Polski
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);