Reducing Pain and Discomfort Associated with Rubber Dam Clamp Placement in Children: A Systematic Review and Meta-Analysis of Effectiveness

Abstract

Abstract Background The application of rubber dams is a widely accepted method of tooth isolation in dental practice. Placement of the rubber dam clamp might be associated with levels of pain and discomfort, especially in younger patients. The purpose of the present study is to systematically review and meta-analyze the efficacy of the proposed methods for reducing pain and discomfort associated with rubber dam clamp placement in children. Materials and Methods English-language literature from inception until September 6th, 2022 was searched in MEDLINE (via PubMed), SCOPUS, Web of Science, Cochrane, EMBASE, and ProQuest Dissertations & Theses Database Global for articles. Randomized controlled trials (RCTs) were retrieved and risk of bias assessment was performed. Studies were summarized and pooled estimates of pain intensity scores and incidence of pain were calculated. The meta-analysis was conducted in four comparison groups. Results Initially, 1452 articles were retrieved. Sixteen RCTs were finally included for reviewing and summarizing. Nine articles were included for quantitative meta-analysis. The differences in pain intensity scores were not significant in any comparison groups. Eight studies were judged as having some concern for risk of bias and the remaining studies were considered as low risk for bias. Conclusion Within the limitations of the current study, no significant differences were found between the proposed methods for reducing pain and discomfort associated with rubber dam clamp placement in children. A larger number of more homogenous studies regarding intervention methods and pain assessment tools need to be conducted in order to draw stronger conclusions.