f. Procedure for Rubber Dam Removal. Rubber dam removal is just as
important as its application, which means that the same careful planning should be
followed for rubber dam removal. The first step in removal should be a clean up of the
operative debris, that is, flush the area with water and use suction to remove the debris.
After this is done, the ligature must be removed. This could be accomplished by cutting it
with scissors. Very carefully, stretch the dam and cut the dam septum. Next, the clamp
is removed, followed by removal of the head strap. The rubber dam and frame are now
removed from the oral cavity. The patient's mouth should be wiped. At this point, allow
the patient to rinse his mouth. After you have allowed your patient to rinse his mouth,
allow him a brief rest period (30 seconds). Now check the occlusion and make those
corrections needed. Before the patient is dismissed, make a final inspection of the
g. The Team Approach. In the team approach, the rubber dam is placed in the
mouth by the dental officer and the dental specialist working together, each following
prearranged steps in the procedure. This procedure is explained in detail in the
Subcourse MD0510, General Duties of the Dental Specialist.
2-16. CAVITY PREPARATION
a. General. Cavity preparation is largely a mechanical procedure in which hand
excavating instruments and motor driven burs, disks, and stones are used to remove
caries and debris and to cut and shape tooth structure. Speeds used with rotating cutting
instruments vary from the range of 4,000 to 10,000 revolutions per minute (rpm) to "high"
speeds of 500,000 rpm or more. Instruments and techniques vary with the speeds. The
dental specialist should be familiar with these differences and be prepared to adapt
readily to assist in the use of any technique.
b. Instrument and Material Setup. Specific instruments used in cavity
preparation will be determined by the dental officer's preference and by the location of the
cavity and the type of restorative material to be used. Instruments and materials used in
preparing the cavity for an amalgam restoration include the contra-angle hand piece and
appropriate hand instruments and burs, stones, and disks.
(1) Resistance form, retention form, and convenience form. The dental
officer will begin each procedure by selecting one of the burs previously discussed and
then outlining the cavity preparation. This establishes the general outline that the
preparation will take or how it will appear on the surface of a tooth. The bur used to
accomplish this procedure will depend on the dental officer's preference. The bur that
might be used is the inverted cone bur, straight fissure bur, or tapered fissure bur. After
outlining the cavity preparation, the dental officer will want to obtain the resistance and
retention forms. Though resistance and retention are not the same, both are
accomplished at the same time. Resistance form is a form whereby the tooth and the