No rubber dam, no root canal treatment


The widely reported (1) trauma suffered by a young woman undergoing root canal treatment was 100% preventable, says Julian Webber, founder of the Harley Street Centre for Endodontics.

The incident in Bristol earlier this month led to widespread commentary in the national media after the patient told her story publicly. She said that an endodontic file went down her throat and when she choked, the file was forced downwards, piercing her stomach lining.

It seems likely, says Dr Webber, that the dentist had not used a rubber dam, a stretchy sheet that both isolates the tooth and protects the patient’s airway. A hole is made in the middle of the sheet so it can be placed around the neck of the tooth, rather like a barber’s gown, so that the tooth is isolated and nothing can fall into the mouth.

The rubber dam serves several functions:
• It prevents anything accidentally failing into the patient’s mouth
• It prevents the strong chemicals that are used to clean the root canal from accidentally spilling into and burning the patient’s mouth
• It isolates the tooth and keeps it dry, helping to achieve a good clinical outcome.
• It reduces the risk of bacteria penetrating the root canals during the procedure, also improving the likelihood of healing and a long-lasting result

Dr Webber continued: ‘This is an accident that was preventable and should not have happened. Single patient use files have been made mandatory in root canal therapy, the same should apply to rubber dam. The cultural norm should be: No rubber dam, no root canal treatment.’
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