Dental CPD

Before placement, gather all necessary equipment: 

• rubber dam sheet
• template
• frame punch
• clamp
• forceps
• dental floss
• wedjets
• instruments

Clamp selection depends on the tooth or teeth planned for isolation, and the condition of the tooth structure. Winged or wingless clamps can be used depending on the clinician's preferred placement of the rubber dam. 

Select the correct dam size and thickness. Mark and punch holes for the teeth to be isolated

​For single tooth isolation:

1. Punch a single hole in the rubber dam, selecting a size appropriate for the tooth. A rubber dam template can be used to aid optimum hole position choose a clamp appropriate for the tooth.
2. Use floss to secure the clamp and protect the patient’s airway.
3. For a winged clamp load the rubber dam onto the clamp before placement.
4. Using the rubber dam forceps gently stretch the clamp over the tooth and place on or below the gingival margin in a position where there is maximum stability for the clamp.
5. Stretch the dam over the wings of the clamp, attach the frame and floss through contacts.
6. Use an instrument such as a flat plastic to invert the rubber dam around the cervical area for a tight seal.
7. Small adjustments to the position of the clamp can be made to maximise the seal.

​For a wingless clamp:

1. Before placing the clamp secure with floss to allow it to be retrieved if required
2. The clamp is first seated on the tooth before the rubber dam.
3. Load the clamp onto the rubber dam forceps and place over the tooth, ensuring the clamp is fully seated.
4. Stretch the rubber dam sheet over the tooth, attach the frame and floss contacts.
5. Invert the rubber dam and adjust the clamp if required.
6. Once the rubber dam liquid has been placed around the margin of the tooth, cure for twenty seconds.
7. Once the procedure has been completed, engage the clamp and remove clamp, frame and sheet.

      3. Place the slit over the teeth planned for isolation. 
      4. Use clamps or wedjets on the most distal teeth to anchor the dam. The clamps can be placed over the rubber dam to aid patient comfort.  
      5. Place the frame. Invert the dam around the teeth.  Putty can be placed on the palatal aspect to seal the dam if this is required. 

​Floss ligatures as a useful adjunct to further stabilise the rubber dam. They help secure the dam around teeth, improve inversion, and maintain a moisture free environment.

1. Choose a strong unwaxed dental floss for better grip. Use a length of 30-40cm to allow easy handling and tying. Create a slipknot by forming a loop and passing one end through it. This allows the ligature to tighten easily around the tooth.
2. Place the ligature around the tooth at the cervical margin, just below the contact point. Ensure the rubber dam is properly seated before tightening. Pull both ends of the floss firmly to tighten the ligature. Avoid excessive force to prevent tissue trauma.
3. Once secured trim the excess floss close to the knot to avoid interference.
4. Wedjets are small elastic stabilisers used to secure the rubber dam when clamps are not required or as an additional anchor. They are ideal for anterior teeth or when extra retention is required.
5. Select a size appropriate for the teeth. Wedjets come in multiple colours for easy identification. Stretch the wedjet slightly and insert into the interproximal space at the cervical margin

Thank you to:

• Dr Michael Young - General Dental Practitioner, NHS Highland and Scottish Clinical Leadership Fellow, PSD Scotland
• Dr Taranjit Kaur - General Dental Practitioner, NHS Lanarkshire and Scottish Clinical Leadership Fellow, PSD Scotland
• Sara Marwick -  Dental Educator, PSD Scotland

• James Bremner - Specialist Digital Lead, PSD Scotland

   

• Edinburgh Dental Education Centre

• Published 03/06/2026
• Due for Review 31/05/2028