In 2009 I picked up a habit. It was a habit that I had all through dental school. When I was in dental school we were all positive that we’d quit, and probably most of us did. I mean, I dabbled in it between 1997 and 2009, but it didn’t really stick. Now, I’m finding that it’s a really tough habit to break.
No, I don’t smoke. I’m talking about the rubber dam. Actually, not the “rubber” dam, but the “nonlatex” dam. It’s just that the name I know it by is rubber dam. Old habits die hard. And new ones are kind of the opposite.
Ever since I started reading and posting on DentalTown I realized that the dentists that I aspired to be like used the dam. And they used it effectively. Most importantly, they took pictures. It was like rubber dam porn. They showed these amazingly clean endo accesses, bone dry restorative fields and perfect isolation for seating crowns and onlays. I wanted that. But it was my habit to isolate with cotton rolls and high volume evacuation. I could think of many reasons NOT to change my habit.
- It would take too long
- Patients don’t like it
- Rubber dam retainers (clamps, for those that like to scare their patients) pinched the gingiva and hurt
- My assistant wouldn’t like the change
But in 2009, I finally decided to suck it up and give it a try. I don’t exactly remember how it worked. I think we (my assistant and I) decided we’d try it on every composite case that came through the door for a month. If we didn’t love it, we could always go back. But we didn’t.
I couldn’t have developed this habit without Shelly’s help. I think at first she didn’t really like it. It was different and kind of uncomfortable. Patients didn’t know what to think about it, because it was different from what we used to do. But we kind of slogged through. At first, I felt defensive about changing up the routine. After awhile, we developed a team technique for placement. We can essentially place a dam relatively comfortably and quickly within a minute or less. I have a pdl syringe in every set up and can use a dam painlessly. I give palatals routinely to allow for retainer placement on the upper.
How do patients react to it? Half the patients love it and ask for it. Most of the other half tolerates it without a lot of questions with a very small percentage of patients that can’t tolerate it. But dentistry is SO much more fun with the dam on and I work so much faster once it’s placed. Shelly and I often wonder out loud how we worked without it!
The rubber dam is a great habit that I’ve developed. Your mileage may vary, but if you’re wondering…you ought to try it.
What’s the next habit I’m looking to acquire? I’ve taken a few classes from David Clark and he advocates using Aluminum Trihydroxide powder blaster to remove all traces of biofilm once you isolate your field. I love the concept. But it’s another habit I’m going to have to work to acquire the habit. It’s messy as heck and to use it efficiently I’m going to have to add an air line to my operatory set up. I’m sure I’ll get there, but it’s a process.
What habits do you have? Are they habits that you’re proud of, or do you need to work to eliminate them? I’d be interested to hear!
My dentist in college was the first one to put on a rubber dam. I agree that the retainers can be uncomfortable for patients- but I’d rather have them if my dentist works better with them in!
I just found your blog! I love the layout.
Haha on the smexy pics of rubber dam placement – there’s just something alluring about stretched latex….. :/ Good for you for caring enough about the quality of your work to get into the habit. I wish more dentists would.