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USE OF RUBBER DAM. 245
Forms of Clamps.—For the molars various sizes and shapes of the
" Southwick " and of the " Huey wisdom-tooth clamp " are sufficient
for general use. In addition to these " Palmer's set of eight," after
the sharp points of the jaws are rounded, will furnish the requisite
variety.
Fig. 216.

Dr. Delos Palmer's set of eight clamps.
The AppUcation of the Clamp.—The selected clamp is extended
by the clamp forceps to enable it to pass over the molar. It is con-
veyed to the middle portion of the tooth, when the inner beak
should be brought against the tooth at the gum margin ; then with
this point as a fulcrum the outer beak is carried to the cervix on the
buccal surface. Much pain may be avoided in the employment of
this appliance by deft and careful placement. Injury of the gum and
needless pain has frequently been inflicted by careless use of force in
the application of this appliance. JNIuch of this may be avoided by
the previous ligation of the tooth, which will prevent the tendency of
the clamp to descend beneath the gum when the necks of the teeth
are much inclined inward.
When it is necessary to force the clamp against the soft tissues the
previous application of a solution of cocain will obtund the tissue and
render the application tolerable.
The Arrangement of the Dam on the Face.—This concerns the
convenience of the operator and the comfort of the patient. To give
easy access and permit the entrance of light, the rubber is drawn aside
at each upper corner by dam-holders. The simpler forms of these are
sufficient and are more convenient than the more complicated ones when
triangular pieces of rubber are employed. In addition a supporter,
shown at Fig. 218, passes over the head and engages at each end with
the holder. The comfort of the patient is secured by including a nap-
kin along with the rubber in the clasps of the holder. The excess of
the rubber at each side should be taken up in a fold and secured to the