Wednesday, October 8, 2014

Latex Allergies in Dentistry

In the past few weeks, we have had two latex-related incidents at our office.

The first was when one of the hygienists used latex gloves for part of a cleaning before she realized the patient had an allergy. The patient was 19 years old and she had a mild dermatitis reaction. Her medical history did note that she was allergic. The patient’s mother was quite upset and asked to speak to me, since I had done the exam. I am not the owner of the practice and have no real power when it comes to office management, but the mother wanted me to promise that our office would get rid of all latex products. I told her I would speak with the owner but that it wasn’t really my decision to make. I did speak to the office manager, but apparently most of the staff hates the feel of non-latex gloves.  I was willing to switch, but my voice was only one in an office of three dentists and three hygienists. We are currently still using latex gloves. The cost of nitrile gloves is higher, which is another thing to consider. We did update our policy to always have a pop-up warning on any patient with a latex allergy; every time the chart is clicked, the warning shows up.

The second issue was with a patient who is not allergic; she is a nurse and is afraid that she will become allergic to latex from exposure over time. She needed a RCT No. 19 and asked that we use only latex-free products. We discussed that we can do a latex-free rubber dam and use latex-free gloves. The patient also was highly concerned about the gutta-percha, as she learned it was form of rubber. We discussed at length the history of gutta-percha as an RCT filler and that there are not a lot of good alternatives. After she left, I tried to research cross reactivity of latex-allergic patients and gutta-percha. Everything I read seemed to indicate that there is no evidence of any cross reactivity. I also discussed the issue with an endodontist, who confirmed that there is no known cross reactivity and that the subject has been studied extensively. 

The moral of the story is that latex allergy is a very real thing, and that it is important to be aware of our patients’ allergies and always get a good medical history. Gutta-percha, however, is completely safe.

From time to time, we are all going to get patients who read too much on the Internet, and it is nice to be ready for them.

Sarah Meyer, DDS

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