Dentist’s gloves – what should they be characterized by?

lic. rat.med. Jerzy A. Kozłows­ki

Ensur­ing prop­er hygiene and pro­tec­tion dur­ing den­tal pro­ce­dures reduces the risk of trans­fer­ring infec­tions from one per­son to anoth­er. This is an extreme­ly impor­tant aspect of safe­ty for the doc­tor, staff, and patient. How to choose gloves for a den­tist and den­tal sur­geon?

 Oral Microflo­ra

Jamę ust­ną zasied­la około 700 gatunków mikroor­ga­nizmów, głównie są to bak­terie i grzy­by, w mniejszych iloś­ci­ach inne patoge­ny. Nie kol­o­nizu­ją jamy ust­nej jed­norod­nie, lecz w dwóch głównych niszach eko­log­icznych stanow­ią­cych lep­sze środowisko do roz­wo­ju: w tkankach mięk­kich (gład­kie powierzch­nie błony ślu­zowej, bro­dawkowa­ta powierzch­nia języ­ka) oraz w tkankach twardych zęba [1]. Mikroflo­ra jamy ust­nej człowieka tworzy się bezpośred­nio po urodze­niu, początkowo są to bak­terie Strep­to­coc­cus sali­var­ius, S. mitis, S. oralis, następ­nie bak­terie Gram-ujemne beztlenowe, a na późniejszym etapie mikroflo­ra jest reprezen­towana głównie przez bak­terie: Strep­to­coc­cus, Veil­lonel­la, Fusobac­teri­um, Por­phy­romonas, Pre­votel­la, Tre­pone­ma, Neis­se­ria, Haemophilus, Eubac­te­ria, Lac­to­bac­teri­um, Cap­no­cy­topha­ga, Eikenel­la, Lep­totrichia, Pep­tostrep-tococ­cus i Pro­pi­oni­bac­teri­um [2]. Oprócz nat­u­ral­nej flo­ry bak­teryjnej jamę ust­ną człowieka mogą zasied­lać też grzy­by zwłaszcza z rodziny Can­di­da, Sac­cha­romyces, Aspergillus, Cryp­to­coc­cus, Fusar­i­um, Alternar­ia i Cla­do-spo­ri­um. Jama ust­na stanowi miejsce bytowa­nia wielu wirusów ssaczych, reprezen­towanych przez TTV (torque teno virus) np. HBV, HCV, cir­cowirusy, herpsewirusy, w tym HSV (Her­pes sim­plex virus) oraz EBV (Epstein-Barr virus) [2]. Trze­ba także mieć na względzie ryzyko prze­niesienia wirusa SARS-CoV­‑2 odpowiedzial­nego za chorobę COVID-19 [3].

The exam­ples men­tioned are just a small part of the oral microflo­ra. Most bac­te­ria are harm­less in the sta­ble con­di­tions of the body’s home­osta­sis. How­ev­er, when trans­ferred to anoth­er host, they can pose a serios threat both to the den­tist and the patient. Also, con­sid­er read­ing an arti­cle about reduc­ing hos­pi­tal infec­tions through the appro­pri­ate selec­tion of gloves..

In addi­tion to den­tal gloves serv­ing as pro­tec­tion against bio­log­i­cal mate­r­i­al, they also act as a bar­ri­er against sub­stances used in the den­tal office that can irri­tate the skin or cause aller­gies.

Gloves for Dentists — Basic Protection

Sin­gle-use gloves are an effec­tive bar­ri­er pro­vid­ed they are used cor­rect­ly and hygiene rules are adhered to. Den­tal sin­gle-use gloves too often are ‘sin­gle-use’ in name only, with staff per­form­ing many tasks in the same gloves, such as oper­at­ing den­tal equip­ment, work­ing in the patien­t’s oral cav­i­ty, han­dling X‑ray machines, fill­ing out patient charts, and answer­ing phone calls. Doing all these in the same pair of gloves only pro­vides an illu­sion of pro­tec­tion. Gloves must be changed after each activ­i­ty where there has been con­tact with pathogens and a risk of trans­fer­ring them to oth­er objects.

What characteristics must glove for a dentist have?

Sin­gle-use gloves for den­tists can be divid­ed into non-ster­ile and ster­ile. The for­mer are most com­mon­ly used for activ­i­ties that do not require steril­i­ty. Most den­tal pro­ce­dures are per­formed using stan­dard per­son­al pro­tec­tive equip­ment – sin­gle-use gloves, pro­tec­tive masks for the mouth and nose, and glass­es or face shields, as well as anti­sep­tic agents [3]. On the oth­er hand, ster­ile den­tal gloves are used dur­ing pro­ce­dures that require steril­i­ty, such as in den­tal surgery, where ster­ile sur­gi­cal gloves are best suit­ed.

When con­sid­er­ing which gloves to order for a den­tal or den­tal surgery office, sev­er­al para­me­ters must be tak­en into account:

• resis­tance to tear­ing – manip­u­lat­ing with­in the oral cav­i­ty cre­ates an increased risk of glove dam­age, espe­cial­ly on the teeth. There­fore, the mate­r­i­al must be resis­tant to abra­sion and tear­ing, but at the same time thin enough not to impair tac­tile sen­si­tiv­i­ty.

• con­trol – mate­r­i­al that is too thick great­ly lim­its the sense of touch and the abil­i­ty to per­form pre­cise move­ments. Gloves for den­tists must pro­vide good tac­tile sen­sa­tion, so they can­not be too thick. Some mod­els also have tex­tured fin­ish­es on the fin­ger­tips, allow­ing for a secure grip on devices while not lim­it­ing tac­tile feed­back.

• fit to the hand – den­tal gloves must be well-fit­ted to ensure they do not con­strict the hand too much, but also do not slip off dur­ing work.

• poten­tial aller­gens – latex is a mate­r­i­al with poten­tial­ly aller­genic prop­er­ties, pos­ing a risk for both the den­tist who may be sus­cep­ti­ble to aller­gies and the patient. There­fore, it’s worth­while to have nitrile or vinyl gloves avail­able in the den­tal office at least as an alter­na­tive.

 

Bibliography:

1. Chałas R., Wój­cik-Chę­cińs­ka I., Woź­ni­ak M. J., Grzon­ka J., Święszkows­ki W., & Kurzy­dłows­ki K. J. (2015). Płyt­ka bak­teryj­na jako biofilm–zagrożenia w jamie ust­nej oraz sposo­by zapo­b­ie­ga­nia. Advances in Hygiene & Exper­i­men­tal Medicine/Postepy Higieny i Medy­cyny Doswiad­czal­nej, 69. s. 1140–1148

2. Binek M. (2012). Mikro­biom człowieka–zdrowie i choro­ba. Postępy Mikro­bi­ologii, 51(1), 27–36.

3. Alek­san­dra L., COVID-19 a pra­ca lekarza den­tysty, termedia.pl (24.03.202);