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CHEMICAL PERMEATION IN DENTISTRY

                                                                                                                             

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The skin is the largest organ in the body and acts as a protective barrier against the external environment. When irritated or inflamed, its barrier integrity becomes compromised, allowing bacteria, viruses and toxins to penetrate more easily.1 Skin irritation and hand dermatitis are particular problems for dental professionals. The prevalence of occupational contact dermatitis among dental personnel has steadily increased over the last two decades and studies suggest it is now between 15% and 33%.2 This is a concern because damaged skin is less effective at protecting against disease, ultraviolet rays, and other external irritants. In addition, hand eczema allows for easier permeation of chemicals through the skin and into the body.  In addition to frequent hand washing and the use of sanitisers which cause skin dryness, dental professionals work with many chemicals that have the potential to damage skin.

Most dental professionals’ gloves are not exposed to chemicals continuously or for long durations. Their gloves are instead exposed to chemicals only in the event of a splash, for brief periods of time. However, depending on the chemical, its concentration, and volatility even limited exposure may cause molecular changes to the glove material, allowing for permeation. In most instances of chemical permeation there is no visible wetness, change in sensation or impact to skin integrity at the time of exposure. Repeated exposure to chemicals over time, however, will eventually lead to irritant contact dermatitis or allergic contact dermatitis. These skin conditions are much harder to diagnose due to delayed reaction.

Gloves made of different polymers will have different chemical resistance properties. Latex, Nitrile and Neoprene each have their strengths and weaknesses when exposed to different types of chemicals.  Gloves made of the same polymer and with similar thickness may not always have the same chemical resistance as the formulation and manufacturing process of the two gloves may not be similar. The below table is only a guide to glove polymers and resistance to chemicals.

  Polymer Good Resistance To…  Poor Resistance To… 
   Natural Rubber • Aqueous solutions
• Acids
• Bases
• Alcohols
• Organic chemicals
• Oils
• Ketones
   Nitrile • Many solvents (organic) including Aliphatic Hydrocarbons, oils, fats • Strong acids
• Halogenated hydrocarbons
• Aldehydes
• Ketones
   Neoprene • Aldehydes
• Acids
• Bases
• Alcohols
• Different solvents
• Aromatic solvents
• Halogenated solvents
• Ketones

Increasing awareness about the health risks of chemical exposures among dental professionals and evaluating chemical permeation of dental products against medical grade gloves helps address and minimise occupational contact dermatitis in dentistry. To learn more download the White Paper Chemical Permeation in Dentistry by Dr Mikael Zimmerman, DDS, PhD.

                                                                                                                             

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REFERENCES

1. Anderson SE, Meade BJ. Potential health effects associated with dermal exposure to occupational chemicals. Environ Health Insights. 2014 Dec 17;8(Suppl 1):51-62. doi: 10.4137/EHI.S15258. eCollection 2014. (1)
2. Lugović-Mihić L, Ferček I, Duvančić T, Bulat V, Ježovita J, Novak-Bilić G, Šitum M. Occupational Contact Dermatitis Amongst Dentists and Dental Clinicians. Acta Clin Croat. 2016 Jun;55(2):293-300