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A Stress-free Approach to Tooth Isolation

By Anthony Mennito, DMD

In my opinion, we are in a golden age of dentistry. The materials we have at our disposal are incredibly esthetic, increasingly durable, and can be placed with minimal to no removal of healthy tooth structure. So why are we so stressed out all the time? The reality is that even though our material armamentarium is robust, the attention to detail required to place these materials successfully is very high.

We all know that our bonding materials are, to varying degrees, moisture intolerant. We also know that the human mouth essentially exists at 100% humidity. And for some reason, when our patients get in the dental chair, their salivary output doubles or triples (or so it would seem). Isolation is critical to doing good dentistry. And, of course, all sorts of options are available for us to keep our working fields clean and dry. But for me, there is only one option that reduces my stress chairside, thus freeing me up to focus on the details required to do great dentistry – the rubber dam.

We all have a bit of PTSD from learning how to use a rubber dam in dental school. I was the same and resisted it for years. Then COVID happened. When our profession was trying to figure out how to return to work safely, it made sense that properly isolating the tooth from the rest of the oral cavity would minimize the risk of viral aerosolization, and using a rubber dam does this the best. So, I committed myself to learning and looked for a simple, repeatable set of tools to help my team and I learn how to do this efficiently. Enter the True™ Dental Dam (Clinician’s Choice®) and “soft” dental clamps.

Dr. Mennito True Dam isolation article FIGURe 1

The “soft” clamps are made from a material called PEEK (polyether ether ketone). What I love about them is that they are much kinder to the tissue and, therefore, more comfortable for the patient than those metal clamps we all struggled with in dental school. Our practice is all about the patient experience, and I don’t want to have to give palatal injections to put a dam on. The good news is that with these, I rarely have to, and I can use them for 90%+ of my cases.

Dr. Mennito True Dental Dam article isolation FIGURE 2

When I tell dentists about my use of rubber dam, the one comment I often hear is “the patients don’t like it.” I will tell you that for a few months in our practice, we trialed a suction/retraction device to see how effective it was and whether our patients preferred it. Resoundingly, our patients’ feedback was that the dental dam was much more comfortable. What we, as clinicians, learned is that the dental dam was also much more effective. The other part that people don’t really talk about is how much our dental team loves the True Dental Dam. How much easier is it for our chairside assistants if they don’t have to retract/tongue wrestle while suctioning and handing us materials and instruments? The buy-in from our team has been unanimous.

Dr. Mennito True Dam isolation article FIG 3

With all that being said, the best part of the True Dental Dam is this: once it’s on, my stress level goes way down. I don’t have to think about moisture, what the patient’s tongue is doing, or whether the patient is going to close down or try talking to me. I can “Just Do Dentistry.” Doesn’t that sound nice?

Anthony Mennito, DMD


Dr. Anthony Mennito graduated from Temple Dental School in 2003. Since then, he has spent his career in dental education and in private practice. He has done research, patented a dental material, started a biotech company, published 21 clinical papers, and established an international speaking career focusing on dental technology and materials. He currently practices at Expertise Dental in Charleston, SC.

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