Oral cavity containment systems. Dental dam
The oral environment is characterized by the presence of saliva, which often interferes with dental maneuvers.
The increased bacterial load of saliva can often be a source of infection and can contaminate both the practitioner and the procedures performed by the practitioner, leading to therapeutic failure.
The main oral fluid consists of the secretory products of the main salivary glands of the oral cavity, the parotid, mandibular and submandibular glands.
It contains the following elements:
water: a large proportion of saliva is made up of water, which is used to soak the food bowl to make it easier to slide down the pharynx and esophagus and then digest in the stomach. The secretion of saliva is stimulated by the presence of food in the oral cavity.
mucin: is the element that gives saliva its mucous, viscous character. Mucin facilitates the passage of food through the digestive tract
enzymes: these enzymes initiate digestion before the food bowl reaches the stomach, the main site of digestion. By crumbling the food bolus, the process is facilitated and then continued by enzymes in the stomach.
proteins, carbohydrates, fats
As mentioned above, dental maneuvers are hampered by the presence of saliva.
Saliva in dental operations
When filling dental cavities, at the stage of applying the adhesives that will bond the dental composite, it is important to ensure a completely dry environment.
Saliva hinders the adhesion of filling materials and this leads to the acceleration of the development of recurrent and secondary, marginal caries.
After the adhesives have been applied and the composite has reconstituted the dental morphology, the light curing light will be used to fix and cure the composite.
While the composite is highly plastic at the time of application so that it can be molded in accordance with the morphological characteristics of the teeth, it becomes hard after light-curing.
In the plastic state, avoiding saliva contamination is essential to ensure therapeutic success. After light-curing, if all preparation and filling steps are strictly followed, saliva is no longer a threat and the protective and absorption systems can be removed.
Saliva in endodontics
Endodontic treatment is the excision of the affected nerve found in the pulp chamber. Carious or traumatic lesions affecting the deep dental structures, i.e., the pulp chamber, require the removal of the nerve, and the cavities remaining after this process will be filled with special materials designed to maintain the tightness of the root canal.
Infection can spread either through the apex, retrogradely or from the coronal level, following fillings with poor marginal closure.
It is very important to keep the oral environment free from saliva during pulp removal and root canal filling to prevent salivary contamination leading to infectious processes over time.
Achieving canal tightness is the goal of endodontic dentistry.
Methods of preventing salivary contamination
Refers to all methods by which saliva penetration is prevented at the site of dental work.
It can be achieved by several methods.
Salivary rolls are used to absorb saliva produced by the glands. They have a limited absorption capacity and require frequent replacement. They do not provide a perfect seal. The dental dam is the best sealant of the oral cavity.
Components of the dental dam:
dam foil: made of rubber, to be applied over the working field, with only the teeth being worked on being removed through it. The other dental units and adjacent mucous membranes are protected by the instruments used by the dentist and saliva is not accessible.
crampon: usually metal, it is applied to one or more teeth to support the dam.
piercing forceps: create holes to fix the dam to the dental units.
dam frame: applied outside the oral cavity, it secures the rubber dam so that the dentist’s access is not impeded by its presence.
The dam system creates a mechanical barrier between the working field and the saliva, a factor that can hinder therapeutic success.
Oral cavity containment systems are used in dentistry to protect the areas around the working area during dental procedures. They are used to avoid contamination of the working area with saliva, blood or other body fluids, and to protect the patient from substances used during treatment.
There are several types of oral cavity containment systems, each with their own advantages and disadvantages.
One of the most commonly used oral cavity isolation systems is the dental dam. This is a thin sheet of plastic or rubber that is placed around the working area to protect it from saliva and other body fluids.
The dental dam can be secured with an adhesive or held in place with a special mechanical device.
Advantages of using dental dams:
Protects the working area from contamination with saliva, blood or other body fluids
Protects the patient from substances used during treatment
Easy to use and apply
Does not require the use of anesthesia or medication to be applied
Disadvantages of using dental dams are:
Can be uncomfortable for the patient
Can be difficult to apply in some cases
Can be difficult to hold in place in some cases
Even though the patient may feel uncomfortable at first due to the application of the dam, they should understand that the benefits outweigh any other containment system.
In conclusion, the dental dam is an effective and easy-to-use oral cavity isolation system that can protect the areas around the working area during dental procedures. However, it can be uncomfortable for the patient and can be difficult to apply in some cases. It is important for the patient to discuss the best oral cavity isolation options with the dentist depending on the individual case.