During the documentation of a clinical case including pictures it is essential for the rubber dam not to have any folds as this will allow us to demonstrate that appropriate isolation is achieved. In order to even the folds the dam needs to be stretched to the opposite side of the arch. Ideally. the isolation needs to extend to include the contralateral premolars As this entails isolating a non anesthetized area the patient might feel the discomfort while isolating the contralateral side. Furthermore, in many situations such as the presence of anterior bridges or orthodontic retainers, it is not possible to extend the isolated area and the appropriate stretching of the dam cannot be guaranteed. An alternative technique would be extending the isolation area until the contralateral canine and using finger pressure to level the dam and remove any creases or folds. Once this in achieved floss could be passed twice to secure the dam and achieve good isolation as well as blocking any voids which will facilitate say removal of the dam following the light curing phase.
Premolar area before the stretch, on the right side folds. on the left side without folds after stretching dam.
We can stretch the dam using our fingers, with a gentle pressure on the contralateral teeth on the buccal side.
Maintaining the pressure, the dental floss goes through the contact point on the corresponding side of the mouth.
Passing the floss twice in the interproximal space.
Now we can cut the excess floss.
Dam properly stretched.