Dentistry being a hands-on profession, requires dentists to wear gloves 40 or more hours a week, to protect themselves from exposure to pathogens in the patients’ saliva and blood. It also serves as a barrier from the harsh and irritating antiseptic solutions that are used during treatment. In addition to protecting the dentist, wearing gloves is a key factor in prevention of transmissible infection for patients. Although disposable latex gloves were introduced in 1958, the use of gloves to treat patients in dentistry began in the late 1980s, owing the transmission of pathogens such as HIV.
Importance of gloves use in dentistry:
Protection of dental professionals from dangerous infections is a major safety issue. It is further important to prevent cross infection, considering that the dentist’s hands come in contact with the patients’ blood and saliva. In the age of several epidemiologically significant pathogens like the human immunodeficiency virus (HIV), drug resistant bacteria such as methicillin resistant- Staphylococcus aureus (MRSA), viral hepatitis and others, glove usage in dentistry is of paramount importance, also considering the small working area of dentists. Adhering to the personal protection protocols can result in a drastic decrease in the risk of transmission of diseases from patients to dentists, vice versa and also between patients.
What are the different types of dental gloves available?
In former times the two types of glove choices available were – Latex and Vinyl. Now the development of various synthetic materials has resulted in a range of gloves to choose from. Each of the materials have their strengths and weaknesses. Therefore, it is in the hands of the dentists to choose the glove types that best suits their needs. The base of dental gloves material is an important factor in assessing barrier integrity of the glove.
Dental gloves made from natural rubber latex account to the a major portion of the gloves being manufactured and used. NRL is produced from the Hevea brasiliensis tree.
←Image showing “rubber tapping”, the process of collection of latex from the rubber tree
They have been considered gold standard since their introduction and for many years NRL was the only material used to manufacture gloves. They come in powdered and non-powdered varieties, the powdered alternative facilitating easier donning of dental gloves.
- Excellent barrier protection
- High stretchability and durability
- Comfort and tactile sensitivity
- Produced from a renewable resource
- Low in cost
- Must not be worn by individuals with latex allergy
- Not recommended for use with certain chemicals
- Ozone, oxygen and UV light can deteriorate the gloves
Nitrile a synthetic elastomeric polymer of carboxylated butadiene and acrylonitrile was a material developed during World War II as a result of latex shortage. However, it was not available commercially until 1969. Nitrile gloves are a suitable alternative for individuals with latex allergy. They are often referred as “medical grade”. Before they are allowed into the market, they must undergo a series of tests conducted by the FDA, ensuring their durability.
- Alternative for individuals with latex related allergies
- Resistant to glutaraldehydes and other chemicals
- Excellent durability
- Highly resistant to punctures
Polyvinyl chloride is a thermoplastic glass at room temperature. When plasticized to reduce its hardness it can be used as a glove material. Vinyl was produces as a synthetic alternative to latex gloves.
But the high rates of failure (as high as 68%) have questioned the safety of using vinyl gloves for surgical procedures. New vinyl blends in the market have been designed to ensure a better fit and comfort of use.
- An alternative for natural rubber latex
- Not affected by ozone or UV light
- Less expensive than other variants
- Less durability
- Not recommended for use with chemicals such as glutaraldehydes and others
- Poor puncture and tear resistance.
Lets get to the important question!
How to choose the right dental glove?
Being the consumable that is used most often by dentists, it is highly significant to choose the right glove to aid the dentist in treating his/her patients. The following parameters should be assessed before choosing gloves:
Choosing the right size of gloves is an important criterion when it comes selecting gloves for use. A glove too loose or too tight may hinder the dentist to perform to his/her full potential and tends to be inconvenient. Gloves are available in sizes ranging from XS to XL. The corresponding measurement the hand is to be done as follows:
- Face the palm of your hands upwards and stretch the thumb out
- Measure the circumference of the hand (in inches) around the ‘V’ of the thumb i.e excluding the thumb in the measurement.
|Mens’ Measurements||6” – 7”||7” – 8”||8”- 9”||9”- 10”||10” – 11”|
|Womens’ Measurements||6”- 6 ½”||6 ½” – 7”||7” – 7 ½”||7 ½” – 8”||8” – 8 ½”|
Glove size is a key factor in determining performance. Gloves too large may result in adverse dexterity and too small a glove size can result in hand fatigue.
It is recommended that surgical gloves must be at least 4 mil. in thickness. Gloves are available in different thickness ranging from 2 mil. to 8 mil. Heavy duty latex gloves are about 15 mil. in thickness (1mil = 1/1000th of an inch)
Tensile strength measured in megapascals (MPa) is the force required to stretch the glove until it breaks. The higher the number, higher the glove’s resistance to tear.
Acceptable Quality Level (AQL):
Acceptable quality level is the barrier protection confidence level. Lower AQL represents a higher quality product, which means that the manufacturing process allowed fewer defects.
Stress at 500% Elongation:
It is the force required to stretch a glove to twice its length. It is also known as the modulus an is measured in megapascal (MPa). Stretch at 500% elongation is a measure of comfort. Lower the number, softer and more comfortable is the glove. However comfort is also affected by other factors such as the fit of the glove and glove thickness
It is the measure of how far the original length of the glove can be stretched before it breaks. For example if a 1 inch sample can be stretched to 9 inches before it breaks then the elongation is 800%. Higher the number, stronger the glove.
The following table shows the recommended values of the above mentioned parameters for latex examination gloves:
Standard Specification for Latex Examination Gloves (ASTM D 3578)
|Tensile Strength||Stress at 500% elongation||Ultimate Elongation||Tensile Strength||Ultimate Elongation|
|Ideal Values||18 MPa min||5.5 MPa max||650 % min||14 MPa min||
500 % min
Do’s and Don’ts of glove use:
- Inspect gloves for barrier breaches such as tears or pinholes before and after wearing them.
- Ensure proper fit of the gloves
- Change examination gloves frequently and surgical gloves periodically during longer surgical procedures.
- If a breach is suspected or realized it is necessary to change gloves.
- Keeping fingernails trimmed and not wearing jewelry can help reduce the risk of perforation.
- Tape and adhesive materials should be used with caution as they may cause tear of the gloves.
- When double gloving change both gloves and wash hands
- Rotating glove stock is significant. The first gloves in should be the first gloves out.
- Gloves are to be kept in their original packing.
- Reuse or decontaminate single use gloves.
- Use a glove that feels too brittle or weak
- Store gloves near heaters, sterilizers, air conditioners or x-ray units.
- Keep gloves on for tasks such as using the computer or a pen and other noninvasive patient interventions.