A person with a latex allergy can be at risk in a dental office. Some materials used in a dental office containing latex are: gloves, prophy cups, tubing, nose pieces, rubber dams, some impression materials, bite blocks and stethoscopes. Therefore a few questions asked before an appointment may help avoid an allergic reaction.
Do you have non latex gloves available for the procedure? Those individuals who come in direct contact with the latex allergic patient must wear non latex gloves. The whole staff should wear non latex gloves. Also make sure the office does not store latex gloves in close proximity to the patient during the procedure, because even if stored in a sealed carton, the proteins leach out into the air.
How do you polish teeth after cleaning? Most offices use disposable prophy angles that have a rubber cap containing latex rubber. The exception is Denticator products that are made of ethylene, propylene and diamine to create a synthetic material. Alternatives to remove stains and polish teeth are a prophy brush or a prophy jet. A prophy jet polishes with air and baking soda. The piece that goes into the mouth and all the tubes from the prophy jet to the polishing piece are plastic
Will this procedure require nitrous oxide? The nose piece for nitrous oxide is rubber latex and a barrier between skin and nose is not sufficient to ensure safety. There is a plastic nose piece surrounded by silicone but it is rigid, uncomfortable and non-conforming, increasing the chances of escape of gas toward the operator. Do without nitrous oxide and ask for local anesthesia. Be aware that the seal in prefilled lidocaine and anesthetic carpels are latex. A glass ampule is preferred, and the medication should be drawn up immediately before administration.
What do you use in place of a rubber dam for a root canal? A rubber dam is a polyisoprene sheet stretched over a frame to isolate the tooth from saliva to keep it dry, increasing the success rate of the root canal. The dam is also a barrier to prevent anything from going down the throat during the procedure. In place of a rubber dam, use a vinyl or non-latex glove, or a double thickness plastic head rest cover over the frame. Lute an opening with an instrument that has been heated (do not attempt to use a punch as the material will tear) and then stretch the material over the frame.
Polyisoprene rubber is also used in head gear and orthodontic bands.
What materials are used to fill the root canal? The material of choice, gutta percha, is not safe for someone who is latex allergic because it is 30% rubber. It also contains zinc oxide, waxes and zinc silicate. This combination is used for endodontic points as a filling material for root canal.
Alternatives to fill canals are glass ionomer cements, zinc phosphate cement and epoxy cement such as AH 26. A last resort is silver points but not an ideal material for root canal. Any of these materials should be used by an endodontist (dentist trained in root canal) as they have the proper instruments and experience in working with these materials.
What materials are used for taking impressions? Impression materials are used to obtain a negative imprint of the tooth for the crowns, inlays or onlays, etc. Some older impression materials are rubber based. Alginate impressions do not contain rubber and are safe.
Other devices used in the dental office containing latex are bite blocks and stethoscope tubing. Also, be aware of personnel wearing disposable gowns instead of reusable ones. Disposable gowns and mask may contain latex and the finish may have irritants to a latex sensitive person.
When is an ideal time to schedule dental appointments? Preferably first thing in the morning, or the first appointment after vacation when the office has been closed. Another good time is after the cleaning crew has been in to vacuum the drapes, blinds, carpets etc. This will help with the removal of the latex tainted corn starch. This risk is reduced in an office that uses powdered latex gloves.
To greatly reduce the risk to you and the staff in the office, suggest that they try a low protein non-powdered glove on a regular basis. Be careful, do not use low protein latex gloves with a patient that is latex sensitive.
A small office with contained operators or separate room as opposed to a very open area is a consideration in choosing a dental practice. Also, a smaller staff can be a plus. The less personnel donning and removing gloves the better.
There are offices that are aware of the latex allergic patient because a staff member is latex allergic. However, many offices are not aware of the serious consequences of latex allergy. Do not allow the dental office to treat this problem lightly.
An initial visit to access an environment before you make an appointment is recommended to ensure your safety. If the office is not aware of the problems associated with latex allergies, use this article as a guide to questions that should be answered.
As in all situations you are your first line of protection in any situation. Make anyone that needs to know about latex allergy an expert; offer to run a short in service for the staff of the dental office.