in the corner of your mouth while they're working, or the dental assistant suctions you periodically. But it's hard to signal when you need it, because they can't see that you need it and you can't talk at all. (But I've also had that problem with regular dental work, so maybe I've just had inattentive dentists ...)

The other problem with it is that the metal frame that holds the dam in place is kind of painful, and my jaws are often sore afterwards because you can't really shift your jaw or half-close your mouth to rest the muscles like you can otherwise.

[ratcreature]

My dentist usually reacts promptly to sounds, like to see whether the local was enough and in the right place.

I'd been wondering whether these don't irritate the gums with the contraption and the latex around the tooth. For me gum irritation is a major cause for pain after dental work. I once had a filling done and it hurt a long time, but there wasn't anything wrong with the tooth, my gums were just irritated so much, because the caries had been relatively low on the side, iirc, so the dentist had to bother my gums a lot. And not just the gums, the whole skin in my mouth is very touchy.

[brownbetty]

My dentists have often just handed me the suction thing to do with as I liked, which is an approach I really like.

[sholio]

Oh, that seems like a very sensible solution! Now that I think about it, I've had that done once or twice, but not at all commonly.

[basingstoke]

I had one used for the first time on my root canal revision two weeks ago. They somehow hooked it under the tooth they were working on to keep any crap from falling down my throat. Given that they were working on a possibly infected area, I was pleased enough.

I managed to swallow behind the thing so it wasn't a problem, but it also wasn't terribly comfortable.

[krait]

Ha! That was *exactly* when I encountered a dental dam - root canal on on an upper molar, so gunk couldn't fall downward. (Not infected gunk, that I know of, just gunk. But yeah.)

[ratcreature]

Huh. I've had several root canals, some in my upper jaw, and even one broken tooth in the upper jaw (it had a large filling, I bit on a hard bread, it broke apart and crumbled -- quite awful pain, it now has a crown), and there never has anything fallen down my throat. I think (of course I can only guess what exactly they are doing in my mouth), in these situations the assistant had the suction tube near the work area, so anything was sucked into it, rather than falling simply down.

[krait]

By "occasionally" I meant, quite specifically, once. (That I recall, naturally. If they were also used in the extraction of my wisdom teeth, well, I was unconscious at the time and have no memory of the procedure.)

[brownbetty]

I have had a couple time when I had super-cheap dental work from the dental students at the school. I suspect it's one of those things taught to the young people as 'best practice' and which old hands feel is an optional frill.

[ratcreature]

That could be. My dentist is older. I mean, when I was a teenager the practice was his father's and he had only been working there a little while, and then eventually took over fully. And it's now two decades later. The first dentist I went to as a child was an old school sadist (he didn't believe in locals for simple drilling, on the theory that some pain might teach you to brush your teeth better - I think the only reason I don't have dentist trauma is that my mother always let me choose a comic she'd buy me as reward).

[jimandblair.livejournal.com]

I can can't comment on using a dental dam to prevent infection damage to other teeth during a procedure (I just looked on wikipedia to find out why they would be used) because I only have a few filings, thankfully. And they were put in a long time ago.

However, if my dentist wasn't wearing surgical gloves, I would refuse to let her treat me.

[ratcreature]

Yeah, it does seem a bit lax.

Well, on the upside my usual visits are dental cleanings, and the assistant who works on my teeth for that then always wears gloves and a mask, because obviously gums can bleed quite a bit, and then there is spatter from the cleaning brushes and such. But for my crown for example while my dentist wore gloves when he ground down the tooth for the fitting and while he was drilling and such, but once all that was finished and he came back at the end to just put on the temporary crown, he didn't. I found that odd and thought about asking (especially since I told him I was sick with a fewer when I declined the handshake at the beginning), but when I saw him gloveless I was in the middle of still having been told to keep my mouth open, and then afterward I was relieved the over two hours of dental visit was over, and I had this fewer with the flu that day and felt horrible and not up to starting anything. Somehow it's always something.

I mean, I keep wanting to at least address it because I notice that he's not meticulous to always wear gloves, but then I tend to forget, or it seems really awkward or something. Because in general I quite like my dentist, and am satisfied with his work. OTOH of course I don't exactly fancy catching hepatitis or something from some hand transfer either.

[jimandblair.livejournal.com]

I remember when I was little and our dentist started using gloves. No word of a lie -- this guy looked like Death (he didn't have a scythe, but I could easily imagine him with one). My mum was quite offended by the fact he wore gloves because she was healthy. I remember saying, "it's not for his protection, mum, it's for yours."

it's your safety, insist on gloves.

[ratcreature]

Easy in theory, a bit more complicated in practice, because socially it feels quite impossible to open with it like "BTW, I remember last time I was here six months ago you didn't wear gloves consistently, could you always wear them this time?" when I hadn't said anything then, and then in the middle of the dentist visits if a new incident pops up, talking is often hard. But you are right, I really should, even if it interrupts something.