The cross-infection guidelines of all major dental associations now recommemd that dentists wear protective gloves for all operative procedures . The recommendation for glove wearing has been made to protect both the operator and the patient from croos-infection . The routine use of gloves should protect the dental team from blood borne viruses such as hepatitis B,C and HIV . The use of gloves does bring other problems , some of which are still not properly understood .
The gloves are chiefly made of latex vinyl or plastic . These gloves, in addition to containing chemicals such as accelerators , cross-linking agents , are often dusted on their surface with donning agents to facilitate putting them on . There is therefore a possibility of close opposition of these agents to skin for prolonged periods of time . The effect of this can be irritation or hypersensitivity
>>Problems caused by these gloves :
The simple effect of deleterious substances from gloves can be irritant contact dermatitis (ICD). This is a non-specific inflammatory reactions to irritant chemicals being put in contact with the skin . Surveys have shown that about a third of dentists suffer from it . ICD can also be caused or exacerbated by poor hand -washing techniques which leave pools of hyperosmotic detergents on the hands . Non-removal of rings or watches can cause stagnation areas underneath them which can also result in ICD ; this can be manifested by so-called ring dermatitis .
The other type of dermatitis is allergic dermatitis (AD) . This type of dermatitis is rare but maybe due to delayed or immediate hypersensitivity .
Delayed hypersensitivity 2 is a type IV or cell-mediated hypersensitivity reaction . It slowly evolves usually taking 24-48 hours to cause swelling , erythema , pruritis , vesiculation , and cracking of the skin . A variety of chemicals can induce delayed hypersensitivity including the thiurams , dithiocarbamates , phenols , peroxides , organic pigments . This type of dermatitis is cured by removing the stimulus ( i.e the glove ) ,and the use of topical steroids in severe cases .
Natural latex contains numerous species of proteins . The proteins present in latex have been studied in detail in the last few years as they appear to be related to allergy . The proteins present in latex have molecular weights of 5 ,14 , 29 , & 46 KDa .These are ammoniated during stabilization of the latex . The protein content of latex examination gloves can vary from 0.17 to 4001 g/g latex . The proteins in gloves are water-soluble but in some surgical gloves are almost totally removed . Exposure to these proteins is not good for health-care workers as type 1 allergies may develop .
The prevention of problems for health care with gloves demands a systematic approach to hand care .Good handwashing techniques , the use of emollient creams and powder and protein-free gloves are necessary to avoid hand problems .
