Context: A proper isolation technique plays a key role in the success of restoration of carious tooth. Aim Of The Study: The aim of this in-vivo study was to evaluate efficacy of addition silicone dam coverage technique with conventional isolation methods in restorative procedures and endodontic treatment. Settings And Design: Forty-Five patients who fulfill the inclusion criteria were selected for the study. Materials And Methods: All the participants underwent clinical procedures using 3 different isolation techniques. Group-1: Clinical procedures were carried out using traditional cotton roll isolation. Group-2: Clinical procedures were carried out using conventional rubber dam isolation procedure. Group-3: Clinical procedures were carried out using addition silicone dam coverage technique. The efficacy of isolation in terms of clinician usage and patient comfort is evaluated by a single evaluator. The results were tabulated and statistically analyzed. Statistical Analysis: IBM SPSS (version 21.0) software was used. Chi-square test was performed, considering P < 0.05 for statistical significance. Results: All the groups demonstrated satisfactory clinical performance. Upon inter and intra-group comparison of the isolation methods, there was statistically significant difference (P > 0.05). Conclusion: It is important to achieve an aseptic environment in clinical restorative and endodontic procedures. Addition silicone dam coverage technique is a chair side modified design which is user friendly with improved treatment efficacy. However, long-term clinical studies must be needed for further evaluation.