Journal - Dental assistant (Chicago, Ill. : 1994) (United States )

Journal - Journal of the American Dental Association (1939) (United States )

Abstract :

BACKGROUND: Allergies to natural rubber latex (NRL) were unknown in dentistry until 1987. That changed with the publication of a report documenting NRL-based anaphylaxis in a dental worker. This case and others prompted regulatory and manufacturing changes in rubber products and increased awareness throughout the profession. However, other common dental chemicals cause allergic reactions and irritation and often are handled with insufficient precautions. Although recognition of NRL allergy has improved, awareness of other potential allergens and irritants in dentistry still is limited. OVERVIEW: Recent research indicates that the prevalence of NRL protein allergy may be decreasing. In contrast, occupation-related dermatoses associated with other dental products may be more common. Encounters with bonding agents, disinfectants, rubber, metals and detergents can cause occupation-based irritant contact dermatitis and allergic contact dermatitis. These conditions may be found in more than one-quarter of dental and medical personnel. Therefore, dental-specific information about the recognition and management of allergic and irritant reactions is needed. CONCLUSIONS AND CLINICAL IMPLICATIONS: The prevalence of occupation-related dermatitis may be increasing in dentistry. Reducing exposure to potential irritants and allergens and educating personnel about proper skin care are essential to reversing this trend.

Journal - Journal of dental hygiene : JDH / American Dental Hygienists' Association (United States )

Abstract :

PURPOSE: Oral health care professionals have been shown to be at risk for developing a type I allergy to natural rubber latex (NRL). The objective of this study was to assess the prevalence of this allergy in dental hygienists. METHODS: Participants attending the 2000-2002 American Dental Hygienists' Association (ADHA) national meetings were screened for type I allergies to NRL using skin prick testing, symptom assessment, and health history. Participants were classified as positive for a type I NRL allergy based on their positive skin prick reactions to standardized NRL solutions. Risk factors and symptom assessments were based on a self-reported health history. RESULTS: Of the 582 ADHA participants who completed the screening and health history questionnaire, 4.8% (n=28) screened positive for a type I allergy to NRL (SPT-positive). These SPT-positive participants were significantly more likely to report an allergy to cross-reacting foods, plants, molds, and pollens, and to report reactions to rubber products. Participants screened SPT-positive were also significantly more likely to report a history of hives and respiratory symptoms after contact with natural rubber. CONCLUSION: Based on skin prick testing, the prevalence of a type I allergy to NRL in dental hygienists appears similar to that reported for other oral health care professionals and is greater than the general population. Educating dental hygienists about type I NRL allergy may help reduce prevalence and improve its management.

Journal - Current opinion in allergy and clinical immunology (United States )

Abstract :

PURPOSE OF REVIEW: Dental professionals and their physicians frequently do not recognize, accurately diagnose or appropriately manage occupational allergies. Dental allergen identification, diagnostics and practical avoidance strategies are summarized in this review. RECENT FINDINGS: Methacrylates, natural rubber latex proteins, rubber glove allergens, and glutaraldehyde are the predominant allergens in dentistry. Reactions range from cell-mediated contact allergy to urticaria and occupational asthma. SUMMARY: Despite recent advances in allergen characterization and increased awareness of selected allergens, treatment of occupational allergies can be improved. Better information and improved cooperation between dental workers and their clinicians is needed.

Journal - Journal of the American Dental Association (1939) (United States )

Abstract :

BACKGROUND: Like other health care workers, dental professionals are at risk of developing allergic contact dermatitis, or ACD, after exposure to allergenic chemicals. Common allergens include antimicrobials, preservatives, rubber additives and methacrylates. CASE DESCRIPTION: The authors describe an orthodontic assistant with severe skin disease, whose symptoms included redness, cracking and bleeding that persisted for 10 years. The patient had previously received an incomplete diagnosis. After performing patch testing, assessing symptoms and evaluating the patient's medical history, the authors diagnosed ACD resulting from exposure to several dental allergens. The patient received appropriate treatment and counseling to better manage her allergies; this resulted in resolution of all symptoms and averted permanent occupational disability. CLINICAL IMPLICATIONS: Not all skin reactions are related to gloves or natural rubber latex. Dental professionals should be aware of common chemical allergens, symptoms of ACD and the appropriate treatment of occupational skin disease.

Journal - Cutis; cutaneous medicine for the practitioner (UNITED STATES )

Abstract :

Hypersensitivity to natural rubber latex, an ingredient of many medical devices and consumer products, appears to be increasing. Chemical additives induce T-cell mediated type IV delayed reactions while proteins that occur naturally in latex elicit antibody-mediated type I immediate reactions. The latter can be fatal. The clinical manifestations of these reactions, the risk factors for developing latex hypersensitivity, and diagnostic options are reviewed. The only reliable management strategy is allergen avoidance. Therefore, factors that can affect the levels of both type I and type II allergens in products are discussed.