The Root Cause
The dental professional’s guide to latex glove allergies
Natural rubber latex is a material found in many dental supplies—mainly exam gloves. In the past decade, there has been a significant increase in the number of healthcare professionals reporting allergic reactions to latex. Since frequent exposure to latex products can lead to increased sensitivity, healthcare professionals are at a higher risk of developing an allergy to latex proteins.
TYPES OF REACTIONS
Generally, people attribute any latex glove-related reaction as an “allergy,” but there are actually two types of latex reactions: Allergic contact dermatitis (Type IV hypersensitivity) and true latex allergy (Type I hypersensitivity).
TYPE IV HYPERSENSITIVITY: Allergic contact dermatitis is a reaction to the chemical additives used in the manufacture of latex gloves (OSAP, 2013). Symptoms take several hours to develop, and include swelling, redness, itching, and blistering/cracking of the skin. Patients and staff with allergic contact dermatitis require the use of vinyl gloves, as nitrile and neoprene gloves contain the same chemical additives found in natural rubber latex.
TYPE I HYPERSENSITIVITY: Conversely, true latex allergy is a reaction to the latex proteins. These proteins can infiltrate the body through skin and mucosa. If latex lightly powdered gloves are used, aerosolized latex proteins can also enter the respiratory system during gloving and ungloving (OSAP, 2013). Reactions can range from erythema and hives to the most severe reactions characterized by anaphylaxis. Patients and staff with true latex allergy require the use of non-latex gloves, such as nitrile, neoprene or vinyl.
Apart from dental healthcare workers, those “at risk” for allergic reactions are patients with asthma, a history of hay fever, or allergies to trees, grasses, animals, dust, molds and certain medications. Dentists can use this checklist to provide a latex-safe facility for patients and staff with possible or documented latex allergy:
- Screen all patients for latex allergy (e.g., obtain their health history)
- Be aware of some common predisposing conditions (e.g., spina bifida, urogenital anomalies, or allergies to avocados, kiwis, nuts, or bananas).
- Be familiar with the different types of hypersensitivity and the risks that these pose for patients and staff.
- Consider sources of latex other than gloves, including prophy cups, rubber dams, and orthodontic elastics.
- Provide an alternative treatment area free of materials containing latex.
- Remove all latex-containing products from the patient’s vicinity and adequately cover/isolate any latex-containing devices that cannot be removed from the treatment area.
- Give patients with latex allergy the first appointments of the day to minimize inadvertent exposure to airborne latex particles.
- Frequently clean all working areas contaminated with latex powder/dust.
- Frequently change ventilation filters and vacuum bags used in latex-contaminated areas.
- Have latex-free kits (e.g., dental treatment and emergency kits) available at all times.
- Be aware that allergic reactions can be provoked from indirect contact as well as direct. Hand hygiene is essential!
- Communicate latex allergy procedures (e.g., verbal instructions, written protocols, posted signs) to other personnel to prevent them from bringing latex-containing materials into the treatment area.
- If latex-related complications occur during or after the procedure, manage the reaction and seek emergency assistance as indicated.