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25 February 2021

Patients’ attitude to rubber dam use: a questionnaire survey

Francesco De Angelis, Camillo D’Arcangelo, Francesca Chella, Maurizio D’Amario, Mirco Vadini


The introduction of the rubber dam (RD) dates back more than 150 years ago and today it is still considered a fundamental element of the "standard of care" in modern dentistry. Despite obvious advantages of using rubber dam in daily dental treatments, the percentage of dentists who steadily use it during restorative and endodontic procedures is still low. The reasons generally provided for not using RD include: fear for patient disapproval, treatment time extended, treatment cost increased, questionable clinical need. On these bases, the main purpose of the present study was to investigate patient opinion towards RD, to evaluate the time required for  the dam  placement (PT) and to estimate its influence on the overall treatment time. Other purposes were to investigate the percentage of patients who already knew and experienced RD in previous treatments, and to compare the mean time required by differently experienced operators to perform dental treatments using RD.

Materials and Methods: In full accordance with the World Medical Association Declaration of Helsinki, 200 questionnaires were distributed among patients treated either by specialized private practitioners or by new graduate young dentists, working in the Unit of Restorative Dentistry and Endodontics of the “G. D’Annunzio” University of Chieti (Italy). The questionnaires gathered information about the kind of treatments performed (endodontic or restorative) and about the quality of experience that the patient perceived during the treatment including the use of the dental dam. Using SPSS, data were sorted and analyzed descriptively. Treatment time mean values were compared by means of Student t test.

Results: The 97% of patients had a positive opinion on RD. The same percentage was positively motivated for receiving further treatments requiring rubber dam. This positive personal motivation seemed somehow linked to the comfort level reported by patients and to the patient understanding of the rubber dam utility. In the most of the cases, the time spent for RD placement was between 0 and 2 min: it was generally shorter for specialized dentists and for endodontic treatments. The 79% of patients were on their first experience with rubber dam..

Conclusions: Rubber dam is still just partially used among Italian general dentists, as suggested by the low percentage of patients who had already experienced RD before this survey. Nevertheless, patients’ personal attitude to rubber dam seems positive and it seems that it could be further improved if patients understand the rationale behind RD use.

Clinical significance: The ratio between RD placing time and the overall treatment time appears low; this fact should encourage general dentists to improve their skills in the context of dental dam isolation, as the time taken to set it up becomes a gain in quality of treatment, safety and comfort for the patient.


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