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The Adverse Reaction Reporting Project (ARRP) was set up to measure the extent and severity of adverse reactions to dental materials in the UK. Further analysis into the use of protective gloves has been carried out to establish the degree to which gloves are having a deleterious effect on the dental profession. In addition the survey aimed to establish the techniques used to manage adverse reactions and their effectiveness. In a 23-month period, 369 reports were received concerning adverse reactions to protective gloves used in dental practices. Reporters were contacted for further information, and a 92% response rate was achieved. The 330 reports analysed showed dentists to be the largest group to report adverse reactions, whilst dental technicians reported the fewest. The referral rate for staff and patients was similar with a third of adverse reactions being referred (n=110) to a specialist for diagnosis. A confirmed diagnosis was received in 65% of referred cases (n=72), but the symptoms reported suggested a larger degree of Type I reactions occurring than diagnosed. The use of non-powdered gloves appeared to be favoured over powdered gloves in 42% of glove changes, and nitrile gloves were used as an alternative to latex in 39% of changes. In conclusion, the results from this survey showed that wearing gloves in dental practices in the UK caused a range of adverse reactions. In 79% (n=330) of cases reported and analysed, these reactions were readily resolved or improved by self-medication, prescribed medication and/or changing to a different type of protective glove.

Objective: To evaluate the attitudes of patients on the importance of glove wearing by dentists., Design: A patient survey using a self-completed patient questionnaire., Setting: Ireland., Subjects and Methods: 164 consecutive patients attending a dental accident and emergency department were asked to participate. All the patients were aged 16 years or over. Of the surveyed patients, 157 completed a questionnaire designed to elucidate the patients' attitudes to the wearing of gloves by dentists., Results: Most patients (93.6%; n = 147) considered that dentists should routinely wear gloves, while 1.9% (n = 3) thought the wearing of gloves was unnecessary. 94.9% (n = 149) considered that gloves were worn to protect both the dentist and the patient, with 1.9% (n = 3) feeling that only the dentist was protected. 72% of patients (n = 113) would not attend a dentist who did not wear gloves. 87.2% (n = 138) of patients thought that the dentist should change gloves between patients, while 1.3% (n = 2) considered glove washing to be sufficient. The remaining 11.4% (n = 17) felt that this decision should be left to the dentist., Conclusion: The majority of surveyed individuals indicated that dentists should wear gloves while treating patients. The results suggest that many patients refuse to have dental treatment carried out by a dentist who does not wear gloves.

A questionnaire about cross-infection control was sent to all GDPs in five FHSAs in the North Western Region. Replies came from 312 dentists, a response rate of 74%. They worked in 185 practices, a response rate of 85%. Gloves were worn routinely by 86% of dentists and 80% of DSAs. Handpieces were autoclaved between patients in 77% of practices. Much however, remains to be improved. DSAs could be better protected if more ultrasonic cleaners were used, eye protection encouraged and heavy duty gloves were available for cleaning instruments. BDA guidelines were reported as being the most influential factor, though it would appear that the media did persuade many practitioners to use autoclavable handpieces and sterilise them after each use.

This study aimed to establish how dentists' knowledge, opinion and behaviour about cross-infection control were related and how they were affected by their ages, gender and the sizes of the practices in which they worked. In 1990/91 all general dental practitioners in the North Western Health Region of England were asked to complete a questionnaire about cross-infection control; 917 (75%) did so. Responses from all single-handed and one dentist selected randomly from each group practice were analysed (n = 546). The score to measure behaviour was based on guidelines on cross-infection control issued by the British Dental Association and this was correlated with scores for knowledge and opinion. The more knowledgeable not only tended to hold favourable opinions about the guidelines but also to practise them. Younger dentists were more knowledgeable about cross-infection control measures than older and more likely to wear gloves. Irrespective of age, all female dentists were more likely to wear gloves than their male colleagues. Single-handed dentists were less willing to treat carriers of HIV and HBV. Although 65% thought that recommended control procedures are feasible, 43% considered them prohibitively expensive.

The attitude of dentists in England and Wales to treatment of patients at high risk to HIV/HBV was tested by means of a postal questionnaire distributed to 1950 dentists randomly selected from those practising within the NHS Regulations. The response rate was 61%, with 52% of respondents indicating that they treated patients at high risk to AIDS/HBV. Analysis of respondent dentists' practice and personal profile showed associations between willingness to treat high-risk category patients and respondents' number of years since graduation, respondents' gender, number of postgraduate courses attended, and respondents' practice type.

This paper reports the findings of a 2-year follow-up study of glove use by dentists practising within the NHS regulations in England and Wales. The questionnaire for this study was distributed in November/December 1991 to 1950 dentists. The response rate was 61.5%. Analysis of the data obtained from the replies indicated that 83% of respondents wore gloves routinely for all patients and all procedures, 15% wore gloves for either selected patients or procedures and 2% never wore gloves. Glove wearing patterns were found to be related to gender, practice type and frequency of attendance at postgraduate courses. Overall, the results indicate increasing levels of compliance with recommendations concerning glove wearing while treating patients.

Dental hospital staff and students were observed during clinical work for their compliance with infection control procedures, as recommended by the British Dental Association. A total of 183 contacts between health care worker and patient were scrutinised during December 1990. Nearly all health care workers (96%) wore gloves to carry out dental treatment, but in some cases gloves were neither changed nor hands washed between patients. Only one half wore protective eyewear and about one third (38%) wore no mask. Some dental surgery assistants used heavy duty gloves and some even scrubbed dirty dental instruments without wearing any gloves. Strict audit is clearly needed in every clinical setting in order to ensure compliance with infection control.

Attitudes to glove wearing by dentists practising within the NHS Regulations were tested by means of a questionnaire distributed to 2000 dentists in England and Wales. The response was 76.5%. The results indicate that 68% of the respondents wore gloves routinely for all patients and procedures, 3% never wore gloves, while the remainder (29%) wore gloves for only selected patients or selected procedures. Reasons given for not wearing gloves routinely included problems of comfort, loss of tactile sensation and the risk of cross-infection, which was perceived to be small. Of the routine glove wearers, only 12% changed gloves between patients, cost being considered to be a factor by 57% of respondents who used gloves for more than one patient. The results indicate that the respondents practising and personal details had an influence on the pattern of glove wearing, with single-handed practitioners and those who graduated before 1979 being less likely to wear gloves routinely. Comparison with the findings of earlier studies of similar type suggest that there is increased awareness in the dental profession of the necessity for glove wearing, but that there is still a need to encourage routine glove use, especially amongst certain groups of GDPs.