Rubber dam is a simple yet essential tool in dentistry, often overlooked but immensely valuable in clinical practice. In this series of Spear Digest articles, we'll explore its significance, origins, and practical benefits. We'll discuss why rubber dam matters, its historical development, and how it enhances dental procedures. From its humble beginnings to its everyday applications, we'll provide insights and tips for efficient rubber dam placement.

The Origin of Rubber Dam

In 1896, a method was described for isolating teeth using a gold band wrapped around the tooth. This technique was known as "cofferdam" (or a watertight enclosure), a term still used in Continental Europe for rubber dams.

The rubber dam was first conceived by Dr. Sanford Christie Barnum from Monticello, Sullivan County, New York.

Dental work in a hospital, Cambridge, Massachusetts, photograph by Lewis Wickes Hine, February 1, 1917
Dental work in a hospital, Cambridge, Massachusetts, photograph by Lewis Wickes Hine, February 1, 1917.

On the 15th of March 1864, he wrote:

“It was a result of my torment caused by saliva. I had passed hours, tired, and distracted by my incessant struggle against unending saliva contamination. I had passed many sleepless nights obsessed over my sad failure asking myself the same old question, which had yet to be answered, ‘How can I keep the cavity dry.’ The answer revealed itself while I was working on a lower left molar, in a mouth in which saliva was flowing everywhere. Desperate and eager to try a new idea, I made a hole in my protective napkin and placed it around a tooth and that is how the rubber dam came to be1.”

How the Cofferdam Went Mainstream

A rubber dam was first used on the patient, Robert C. Benedict, a jeweler at Strong, Stern and Co., Main Street, Monticello.

Rubber dam usage was first documented in the Dental Cosmos by Francis in 1865 and described as “Barnum’s Rubber Dam.” The paper also recommends the use of “waxed silk” to floss between the contacts and improve adaptation.

Barnum declined to patent his invention and, after advice from his uncle, Dr. Clowes, and a close friend, Dr. John Allen, presented it to the dental profession as his gift. This was noted by The American Dental Association at their meeting in Nashville, TN, in August 1870, with the resolution:

“That the thanks of the American Dental Association be and hereby are tendered to Dr Sanford C Barnum for the invention, perfection, introduction, and donation of the Rubber Dam to the Dental Profession.”

This presentation was accompanied by the gifting of a gold watch and chain, marking a significant moment of recognition for Barnum. His contribution garnered worldwide acknowledgment and further citations from The California State Dental Association and The American Dental Society of Europe.

Continuing Innovation Based on Barnum's Legacy

In 1882, SS White, a dental manufacturing firm founded by the dentist Samuel Stockton White, developed the rubber dam hole punch, which remains in use today.

In June 1875, Delos Palmer, a dentist from New York City, patented "Clamps for Rubber Dams" (US Patent 164,870), which are now showcased at The National Museum of American History in Washington, DC. These clamps and the associated forceps bear a striking resemblance to the instruments used in contemporary dentistry.

Later, modifications for clamps were made by Bancroft, Tee, Evans, and Long, among many others.

In 1972, Dr. Hunter A. Brinker, a dentist from Oviedo, FL, described a technique for rubber dam retraction of tissues prior to root planing. The modified clamps he described are excellent for tissue retraction and will be discussed in a later article.

His quote, "To see is to know," aptly explains the necessity for rubber dam in operative dentistry.

The exploration of rubber dam's history and significance underscores its vital role in modern dentistry. From its inception to its practical applications, it's clear that rubber dam offers numerous benefits, including improved isolation, infection control, and patient comfort. In the next Spear Digest articles, I will delve deeper into the advantages of rubber dam usage, shedding light on how this tool can enhance dental procedures.

Jason Smithson, BDS (Lond), DipRestDentRCS (Eng), is a member of Spear Resident Faculty.

References:

  1. Thorpe, B. L. "The Profession’s Benefactor, The Originator of The Rubber Dam." The Dental Review, Vol. 17, 1903.

  2. Francis, C. E. "The Rubber Dam." The Dental Cosmos, pp. 185-187, Vol. VII, Philadelphia, 1865.

  3. Brinker, H. A. "Access - The Key to Success." Journal of Prosthetic Dentistry, vol. 28, no. 4, 1972, pp. 391-401.

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