Allergic Reactions During Dental Treatment
By Joseph Preziosi Jr., DMD
There are three distinct classifications of allergic reactions a patient can have and each has it own allergen,the agent that causes the allergic response, and the host response, the body’s response to the allergen that may or may not involve the patient’s immune system.
The allergic reaction classifications are broken down into:
- Type I or Immediate Allergy
- Type IV or Delayed Allergy (also known as Allergic Contact Dermatitis), and
- Irritant Contact Dermatitis.
This article will break down these three categories of allergic reactions as they relate to dental treatment.
Allergic Reactions During Dental Treatment
Type I Immediate Allergic Reaction in the dental environment is primarily due to patient exposure to the plant based proteins in natural rubber latex products. These natural rubber latex products are fond in treatment gloves, rubber dams, hoses, rubber stoppers in local anesthetic as well as any other product made of natural rubber latex. This allergen elicits a systemic, or body wide, immune system response or allergic reaction. Therefore, the reaction can be located anywhere over the patient’s entire body.
The symptoms of Type I Allergic Reaction can occur within minutes or exposure and include hives, swelling, burning, tightness, itching, redness and tingling of the skin. Asthma, wheezing, bronchospasm,coughing, sneezing, rhinits and angioedema can affect the lungs. Other allergic reaction symptoms may include nausea, vomiting, diarrhea, cramps, hypotension (low blood pressure), tachycardia (high heart rate), and anaphylactic shock. Symptoms will cease a few hours after the offending allergen is removed.
Potential risk factors to Type I Immediate Allergic Reaction are allergic reactions to kiwis, bananas, avocados, chestnuts,and tomatoes. Also a history of allergic reactions to latex balloons, condoms, gloves or any other natural rubber product is a potential risk factor. As well as a history of regular and repeated occupational or surgical exposure to latex products is a potential risk factor.
Type IV Delayed Allergic Reaction in the dental environment is primarily due to patient exposure to the chemicals used in processing natural and synthetic rubber and the products that have natural rubber as a component.
Therefore, these allergens are fond in all the same products as the natural rubber latex protein. These processing chemicals elicit a localized immune system response or allergic reaction so the allergic reaction is usually confined to the contact area of exposed skin.
The symptoms usually take hours or days to manifest after exposure to the allergens and consist of soreness, itching, cracking, peeling, scabbing, crusting, drying, swelling, thickening, redness, scaling, papule, or vesicle formation of the skin. Cessation of symptoms will occur a few weeks after the offending allergen is removed. Potential risk factors include a history of skin allergies, skin reactions, eczema or dermatitis.
Irritant Contact Dermatitis is due to exposure to chemicals such as detergents, acids, alkalies, oils and solvents and continual exposure to abrasive, caustic or wet environments. These products are commonly found in the home and work place and the allergens they contain elicit a localized inflammatory response with no immune system involvement. This leads to a very localized allergic reaction confined to the exposed skin that manifests within a few minutes to an hour after contact with the allergen. The dermatological symptoms are soreness, burning, stinging, redness, swelling and blisters that cease soon after the allergen is removed. Potential risk factors are a history of allergies, skin reactions, eczema and dermatitis.
If a patient is suspected of being prone to allergic reactions due to any of the previous stated allergens there are diagnostic tests that can be done to identify the specific offending allergen or allergens. This should assist the patient in avoiding these allergens directly and the products that contain any of these allergens. Since there is no cure for allergic reactions the best way to manage these conditions is to know what a patient is allergic to and then avoid these allergens. So let your doctor know of any allergies you might have or even those you suspect you might have.
About the Author:
Joseph Preziosi Jr., DMD
New Jersey Cosmetic Dentist
phone: (908) 654-7100
fax: (908) 654-8764
email: Drpreziosi@aol.com
url: http://www.preziosidentistry.com/
