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| LETTER TO EDITOR |
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| Year : 2013 | Volume
: 3
| Issue : 2 | Page : 95 |
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Safety tools in endodontics
N Vasudev Ballal
Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| Date of Web Publication | 13-Sep-2013 |
Correspondence Address:
N Vasudev Ballal
Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal University, Manipal - 576 104, Karnataka
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1658-5984.118161
How to cite this article:
Ballal N V. Safety tools in endodontics. Saudi Endod J 2013;3:95 |
Sir,
I read with great interest the case report by Tavargeri AK et al. regarding the retrieval of swallowed endodontic file by gastro-scope, which has been published in your esteemed journal (SEJ 2013;3(1):31-33). It was harrowing to see the endodontic file in the stomach of the child. This is potentially life-threatening. The need to work under dry conditions, free of saliva, has been recognized for centuries, and the idea of using a sheet of rubber to isolate the tooth dates almost 120 years. It is surprising that even today the use of rubber dam for endodontics among dental practitioners is low. Many reasons such as, time for rubber dam placement, cost of equipment and materials, difficulty in use, and patient acceptance are some of the disincentives to rubber dam use given by the dentists. [1] The majority of these disincentives are based on unfound myths rather than evidence-based reasoning. It is worth spending a few seconds in organizing rubber dam for use in endodontic procedures and thus, it protects the patients from possible aspiration or swallowing of endodontic instruments, medicaments, irrigating solutions and debris, and also improves the entire treatment. [2] As an endodontist, I would like to share few of the safety measures, which can prevent the accidental ingestion of any foreign objects when rubber dam application is not possible. First, while performing instrumentation of the root canal system, the operator can use "Safety Chain" (B.F. Mulholland Dental Supplier, UK), which consists of a clasp that secures the instrument safely to a chain linked to a ring worn on the operator's finger. Secondly, a new dental device known as "Isolite" (Isolite systems, USA) has been marketed, which simultaneously delivers continuous throat protection, illumination, retraction, and isolation. It has a unique soft, flexible mouthpiece, which prevents the aspiration of foreign objects, retracts and protects the soft tissues from accidental damage from high speed turbines, delivers shadow less illumination, continuously aspirates fluids, and isolates maxillary and mandibular quadrants simultaneously. The mouth piece is disposable, and hence, there is no risk of cross infection, easy to place, and comfortable to the patient. It can particularly be useful in pediatric patients with incompletely erupted teeth where application of rubber dam may be difficult. Third, similar device like Isolite known as "Isodry" (Isolite systems, USA) is also available, which performs the same function, but requires external lighting. Finally, the American Association of Endodontic considered tooth isolation using the dental rubber dam as the standard of care; it is integral and essential for any non-surgical endodontic treatment. [3] In addition, the European Society of Endodontology insists that root canal treatment procedures should be carried out only when the tooth is isolated by rubber dam. [4]
| References | |  |
| 1. | Ahmad IA. Rubber dam usage for endodontic treatment: A review. Int Endod J 2009;42:963-72. 
[PUBMED] |
| 2. | Glickman GM, Pettiette MT. Preparation for treatment. In: Cohen S, Hargreaves KM, Keiser K, editors. Pathways of the Pulp. 9 th ed. St. Louis, MO: Mosby; 2006. p. 120-32.
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| 3. | American Association of Endodontists. AAE position statement: dental dams 2010. Available from: http://www.aae.org/Publications/Content.aspx?id=474andterms=dental%20dams.http://www.aae.org/uploadedFiles/Publications_and_Research/Guidelines_and_Position_Statements/dentaldamstatement.pdf. [Last accessed on 2013 Jul 30]
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| 4. | European Society of Endodontology. Quality guidelines for endodontic treatment: Consensus report of the European Society of Endodontology. Int Endod J 2006;39:921-30.
[PUBMED] |
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