Use of rubber dam and irrigant selection in UK general dental practice

Aim To evaluate factors which influence rubber dam use and irrigant selecti on in UI(National Health Service (NHS) endodontics. Methodology A postal survey was conducted amongst two age cohorts of dentis ts, representing all of the 1970-73 (older) and 1990-93 (younger) graduates of two northern English dental schools (n = 643). Key and supplementary qu estions were posed on levels of rubber dam use, irrigant selection, and fac tors influencing practice in NHS endodontics. After manual checking, valida ted (dual) entry of responses was made to a flat ASCII data file before ana lysis with SPSS software. The threshold for statistical significance was se t at the 95% probability level. Results Eighty-five per cent of the valid sample responded to the questionn aire. Regardless of age and qualifying school, less than one-fifth of denti sts always or frequently used rubber darn, whilst 60% never used it. Qualif ying school had a significant influence on rubber dam use, whilst age had a variable influence. Major disincentives to the use of rubber dam included the perception that patients do not like it, that the NHS fee was inadequat e to justify its use, that it took too long to apply, and that dentists had received inadequate training. Frequent users of rubber dam were significan tly less likely to cite these disincentives than nonusers. Overall, local a naesthetic solution was the most common endodontic irrigant, Irrigant choic e was strongly linked to rubber dam use, and to graduation cohort. Seventy- one per cent of rubber dam users irrigated with sodium hypochlorite, compar ed with only 38% of nonusers. This pattern was reversed for local anaesthet ic irrigation. Younger graduates were significantly more likely to irrigate with local anaesthetic solution than their older counterparts, and the you nger graduates of one school showed a highly significant increase in the us e of chlorhexidine. Conclusions 1) The majority of UK Health Service dentists never use rubber dam isolation in endodontic treatment. 2) Qualifying school has a significa nt impact on rubber dam use, and irrigant selection. 3) Use of rubber dam h as a significant association with irrigant choice in endodontics.