title: Influence of rubber dam on objective and subjective parameters of stress during dental treatment of children and adolescents - a randomized controlled clinical pilot study.
abstract: BACKGROUND
  Rubber dam is recommended for isolating the working field during adhesive dentistry procedures; however, dentists often omit rubber dam, particularly in paediatric dentistry, supposing that it would stress the patient.
  
  
  OBJECTIVE
  The aim of this study was to evaluate stress parameters during a standardized dental treatment procedure performed with or without rubber dam. The treatment time was measured as a secondary outcome variable.
  
  
  METHODS
  This study was designed as a randomized, controlled, clinical study with 72 patients (6-16 years; mean age, 11.1). During standardized fissure sealing procedures, objective parameters of stress (e.g., skin resistance, breath rate) were recorded. The operator's stress level was measured by pulse rate. Subjective pain (patients) and stress perception (operator) were evaluated by an interview.
  
  
  RESULTS
  The breath rate was significantly (P<0.05) lower and the skin resistance level was significantly higher during treatment with rubber dam compared to the control group. Subjective pain perception was significantly lower for the test group. The treatment time needed for the fissure sealing procedure was 12.4% less in the test group.
  
  
  CONCLUSIONS
  Isolation with rubber dam caused less stress in children and adolescents compared to relative isolation with cotton rolls if applied by an experienced dentist.
authors.affiliation: Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ammann
authors.forename: Andreas
authors.initials: A
authors.lastname: Kolb
authors.forename: Adrian
authors.initials: A
authors.lastname: Lussi
authors.forename: Rainer
authors.initials: R
authors.lastname: Seemann
mesh_terms: D000293:Adolescent; D002648:Child; D019140:Dental Care for Children / Q000523:psychology*; D005157:Facial Pain / Q000523:psychology*; D005260:Female; D005712:Galvanic Skin Response; D006339:Heart Rate; D006801:Humans; D008297:Male; D058748:Pain Perception; D010865:Pilot Projects; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D056152:Respiratory Rate; D016733:Rubber Dams / Q000009:adverse effects* / Q000523:psychology; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D013784:Textiles; D013997:Time Factors
chemical_list: D010895:Pit and Fissure Sealants