Latex Hypersensitivity: A closer look at considerations in dentistry

Dan Boboia 5/6/10 Lit. Review

Title: Latex Hypersensitivity: A closer look at considerations in dentistry
Author: Kean et al
Type of Article: Review

Latex Hypersensitivity:
Natural latex contains 11 potential allergens. Exposure to these allergens occurs via mucous membranes, the vascular system, inhalation, and direct skin contact. Adverse rxns. Include non-allergic contact dermatitis (direct response to chemicals and additives in latex presenting as skin erythema, chapping and vesicles), delayed type I hypersensitivity rxns, and immediate type I hypersensitivity rxns. Most are irritant contact dermatitis and type IV hypersensitivity (occurs 24-96 hrs after contact and results in purities, eczema, and paules).

Populations at risk:
· Family Hx of allergy (atopy)
· Thos exposed through occupation
· Latex-fruit syndrome: cross-reaction involving IgE antibodies in fruit allergic patients (bananas, kiwi, tomatoes)
· Pts with Spina Bifida at high risk due to repeated latex exposure
· Powder free gloves have been associated with a drop in overall prevalence of type I hypersensitivity.

Box 2 lists latex containing products.

· Cross-reactivity to gutta-percha not substantiated

Management:
· Prophylactic antihistamines or corticosteroids to known risk patients
· Clarke reports 81% of latex allergic patients did not suffer adverse rxns.
· Knowledge of how to deal with issue is best approach
· Contact dermatitis and type IV allergy – topical corticosteroids
· Mild type I rxns without resp, distress – topical steroids and Benedryl 50mg QID till stops
· Severe type I with resp distress – PABC’s, activate EMS, O2, epi .01mg/kg 1:1000 or .1mg/kg 1:10000, benedryl and corticosteroids for post-op.