August 31, 2011

“Chipped porcelain is problem, this is a disaster” – The ethics of rubber

Yesterday I was talking about the ethical problems of being asked to replace a functioning, healthy tooth restoration. Today I’d like to talk about the ethical obligations involved in ensuring proper isolation. Specifically, using a rubber dam.

I think this subject is important enough to merit its own discussion.

Even today there are dentists who, while they may encourage removal of amalgam fillings, don’t use a rubber dam.

It should go without saying that each time another restoration is placed, it is necessary that more tooth structure be removed. You’ll know this from your practical experience in restoring teeth.

It’s the immediate responsibility of the dentist to be as conservative as is clinically possible when restoring a tooth.

One of the hardest substances in the body is enamel; before modern diets and refined sugars, enamel was a life-long oral companion.

In developing a plan for an aesthetic treatment, the clinician’s goal should be to diminish the risk of failure in the restoration, not merely failure of the tooth.

A chipped piece of porcelain is a problem, but a tooth breaking at the gum line is comparatively catastrophic.

A dentist wouldn’t hesitate to refuse to complete an aesthetic procedure which compromises the integrity of a tooth, so why would a practicioner hesitate to require the use of a rubber dam in their restorative procedures?

I welcome any views on the subject, and of course, you’re welcome to join this debate. Feel free to leave a comment here, or get in touch over our social media channels:

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Image courtesyof: Renjith Krishnan

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