Page 199 - My FlipBook

THE RUBBER DAM. 81

considered later. In any case in which the rubber dam is placed
on the bicuspids and one or more molars beginning? with the
mesial tooth and proceeding backward, the clamp should at once
be placed on the distal tooth by the assistant, or by the operator
himself, if he is working alone. If this is done by the assistant,
it is done at the moment the rubber is stretched over the distal
tooth and secures it perfectly in position at the point at which
it is most liable to be pulled awa3^ The plan of placing this
by the operator alone will be given later. In the placing of the
rubber on bicuspid and molar teeth beginning with the distal
tooth, the immediate use of the clamp to secure the rul)ber dam
in position, instead of using ligatures, simplifies the matter of
securing the first hold on the teeth in all of the more difficult
cases. After this has been done, the rubber may be placed over
other teeth toward the front, one after the other, without danger
of loosing this first hold. The simplest way of doing this is to
place the rubber over the distal tooth of the group to be exposed
and while holding it in position have an assistant set on a clamp.
In this it is unimportant as to passing the contacts in the first
instance in placing the rubber dam over the tooth. This can be
done with the ligature later. In doing this, any of the rubber
dam grasps may be used, but some dexterity must be acquired
by the operator in getting his own hands out of the way of the
assistant while placing the clamp. For this reason the fourth
or fifth grasp is preferred because the fingers will take up less
room and will allow the hand more freedom of motion in clearing
the way for the clamj) while still holding the dam over the tooth.
In the act of passing the clamp on the tooth, it is also necessary
that the fingers slip away as the clamp slips over the tooth to
the gum line. When the two persons have practiced these move-
ments until they are readily done in concert, the time required
is only a few seconds.
For one to do this alone is not so easy. However, in those
cases in which the rubber may be made to joass the contacts, it
is easily held down by a finger of the left hand on one side of
the tooth only while the clamp is being placed with the right.
When the contacts can not be passed in this way, it is necessary
to contrive to hold the rubber on both sides of the tooth with the
fingers of one hand. (In any of the ways of placing it alone the
clamp must be in the forceps and should be opened to the neces-
sary width to go easily over the tooth, and laid in readiness.)
For this purpose I have usually used a modification of the fourth
rubber dam grasp in which the second finger of the left hand is