The permeability of dental gloves following exposure to certain dental materials

Skin Exposure to Acrylates in Nail Salons

OBJECTIVES

The nail salon industry has seen significant growth in recent years. Nail technicians provide manicures, pedicures and apply artificial nails; tasks that expose them to chemicals, including acrylates that are known skin and respiratory sensitizers. This paper reports on potential skin exposure to acrylates among nail technicians in Toronto, Canada.

METHODS

Hand skin wipes were collected after (i) the application of artificial nails, (ii) the application of ultraviolet cured gel nail polish, and (iii) deliberate contact with nail polish. Surface wipes were collected from work areas and surfaces contaminated with known products. Wipe samples were analysed for eight acrylates: methyl acrylate (MA), ethyl acrylate (EA), methyl methacrylate (MMA), ethyl methacrylate (EMA), 2-hydroxyethyl acrylate (HEA), 2-hydroxyethyl methacrylate (HEMA), 2-hydroxypropyl methacrylate (HPMA), and ethylene glycol dimethacrylate (EGDMA) by gas chromatography with mass spectrometry.

RESULTS

Thirty-five wipe samples were collected. No acrylates were detected in skin samples (n = 8) or work surfaces (n = 6). However, MMA, EMA, EA, HEMA, and HPMA were detected in the samples of surfaces contaminated with known products. MMA was detected in 28% of products tested. HEMA and HPMA were detected where deliberate contact with nail polish occurred.

CONCLUSIONS

These results confirm that acrylates are present in nail products. However, no acrylates were detected in skin wipes. MMA, a chemical prohibited for use in cosmetics in Canada, was detected in nail polishes. Nail technicians should continue to employ safe work practices that reduce the probability of skin contact with acrylates and other chemicals.

FDI report on adverse reactions to resin-based materials

Resin-based restorative materials are considered safe for the vast majority of dental patients. Although constituent chemicals such as monomers, accelerators and initiators can potentially leach out of cured resin-based materials after placement, adverse reactions to these chemicals are rare and reaction symptoms commonly subside after removal of the materials. Dentists should be aware of the rare possibility that patients could have adverse reactions to constituents of resin-based materials and be vigilant in observing any adverse reactions after restoration placement. Dentists should also be cognisant of patient complaints about adverse reactions that may result from components of resin-based materials. To minimise monomer leaching and any potential risk of dermatological reactions, resin-based materials should be adequately cured. Dental health care workers should avoid direct skin contact with uncured resin-based materials. Latex and vinyl gloves do not provide adequate barrier protection to the monomers in resin-based materials.

Adverse reactions to protective gloves used in the dental profession: experience of the UK Adverse Reaction Reporting Project

The Adverse Reaction Reporting Project (ARRP) was set up to measure the extent and severity of adverse reactions to dental materials in the UK. Further analysis into the use of protective gloves has been carried out to establish the degree to which gloves are having a deleterious effect on the dental profession. In addition the survey aimed to establish the techniques used to manage adverse reactions and their effectiveness. In a 23-month period, 369 reports were received concerning adverse reactions to protective gloves used in dental practices. Reporters were contacted for further information, and a 92% response rate was achieved. The 330 reports analysed showed dentists to be the largest group to report adverse reactions, whilst dental technicians reported the fewest. The referral rate for staff and patients was similar with a third of adverse reactions being referred (n=110) to a specialist for diagnosis. A confirmed diagnosis was received in 65% of referred cases (n=72), but the symptoms reported suggested a larger degree of Type I reactions occurring than diagnosed. The use of non-powdered gloves appeared to be favoured over powdered gloves in 42% of glove changes, and nitrile gloves were used as an alternative to latex in 39% of changes. In conclusion, the results from this survey showed that wearing gloves in dental practices in the UK caused a range of adverse reactions. In 79% (n=330) of cases reported and analysed, these reactions were readily resolved or improved by self-medication, prescribed medication and/or changing to a different type of protective glove.

On permeability of methyl methacrylate, 2-hydroxyethyl methacrylate and triethyleneglycol dimethacrylate through protective gloves in dentistry

Continuous glove use is more common in dentistry than in most other occupations, and the glove should offer protection against blood-borne infections, skin irritants and contact allergens. Methacrylate monomers are potent contact allergens, and it is known that these substances may penetrate the glove materials commonly used. The aim of this study was to assess the permeability of various types of gloves to methyl methacrylate (MMA), 2-hydroxyethyl methacrylate (HEMA) and triethyleneglycol dimethacrylate (TEGDMA) with special reference to combinations with ethanol or acetone. The permeation rate and time lag breakthrough (lag-BT) for MMA (neat, or diluted to 30% in ethanol or acetone), HEMA (30% in water, ethanol, or acetone) and TEGDMA (30% in ethanol or acetone) were investigated for different protective gloves. Nine different types of gloves were tested for one or several of these methacrylates. The lag-BT for neat MMA was </= 2 min for all gloves. For 30% MMA in ethanol or acetone, the latex gloves and the polyethene-copolymer glove showed the best protection, but the lag-BTs were short for all gloves. For HEMA and TEGDMA, the lag-BTs were generally longer than for MMA. A neoprene glove seemed to be the best choice for protection against penetration of HEMA and TEGDMA. The decision on which types of gloves to use should also take into account the risks of latex allergy and contact allergy to rubber chemicals and the convenience of the gloves for fine manual work.

Monomer permeability of disposable dental gloves

STATEMENT OF PROBLEM

Studies have suggested that monomers may be able to permeate dental gloves.

PURPOSE

This study examined the permeability of disposable dental gloves to 6 kinds of dental monomers.

MATERIAL AND METHODS

The permeability of 6 kinds of dental monomers (methyl methacrylate [MMA], 2-hydroxyethyl methacrylate [HEMA], triethyleneglycol methacrylate [TEGDMA], ethyleneglycol dimethacrylate [EGDMA], urethane dimethacrylate [UDMA], and Bis-glycidyl methacrylate [Bis-GMA]) through 5 kinds of dental gloves (latex, powder-free latex, coated latex, polychloroprene, and polyvinyl chloride) was examined for up to 180 minutes at 37 degrees C. The fingers of unused gloves without pin holes were cut and used in the experiments. Five specimens per test group were examined. One type of monomer was poured into each finger and dipped in ethanol. The ethanol for extraction was measured by a spectrophotometer at a wavelength of 210 nm, and the results were analyzed by analysis of variance and the Kruskal-Wallis test (P<.05).

RESULTS

Four of the monomers tested (MMA, HEMA, TEGDMA, and EGDMA) permeated the gloves tested, whereas 2 (UDMA and Bis-GMA) did not (P>.01). The amount of monomers permeating the latex in 10 minutes was 0.8 +/- 0.6, 0.6 +/- 0.6, 0.07 +/- 0.1, 0.07 +/- 0.1, 0.1 +/- 0.1 and 0.06 +/- 0.1 microL/mL for MMA, HEMA, EGDMA, TEGDMA, UDMA, and Bis-GMA, respectively. The amount of permeated monomer was then increased in relation to the examination time, and in MMA and HEMA, permeation occurred rapidly during the initial 60 minutes at 3 times the 10-minute values, then continued gradually and linearly. The polyvinyl chloride glove showed the greatest monomer permeability. Two-way analysis of variance showed significant correlations between MMA, HEMA, EGDMA or TEGDMA and UDMA or Bis-GMA (P<.01). Statistical significance was shown between polyvinyl chloride and latex, powder-free latex, coated latex or polychloroprene (P<.01). However, there was no significant relation between any kind of dental monomer and any kind of dental glove.

CONCLUSION

Within the limitations of this study, 4 of the monomers tested permeated all of the gloves tested.

An evaluation of the flammability of five dental gloves

OBJECTIVE

To assess the flammability of five brands of dental procedure glove.

DESIGN

A total of ten gloves of each brand (Biogel-D, Premier Protectors, Roeko-D, Safeskin Satin Plus and Schottlander Low Allergy) underwent flammability testing. Five of these were tested as supplied (unwashed) and five following the application of the hand disinfectant Hydrex (washed). Each glove was stretched over a metal frame and the time to ignition, when exposed to a standardised butane flame, recorded. In addition, the thickness of each glove was also assessed by micrometer measurement.

RESULTS

All the gloves tested ignited in less than 2.5 seconds. Two way analysis of variance revealed significant effects of glove type (P< 0.001) and treatment (P< 0.05), together with a significant interaction of these factors (P < 0.05), upon the ignition time. Washing Roeko-D gloves with Hydrex significantly (P< 0.01) retarded the ignition time compared with those in the unwashed state. Both the glove thickness and material type appeared to be related to ignition time.

CONCLUSION

The work presented here demonstrates the acute and varying flammability of a range of dental procedure gloves. It should serve as a reminder to those who routinely use open flames whilst gloved of the dangers of this practice.

Permeability of protective gloves by HEMA and TEGDMA in the presence of solvents

The breakthrough times and permeation rates of two commonly used allergenic components in dentin bonding agents or resins, HEMA and TEGDMA, were measured for 5 types of latex gloves and 5 types of nitrile gloves. In addition, the breakthrough times and permeation rates for the gloves were measured for HEMA and TEGDMA when diluted with either ethanol or acetone-solvents often appearing in dentin bonding agents. The mean breakthrough times for the 5 latex gloves for HEMA and TEGDMA, concentrated, diluted in ethanol, or diluted in acetone, were 4.9, 4.8, and 2.8 min, respectively. For the 5 nitrile gloves the equivalent breakthrough times were 15.7, 9.9, and 2.8 min, respectively. There were great variations between the various gloves, and 1 nitrile glove showed a breakthrough time of 28-30 min when tested with concentrated HEMA and TEGDMA. Compared to latex gloves, nitrile gloves have a longer-lasting protection against skin contamination with methacrylates in the absence of solvents. The longer protection was reduced or not present for methacrylates diluted in organic solvents, especially acetone. In addition, the nitrile gloves showed fairly high permeation rates in the presence of this solvent. The results indicate that latex and nitrile gloves only give a limited protection against allergenic methacrylates in dentin bonding agents when they contain acetone.

Dental materials citations: Part A, January to June 1997

OBJECTIVE

A search was conducted in biomedical journals published from January 1997 to June 1997 to identify all dental materials publications and sort them into major categories.

METHODS

Tables of contents for 79 journals for the period of January to June, 1997 were inspected and divided into 17 categories. Citations were analyzed by both frequency in journals and in categories, as well as compared to frequencies for previous years.

RESULTS

A total of 445 citations were detected in 79 journals for the period January 1997 to June 1997. Certain journals (n = 19) demonstrated a higher citation frequency (> or = 10 citations for 6 months) and represented 77.8% of all citations. The greatest number of citations continued to involve bonding (n = 97), resin-based restorative materials (composites; glass ionomers) (n = 95), prosthodontic materials (n = 51), and pulp protection/luting materials (n = 48). Frequencies by category were very similar to those for the last four years.

SIGNIFICANCE

The compiled literature citations provide a supplement for researchers and academicians seeking information in existing electronic databases.