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194 , OPERATIVE DENTISTRY

tightly as to cause the patient pain or in any way injure the soft
tissues.
The Method of Applying the Clamp with the dam is to stretch
the rubber over the clamp, then apply the clamp forceps and carry
all to position on the desired tooth, using the hole in the dam thus
intended as a means of getting a view of the tooth to be clamped,
which aids in the placing.
Some of the older makes of clamps require that they first be placed
in position on the tooth and then with the first fingers of each hand
the hole is distended in the rubber dam sufficiently to permit it to
slip over the bow of the clamp.
In Using Cervical Clamps for cavities on the buccal and labial
surfaces in the gingival third the dam is first passed to position and
then the clamp applied.
The Removal of the Rubber Dam is accomplished by the folloAv-
ing order of procedure:
First—The removal of the ligations as before described.
Second—Pull the rubber to the buccal or labial and with a sharp
pair of scissors cut strips passing between the teeth.
Third—Disengage one side of the dam holder.
Fourth—With the right hand remove the clamp which should
be holding the rubber dam, remove all clear of the mouth immedi-
ately, as the patient does not take kindly to any delays at this
stage of the procedure.
Fifth—Inspect the rubber to see if it has all been removed.
Sixth—Inspect the teeth for any portions of rubber dam, liga-
tures or stray particles of filling material. Now proceed to knead
the gums with the fingers, at the same time flooding them with
a forceful stream of water from the syringe, to cleanse them and
to re-establish circulation.
The Use of Absorbents may be resorted to in place of the rubber
dam for short operations and more particularly with the upper
teeth as these are the most easily managed. Absorbents are to
be had in the market in the form of rolls and napkins at small cost
and are to be discarded after once used, which is the only hygienic
method. In their use particular attention must be paid to the
mouths of the ducts responsible for the most abundant secretions
and the absorbents so placed as to not only readily absorb the fluid
which is ejected, but also that they compress the ducts thereby re-
stricting the flow.