Nobody Uses Dental Dams

So why do they still exist? An Object Lesson.

WhiteJack / Shutterstock / The Atlantic

The students have survived watching their teacher demonstrate how to put a condom on a “wooden penis model.” They’ve been assigned homework to find examples of contraception use in sex scenes in movies or TV shows. But before they go, they have one final lesson, one last barrier method for their teacher to sheepishly explain: the dental dam, a latex sheet used as a barrier during oral sex.

According to a sex-education curriculum used by school districts in San Diego, Boston, Portland, and elsewhere, their teacher would show them how to remove a dam from its package and place it over genitalia by forming an “O” with their hand. The instructor would inform the students that dental dams are flavored, and that they should only be used once and then thrown away. Most important, the teacher would instruct them to always use dental dams when performing oral sex on women, or they’ll be at risk of transmitting STIs.There’s just one problem: The pupils are unlikely to ever take their teacher up on the suggestion. Even the teachers, preaching about the dangers of STIs, have probably never bought one themselves.

Carol Queen, a staff sexologist for the sex-shop chain Good Vibrations, says the company sells less than 600 dams per month in the United States, across 13 stores and its website. Mary Jane Minkin, a clinical professor in the department of obstetrics, gynecology, and reproductive sciences at the Yale University School of Medicine, puts it more simply: “Nobody is using them.”

It might seem like that would spell doom for the dental dam. But it has managed to live on: first as a staple of sex education, but now as a symbol of sex positivity for queer women—whether or not anybody ever uses them.

Sanford Barnum invented the rubber dental dam in 1864 to isolate individual teeth from saliva during dental surgery. For more than a century, the product’s use seems to have been limited to dental operations. But in the late 1980s, as millions of gay men began dying of AIDS, safe-sex advocates adopted the dental dam for an entirely new purpose.

It’s not clear who initiated this reinvention, which appears in records of gay media and activism as early as 1988. Clive Woodworth, the managing director of the Australian condom-manufacturing company Glyde Health, claims he invented the modern dental dam in 1993 after lesbians asked him for their own safe-sex product.

“They didn’t understand why companies like mine were selling sexual-health products for everyone but lesbians,” Woodworth says. “They were tired of cutting up condoms and saran wrap because they didn’t like the idea of fluid being transmitted without a barrier.”

At this time, there was no scientific consensus around HIV transmission, so as the epidemic killed millions of gay men, gay women thought they might be next.

“Lesbians were like, ‘Hey, we need services too! We don’t know what we need them for, but we need them,’” says Katie Batza, the author of Before AIDS.

In the nearly four decades since, science has shown that HIV is practically impossible to transmit between women, and dental dams were more a product of AIDS panic than of genuine medical necessity. But dental dams are still around, even if not because of consumer demand.

Their potential to prevent more common STDs has gone largely unrealized. Juliet Richters, a former professor of sexual health at the University of New South Wales, is one of few researchers who have performed quantitative research on dental-dam use. In one of her studies, she found that among 330 Australian women who had sex with women, only 9.7 percent had ever used a dental dam, and just 2.1 percent used them often. In another study, Richters found that only 4 percent of women prisoners in New South Wales had used the device. For context, according to the National Center for Health Statistics, 93 percent of American women who have had sexual intercourse have used a condom at least once, though just 17 percent of people had used a condom for oral sex.

Richters wasn’t surprised by the results; she had never thought that dental dams were widely used. “They used to give out dental dams at lesbian events, but nobody took them,” Richters says. “You’d find them all left on the floor.”

From a medical perspective, it makes sense that dental dams aren’t highly sought after. Cunnilingus is one of the safest forms of sex in terms of STD transmission. Minkin, the Yale School of Medicine professor, says this is likely because the labia tissue is more similar to external skin than the internal tissue exposed during anal or vaginal sex, and thus less susceptible to STD transmission.

Sexually transmitted diseases and infections such as gonorrhea, herpes, and HPV can still be transmitted via oral sex, though the HPV vaccine adds another level of safety against that virus; 66 percent of adolescents now get the vaccine, which should reduce the risk of exposure via oral sex over time.

“If we can’t even get people to use condoms all the time, even when pregnancy is at stake, dental dams are a tough sell,” Minkin says. And compared with condoms, which are ubiquitous in pharmacies and convenience stores, dental dams are generally only available online or in sex shops. They’re pricey, too—often more than twice as expensive as condoms.

They are also awkward, both to talk about and to use, says Chris Barcelos, an assistant professor at the University of Wisconsin at Madison who researches safe sex in queer communities. “People say dental dams take the fun out of oral sex,” Barcelos says. “You lose a lot of sensation and pleasure when you give or receive oral sex with a dam.” Jay Botsford, the co-host of the Queer Sex Ed podcast, agrees. “The people I know who’ve tried them really hated them, because they were just uncomfortable and awkward to use. It’s obvious that they weren’t made for sex,” Botsford says. Some new, speculative designs for dental dams are trying to solve those problems; among them is a dam in the form of women’s underwear. But that product hasn’t yet been approved by the Food and Drug Administration as a viable way to prevent disease.

So if dental dams aren’t widely used, accessible, pleasurable, or necessary to protect against serious STD risk, it could make sense to leave them in the past, a footnote in the history of the 1980s. But young people often still learn about them in sex ed.

Students in Farmington, Michigan, learn about the proper use of dental dams for oral sex. Students in Washoe County, Nevada, are reminded to check the expiration date of their dental dams, and store them in a cool place. Students in Kentucky public schools learn that having oral sex without a dental dam is unsafe and that dental dams help prevent HIV transmission, and students in Los Angeles learn that Saran wrap can be used in a pinch as a dental-dam substitute.

The decentralization of American education makes it practically impossible to know how many schools across the country teach about dental dams, or when they entered the sex-education canon, explains Alexandra Lord, the author of Condom Nation. The Centers for Disease Control recommends dental-dam use, but it does not mention dental dams in its study of school sex-education-program curricula around the United States.

Planned Parenthood includes dental dams as a consistent component of its curricula. “A big part of Planned Parenthood’s sex-education value system is helping young people make their own decisions,” says Julia Bennett, the director of learning strategy at Planned Parenthood Federation of America. “For some people, dental dams might make a lot of sense, but for other people, other safer-sex methods might be more useful to them. It’s not up to us to make that decision for them.” The sex educator Karen Rayne agrees, noting that while she knows people don’t really use dental dams, she’s still wary of cutting them out of her curricula. “I would never want someone to contract an STI because I didn’t teach them about dental dams,” she says.

This is the common justification for including dental dams in sex ed: There’s no harm. But some people feel uncomfortable advocating for a product they know is rarely actually used. “There’s this inside joke among sex educators that part of our job is to tell people about dental dams, when nobody is actually using them,” Barcelos says. They worry they’ll be seen as hypocritical, advocating for a supposedly safer option while ignoring the fact that the option is rarely actually exercised. “We’re taught to impose this pressure to use dental dams, even though nobody does, including us,” Botsford adds.

Botsford believes sex educators are taught to emphasize STD prevention in this way because of a preoccupation with negative sex outcomes rather than pleasure. “We don’t blame people for getting cancer or getting the flu; we blame the existence of those illnesses. But with STIs, the problem isn’t the existence of the virus: It’s the fact that you had sex and you didn’t do the things you should have done.”

This fixation on the potential harms of sex is embedded in the basic structure of sex education, says Jessica Halem, who does outreach for the Harvard Medical School’s Sexual and Gender Minorities Health Equity Initiative.

“Sex education should center pleasure, and disease and infection conversations should happen with pediatricians,” Halem says. “Why don’t we talk about HPV alongside the flu? They’re both illnesses that can be vaccinated against, but only one of them is all wrapped up in anxiety about sex. If you reframe sex education [around] pleasure, a lot of this stuff just seems silly. Can people even achieve orgasm with a dental dam? I have no idea.”

Halem argues that dental dams should be struck from curricula entirely. “If you only have a short period of time to educate young people about sex, dental dams should not be taking up any of those precious moments,” Halem says. “I just really don’t want anybody not having oral sex because they can’t find a dental dam. My god, that’s a tragedy!”

Even if no one uses them, dental dams can still serve a purpose. To some, the existence of dental dams is a validation of a type of sex often minimized or ignored.

“There’s a broader cultural idea that lesbian sex is a joke, and that when queer women have sex, they’re just gently rubbing up against each other or something,” Barcelos says. “Using things like dental dams is one way to establish that [lesbian] sex is really sex. If you need a product, that makes it real.”

Maureen Kelly, the founder of Planned Parenthood’s LGBT Health & Wellness program, has noticed the impact of that validation firsthand. She’s had young queer people in her sex-ed classrooms come thank her for talking about dental dams, as even just mentioning the existence of dental dams acknowledges a type of sex that centers both women’s pleasure and queer identity.

“Young queer kids in particular are very attuned to whether or not their identities are being included in an education setting,” Kelly says. “When they notice that they are seen, that makes a huge difference and can go a long way in education.” For Kelly, that might be reason enough to keep dental dams around: They can be symbols of security and validation, even if nobody is actually using them.