Dental management of children with latex allergy

This paper reviews the aetiology, epidemiology and dental management of children with latex allergy. The issue of latex allergy has serious consequences for the dental management of children with one or more of the following risk factors: spina bifida, atopy, first surgery before one year of age, history of multiple surgical procedures, congenital urologic abnormalities, gastrointestinal malformations, hydrocephalus internus, ventriculo-peritoneal shunts, spinal cord injuries, and family history of atopy. Management of latex allergy is based upon the diligent avoidance of latex exposure. Universal use of powder-free low-allergen latex gloves is recommended.     

Reported latex allergy in dental patients

OBJECTIVE: The purpose of this study was to alert doctors of dental surgery to the possibility of latex sensitivity in both outpatients and inpatients. STUDY DESIGN: The study involved 2 groups: group A was composed of 21 subjects with a history of immediate reaction in dental environment; group B was composed of 24 healthy individuals. Patients underwent skin prick tests with common inhalant allergens, with latex cross-reacting foods, with a commercial extract of non-ammoniated latex, and the incremental challenge test with local anesthetics. Specific IgE to latex and to latex cross-reacting foods were measured with the fluorescent enzyme immunoassay. RESULTS: All patients in group A and none in group B were latex-allergic. Subjects who were latex-allergic were significantly more likely to be atopic and had positive IgE test to cross-reactive foods. CONCLUSIONS: Dentists and people working in a dental surgery environment must obtain detailed patient history to help identify individuals at risk of latex allergy or those actually allergic to latex. If an allergy exists, equipment used should be made of alternative materials.     

Screening for latex allergy with a questionnaire: comparison with latex skin testing in a group of dental professionals

BACKGROUND: Latex allergy has emerged as an important cause of allergic reactions particularly in health workers. Due to the lack of a standardized extract for objective skin testing a screening questionnaire was developed. METHODS: At the 1995 Australian Dental Association Conference, all attendees were invited to complete a questionnaire and undergo skin testing to assess the level of latex allergy in this population and to assess the performance of the questionnaire as a screening test for latex allergy. RESULTS: The questionnaire had high specificity but poor sensitivity compared to skin testing with latex extract. CONCLUSION: This study compares at risk individuals identified by a screening questionnaire with those identified by objective skin testing. A questionnaire designed to screen for latex allergy was reliable for identifying those with low risk while overestimating those at risk of true latex allergy, demonstrating the need for objective testing with reliable allergens.     

Integrity of powdered and powder-free latex examination gloves

OBJECTIVES: The difference in permeability between one brand of powdered and another of powder-free latex examination gloves was evaluated to determine leak rates. METHODS: Thirty-one of each type of glove were tested for each of three different conditions: usage by dental personnel (1) for 15 minutes or longer, (2) for less than 15 minutes, and (3) directly from the manufacturer's packaging (zero usage time). Each glove was evaluated in the fingers and the palm. The phiX-174 viral solution in the glove was allowed to penetrate for 15 minutes. Powder (cornstarch) was subsequently added to 20 powder-free gloves, and 15 of these were pierced with a 30-gauge needle. RESULTS: Powdered gloves showed no leakage rates. Because of this, 30-, 27-, and 25-gauge needles were used to pierce five gloves each. One glove with 27- and 25-gauge needle holes showed leakage. Leakage rates for powder-free gloves: 45.1 percent for more than 15 minutes of use, 25.8 percent for less than 15 minutes of use, and 16.1 percent for zero minutes of use. Two of the 20 pierced and one of the five unpierced powder-free gloves with added cornstarch leaked. CONCLUSION: Significant differences in leak results between powdered and powder-free gloves suggest further study is needed.     

Electrochemical properties of mono-particle-layer films of polyaniline-coated latex microspheres

Latex particles with the structure of a polystyrene core and a polyaniline shell were synthesized. They were nearly mono-dispersed spheres 1.62 μm in diameter. The aqueous suspension of the latex particles was spread on a glass substrate and dried in a mono-particle layer. The arrangement of the spread particles depended on the concentrations of the latex, those of the surfactant, and drying speed. The particles were also arranged on a platinum electrode in a mono-particle layer at a very slow drying speed although the particles were likely to gather at the boundary between the platinum and the insulating wall. The cyclic voltammograms of the mono-particle layer were similar to those of electrochemically polymerized films and of the film prepared by spreading and drying the polyaniline-dissolved pyrrolidone. The peak currents at high scan rates deviated downward from a linear relation with the scan rate. The mono-particle layer was inserted into tetrahydrofuran to remove the core-polystyrene. The resulting film covered the electrode surface smoothly. Its voltammetric peak current was almost proportional to the scan rate, as was observed at electropolymerized films.     

An allergic reaction to latex rubber gloves

Most dental practitioners are gloving up to work. With this trend, reports on manual dexterity, barrier effectiveness, and more have been recorded. This case report describes a new consideration--an allergic reaction by a patient to the dentist's rubber-gloved hands.     

Natural rubber latex allergy and dental practice

Natural rubber latex (NRL) allergy is a significant clinical problem with potentially life-threatening complications. Oral health care professionals must be able to screen for NRL allergy and refer patients or staff to a specialist for definitive diagnosis. Protocol for its management must be developed and incorporated into daily practice. Practitioners must be able to recognize and treat NRL exposure emergencies. Knowledge of the availability of substitute products and an adequate fresh stock of such products in dental practice can minimise the risk of adverse NRL sensitivity.     

正畸乳胶牵引圈拉伸性能的测定

目的：???测定临床常用的4种正畸乳胶牵引圈的拉伸性能。方法???选择具有相同弹力参数的正畸乳胶牵引圈，根据圈内径分为3/16组、1/4组、5/16组和3/8组，使用电子拉伸实验机分别进行力学测定，分析4种牵引圈在0~60?mm形变范围内形变量与载荷的关系，建立形变-载荷对照表。结果??圈内径、形变量对乳胶牵引圈载荷均有显著影响（P=0.000）；相同形变量不同牵引圈载荷有显著性差异；形变量在5~40?mm范围内各牵引圈的形变-载荷曲线近似直线关系，斜率间的差异无统计学意义；在3倍拉伸长度下，1/4组与3/8组牵引圈载荷和弹力参数间的差异无统计学意义（P>0.05），而3/16组与5/16组牵引圈载荷和弹力参数间的差异有统计学意义（P<0.05）。结论???正畸乳胶牵引圈的载荷随圈内径及形变量的变化而变化，临床上应当根据所需力值大小选择合适的牵引圈。     

Electrocatalysis of carbon dioxide with hemin and hemin-coated latex

Carbon dioxide was reduced catalytically with hemin in 2-propanol to reveal a cathodic wave at ?1.1 V. The catalytic activity was demonstrated with the UV spectra in which Fe²⁺ (hemin) was oxidized with CO₂. Hemin was immobilized on polyallylamine–polystyrene latex as a quasi solid catalyst. The hemin-coated latex in a suspension of 2-propanol showed the catalytic activity for CO₂ similar to the hemin molecule. The rate constant of the catalytic reaction of dissolved hemin was evaluated on the assumption of the pseudo-first order reaction to give 11.5 M^?1 s^?1, whereas the hemin-coated latex suspension did not obey the simple combination of the pseudo-first order reaction and diffusion because of the reaction with CO₂ accumulated in the particles.     

Absorption of UVA light by latex and vinyl gloves

Abstract – UVA-radiation can produce malignant changes in skin. When making light cured dental fillings, dentist and dental assistant, particularly on their fingers, may be exposed to UVA radiation. The latex examination gloves were able to absorb 76% of the radiation, whereas the vinyl examination gloves absorbed only 33% of the radiation. Latex gloves thus proved to give more effective protection against UVA radiation than vinyl gloves.     

Efficacy of protection by latex gloves during orthodontic therapy

The wearing of gloves during orthodontic or dental treatment is generally indicated for reasons of hygiene and protection against infection. This study was aimed at determining the extent and localization of perforations caused by the various orthodontic treatment techniques and interrupting the infection barrier.The impermeability was tested by means of a water retention test according to European standard EN 455, Part 1, performed on 1600 Centramed^® (Centramed, Koblenz), Tekmedic^® and SafeEx^® non-sterile disposable latex gloves (both by Safe Med, Switzerland) and Safe Gan^® latex gloves with an additional acrylate coating (also by Safe Med).The perforation rate in unused gloves was between 0.5% and 7.5%, rising on average to 11% with increasing use. 36% of the total number of lesions resulted from handling removable appliances, and 57% from handling fixed appliances, especially when replacing archwires and elastics. Most lesions were in the thumb, index finger and palm region. Only 18% of the defects were noticed by the dentists themselves. The gloves worn by beginners in their first year of postgraduate orthodontic training had about twice as many defects as those worn by qualified orthodontists.When patients with an increased risk of infection are to be treated, additional hand disinfection measures should be taken and 2 pairs of gloves worn in view of the relatively unreliable protection offered by commercially available latex gloves.     

Absorption of UVA light by latex and vinyl gloves

UVA-radiation can produce malignant changes in skin. When making light cured dental fillings, dentist and dental assistant, particularly on their fingers, may be exposed to UVA radiation. The latex examination gloves were able to absorb 76% of the radiation, whereas the vinyl examination gloves absorbed only 33% of the radiation. Latex gloves thus proved to give more effective protection against UVA radiation than vinyl gloves.     

Orthodontic latex elastics: a force relaxation study

The objectives of this study were to assess the force relaxation of latex elastics occurring within 24 hours of extension and to estimate the extension required to reach the reported force. Five specimens of various manufacturers' latex elastics size and force levels were mounted on a custom-made setup capable of monitoring force levels in real time with a continuous mode and without operator intervention. The percentage of force relaxation was estimated from the initial and 24-hour levels, and the results were analyzed with one-way analysis of variance and the Tukey test at alpha = 0.05 level of significance. The elastics showed force relaxation in the order of 25%, which consisted of an initial high slope component and a latent part of decreased rate. Most relaxation occurred within the first 3-5 hours after extension, regardless of size, manufacturer, or force level of the elastic. The overall as well as the initial relaxation curves were fitted to equations, which described the variation of force with time. Elastic extension to achieve the reported force was found to range between 2.7 and five times the original length. Latex elastics show force relaxation in the order of 25%, which consists of an initial high slope component and a latent part of decreased rate. Most relaxation occurs within the first 3-5 hours after extension, regardless of size, manufacturer, or force level of the elastic. The empirical rule of "3" shows remarkable variation, ranging from 2.7 to five.