DentaltownUK July 2017 - 95

W8A for molars and a premolar clamp for premolars and primary teeth. These two work for all
my posterior work. For anteriors I use Wedjets to hold dam between premolar and canine. Always
place wedge where you are doing interproximal work to protect tissue and rubber dam. Way too much
stress if I didn't have the dam. Love using it for crowns. I tell my staff I use it for isolation when doing
the BU and then for retraction (tongue, cheeks, etc.) when doing the prep and placing cord. I clip the
interproximals around the tooth I am preparing so the dam doesn't get in the way. ■

sddds
Member Since: 08/01/03
Post: 11 of 98

4/1/2017

dbottner4

I find that clamping second molars is difficult. The dam keeps popping off when I hook it around
the frame. Could it be my clamp selection, lack of K-Y jelly, hole punching location, or all of the above?
Great thread! ■

Member Since: 05/14/14
Post: 12 of 98

I get your frustration with the second molars. Have the patient "sling" their lower jaw to the side
you are working and have them close a little. This gives me more room to place the retainer. Once it's
on, have them do the same thing to put the dam on. I then have them open normally and place the bite
block, then place frame. ■
4/1/2017

Member Since: 08/01/03
Post: 13 of 98

4/1/2017

My go to clamps for molars are usually 12A and 13A, with the narrow side of the beak on the
lingual or palatal. Occasionally, you'll find an awkwardly shaped tooth (more often mandibular molars)
and it will do better with the opposite clamp than usual.
I liked winged as I can put the clamp on the dam and the dam on the frame and take it to the
mouth all in one. Make sure there is laxity in the dam so that it will stretch back to the molar (usually
second molar).
Personally, I don't use lubricant or a napkin. I like Hedy Isodam 6x6 Heavy. It's non-latex and really
easy to get between the contacts. Once the tooth is clamped, I'll flick the dam off the wings and start by
trying to get the dam between the anterior teeth first. Then just floss your way back to the clamp. Floss
through once, double it over and floss through again, then pull the floss out the buccal. Use an explorer
to invert the dam running it along the buccal and lingual.
The only time I like to use my latex dam (heavy) is when doing anterior black-triangle or diastema
closures, because it is heavy and less "stretchy" and does a better job of displacing the interproximal
gingiva. It's tougher to put on, but worth it for the added displacement of the tissue and it holds the
matrices against the tooth better. (The matrix slips down between the tooth and the dam.)
For the anterior aspect, I usually don't use anything. Just floss it down around the central incisor on
the other side of the arch. It just stays in place.
When working on anterior teeth, I've seen people go clampless and use Wedjets stabilizing cord
distal to the canines or first bis. I tend to just use a winged premolar clamp on the first or second bis
(forget which # clamp), but that's just me.
I will use wedges to "pre-wedge" when doing Class II composites or deep Class III or IVs in the
anterior. It helps to protect the rubber dam interproximally when prepping and will give a slight separation that helps (along with the retainer ring/wedge) to ensure a nice tight contact to the composite
restoration. ■

sddds

Brett Mansfield
Member Since: 08/19/05
Posts: 15 and 18 of 98

4/1/2017

To keep the dam out of the way I pre-wedge with the contoured wooden wedges that come in
different colors (Waterpik brand?). I stretch the dam to the buccal, then wiggle the wedges up and down
as I slide them in from the buccal. Then I release the dam. This usually results in a good seal and keeps
the dam from being bunched up on the lingual and prevents the dam from sliding the wedge back out.
Then I prep away and don't worry if I chew up the wedge as it protects the rubber dam. ■

FluorideNinja
Member Since: 02/21/10
Post: 19 of 98

4/1/2017

The clamp needs to sit with all four tines giving decent pressure on the tooth. If the clamp is not
doing this, chances are the clamp will pop off or rotate with a mesial inclination of the bow.
Sometimes this mesial incline or the Curve of Spee will not allow you to re-engage the RD clamp
holes, so you can get the clamp off or reposition it with your RD forceps. If this happens you can use
your XR ring forcep in a reverse position and engage the bow. Apply outward pressure to the bow to
release the clamp tines. At this point inspect your clamp for fatigue and use the 110s to tighten them
again or toss and get a new clamp.
I use the third largest punch hole for the molars, the next smaller for premolars and the next smaller
for anteriors. I never use the largest or smallest punches. ■

Tyler11
Member Since: 05/24/04
Post: 41 of 98

4/2/2017

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