Expert: Gary Backlund, DMD, MSD - 10/30/2008

Question
Hello My friend was in deseperate need of a root canal and went to a dentist that was to preform the procedure. During the procedure the doctor failed to use a dental dam or a tooth brace to isolate the tooth or the area from infection. He did everything free hand and without any help. As he completed the drilling of the tooth he told her "open your mouth wide you don't want to get burned". He then proceeded to try to cauterize the area- in doing so he set the tool on my friends lip. It gave her second to third degree burns on her lip. She developed infections and had severe pain from the burns for weeks. She now has a permanant scar that can only be fixed through surgery.  Here is my question-  Would the dental dam have prevented the burning of her lip and well as the ensuing infections? Also is the dental dam a requirement in the use of root canals if the tooth is easily accessable and not cracked or broken? She is still requireing repair to both her lips ad teeth and is afraid to continue because of all the problems she has experienced. I look foward to you answers.

Answer
Hi Andrew,

I'm sorry to hear all this happened to your friend. Since I wasn't there nor can I hear the "other side of the story", all I can give you is the standard of care in our area...you'll need to take it from there.

As a specialist, I would NEVER consider doing a root canal without a rubber dam. In fact, that would be an indication for extraction if I were unable to use one. However, it is not REQUIRED to use one. There are many reasons a dam is necessary....control of saliva and contamination and protection of the patient in case an instrument were dropped are the main ones. I don't know any endodontists that cauterize anymore either....we feel cleaning, shaping and filling will allow the tooth to heal.

As for whether the dam would have prevented the burn, I doubt it. It sounds like your friend was burned pretty badly and a dam is just a thin piece of rubber that would probably been burned right through.

Hope this helps.

Gary Backlund DMD, MSD