OSAP Ch.6

How can you keep your hands and skin healthy both inside and outside the dental setting?

-Always rinse and dry hands thoroughly after handwashing -avoid bare-handed contact with sensitizers and irritants such as disinfectants, acrylic monomers, and antimicrobial and pharmacological solutions -be wary of chemicals that can permeate glove materials such as bonding agents, acrylics, and bases and liners.

Items that you can find with latex in the dental setting

-anesthesia masks -anesthetic carpules(stoppers) -blood pressure cuffs -dental dams -disposable gloves -goggles -injection ports -surgical masks -stethoscopes

How can you provide a "latex safe" environment for patients?

-keep nonlatex gloves and treatment kits stocked and use them on latex-allergic patients -identify all latex-containing products and devices in the operatory to prevent their accidental exposure to the hypersensitive patient -have emergency kits w/latex free supplies -be alert to signs/symptoms of allergic reaction and how to treat them -change ventilation filters and vaccum bags used in latex-contaminated rooms -use signs, verbal instructions, and checklists to prevent dental team members from bringing latex into the area -try and schedule latex-allergic patients for the first appointment of the day to ensure that the amount of latex proteins in the air is at a minimum

Anaphylaxis "Type IV" or "delayed" hypersensitivity

A sudden, severe, potentially fatal systemic allergic reaction with symptoms that can include hives, watery eyes, and difficulty breathing.

Allergic contact dermatitis Delayed (Type IV) hypersensitivity

Cause - Allergy to : Chemicals found in the dental practice setting, including methacrylates, glutaraldehyde, and chemicals used in the glove manufacturing process Symptoms- Acute: small, clustered bumps; vesicles;itching;redness;pain Chronic:Dry, thickened skin; cracking, sores; spaced bumps Redness, vessicle formation typically develops several hours after contact and usually confined to but may slightly extend beyond the area of contact Corrective Action- consult an allergist/dermatologist; get a definitive diagnosis. Select a glove that is low in offending chemical allergen

Latex Allergy Immediate (type I)hypersensitivity

Cause- Allergy to the proteins in natural rubber latex Symptoms-Hives, swelling, watery eyes, runny nose, difficulty breathing, abdominal cramps, dizziness, low blood pressure, tachycardia(rapid heart rate), anaphylaxis

What should you do if you think you have an occupational allergy?

Get evaluated, get a diagnosis, and let the diagnosis drive the decision on how to manage the problem in your work setting.

Hives are a symptom of which condition?

Latex hypersensitivity

What should you do for patient screening?

Screen all patients for latex allergy and take a thorough health history and consult with the patient's physician if needed. Obtain a medical consultation when latex allergy is suspected. (ask about reactions to common household products that contain latex, like cleaning gloves, and balloons) (ask about common predisposing conditions: previous history of allergies; history of spina bifida; urogenital anomalies; or allergies to avocado, kiwis, nuts, or bananas)

How can you tell if you're allergic to latex?

See an allergist or dermatologist and get a skin prick test or blood test done to diagnose a latex type-I hyperseinsitivy.

What gloves can someone that's allergic to latex wear?

Vinyl or nitrile

Can workers develop an allergy to latex proteins?

Yes, because of the role of glove powder in latex-protein exposure, powder-free gloves are a good choice for reducing the risk of developing a latex allergy.

Can contact with someone who has worn latex gloves trigger a reaction?

Yes, thoroughly wash your hands after wearing latex gloves especially when working with a highly latex-allergic patient

How can you tell if you have contact (type IV) allergies to glove chemicals?

You can also have a patch test done in which potential allergens are placed in contact with the skin for several days and will determine if you have any contact (type IV) allergies, including those to common glove chemicals.

Irritant contact dermatitis

cause- physical irritation; not an allergy. May be caused by unrinsed scrubs,disinfectants; excessive powder; occlusion; hyperhydration; excessive chemical additives Symptoms- Acute: inflammation, burning itching Chronic: Dry, thickened skin; cracking, sores; spaced bumps. Typically limited to areas of contact Corrective Action-Consult an allergist/dermatologist. Use moisturizing lotions and creams during and after work. Pay careful attention to handwashing techniques (rinsing)

What should you wear when working with gluataraldehyde?

chemical and puncture resistant- utility gloves

True or false:Glove powder is the allergen responsible for latex hypersensitivity

false

How does latex spread through inhalation/aerosols?

latex proteins in gloves attach themselves to glove powder. when powdered latex gloves are donned or removed, latex protein/powder particles become aerosolized.