Allergic reaction from dental bonding material through nitrile gloves: Clinical case study and glove permeability testing

Objective This study examines monomer permeation of commercial dental adhesive through nitrile-based gloves, and correlates findings with clinical case studies of dental students having localized skin eruptions following resin placement on a gloved hand to manipulate composite. Methods Three dental students self-reported presenting itchy, red skin lesions underneath the area where they placed uncured adhesive resin on a nitrile-gloved hand. Histories and cursory examinations were performed in the Department of Dermatology at The Medical College of Georgia. Infrared spectroscopic methods were used to determine permeation times of known monomer components of commercial adhesive material used through nitrile glove. Monomer permeation times were correlated with the time when the commercial adhesive first applied and penetrated through the glove. Results Assessment by the dermatologist concluded that the reporting students had occupational contact dermatitis resulting from components of the adhesive permeating through the barrier glove. Permeation times of neat monomer components of the adhesive resin varied over a wide range, with lower molecular weight showing faster pass-through times. Spectroscopic interpretation indicated that the probable causative agent for the student's skin reaction was 2-hydroxyethyl methacrylate (HEMA). Conclusions Probable correlation of the observed skin reaction sites was made with diffusion of HEMA in the uncured dental adhesive formulation through nitrile glove material. Clinical Significance All measures to prevent skin contact with uncured methacrylate-based resin components should be taken, including avoidance of resin permeation through a gloved hand. Sensitization to one type of methacrylate can result in sensitization to other types of resins within this family, significantly impacting the careers of both dental auxiliaries as well as clinicians.