Thursday January 2, 2003
Dear Dr. Mady: The other day I was at my dentist's office and I had a reaction where my face broke out in hives and I had trouble breathing. My dentist said that I should be tested by an allergist for a latex allergy. Is it possible that this could be true and does this mean that it is now unsafe for me to go to a dental appointment? -Devon in Cottam
Dear Devon: It is extremely likely that you do have an allergy to latex. Natural rubber latex is commonly found in many things that we use everyday, but it is almost always used in dental offices in such items as gloves, masks, syringes and even in dental anaesthetic carpules. Most natural latex is derived from rubber trees and there are many materials made from synthetic latex, but these types do not commonly cause allergic reactions. This is why you may come into contact with many rubber products every day and not experience any problems.
A latex allergy generally develops over a long period of time from repeated exposure to natural latex materials. This is why most individuals with a latex allergy, and the ones at risk are health care workers including but not limited to doctors, dentists and nurses. Actually anyone that is over-exposed is at risk, like individuals who have had multiple surgeries and ones that are rubber industry workers.
The most common culprits in a health care environment are latex gloves. Also, the powder in the latex gloves can actually absorb latex proteins and increase the exposure and if an allergy exists, this powder may even be as much of an irritant as the natural rubber itself. This powder also has the capability of becoming airborne during manipulation of latex gloves and especially during removal of them. It is at this time that the eyes, nose and mouth are affected and more ingestion can occur.
If you are allergic, after exposure you can develop hives, rash or have trouble breathing from nasal congestion or affected lungs. However, if the allergy becomes severe over time, an anaphylactic reaction is possible and this can be deadly if proper action is not taken immediately. Anaphylaxis can affect your entire system by lowering your blood pressure and may cause your throat to swell and as a result block your airway. Your tongue and nose can swell also and you could lose consciousness quickly. If you are alone or if you are not carrying an epinephrine pen, there could be catastrophic consequences.
I don't know what kind of work you do, but now that you have had such a reaction, I recommend that you do what your dentist is telling you and see your physician immediately for a referral to a local allergist. Until you see the allergist, try and avoid latex and rubber products as much as possible. The allergist will determine what exactly you are allergic to as well as a strategy for dealing with it.
It is safe for you to continue going to your dentist. Inform them of the results of your testing so that they can update your medical history and put a red flag on your chart. If you are in fact latex allergic, the dentist can take necessary precautions. There are other options to replace latex gloves with including vinyl and nitrile and most dental offices now have at least a few latex-allergic patients and will know what guidelines to follow to prevent exposure. Did you know that every dental clinic has an emergency kit with medications to deal with a serious reaction also?
Just remember that when you schedule your dental appointments, try and make yourself the first patient of the day. This will minimize the chance of exposure due to the fact that airborne latex from previous patients will not be floating around as much. In addition the dental office staff would have not had any other exposure themselves at that point, thus minimizing the chance of contamination from anything else or anybody that you will be coming into contact with. If they know that you are coming, everything in that treatment room will have been thoroughly cleaned prior to your arrival and I am confident that you will be problem free.
This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5