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Knowledge, Attitude &Perception Of Patients towards the Use Of Rubber Dam In Dental Clinics At Riyadh City.

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Alaa Al-yousef , Roula Al Bounni


  • Abstract :


Background:Majority of patients visiting the Dental clinic have poor knowledge about the use of rubber dam , Also Majority of patients have negative attitude towards treated under rubber dam .

Objective : To determine the knowledge, attitude and perception of patients towards the use of rubber dam at Riyadh City.

Design : questionnaire survey.

Material and method :Study area: the study will be conducted in Riyadh city, kingdom of Saudi Arabia .Study design The study was a descriptive cross-sectional on Riyadh population  .sample size is of(302)will reached. The study population implicated adult patients aged between 16-50 years of age, This study conducted the time frame of2 months.

Results : A total of 302 questionnaires were distributed, the gender distribution was the 46%patients (n = 163) were male and 54% (n = 139) women. The patients had seen the Rubber Dam before  29.1%(n=88) and 70.9% (n= 214) had never seen the Rubber dam before . of the 88 patients who had previous Rubber dam application, had it placed by a dental student 18.9% (n=57)and 6.6% (n=20) by current dentist and 3.6% (n=11) by different dentist.

Conclusions : in our study we found the majority of patientshave not any  knowledge about  rubber dam .


Keywords: Rubber dam , patient’s attitude, questionnaire, isolation .



  • Introduction :
  • The Rubber Dam (RD) was introduced into dentistry in 1864 by s.c. Barnum, a New York City Dentist. Its use in dentistry is essential as it confers benefits to both the Dentist & the patient. The Rubber Dam is used to define the operating field by isolating one or more teeth from the oral environment. It eliminates saliva from the operating site and retracts the soft tissues. When the Rubber Dam is used, many procedures are facilitated as dryness is ensured during tooth preparation and restoration. In addition, there are fewer interruptions to replace cotton rolls to maintain isolation. When excavating a deep carious lesion that has risk of pulpal exposure, use of the Rubber Dam is strongly recommended to prevent pulpal contamination from oral fluids (1) . The goal of the rubber dam is to achieve isolation and the benefits of this is good moisture control, Operative dentistry cannot be executed properly unless the moisture in the mouth is controlled. The moisture control refers to excluding sulcular fluid, saliva and gingival bleeding from the operating field. Rubber dam also prevents the hand piece spray and restorative debris being swallowed or aspirated by the patient' (2). Generally the rubber dam is the recommended technique for moisture control. However,  have reported that achieving effective isolation is more important than the specific technique utilized. The other techniques for achieving

isolation are the use of cotton rolls, cellulose wafers, throat shields, high volume

evacuators, saliva ejectors, retraction cord, mirror and evacuator tip retraction, Mouth props and use of drugs to control salivation is rarely indicated in restorative dentistry and

is generally limited to Atrophine.(3,4). The other advantages of the Rubber Dam are that it provides a dry, clean Operating

Field, improves properties of dental materials, ensures Protection of the patient and the operator, and improves Operating efficiency. The positive benefits to operator and patient of using rubber dam (RD), particularly for endodontic treatment are well recognized (5).


  • Aim and Objective:to investigate  the awareness of people about  the usage & Objective of rubber dam in Dental Clinics At Riyadh city . To determine the knowledge, attitude and perception of patients towards the use of rubber dam at Riyadh .


  • Material and Methods:

Study area : The study will conducted Riyadh city, kingdom of Saudi Arabia .

Study design :The study was a descriptive cross-sectional on Riyadh population.

Study population :The study population implicated adult patients aged between 16-50 years of age, This study will conducted the time frame of 2 months. Thesample size is of 302 of sample .

Inclusion criteria :

• Patients who consent to follow up with this study

• Patients aged 16 -50 years visiting Dental  Clinic for conservative dentalProcedures

Exclusion criteria :

• Patients not willing to participate

• out the aforementioned aged group

After preparing the questionnaire with the determined questions, we distributed it on the selective patients in order to get the answers and analyses them. Each patient answered the questions included in a special form that designed specifically for this study, then all data subjected to statistical analysis to gain accurate results.

302 patient included in our study, each patient subjected to individual form of the same questions, this questioner was structureedspecific points including: personal data (age, gender ,adders) , questions related with awareness of patient about using and benefits of rubber dam isolation . Then we used  statistical analysis to get the results by program(Spss version 21) . 

  • Result :

The sample size of research was 302. The according to distribution of respondents by age and gender ,shown in Figure 1 & figure 2.    

The patients had seen the Rubber Dam before  29.1%(n=88) and 70.9% (n= 214) had never seen the Rubber dam before . shown in Figure 3 &table 1 .

The patient had it placed the rubber dam isolation by a dental student 18.9% (n=57) and  6.6% (n=20) by current dentist and 3.6% (n=11) by different dentist. shown in Figure 5 & table 3.

In comparison with the previous experience 59(19.5%) , patients considered the present'

experience better than the previous one, 21(7 %) had the same experience while

8(2.6%) consider the present experience worse than the previous . show figure6 ,table4 ,

The 20 (6.6%) of the patients on whom the rubber dam was used, were not given any

explanation by the dentist/dental student of the reason for Rubber dam use before its

application. 68 (22.5%) of patients claimed that an explanation was given to them. show figure7,table5

And the 57(18.9%) of the patients said that the purpose of the Rubber dam was clear to them

while only 11(3.6%) respondents stated that they did not understandthe explanation. show figure 8 , table 6.


In our study the aim was to investigate the awareness of population in Riyadh city   about the rubber dam isolation, we found that 70.9 % of population have no information

About using or benefit of the rubber dam using. we are in same line with (Kapitan_et_al-2015 ) who found that there are a lot of benefits from using the rubber dam in dental procedure. We are in disagreement with (SAURAB SINGH VIRDI 2006) who foundthat  60% of patient responded in positive way to word using the rubber dam while in our study high percentage of subjects  (70.9%) don’t know about the rubber dam isolation,but again, We are in accordance with (Kapitan_et_al-2015) who stated that the dentist attitude about explanation of benefits of using the rubber dam to his patients has a positive influence on the cooperation of patient in dentaltreatment.  .



In our study we found that the awareness of this  isolation method is very poor among population in Riyadh city ,the majority of patients have no information about rubber dam So we need to condense our efforts to increases the awareness of importance  and benefits of this beneficial method  in this country to accomplish long lasting successful results in all dental treatment .




1-      Theodore M. Roberson. H Heymann, E J Swift JR. Art & Science ofOperative Dentistry 4th edition. Mosby, Inc . 2002

2-        Pinkham, Casamassimo , Fields, McTigue, Nowak. Pediatric Dentistry Infancy through Adolescence 4th edition, Elsevier ,Inc 2005.

3-        Raskin A ,Setcos JC, Vreven J. Influence on the isolation method on the 10year clinical behaviour of posterior resin composite restorations, Clinical OralInvestigation 2000 :25: 148 -152.

4-       Fusayama T. Total etch technique and cavity isolation, Journal Of Esthetic Dentistry 1992 :4: 105- 109

5-       European Society of Endodontology. Consensus report of the European Society of Endodontology on quality guidelines for endodontic treatment.International endodontic journal 1994 : 27 :115 -24

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