ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title New, Low Protein, Powder Free Latex Gloves Can Be Routinely Used Without Increasing The Risk Of Latex Allergy In Dental Students
Clinical Question Can the newer low protein, powder free latex gloves be used routinely in the dental clinics without increasing the risk of latex allergy in dental students?
Clinical Bottom Line Studies suggest that the newer low protein, powder free latex gloves can be used routinely in the clinic without increasing the risk of the dental student being sensitized to natural rubber latex.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 15240339Jones/200463 Dental StudentsProspective Cohort Study
Key resultsNone of the dental students using low protein, powder free latex gloves developed latex sensitivity during the 4-year period of this study. Yearly skin prick tests were done. Initial skin prick tests showed a positive result in 3 of 63 students who were advised to use nitrile gloves. Of these three students, one continued to show a positive result and one a negative result, while one subject declined further testing. The authors concluded that “exposure to powder-free Latex gloves was not associated with subsequent sensitization over 5 yr."
#2) 21720169Palosuo/2011NAReview
Key resultsThis recent review concluded that it is time for a reappraisal of the ban on use of natural rubber latex gloves. New, low protein, powder free latex gloves that are now available have resolved the allergenic potential that was a problem in the past. The authors reviewed evidence that Latex gloves have superior strength, excellent barrier properties and better acceptance by clinicians compared with synthetic gloves. Palosuo et. al., argue that the natural rubber latex gloves are also economically and environmentally friendly.
Evidence Search ("Gloves, Protective/adverse effects" AND "Latex Hypersensitivity/immunology") AND "Students, Dental"
Comments on
The Evidence
Palosuo et. al., 2011 reviewed original articles and reviews that were published between 1990 and 2010. It should be noted, this was not a systematic review, nor was a meta-analysis provided. The senior author, Palosuo, acknowledges possible conflict of interests on the first page of the published article. Jones et al, 2004 clearly defined their groups at the start of their 4-year longitudinal study of 63 dental students. The exposures and outcomes were measured identically and at yearly intervals during 4 years. There was no dose-response gradient. The number of sensitizations in this study was similar to previous studies. No competing interests were apparent.
Applicability The Palosuo article reviewed many aspects of protective gloves that would be relevant to all clinicians and patients. The Jones article used a subject population at Cardiff Dental School in the UK; however, the results would likely generalize to US Dental Schools. For those who do have clinically relevant symptoms to natural rubber latex, it was suggested that they use nitrile gloves as an alternative. Potential Harms: Type 1 allergic reaction in sensitized patients. Potential Benefits: Practitioner will see a reduction in cost spent on gloves.
Specialty/Discipline (Public Health) (Endodontics) (General Dentistry) (Oral Surgery) (Orthodontics) (Pediatric Dentistry) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords Latex Gloves, Natural Rubber Latex (NRL), Type 1 Allergic Reaction
ID# 2290
Date of submission: 04/23/2012spacer
E-mail phillipsc3@livemail.uthscsa.edu
Author Carson Phillips
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author John D. Rugh, PhD
Faculty mentor/Co-author e-mail Rugh@uthscsa.edu
Basic Science Rationale
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