Isolating the Last Tooth in the Arch

Rubber Dam isolation can be tricky enough sometimes - it is especially awkward when the TERMINAL MOLAR needs restoring. How on earth does one isolate AND matrix this tooth?
In this episode Isolating the Last Tooth in the Arch #RubberDamFam, Dr. Celine Higton delves into the intricacies of rubber dam isolation, particularly focusing on the last tooth in the arch. This discussion ties into the broader theme of mental health, highlighting how mastering such techniques can lead to a more enjoyable and stress-free practice.
Protrusive Dental Pearl: "Cow Mode" as a technique to improve access to the mouth's hard-to-reach areas, especially around the last molars. By instructing patients to shift their jaw to one side, akin to a cow's chewing, this approach aids in better oral hygiene practices and facilitates procedures like rubber dam isolation when clamping the terminal molar.
Highlights of this episode:
0:00 Introduction
02:24 Protrusive Dental Pearl
5:36 Introduction to Dr Céline Higton
7:07 The Journey from Architecture to Dentistry
9:15 Mastering Rubber Dam Isolation: Tips and Techniques
14:12 Types of Clamps Ideal for Isolating the Last Tooth (Upper)
18:01 Dental Pearl - Cow Mode
19:22 Accessing the Last Tooth
22:13 Dr. Céline’s Personal Choice of Rubber Dam
23:11 Proper Lubrication for Rubber Dam
25:00 Correct Flossing Technique
27:01 Matrixing the Last Tooth
32:09 Cavity Preparation
35:37 Isolating the Last Tooth (Lower)
37:28 Coronoid Process in Clamp Placement
38:36 How to get in touch with Dr Celine
Reach out to Dr. Céline Higton via her Instagram, @drcelinehigton and via her website, #RUBBERDAMFAM - rubberdamfam.com/
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[@xevora9310]

Excellent topic. Here's my method for matrixing the distal surface of the last tooth. Put on a rubber dam. Put a sectional matrix on the distal surface, hold it tightly against the margin with a carver. Create a strut between the clamp and the upper rim of the sectional with high viscosity flowable composite, have the assistant light cure it. The matrix will now stay in place. Add more struts if needed, it'll look like a web. If I need a tighter seal, I'll add teflon tape. The bonus of this method is not having to remove your clamp to put on a tofflemire.
In the beginning, I used to 3D-print the distal wall with high viscosity flowable and then finish it with a disc if needed. If you smooth out each increment with a probe, the end result is very similar to what you might get with a matrix and no finishing is actually needed. In order to use this method, the adhesive applicator and the cannulas for the etchant and the composite need to be double-angled (bent twice with tweezers). Many tweezers have a small hole in one of the arms. This hole is perfect for bending the cannula. For smoothing out the composite, you need a double-angled probe, like the ones periodontists sometimes use. A regular probe won't reach the distal surface. Side note: if only there was a way to double-angle the tip of the sandblaster. Also, the air-water syringe.

[@joyafif1156]

I saw a webinar with Dr. Celine about a year ago and she really inspired me to up my game using rubber dam. I have been practising for 24 years now and wish I had learned how to use it a lot earlier on. It really is a game changer in terms of reducing stress and enjoying your work.
I’m still facing challenges with it but it’s definitely getting easier and conversations like these make me feel I’m not alone! Thank you both ❤

[@AgnieszkaAnonymus]

Thank You so much for a great conversation and all tips! Greetings from Poland!

[@user-et1xm9dq1q]

Thank you!!