This course is based on a review of the literature and presents the etiology and epidemiology of adverse
reactions to latex products, clinical manifestations of adverse reactions to latex products, and strategies for
the prevention and treatment of adverse reactions to latex products.
ADA CERP
The Procter & Gamble Company is designated as an Approved PACE Program Provider
by the Academy of General Dentistry. The formal continuing education programs of this
program provider are accepted by AGD for Fellowship, Mastership, and Membership
Maintenance Credit. Approval does not imply acceptance by a state or provincial board
of dentistry or AGD endorsement. The current term of approval extends from 8/1/2013 to
7/31/2017. Provider ID# 211886
Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
Overview
Learning Objectives
Upon completion of this course, the dental professional should be able to:
Discuss the etiology and epidemiology of adverse reactions to latex products.
Recognize the clinical manifestations of irritant contact dermatitis, allergic contact dermatitis, and
immediate allergic reactions.
Discuss diagnostic issues related to adverse reactions to latex products.
Establish strategies for the prevention of adverse reactions to latex products.
Implement strategies for the treatment of adverse reactions to latex products.
Course Contents
Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
Clinical Manifestations
Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
Figure 2. Acute urticaria characterized by pruritic, red wheals that range from 1.5 to
3.0 cm in diameter, which began about an hour after exposure to latex gloves.
Angioedema
Angioedema may be a feature of urticaria. It
is characterized by episodes of localized, wellcircumscribed, nonpitting swelling commonly
affecting the lips (Figure 3), face, limbs, trunk,
abdominal viscera, and larynx. When edema
affects the larynx, upper airway obstruction can
be severe and life threatening. Involvement of
the gastrointestinal tract is associated with severe
pain.
Allergic Rhinoconjunctivitis and Asthma
Nasal congestion, sneezing, rhinorrhea,
watery eyes, and an itching sensation of the
oropharyngeal mucosa are clinical symptoms of
a type I hypersensitive reaction known as allergic
rhinoconjunctivitis.22 It is generally accepted
that deposits of aeroallergens (in this case latex
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Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
Diagnosis
Laboratory Testing
There is no standardized testing protocol for
diagnosing latex allergy and screening for latex
allergy in the general population has not been
found useful and is not indicated.7,55 However,
testing may be helpful in high-risk patients (e.g.,
patients with a high number of previous surgical
procedures, a history of atopy, and a history of
adverse reaction to latex).28,47,56
Skin-patch Testing
Skin-patch testing is a sensitive test for diagnosing
type IV delayed hypersensitivity reactions to
rubber additives (e.g., chemical accelerators,
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Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
Treatment Strategies
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Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
Conclusion
Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
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Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
To receive Continuing Education credit for this course, you must complete the online test. Please go to:
www.dentalcare.com/en-us/dental-education/continuing-education/ce81/ce81-test.aspx
1.
Naturally occurring proteins found in latex are believed to be responsible for inducing what
type of allergic reaction?
a. Type I
b. Type II
c. Type III
d. Type IV
2.
3.
4.
During the donning process, donning powder may become suspended in the air for up to
__________.
a. 10 minutes
b. 1 hour
c. 6 hours
d. 24 hours
5.
Residual chemicals associated with the manufacturing of non-latex gloves may also induce
delayed hypersensitivity reactions.
a. True
b. False
6.
The most common form of adverse reaction to latex glove use is ____________.
a. irritant contact dermatitis
b. allergic contact dermatitis
c. immediate hypersensitivity reaction
7.
8.
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Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
9.
One of your assistants develops a hand rash while working in the office. She relates that the
rash only occurs when she wears brand X, but not brand Y. She is most likely describing
what type of adverse reaction?
a. Irritant contact dermatitis
b. Allergic contact dermatitis
c. Immediate hypersensitivity reaction
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Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
17. To reduce latex exposure, when performing routine restorative dentistry which of the
following is not recommended?
a. Use only properly sized surgical gloves.
b. Use reduced protein, powder-free gloves.
c. When possible, use latex-free products
d. Practice proper hand hygiene
18. When managing a patient who has a confirmed type I hypersensitivity to latex, which of the
following is not recommended?
a. Premedicate the patient with an antihistamine one hour prior to the appointment.
b. Schedule the patient for the first appointment of the day.
c. Schedule the patient for the last available appointment of the day.
d. A and C
19. The most effective medication available to manage allergic contact dermatitis is
____________.
a. Epinephrine
b. Benadryl
c. A topical corticosteroid
d. An oral H1 receptor antagonist
20. Which of the following medication is most critical for managing anaphylaxis?
a. Epinephrine
b. Benadryl
c. An inhaled beta2-adrenergic agonist
d. An oral H1 receptor antagonist
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Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
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Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014
officer of the Dental Corps, United States Navy. Dr. Hubers assignments included numerous ships
and shore stations and served as Chairman, Department of Oral Medicine and Maxillofacial Radiology
and Director, Graduate Program in Oral Medicine, National Naval Dental Center, Bethesda, Maryland.
In addition he served as Specialty Leader for Oral Medicine to the Surgeon General of the United
States Navy, Washington, DC; and Force Dental Officer, Naval Air Force Atlantic, Norfolk, Virginia. He
has many professional affiliations and over the past 24 years, he has held a variety of positions in
professional organizations.
Since joining the faculty in 2002, Dr. Huber has been teaching both pre-doctoral and graduate dental
students at the University of Texas Health Science Center Dental School, San Antonio, Texas, and is the
Director of the schools Oral Medicine Tertiary Care Clinic. He is currently serving as the Public Affairs
Chairman for the American Academy of Oral Medicine. Dr. Huber has accepted invitations to lecture
before many local, state, and national professional organizations. He has been published in numerous
journals including: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology;
Dental Clinics of North America, Journal of the American Dental Association, and Quintessence
International.
Email: huberm@uthscsa.edu
Gza T. Terzhalmy, DDS, MA
Professor and Dean Emeritus
School of Dental Medicine
Case Western Reserve University
Dr. Terzhalmy is Professor and Dean Emeritus, School of Dental Medicine, Case
Western Reserve University. In addition, he is a Consultant, Naval Postgraduate
Dental School, National Naval Medical Center; and Civilian National Consultant for
Dental Pharmacotherapeutics, Department of the Air Force.
Dr. Terzhalmy earned a B.S. degree from John Carroll University; a D.D.S. degree from Case
Western Reserve University; an M.A. in Higher Education and Human Development from The George
Washington University; and a Certificate in Oral Medicine from the National Naval Dental Center. Dr.
Terzhalmy is certified by the American Board of Oral Medicine and the American Board of Oral and
Maxillofacial Radiology (Life).
Dr. Terzhalmy has many professional affiliations and over the past 40 years, has held more than
30 positions in professional societies. He has served as editor or contributing editor for several
publications, co-authored or contributed chapters for several books and has had over 200 papers
and abstracts published. Dr. Terzhalmy has accepted invitations to lecture before many local, state,
national, and international professional societies.
Email: TEREZHALMY@uthscsa.edu
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Crest Oral-B at dentalcare.com Continuing Education Course, Revised January 31, 2014