Preparing for Rubber Dam Placement

Pre-Placement Checks

Examine the teeth for any calculus and remove them before placing the rubber dam, especially near the treatment area.
Calculus deposits can prevent the dam from seating correctly, leading to leakage or tearing.

Floss between the teeth to detect any sharp edges or overhanging restorations that could tear the dam during placement
Smooth these areas as needed—for example, by using interproximal finishing strips or disks.

Gently pass floss obliquely (from the buccal or lingual) through the contacts. This technique prevents the floss from forcefully snapping down and traumatizing the gingiva.
For tight contacts: Consider using a medium-thickness dam instead of a heavy one for easier passage.
For extremely tight contacts:
When flossing proves difficult, place a wedge to create slight separation before attempting to place the dam.

Mark maximum intercuspation contacts with articulating paper before rubber dam application when the procedure involves occlusal surfaces
To preserve these markings during the procedure,apply and light-cure a thin layer of clear bonding agent or varnish over the marks.

Local anesthesia is administered before placing the rubber dam.
- Profound anesthesia is typically achieved while you are placing the dam.
When the points of the clamp’s jaw are firmly on the tooth and have not penetrated gingival tissue (passive clamps), the patient may experience slight pressure discomfort.
- This feeling usually subsides within a minute due to “pressure anesthesia”, making infiltration anesthesia for gingival tissue unnecessary.
If additional gingival comfort is needed, applying a topical anesthetic gel is often sufficient.