dental dam?

MoneySeeker1

Been waiting ages (courtesy of Lockdown) to get to my dentist for a couple of fillings. 

Was in there all mentally geared-up to have them and they started trying to put a blue plastic sheet into my mouth. I had already said it takes me a lot of doing to cope with anything in my mouth and then that happened. I instantly pushed them away and said firmly "I don't like that - whatever that is. I've had fillings before and not come across that. So it's not necessary" and lie back down and waited for them to re-start (only this time without trying to use that plastic sheet stuff).

They had another go at doing so!!!!! I thought I'd been quite plain I wasn't going to use it!!! So I had to say a - very firm/absolutely unmistakeable "NO!" to it that no-one could possibly mistake for agreement. Laid back down - job done this time - without any further attempts at using that. Whew! I had thought for a minute I'd have to bolt for the door and head back out without my fillings - and change dentist and get another one to do it instead.

I'd never heard of this idea before and googled and I think it must be a "dental dam" - something I'd never heard of before. Very puzzled as to why someone tried to use that on me and even had a second go (after I thought I'd made it plain I wasn't going to have it) and I wasnt asked what I thought about it (and I was the one that was the patient!!!!).

WHY?

1. Was it the dentists personal choice for everyone regardless and they just didnt stop to think to ask me whether it was MY choice or no?

OR

2. It was being used for some sort of reason to do with "Covid and all that" and I wasn't being asked what my own choice was?
As I said - I very nearly had to walk out without my fillings - as, whatever the reason, I wasnt going to use it (because if it really WAS necessary - then I'd have encountered it before with previous fillings and would now have a mouth full of teeth with holes in instead).

Can any dentist on here answer as to "Why???!!!!" - as I felt quite shocked about it.

brook2jack2

It is compulsory to use rubber dam if you are going to do an aerosol producing procedure eg drilling . 

If you want the filling you should  have to had it on or wait until dentists are not obliged to follow covid precautions. By not having it on you put the dentist , their team and their next patients at risk . The amount of aerosol produced is drastically reduced with rubber dam and as saliva doesn't contaminate the tooth fillings stick better. https://www.dentistry.co.uk/2020/05/05/dentistry-post-lockdown-protect-patients/

This link is the easy to explain version but the chief dental officers of England , Wales , Scotland and NI have produced operating procedures that say dentists must use rubber dam to decrease the aerosol production that drilling etc produces , unless it's impossible to do so. 

MoneySeeker1

Thanks for clarifying - as I was genuinely puzzled why they were trying to do something I'd never experienced/never heard of.

In the event - as they knew when I booked the appointment that I would be having fillings - then they should obviously have told me they planned in adding in that extra (unnecessary - but demanded by Covid stuff type regulations) step. It came right out of the blue. When they tried to make me do it - I had no idea to expect it and thought it must be something they personally chose to do and had omitted to ask me (the person making the choice) about whether I agreed or no.

If I'd known they planned to force that on me - for first time in life and with no notification whatsoever/or asking my permission whatsoever - I would have cancelled the appointment and just "waited" until things are back to Normal before I went in. I thought things were basically back to Normal (apart from them wearing a load of protective gear - which they had told me about and comments from other people that I'd even be expected to leave my handbag at reception). So I knew those things were different to Normal and expected them all garbed up and that I'd have to wear my keys/money in mini body bag under loose top and leave my handbag etc there. But no-one - at any point - said "Dental dam to have fillings - or else" basically. I'd never read it anywhere.

In the event it worked out - as I got my fillings and without having a load of stuff shoved into my mouth totally unexpectedly and frightening the heck out of me. So, at least the work is done. All I'd been told was "You can have proper fillings now and it's allowed - instead of the temporary ones I was going to give you". So I presume I do have the proper fillings - and I know I was charged the price I was quoted (which included proper fillings) - so it must be the case that's what I have.

Very surprised at all this and quite shocked. It felt like a form of attempted "medical rape" to try and force an unpleasant procedure I was in no way expecting on me - equivalent to a friend years back going in in all innocence to have a coil fitted - and no-one had told her it would be very painful or given her any anaesthetic to make sure it wasnt and daft b&gger friend let them go ahead (which I wouldnt have myself) and would have walked out the second they started dishing out unexpected pain in the course of the procedure.

Just remembered the phrase I'm after - "informed consent".

Emmia

I think "medical rape" is a bit over the top - you went to the dentist for treatment, and while the dam sounds unpleasant, this is really to make the procedure as risk free as possible in terms of the transmission of covid-19. 

minimad1970

brook2jack2 said:

It is compulsory to use rubber dam if you are going to do an aerosol producing procedure eg drilling . 

If you want the filling you should  have to had it on or wait until dentists are not obliged to follow covid precautions. By not having it on you put the dentist , their team and their next patients at risk . The amount of aerosol produced is drastically reduced with rubber dam and as saliva doesn't contaminate the tooth fillings stick better. https://www.dentistry.co.uk/2020/05/05/dentistry-post-lockdown-protect-patients/

This link is the easy to explain version but the chief dental officers of England , Wales , Scotland and NI have produced operating procedures that say dentists must use rubber dam to decrease the aerosol production that drilling etc produces , unless it's impossible to do so. 

I'm glad you've posted this information. I've got an appointment soon for a filling and I certainly wouldn't want to put the dentist at any risk by refusing to have this used. I've only had one experience with them using a rubber dam and it brought on a panic attack, so I will cancel my appoitment.

MoneySeeker1

minimad1970 said:

brook2jack2 said:

It is compulsory to use rubber dam if you are going to do an aerosol producing procedure eg drilling . 

If you want the filling you should  have to had it on or wait until dentists are not obliged to follow covid precautions. By not having it on you put the dentist , their team and their next patients at risk . The amount of aerosol produced is drastically reduced with rubber dam and as saliva doesn't contaminate the tooth fillings stick better. https://www.dentistry.co.uk/2020/05/05/dentistry-post-lockdown-protect-patients/

This link is the easy to explain version but the chief dental officers of England , Wales , Scotland and NI have produced operating procedures that say dentists must use rubber dam to decrease the aerosol production that drilling etc produces , unless it's impossible to do so. 

I'm glad you've posted this information. I've got an appointment soon for a filling and I certainly wouldn't want to put the dentist at any risk by refusing to have this used. I've only had one experience with them using a rubber dam and it brought on a panic attack, so I will cancel my appoitment.

This is part of why I posted it - because I thought "Well if I wasn't informed/asked what I thought - then I won't be the only one. They'll be trying this on on other people too". We all have the right to know this sort of thing in advance and then we make "OUR" decisions accordingly.

I did google around generally. Had to start with something about "dentist putting plastic sheeting in mouth" to see what it was called even. I came across mention of dentists can be a bit awkward and insistent about it in America (and that's in Normal Times - not Covid Times). Also mention that many patients don't like it (whatever country one is in) and won't have it - as it really upsets them.

If dentists probably know (certainly should know) that many of us won't use these dental dams - then why on earth don't they tell us clearly "The Government is making us force dental dams on those needing fillings until things are back to Normal" in advance - at the time we are trying to make the appointment with them? Not leave us in ignorance and we turn up expecting our treatment and then finds this happens. As I said - I got my treatment anyway - and without that dam I hadn't known they wanted to use. But I could have gone all that way to the dentist and then found I had to walk straight out again without the fillings I'd come for and they might have even "added insult to injury" and still tried to charge me anyway (though it would have been their fault I wouldnt have known in advance). Obviously, I'd have refused to pay - as the non-treatment wouldnt have been my doing iyswim.

brook2jack2

Rubber dam is very commonly used. It should be used for all root canals and has many advantages 
it allows the field to stay dry and uncontaminated so fillings that need to be glued in stay in much better and root canals have a much better chance of success

it keeps chemicals used in root treatment and fillings out of the mouth Increasing patient comfort

it keeps saliva and aerosol contamination around the patient down 

it is by no means unnecessary it is gold standard dentistry in non covid times , in covid times it gives a measure of protection to the staff who are widely acknowledged to be at the highest risk and who have to follow covid protocols. 

minimad1970

brook2jack2 said:

Rubber dam is very commonly used. It should be used for all root canals and has many advantages 
it allows the field to stay dry and uncontaminated so fillings that need to be glued in stay in much better and root canals have a much better chance of success

it keeps chemicals used in root treatment and fillings out of the mouth Increasing patient comfort

it keeps saliva and aerosol contamination around the patient down 

it is by no means unnecessary it is gold standard dentistry in non covid times , in covid times it gives a measure of protection to the staff who are widely acknowledged to be at the highest risk and who have to follow covid protocols. 

It was a root canal that I was having done when the rubber dam was used. I don't blame dentists for taking every precaution to keep themselves safe.

silvercar

In my experience the whole procedure is far more pleasant when the dentist uses a rubber dam. You can swallow as you normally would And the procedure feels more distanced from you. 

pramsay13

If you feel strange about things being put in your mouth you should maybe be asking before booking if there are any changes to normal procedures during this time.

MoneySeeker1

brook2jack2 said:

Rubber dam is very commonly used. It should be used for all root canals and has many advantages 
it allows the field to stay dry and uncontaminated so fillings that need to be glued in stay in much better and root canals have a much better chance of success

it keeps chemicals used in root treatment and fillings out of the mouth Increasing patient comfort

it keeps saliva and aerosol contamination around the patient down 

it is by no means unnecessary it is gold standard dentistry in non covid times , in covid times it gives a measure of protection to the staff who are widely acknowledged to be at the highest risk and who have to follow covid protocols. 

I've never had and wouldnt ever have a root canal filling personally. Fingers crossed it will never come to that sort of situation. 

All I've ever had from dentists is inspection, polish and clean, fillings, the lowest possible amount of x-rays I can manage and that's that. My decision had already been made almost certainly never to have a root canal filling - and, if a dental dam is part of that procedure in Normal Times with any dentist, then that's my decision 100% made on that then. That being I will never have root canal fillings.

There must be lots of us that have never had root canal fillings and I would imagine that dentists can easily tell from visual inspection of our mouths whether we personally have or no and therefore the dentist would have already known I'd never had one of those and therefore there was a very good chance I'd never encountered a dental dam before. I've not had many people I know tell me they've had that type of filling and those that did never mentioned dental dams as being part of it.

Hence my total astonishment and horror - when they were trying to use one of them for the standard type of fillings like I'd had before.

All medical professionals must get "informed consent" before any procedure they plan on doing - whether in Normal Times or Covid Times. This "informed consent" must be given IN ADVANCE (ie in advance of the visit). I thought I was established finally with a dentist I was okay with - but am definitely reviewing this and wondering whether to swop again in the light of not having been told in advance and asked for my "informed consent" to this before I went there. It's definitely got me seeing that dentist in a new light and wondering whether to swop for future reference.