Dr. Abdulaziz Nasser Maher Isolation Instrument Dr. Abdulaziz Nasser Maher

Environment of the Dental Operatory Microbial exposures in the dental operatory involve : 1. Airborne contamination . 2. Digital contamination of surfaces . (i.e., hands soiled with saliva that repeatedly contact operatory equipment and surfaces and return to the patient's mouth during treatments).

Environment of the Dental Operatory Airborne Contamination High-speed handpiece : Create airborne contaminants from : Bacterial residents in the dental unit water spray system . Microbial contaminants from saliva, tissues, blood, plaque, and fine debris cut from carious teeth . Airborne contaminants exist in the form of spatter, mists, and aerosols. Aerosols Invisible particles ranging from 50 - 5 um that can remain suspended in the air and breathed for hours.

Environment of the Dental Operatory Mists Become visible in a beam of light, Consist of droplets estimated to approach or exceed 50 um. Heavy mists tend to gradually settle from the air after 5 - 15 minutes. Both aerosols and mists produced by the cough of patient with unrecognized active pulmonary or pharyngeal tuberculosis (TB) are very likely to transmit the infection.

Environment of the Dental Operatory Spatter Consists of particles generally larger than 50 um and are even visible splashes. Spatter has a distinct trajectory, usually falling within 3 feet of the patient's mouth . Spatter or splashing of mucosa is considered a potential route of infection for dental personnel by blood borne pathogens .

(a) Mask (b) Safety glasses (c) Face shields Protective gloves Non-permeable barriers

Isolation Instrument complete and partial isolation Rubber Dam equipment (punch, forceps, holder & clamps ). Saliva ejector. Cotton roll holder.

complete isolation

Rubber Dam Advantages Disadvantages Dry clean operating field Better access and visibility Protection of Patient and Operator Increased operating efficiency Improves the properties of dental materials indirectly. Disadvantages Time consumption Objectionable to some patients

Anisworth Design (Hygenic) Rubber dam punch Functions Used to make holes of different sizes in the RD sheet . Punch stylus pierces a hole in the rubber dam sheet. Anisworth Design (Hygenic) Ivory Design

Rubber Dam sheet MATERIAL Available in 5 different thickness : Sizes : 5X5 inch and 6X6 inch sheets. Available in 5 different thickness : Thin 0.15 mm (0.006 inch) Medium 0.20 mm (0.008 inch) Heavy 0.25 mm (0.0010 inch) Extra Heavy 0.30 mm (0.012 inch) Special Heavy 0.35 mm (0.014 inch) The rubber dam has shiny and dull side.

Rubber Dam frame and clamp Rubber dam holder ( frame) is used to secure the borders of RD in stretched condition. Young´s rubber dam holder is U shaped metal frame with small projections to hold the dam. Rubber dam retainer or clamp Used to anchor the rubber dam to the most posterior tooth to be isolated. It consists of 4 prongs and 2 jaws connected by a bow. Prongs make four point contact with the tooth.

Rubber dam retainer or clamp Appropriate Teeth W56 most molars W4 most premolars W7 mandibular molars W2 small premolars W8 maxillary molars W- wingless W8A - A active W27 distal extension-mandibular molars - D distal extension Hyg B-6 anterior teeth

Rubber dam retainer or clamp

Rubber dam clamp forceps Functions and features 1.Used to place and remove rubber dam clamps on and from a tooth Work with a spring action when handles are squeezed together 2. Beaks fit into the holes of the rubber dam clamp for secure placement 3. Sliding ring allows forceps to lock when placing the clamp and to be released when removing the clamp 4. Handle shaped to allow a firm palm-grasp by the operator Ivory Design Stoke type

Rubber Dam Unfavorable Conditions for Dam Placement Insufficiently erupted teeth Some third molars Extremely malpositioned teeth Asthmatic patients Latex allergy

Rubber Dam

Rubber Dam

partial isolation Cotton roll holder

Saliva ejector used for both complete and partial isolation

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