The US Centers for Disease Control website states: ‘use a new latex or polyurethane dental dam every time you have oral sex’. The site explains how a dental dam works, and then goes on to tell readers how to make their own dam using a spatchcocked condom…
So why exactly is the CDC anticipating the need for a bit of pre-coital DIY? Well, for historical reasons I’ll go on to explain, dental dams are hard to get hold of, rarely used, and under-researched.
A few weeks ago I was at my local sexual health clinic getting a check-up. Towards the end of what was a friendly and professional consultation they asked if I had any questions. Nerdy sex historian that I am, I asked if they had any dental dams. The doctor replied, ‘Dental dams? I’m sorry I don’t know what that is?’ So awkwardly I explained. The doctor left to try to hunt some down and the nurse and I began chatting about the dental dam’s neglected place in queer sexual health history. The nurse herself had never seen one. When the doctor returned empty handed, I apologised for sending her on a wild-goose-chase and left.
While I was a bit perturbed that my doctor had never even heard of dental dams, I was not really surprised they didn’t have any at the clinic. I live in Birmingham, and although the clinic I attended is large and serves a varied demographic – including LGBTQ communities – in truth, very few people use dental dams. The jury is still out about whether those who do should even bother.
Indeed, the website for the sexual health charity for young people, Brook, currently states: ‘The dam might be useful for preventing sexually transmitted infections (STIs) but there is currently no research to verify this’ [my emphasis].
(The absence of research on dental dams is in part to due to their infrequent use, which in turn limits the commercial incentives required to get prophylactic manufacturers to pay for research proving they work ‘when used properly’.)
So if they only maybe work, why do they exist? And why have I been trying to get my hands on one? The answer lies in the history of HIV prevention and lesbian health activism.
As an object, the dental dam awkwardly straddles the history of AIDS activism and queer sexuality, acting as an assertion that sex doesn’t require the presence of a penis to be real sex, while acknowledging simultaneously that such sex still carries risks. The dental dam was deployed as an object for sexual use in an attempt to abate the risk of HIV transmission, but its questionable efficacy as a barrier against the virus has reduced it, for some at least, to a latex relic of historical fears.
So what was/is a dental dam?
The dental dam was a repurposed rubber barrier probably in use since around 1864. It was originally used to protect dentists/patients from contamination during dental surgery and to isolate the tooth being drilled. For sexual purposes, it was a ‘make-do prevention tool’ born of the early days of AIDS crisis, first deployed in response to fears of HIV transmissions through oral sex between cis women – though later it was taken up by the wider LGBTQ communities, albeit in a limited way. As Da Choong, Women’s Development officer for Terrence Higgins Trust reflected in 1992:
When I first joined Terrence Higgins Trust the talk was all about dental dams. Providing dental dams was a way of discussing the issue with lesbians in a way for them to start thinking about it seriously. Dental dams have never been tested as an HIV barrier, aren’t easily available and are not easy to use. But we were providing condoms for men, so we had to provide something for lesbians to use.
— Sue O’Sullivan and Pratibha Parmar, Lesbians Talk (Safer Sex), (London: Scarlet Press, 1992), p. 44-45
The dental dam was ‘difficult to use’ and untested, in part because it was a re-purposed Victorian technology only adapted for sexual purposes to meet the challenges of the AIDS crisis. The condom, in contrast, was, as one Health Education Council advert argued, a fairly reliable and easy to use old technology which had undergone development over the years. Indeed, as one Durex poster suggested, you just ‘slip’ them on – though the fine print did warn that users should read the instructions…
In contrast to the thin latex of the condom, dental dams:
[were] pieces of latex about 5-inches square… designed for use in dental surgery and are thicker than condoms. You can buy dental dams in quantity at dental or medical supply stores. Hopefully the demand for them will encourage suppliers to create a thinner variety. Some people use Saran Wrap or other plastics, but none of these have been tested to see how well they protect.
— Making It: A Woman’s Guide to Sex in the Age of AIDS explained in 1987, p.13-14
The wish for an improved dam was granted in 1993 and 1994 when Glyde Health and Line One Laboratories both began making thinner dams especially for oral sex. Despite this innovation, and in addition to the difficulty of actually getting hold of one, more problems damned the dam. They weren’t as user-friendly as the ‘slip it on’ condom:
When you use dental dams, make sure to rinse them off first. They come sprinkled with talc, which can be irritating and dangerous to delicate body parts. It may be hard to keep track of which side has mouth juice and which side has vagina/ass juice.
— Making It, p. 14
And, as later participants at a lesbian health conference in Birmingham complained ‘they aren’t exactly sexy’ (See Figure 2). In anticipation of such a complaint, Making It suggested the following more seductive adaptions:
Inventive dental dam users have made holders out of garters, lace panties, and other favourite garments. Some people make masks using elastic ties.
— Making It, p. 14
Others suggested the addition of ‘honey, yogurt, or chocolate’ be added to a dam before cunnilingus or analingus to cover up the rubber taste.
Some years later, during the 1995 LesBeWell ‘Dykenosis in the Flesh’ health conference, the dental dam came up in a sexual health workshop, and participants apparently found it ‘very difficult to think of good things to say’ about them.
Perhaps the reasons listed above have something to do with why I can’t get hold of a dental dam.
Another reason might be dental dams’ historical (and ongoing) disputed necessity among sexual health campaigners. In 1992, changing perceptions of the HIV transmission risk engendered by oral sex, and risks among lesbians more generally, led the Terrence Higgins Trust to confidently assert cunnilingus was ‘very low risk …so ditch those dental dams’, causing outcry and consternation among those who felt this advice was cavalier. In part the THT was trying to raise the profile of the risks presented to lesbians by condomless sex with cis men, needle sharing, or artificial insemination. But intent was rather lost in the consequent uproar.
While the THT might have been publically abandoning the dental dam to foster more ‘accurate’ discussions of safer-sex in 1992, other more conservative sexual health educators didn’t even acknowledge their existence as a possible barrier method. While government-sanctioned sexual health education advocated condom use between sexually active adults, and discussed safer-sex as part of adolescent health education (albeit in a limited way), oral sex either went undiscussed, or was generally declared risky and presented as a paraphilia best avoided, especially where cunnilingus and analingus were concerned.
So if you can’t buy them or use them easily, and we don’t really have the data on their status as a reliable barrier method, why are they still a thing? In part it’s because we still need to think about and talk about risk.
Some have argued the dental dam must maintain its place on sexual health curriculums because it occupies what would otherwise be a notable gulf in sex education and sexual health discourse by disrupting the heterosexism which would otherwise dominate; making space for pleasure without penetration. Indeed, the absence of a public health push for universal dental dam use, unlike the championing of the condom, is indicative of wider perceptions about what counts as sex, what counts as risk, and which bodies count as risky. As Choong pointed out in 1992 ‘Dental dams have never been pushed for heterosexuals.’ I’d argue, we must keep asking: “why”?
In an echo of its sexual history, it would appear that not even dentists like using dental dams. Read about their history here: Chris Emery, ‘Rubber Dam: An Overview’, Vital 10, no. 1 (November 2012): pp. 29–33. (TW for link: Very scary pictures of dentistry).https://www.nature.com/articles/vital1606
For a discussion of dental dam use between men see Peter Tatchell and Robert Taylor, Safer Sexy: The Guide to Gay Sex Safely (London: Continuum International Publishing , 1994).
Sue O’Sullivan and Pratibha Parmar, Lesbians Talk (Safer Sex), (London: Scarlet Press, 1992)
Cindy Patton and Janice Kelly, Making It: A Woman’s Guide to Sex in the Age of AIDS, (San Francisco: Firebrand Books, 1987)
Hannah J. Elizabeth is a cultural historian of emotions and public health specialising in the history of HIV, childhood, and sexuality.
Find Hannah @sexhistorian