Factors associated with dental dam use during non-surgical root canal treatment: A national dental PBRN study
Bibliographic record
Abstract
OBJECTIVE: Dental dam (DD) isolation is widely recognized as the standard of care during non-surgical root canal treatment (RCT), yet its routine use by general dentists (GDs) remains inconsistent. This study utilized real-world data from the National Dental Practice-Based Research Network ("Network") to quantify the frequency of DD use and identify practitioner and practice characteristics associated with it. METHODS: A total of 153 Network dentists (49 endodontists, 104 GDs) enrolled 1860 adult patients requiring RCT across all six Network regions. After exclusions, data from 1701 patients were analyzed. Dentists recorded detailed pre- and post-treatment data for each RCT completed, including whether DD isolation was used. Statistical analyses were performed, including bivariate and multivariable models that adjusted for clustering of patients within practitioners. RESULTS: Endodontists reported near-universal DD use (99%). GDs used DDs in 72% of the teeth that received RCT, with wide inter-practitioner variability (SD=40%). Among GDs, higher DD use was significantly associated with practicing in large group or academic settings (OR=6.2, p=.04) and being located in the Midwest or Western Network region (OR=5.2, p=.005). GDs who identified as White, Asian, or Hispanic had higher DD use compared to other groups (OR=2.9, p=.09). DD use among GDs was not associated with tooth type, nor with the GD's sex, age, or professional membership. CONCLUSIONS: Despite improvements in DD use compared to prior reports, substantial variation persists among GDs. Practice setting and Network region are the strongest predictors of adherence to DD use. CLINICAL SIGNIFICANCE: DD use during RCT remains inconsistent among GDs, with practice setting and Network region strongly associated with adherence. Targeted institutional and regional strategies may improve compliance, ensuring safer, higher-quality care and reinforcing DD isolation as a critical clinical standard in endodontics.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".