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Azerbaycan Saytlari

 »  Home  »  Endodontic Articles 10  »  Patients attitudes to rubber dam
Patients attitudes to rubber dam
Introduction - Materials and method.



D. A. Stewardson & E. S. McHugh.
Conservative Dentistry, School of Dentistry, University of Birmingham, Birmingham, UK.
Department of Statistics, University of Glasgow, Glasgow, UK.

Introduction.
The positive benefits to operator and patient of using rubber dam (RD), particularly for endodontic treatment are well recognized (European Society of Endodontology 1994). In all the dental schools in UK the use of rubber dam is encouraged for many operative procedures and is mandatory when students undertake root-canal treatment. However, rubber dam is rarely used even for endodontics in general practice (British Endodontic Society 1983). Numerous reasons are given for not using it (Marshall & Page 1990). One of the main reasons being that patients do not like its use. Other practitioners (Reuter1983, Jones & Reid1988, Gergely1989) have suggested that there is no problem with patient acceptance. Reuter (1983) offered anecdotal evidence that, based on extensive personal experience, his patients preferred the use of rubber dam for restorative procedures. Gergely (1989) interviewed 72 of his patients and found that approximately 72% expressed a preference for treatment with rubber dam. Eight percent preferred treatment without, and1 9% had no preference. In this study, however, the interviews were conducted by the clinician which may have influenced the way the patient responded. Jones & Reid (1988) surveyed the opinions of 100 patients attending a child dental health unit for treatment. The patients were interviewed and also completed a questionnaire. A consensus on the patient’s opinion was reached by the operator and the patient’s mother where the child was too young to understand the questions. They concluded that 79% of their patients demonstrated good acceptance of rubber dam. This research has the same limitation as that of Gergely (1989). In addition, some of the responses were not given by the patient themselves, and the responses from children may be influenced by different factors from those of adults.
The aims of the present survey were:

  1. To record patients views of their experience of rubber dam use in an objective manner.
  2. To evaluate the influence of some personal and clinical factors on patients’opinion.

Materials and method.
A simple confidential questionnaire containing10 questions was designed. The questionnaire drew on work by previous investigators (Jones & Reid1988, Gergely1989) and was also designed to gain information that is considered pertinent by the authors (Fig.1).
The questions enquired in to:

  • Personal details of age and gender.
  • The patient’s previous experience of RD use.
  • Their current experience.
  • Their preference for future RD use.

Also entered on the form was:

  • The type of procedure being carried out.
  • The time taken to apply the dam.
  • The approximate duration of its use.

It was decided to undertake this survey amongst two groups of patients; adult patients who were receiving dental treatment under RD from,

  • (a) final-year dental students at Birmingham Dental School, UK (student patients, SP), and
  • (b ) four general dental practitioners (DP).

Figure 1. Questionnaire used to gather information.

Questionnaire used to gather information

The intention was to enable an assessment to be made concerning the influence of the operator’s experience on the patient’s views regarding RD. Patients were asked, at the end of their appointment, to complete the questionnaire. This was undertaken in the waiting area, and the patients in group SP then passed the form to the receptionist for subsequent collection. Group DP patients were provided with a stamped addressed envelope to return the form to the author. The information concerning procedure, application time and duration were entered by the supervising clinician at the dental school, and by the practitioner’s assistant in the practices. As far as possible, the students and dentists were not in volved in the survey process, and the patient was assured that the forms were anonymous and confidential. Patients were only asked to complete one form each; some students would have more than one of their patients included in the survey. No students had more than three of their patients included. The dentists who participated we re responding to a request made for volunteers at a postgraduate course held at the Birmingham Dental School. They were all male, non-specialists who provided the majority of their dental treatment out with the National Health Service. Three graduated in the early eighties and one in the early sixties. Each had reported that they utilized RD for over 75% of endodontic treatment and posterior composite placement, and for approximately 50% of anterior composite placement.
The survey was continued until 100 forms had been collected from group SP that had been correctly completed. The dentists were provided with 30 forms each in order to achieve 100 returned useable forms and to make allowance for non-responses. Data from the completed question aires were entered into a database and subsequently analyzed using statistical package for the social sciences (SPSS). Analyses were confined to simple cross-tabulations of the patients’responses and potential associated factors, using w2- and appropriate follow-up tests as necessary.