Rubber Dam Use During Root Canal Treatment: from The Dental-PBRN

Objectives: The Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org) comprises dental practices in the United States and Scandinavia.  Among other opportunities, DPBRN provides a venue to investigate whether certain procedures are performed routinely in everyday dental practice.  The objectives for this study were to: (1) quantify rubber dam use during root canal treatment; and (2) test the hypothesis that certain dentist or practice characteristics are associated with its use. 

Methods: As part of a larger questionnaire about network infrastructure capabilities, 991 DPBRN practitioner-investigators were invited to participate in an online questionnaire that included items about rubber dam use and other forms of isolation used during root canal treatment.  Merger with DPBRN Enrollment Questionnaire data provided certain dentist and practice characteristics. 

Results: A total of 729 practitioner-investigators responded; of these, 553 practitioner-investigators do root canal treatment and reported the percentage of root canal procedures in which they use a rubber dam.  Of these 553 practitioner-investigators, 45% use a rubber dam for all root canal treatment; 23% use it for 51%-99% of root canal treatment, 17% use it for 1%-50%; and 15% never use a rubber dam during root canal treatment.  Cotton rolls and other forms of isolation were also reported.  Certain dentist and practice characteristics were significantly associated with rubber dam use during root canal treatment.  For example, geographic region was significantly associated with use, as were type of practice (solo private practice, group practice, public health practice), type of dentist (general dentist, endodontist, other), and year of graduation from dental school (all p<0.05, Mantel-Haenszel chi-square trend tests).

Conclusions: Not all DPBRN practitioner-investigators who do root canal procedures use a rubber dam during root canal treatment, even though doing so is the current clinical standard of care.  Support: U01-DE-16746, U01-DE-16747.