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THE RUBBER DAM. 69

THE RUBBER DAM.

ILLUSTRATIONS: FIGURES 62-99.
THE rubber dam is a thin sheet rubber used for the purpose
of keeping any field of operations on the teetli clean and
dry; also for keeping the field aseptic when that is required.
This latter is desirable when treating or filling the roots of teeth.
In use, a piece of the rubber of suitable size for the purpose is
cut or selected and holes much smaller than the teeth punched
at proi^er positions. These are stretched over each of as many
teeth as may be necessary. The rubber draws tightly around the
necks of the teeth and becomes moisture tight, if well arranged.
Then so many teeth as are in this way exposed can be kept clean
and dry for any desired operation. This is essential in all fill-
ing operations, in all treatments of the pulps of teeth, or in the
treatment and filling of root canals. The rubber is furnished
by the dealers in several grades as to thickness. Generally, a
medium thickness is to be preferred. If of good quality, it is
very elastic, tough and strong.
Preparation for placing the rubber dam. Teeth upon
which the rubber dam is to be placed should be clean. This
should always be looked to carefully as the first step prepara-
toiy to placing the rubber dam. Especially any accumulations
about the margins of the gums should be carefully removed.
Often these accumulations are composed mostly of microorgan-
isms, and, if they are not removed, will frequently be pushed
under the free margin of the gum in placing the rubber dam.
Then, with some l)ruisiug of the soft tissues that often occurs,
there will be infection and inflammation; and in some instances
suppuration following. This is caused by forcing microorgan-
ims into the bruised tissues, and should always be avoided by
careful cleaning. Especially great care should be had to clean
the interproximal spaces. This is most easily done with the
ligature. The ligature should first be passed between the con-
tact points to determine whether or not there will be any diffi-
culty in passing them with the rubber dam. While this is being
done, the apace may be well cleaned with the ligature. In many
eases where it is desirable to place the rubber dam, there is more