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Azerbaycan Saytlari

 »  Home  »  Endodontic Articles 10  »  Patients attitudes to rubber dam
Patients attitudes to rubber dam
Discussion - References.



The method used to gather this information was designed to allow more candid responses than may have been achieved in the similar surveys already referred to (Jones & Reid1988, Gergely1989).This survey enables the opinions of many patients to be assessed, and compares experienced and inexperienced operators. It is clear that only a small number amongst either patient group surveyed actively did not wish to have RD used for future appointments. Whilst this shows that there are patients who do not like RD, as has been asserted (Marshall & Page 1990), it also demonstrates that the majority are not negative towards RD, and indeed many like it and want it to be used.
No clear association could be established between most of the factors assessed and either the patients’ judgement of the experience of rubber dam use, or their preference for its use in future. A greater proportion of males than females did not express any preference for RD use next time, but no statistically significant difference could be seen between the sexes regarding their preference. As the age group of patients increased, the proportion of respondents who did not want RD to be used was very similar, whilst the percentage of those who would want RD used increased and the percentage of those without a preference decreased. No patients who reported a positive experience of RD use were against its use in future; however, some who had a negative experience still wished to have RD used again. There was a suggestion that increased duration of RD influenced the patient’s opinion of their experience, but not their preference for future use.
It would appear that there are few factors related to the patients or the procedure that may be used to predict a patient’s preference for or against RD. The experience of the dentist and by inference their level of skill does influence the patient’s opinion. The best way to improve patient acceptance of RD is for clinicians to use it frequently and thereby become proficient. They should also be aware of patients’ concerns. A few patients entered their comments on their experience of RD. Positive comments included the absence of debris in the mouth or passing into the throat, and protection of the tongue. Negative comments referred to dribbling, being unable to swallow, and having an increase in saliva. For two patients, the clamps had proved uncomfortable. Such complaints may be addressed by careful technique, specifically by ensuring saliva ejectors are efficient, clamps are placed carefully and that local analgesia is adequate. For some patients, their acceptance of rubber dam may be improved by limiting the time for which it is used. The effect of this may have improved patient acceptance, but could not be evaluated here. By adopting a positive approach to RD, the dentist may engender a positive attitude in the patient (Gergely1989).
This investigation found few of the associations reported by Gergely (1989) but is in agreement with his general finding that acceptance of RD is good. In comparison with Gergely’s figures, amongst the dentists patients surveyed here, a similar percentage preferred its use, a higher percentage expressed no preference, but fewer did not wish it to be used in future. There were fewer student patients who preferred RD use, and more who either did not wish it used or expressed no preference. This information will hopefully help to dispel the widely held belief that patients generally do not like rubber dam, and encourage more frequent use of this valuable procedure. Another quoted obstacle to using rubber dam is the time taken to place it. In the hands of most students and experienced dentists, placement took only between 1 and 2 min. Further work is needed to overcome the other reported obstacle, namely dentists’ lack of skill and difficulty in placing dam.

References.

British Endodontic Society (1983) A survey of endodontics in general practice in England. British Dental Journal 154, 222-4.
European Society of Endodontology (1994) Consensus report of the European Society of Endodontology on quality guidelines for endodontic treatment. International Endodontic Journal 27, 115-24.
Gergely EJ (1989) Rubber dam acceptance. British Dental Journal 167, 249-52.
Jones C, Reid J (1988) Patient and operator attitudes toward rubber dam. Journal of Dentistry for Children 55, 452-4.
MarshallK, Page J (1990) The use of rubber dam in the UK: a survey. British Dental Journal169, 286-91.
Reuter JE (1983) The isolation of teeth and the protection of the patient during endodontic treatment. International Endodontic Journal16, 173-81.