Prevalence and Influencing Factors of Rubber Dam Use among Tunisian Dentists: A Cross-Sectional Study.

Context: Despite its undeniable advantages, the rubber dam (RD) is still struggling to claim its rightful place as the most effective used isolation tool in endodontics. The study aimed to estimate the prevalence of RD use during endodontic treatment and to identify factors associated with its use by Tunisian dentists.

Materials And Methods: A cross-sectional study was conducted. An online Google Form was emailed to a sample of Tunisian dentists, randomly selected from the National Dental Council register. It contains 33 questions divided into five parts: demographic characteristics, general endodontic practice, clinical applications of RD, reasons for not using RD, and alternative methods. The sample size, comprising 300 dentists, was calculated considering a previous prevalence. Chi-square/Fisher exact tests and test have been used to investigate factors influencing RD use. For the multivariable analysis, we used binary logistic regression.

Results: Among the 174 respondents, 56.3% were women, with a mean age of 37.7 ± 6.6 years. Seventy-three percent did not have postgraduate training on RD placement. Seventy-one percent reported never using RD for root canal treatments (RCTs) during undergraduate study. Forty-four percent used it with variable frequencies. In the univariable analysis, the number of RCTs per week, years of experience, duration of endodontic sessions, age, pre-endodontic buildup, and undergraduate training were associated with RD use. In the logistic regression, the duration of endodontic sessions [adjusted odds ratio (OR) = 1.053; 95% confidence interval (CI) = 1.023-1.083; < 10] and the undergraduate training (adjusted OR = 4.625; 95% CI = [1.88-11.378]; = 0.001) were associated with RD use.

Conclusion: The use of RD by Tunisian dentists during endodontic procedures is not common. RD application is associated with the duration of the endodontic session and the undergraduate training. Greater emphasis should be placed on the application of RD at dental school and in clinical practice through continuous dental education programs.