Adverse reactions to protective gloves used in the dental profession: experience of the UK Adverse Reaction Reporting Project

Abstract

The Adverse Reaction Reporting Project (ARRP) was set up to measure the extent and severity of adverse reactions to dental materials in the UK. Further analysis into the use of protective gloves has been carried out to establish the degree to which gloves are having a deleterious effect on the dental profession. In addition the survey aimed to establish the techniques used to manage adverse reactions and their effectiveness. In a 23-month period, 369 reports were received concerning adverse reactions to protective gloves used in dental practices. Reporters were contacted for further information, and a 92% response rate was achieved. The 330 reports analysed showed dentists to be the largest group to report adverse reactions, whilst dental technicians reported the fewest. The referral rate for staff and patients was similar with a third of adverse reactions being referred (n=110) to a specialist for diagnosis. A confirmed diagnosis was received in 65% of referred cases (n=72), but the symptoms reported suggested a larger degree of Type I reactions occurring than diagnosed. The use of non-powdered gloves appeared to be favoured over powdered gloves in 42% of glove changes, and nitrile gloves were used as an alternative to latex in 39% of changes. In conclusion, the results from this survey showed that wearing gloves in dental practices in the UK caused a range of adverse reactions. In 79% (n=330) of cases reported and analysed, these reactions were readily resolved or improved by selfmedication, prescribed medication and / or changing to a different type of protective glove.

Occupational Contact Dermatitis Amongst Dentists and Dental Technicians

“…Subsequent research showed a decline in the incidence from 8.5% to 4.3%, which was related to using latex gloves of better quality with lesser amounts of allergens 7,21,27,28 . A study performed in Great Britain on the side eff ects of latex gloves among dentists revealed that the majority of allergies to latex could be controlled by self-medication, prescribed therapy and/or changing to other types of gloves 29 . Successful preventive programs were also introduced in order to decrease the incidence of allergies to latex or other dental materials (i.e.…”

“…For some people with CD, it is possible to wear latex gloves that do not contain other chemicals. Furthermore, frequent hand washing after the use of gloves is recommended, as well as the usage of appropriate skin care (hydrating creams or ointments), while for periods of worsening, topical corticosteroids and sometimes systemic antihistamines are usually applied 19,29 . In some countries, local state authorities participate in the prevention of these disorders through regulatory actions that reduce the risk of latex products in health workers and patients.…”

The national survey of adverse reactions to dental materials in the UK: a preliminary study by the UK Adverse Reactions Reporting Project

“…Further analyses by the ARRP into glove related adverse reactions have been carried out and forms the basis of a separate article in the British Dental Journal. 15 The degree of reactions reported was mainly moderate (n = 469: 44%) however most of these reports did not always follow closely to the ARRP guidelines, mainly through a lack of referring the affected person to a specialist for diagnosis which is a prerequisite of the ARRP moderate reaction type definition. When the figures were revised to follow the guidelines, 43% were mild (n = 457), 30% moderate (n = 324) and 12% severe (n =126).…”

Hand eczema among Lebanese dentists: An epidemiological study

“…27 If this step is unsuccessful, they should change to non-latex gloves or should wear glove liners under their latex gloves. 28 Additionally, washing the hands frequently after the use of gloves could help remove irritants causing allergy. 27 Dentists with known NRL protein hypersensitivity should use only non-latex (nitrile) gloves and should undertake proper hand care in the form of topical moisturizers and corticosteroid-or antihistaminecontaining ointments, which is why the usage of nitrile gloves is the most important preventive measure in the dental occupation.…”

“…27 Dentists with known NRL protein hypersensitivity should use only non-latex (nitrile) gloves and should undertake proper hand care in the form of topical moisturizers and corticosteroid-or antihistaminecontaining ointments, which is why the usage of nitrile gloves is the most important preventive measure in the dental occupation. 17,28 To prevent hand eczema caused by methyl methacrylates, it is important to develop no-touch techniques to avoid skin exposure to these chemicals. 29 Additionally, protection can be improved using nitrile rubber gloves or double gloving to prevent small molecular acrylates from permeating the gloves;in this manner, direct skin contact could be avoided.…”