World Journal of Dentistry

Register      Login

VOLUME 12 , ISSUE 4 ( July-August, 2021 ) > List of Articles


Dentist's Attitudes, Practice, and Barriers toward the Use of Rubber Dam during Operative and Endodontic Treatments: An Online Questionnaire Survey

Nezar Boreak, Aeshah Hanbashi, Hala Otayf, Hamed Alshawkani, Mohammed Mashyakhy, Hemant Chourasia

Keywords : Dentists, Endodontics, Online survey, Questionnaire, Rubber dam

Citation Information : Boreak N, Hanbashi A, Otayf H, Alshawkani H, Mashyakhy M, Chourasia H. Dentist's Attitudes, Practice, and Barriers toward the Use of Rubber Dam during Operative and Endodontic Treatments: An Online Questionnaire Survey. World J Dent 2021; 12 (4):306-310.

DOI: 10.5005/jp-journals-10015-1840

License: CC BY-NC 4.0

Published Online: 15-07-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim and objective: To assess the attitude, practice, and barriers toward the use of rubber dam during endodontic and operative procedures among dentists in Jazan, Saudi Arabia. Materials and methods: An online descriptive cross-sectional questionnaire survey was conducted among the dentists practicing in the Jazan region, Saudi Arabia. A total of 259 dentists participated in this study. Convenience sampling was used due to the limitation in the study duration and COVID-19 pandemic. The data collection were done online using a questionnaire designed at The association between the independent variables and the responses to the questions was tested using the Chi-square test. Statistical significance was determined at α = 0.05. Results: About 75% of participants mentioned that rubber dam was available in their clinic; however, only 71% had used it for their patients. Regarding the barriers that prevent the usage of rubber dam, 68% cited as financial reasons, 25% mentioned that they are not fully aware of how to use it, while 6% said that rubber dam was not available. A statistically significant association was found between training on rubber dam use, the working sector professional classification and experience, and using rubber dam for patients in the clinic. No statistically significant association was observed between rubber dam use and gender and place of education. Conclusion: The participants had a favorable attitude toward rubber dam use. The training, operator experience, and workplace are favorably associated with rubber dam use. Increased cost, insufficient training, and non-availability of rubber dam were reported as the greatest barriers to regular usage. Clinical significance: Most of the barriers reported for the non-usage of rubber dam are myths that have been propagated over time. The benefits of rubber dam use significantly outweigh the costs incurred.

  1. Wang Y, Li C, Yuan H, et al. Rubber dam isolation for restorative treatment in dental patients. Cochrane Database Syst Rev 2016;9(9):CD009858. DOI: 10.1002/14651858.CD009858.pub2.
  2. Sanghvi AM, Nagda RJ, Raju PJ. A cross-sectional study on frequency of rubber dam usage among dentists practicing in Maharashtra. India Saudi Endod J 2018;8(1):39–43. DOI: 10.4103/sej.sej_92_16.
  3. Ibhawoh LO, Enabulele JE. Rubber dam use during non-surgical endodontic treatment among a population of dentists in Edo State. Nig J Dent Res 2020;5(1):35–41.
  4. Ahmed HM. Rubber dam application in endodontics: evidence and practice. Eur J Gen Dent 2015;4(3):161–162. DOI: 10.4103/2278-9626.163320.
  5. Ahmed HM, Cohen S, Levy G, et al. Rubber dam application in endodontic practice: an update on critical educational and ethical dilemmas. Aust Dent J 2014;59(4):457–463. DOI: 10.1111/adj.12210.
  6. Hedge MN, Hedge P, Hegde A. Rubber dam isolation for endodontic treatment in difficult clinical situations. J Dent Sci 2014;2:12–18.
  7. Ahmad CA. Rubber dam usage for endodontic treatment: a review. Int Endod J 2009;42(11):963–972. DOI: 10.1111/j.1365-2591.2009.01623.x.
  8. Cochran MA, Miller CH, Sheldrake MA. The efficacy of the rubber dam as a barrier to the spread of micro-organisms during dental treatment. J Am Dent Assoc 1989;119(1):141–145. DOI: 10.14219/jada.archive.1989.0131.
  9. Castellucci A. Tooth isolation-rubber dam. In: Textbook of endodontics, vol. I., IL Tridente 2004. pp. 226–243.
  10. Weisman MI. Remedy for dental dam leakage problems. J Endod 1991;17(2):88–89. DOI: 10.1016/S0099-2399(06)81615-8.
  11. Khan HR, Azam S, Qureshi B. Knowledge and attitude of house officers regarding rubber dam use. PODJ 2018;38(1):97–101.
  12. Tanwir A, Amin M, Choudhry Z, et al. Knowledge, attitude and perception of dental fraternity towards practice of rubber dam. Pakistan Oral Dent J 2015;35(4):691–694.
  13. Tanalp J, Kayatas M, Can ED, et al. Evaluation of senior dental students’ general attitude towards the use of rubber dam: a survey among two dental schools. Sci World J 2014;2014:290101. DOI: 10.1155/2014/290101.
  14. Shashirekha G, Jena A, Maity AB, et al. Prevalence of rubber dam usage during endodontic procedure: a questionnaire survey. J Clin Diagnos Res: JCDR 2014;8(6):ZC01.
  15. Lynch CD, McConnell R. Attitudes and use of rubber dam by Irish general dental practitioners. Int Endodon J 2007;40(6):427–432. DOI: 10.1111/j.1365-2591.2007.01212.x.
  16. Al Qarni MA. A survey on usage of rubber dam during composite restorative procedures by general and specialist dental practitioners in Saudi Arabia. J Orofac Res 1970;3(1):1–4. Available from:
  17. Unal GC, Kaya BU, Tac AG, et al. Survey of attitudes, materials and methods preferred in root canal therapy by general dental practice in Turkey: Part 1. Eur J Dent 2012;6(4):376–384. DOI: 10.1055/s-0039-1698975.
  18. Peciuliene V, Rimkuviene J, Aleksejuniene J, et al. Technical aspects of endodontic treatment procedures among Lithuanian general dental practitioners. Stomatologija 2010;12(2):42–50.
  19. Slaus G, Bottenberg P. A survey of endodontic practice amongst Flemish dentists. Int Endod J 2002;35(9):759–767. DOI: 10.1046/j.1365-2591.2002.00564.x.
  20. Koshy S, Chandler NP. Use of rubber dam and its association with other endodontic procedures in New Zealand. N Z Dent J 2002;98(431):12–16.
  21. Csinszka K, Monica M, Mihai P, et al. Prevalence of rubber dam usage among dental practitioners and final year students in tirgu mures: a questionnaire survey. Acta Marisien Seria Medica 2015;61(3):188–191. DOI: 10.1515/amma-2015-0059.
  22. Abraham SB, Rahman B, Istarabadi A, et al. Attitudes towards use of rubber dam in private practices in the United Arab Emirates. Saudi Endod J 2012;2(3):142–146. DOI: 10.4103/1658-5984.112708.
  23. Whitworth JM, Seccombe GV, Shoker K, et al. Use of rubber dam and irrigant selection in UK general dental practice. Int Endod J 2000;33(5):435–441. DOI: 10.1046/j.1365-2591.2000.00329.x.
  24. Mala S, Lynch CD, Burke FM, et al. Attitudes of final year dental students to the use of rubber dam. Int Endodon J 2009;42(7):632–638. DOI: 10.1111/j.1365-2591.2009.01569.x.
  25. Marshall K, Page J. The use of rubber dam in the UK. A survey. Br Dent J 1990;169(9):286–291. DOI: 10.1038/sj.bdj.4807357.
  26. Palmer NO, Ahmed M, Grieveson B. An investigation of current endodontic practice and training needs in primary care in the north west of England. Br Dent J 2009;206(11):E22. discussion 584-5 10.1038/sj.bdj.2009.473.
  27. Stewardson DA. Endodontics and new graduates: Part I, practice vs training. Eur J Prosthodont Restor Dent 2002;10(3):131–137.
  28. Joynt RB, Davis EL, Schreier PH. Rubber dam usage among practicing dentists. Oper Dent 1989;14(4):176–181.
  29. Gergely EJ. Desmond greer walker award. Rubber dam acceptance. Br Dent J 1989;167(7):249–252. DOI: 10.1038/sj.bdj.4806985.
  30. Filipović J, Jukić S, Miletić I, et al. Patient's attitude to rubber dam use. Acta Stomatol Croat 2004;38:319–322.
  31. Stewardson DA, McHugh ES. Patients’ attitudes to rubber dam. Int Endod J 2002;35(10):812–819. DOI: 10.1046/j.1365-2591.2002.00571.x.
  32. Samaranayake LP, Reid J, Evans D. The efficacy of rubber dam isolation in reducing atmospheric bacterial contamination. ASDC J Dent Child 1989;56(6):442–444.
  33. Seron MA, Strazzi-Sahyon HB, Banci HA, et al. The importance of rubber dam isolation in endodontics throughout COVID-19 outbreak. Braz Dent J 2020;31(6):567. DOI: 10.1590/0103-6440202003760.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.