01 Gennaio 2021

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Patients’ attitude to rubber dam use: a questionnaire survey

Original article

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

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Objectives  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-Pescara (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 den­     tists, 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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doi: https://doi.org/10.19256/d.cadmos.01.2021.09