Gloves are a crucial daily item for a dentist's practice, used so often that we may sometimes forget their importance, and, how critical it is to pay attention to the material, fit, and quality. Oral Health professionals are at risk of disease exposure on a day-to-day basis, it is important for us to use the best quality dental gloves to protect our staff and patients.
Recommendations and regulations have been formulated by the federal government for the prevention of disease transmission and the performance of safe procedures. The Center for Disease Control and Prevention in the United States has developed recommendations and guidelines for both patients and clinicians alike. As of now, infection control in a dental practice particularly comes from the 'Guidelines for Infection Control in Dental Healthcare Settings' laid down by the CDC in 2003.
Here’s what we are going to cover:
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Types of disposable medical gloves
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Glove types based on material
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Advantages & disadvantages of nitrile gloves
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5 steps to selecting the right glove
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The importance of ergonomics and fit
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Facts & Myths on dentist use of gloves
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Our community selection of top products
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Medical Glove FAQs
In order to have adequate protection and safety for both clinicians and patients, it is essential to follow these guidelines, practice proper hand hygiene, select the right disposable medical glove type, brand and follow the steps of correct glove use.
Here is a complete guide on the uses of nitrile gloves for savvy dentists followed by the frequently asked questions. But first, let’s see what the types of gloves are.
Types of medical gloves
1) Examination gloves and surgical gloves
For use in the medical fields, the gloves are categorized as Examination and Surgical. Both categories are subject to FDA authorization and only those which are FDA-approved can be used in clinics by doctors and dentists.
The examination gloves are not meant for surgical procedures. They are utilized when examining patients and carrying out procedures involving contact with mucous membranes. In contrast, the surgical gloves are sterile and are to be used for oral surgeries. Both examination and surgical gloves are medical-grade. However, the surgical ones are superior in quality and provide a more accurate fit and better tactile sensation.
2) Chlorinated and Non-chlorinated Gloves
In the category of powder-free gloves, you can choose between chlorinated or non-chlorinated disposable medical gloves. As the name suggests, chlorinated gloves are chlorine-treated rather than the typical powder, but retain the benefits of powdered gloves.
On the contrary, chlorine-free gloves are more like the regular examination glove minus the chlorine odor. Note that non-chlorinated gloves are lined by gel/silicone coating and are more liable to cause allergies as compared to the chlorinated ones.
3) Powdered and Powder-free Gloves
Most of the nitrile gloves are powder-free. The powdered gloves were lined with cornstarch for easier donning but they were banned by the FDA in December 2016. This was due to allergies they might cause to the user’s skin and patient sensitivity.
On the other hand, the gloves that are not lined with powder are free of residue and decrease the risk of an allergic reaction.
Glove types based on material
1. Nitrile Gloves
Nitrile gloves are superlative all-purpose gloves, appropriate for an array of applications. They provide the following features and benefits.
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Can be used as a good barrier for solvents, oils, hydrocarbons, and some acids and bases.
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Are highly puncture-resistant, and has excellent chemical resistance.
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Any damage or tear is easily seen.
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Nitrile gloves are a great choice for unexpected chemical splash protection.
2. Latex gloves
Have high dexterity and sensitivity due to thin material usage, latex medical gloves are one of the most commonly used in the medical field. Additional features and precautions include the following.
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Provide a good barrier and protection against infection.
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These are suitable for inorganic chemicals but not very suitable for organic solvents.
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Oils and hydrocarbon derivatives should be avoided.
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They have high flexibility and dexterity.
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Puncture holes are hard to detect.
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High dermatitis potential.
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Common cause of latex allergy.
3. Vinyl gloves
Often used as the less expensive choice, the use of vinyl gloves is not recommended with glutaraldehyde, alcohol or chemotherapeutic drugs. Its highlights include:
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Resistant to oils and ozone.
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Are latex-free.
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Anti-static.
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Have limited durability.
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Mediocre elasticity and tensile strength.
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Increased potential for punctures and tears.
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Their use of chemicals is limited.
Advantages of Nitrile Disposable Gloves
Nitrile gloves are best against tear, cut, and puncture resistance. The material is also good for handling abrasives and chemicals.
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Durable and long-lasting.
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Have excellent puncture and tear resistance.
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Provide an effective barrier against a variety of chemicals.
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Particularly important and used in cases of latex allergy.
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Can be molded to your hands for a good fit.
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Comfortable when worn for long periods.
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Can be used in high-risk cases involving infection.
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Resistant to numerous chemicals.
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Their dark colors (blue or black) help in the identification of punctures.
Limitations of Nitrile Gloves
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They are not very flexible when compared to natural rubber latex gloves
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Can be damaged with oxygen, ozone, and ultraviolet light [1]
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Might have less tactile sensitivity and have a slightly higher average price point.
Considerations for Glove Selection
When looking at buying your dental glove supplies in bulk, ensure to keep in mind the below pointers.
1. Barrier Integrity
The performance reliability of gloves varies from one type to another. The barrier integrity is one of the factors that influence their infection control potential. It is described as the level of protection from pathogens (absence of tears or holes) it offers during use.
Barrier integrity is affected by the manufacturing process and gloves’ base material. When choosing gloves, the barrier integrity that your brand provides should be considered.
2. Quality of the Manufacturing Process
The manufacturing of gloves is an intricate procedure. To summarize, it involves dipping of the glove precursors into a liquid solution or suspension, next, rinsing, curing, and stripping of the gloves is done after which drying follows. Powder-free gloves then need further processing. High-quality standards of manufacturing are crucial for tailoring first-rate quality medical gloves.
Thus, it is important to rigorously monitor the glove manufacturing process in order to obtain the excellent physical properties of the final product.
It’s okay to request from the manufacturer the barrier performance data before you make a purchase, typically resellers will also have this data.
3. Base Glove Materials
Understanding the material used to manufacture the gloves holds will help you choose the right gloves for you and it also reflects its barrier integrity. Most commonly used exam gloves’ base material include:
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Natural rubber latex (NRL)
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Two synthetic materials including acrylonitrile-butadiene (nitrile), and polyvinyl chloride (vinyl, PVC).
While the intrinsic physical properties of the diverse glove materials is important, the in-use durability of the gloves should also be assessed. This has been evaluated in several published studies on NRL, vinyl and nitrile exam gloves. These studies were done in diverse conditions and with varied stressors. Showing different strengths and durability with different materials. For example, Ker et al.’s 2002 study stated that the leakage percentage rates of standard vinyl and latex (NRL) were 35% and 9.0% respectively while in 2004 Ker et al.’s durability study reported the same to be 35.5%, 9.0% for these two materials including 7.5% for nitrile. [2, 3]
Given the data, it is shown that nitrile gloves have the least leakage rate and are the most durable of the three materials. Glove selection recommendations have been made based on such studies. For instance, CDC’s Guidelines for Isolation Precautions, categorizes nitrile and NRL gloves to be preferable over vinyl for various clinical procedures that are done dexterously or those that may involve patient contact. [4]
4. Anticipated Characteristics
Beside barrier integrity, several important characteristics are desired by dentists and medical professionals wearing disposable medical gloves. The attributes commonly desired are as follows.
These predilections are subjective and task-dependent. Hence, individual staff glove evaluation is suggestive to ensure quality.
5 Steps to Choose the Best Glove Type
Make the best choice of glove depending upon the following aspects.
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The procedure to be undertaken. The best choice of the gloves should be made according to the task at hand e.g., patient examination or surgery)
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The material of the glove depending upon skin sensitivity. In case of latex allergy, non-latex, such as dental nitrile gloves should be used. Visa versa, latex gloves should be used for nitrile allergy.
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Choose the right fit. Ensure that the size of the glove best fits your hand before making a bulk purchase. It should not be too loose or too tight. Ideally, a variety of sizes should be available at your office. Too large a size can hinder your task performance whereas, too small gloves may be uncomfortable.
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Good tactile sensation. When choosing the right glove it should be ensured that the tactile sensation of your skin should not be dramatically reduced. This depends upon the glove grip, thickness, and slipperiness of the material when wet.
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Prefer ambidextrous gloves. The gloves should allow equally well usage of both right and left hands; largely dependent upon the clinician’s preference.
Why Are Glove Ergonomics Important?
We all know that clinicians and hygienists wear gloves while examining or treating patients in order to minimize cross-contamination and maximize both clinician and patient safety. But, what most of us don’t know is that day-to-day use of disposable dental gloves may subsequently lead to incapacitating musculoskeletal disorders (MSDs).
Wearing gloves for extended periods constricts your hands which in turn can compress the nerves and vessels. While you know that dental procedures involve repetitive hand and wrist muscle activity, this, in a pinched position can severely impact the hand and arm. As a result, symptoms such as hand fatigue, inflammation of the tendons, and carpal tunnel syndrome can occur.
More than 50% of dentists have reportedly had hand fatigue 1 and about 65% of registered dental hygienists have had carpal tunnel syndrome. The signs of MSD can include the following.
Despite that these conditions are painful, they can also result in the loss of productivity, expensive medical treatment, and possible long-standing impairment if not treated. Hence, it is important to be vigilant about using ergonomically-right gloves.
While the use of gloves in the dental profession dates back to several decades, their long-term effects on hand ergonomics have been largely unknown. However, it was only recently that some brands are starting to pay attention to the health of the hands of dental professionals by producing ergonomically-friendly gloves. [5]
Myths and Facts on Disposable Gloves
There are several myths prevailing about gloves and their performance. Knowing these myths and their realities is important to select the right glove for each task performance. These myths include the following.
Myth #1: Textured gloves provide superior grip
Reality: About disposable gloves, it is thought that the more textured they are the better grip they provide. However, texture plays an insignificant role in grip and smooth-surfaced gloves can also provide better grip. The grip largely depends on the surface treatment of the glove such as surface chlorination and coating. Chlorination alters the surface characteristics and produces a lower-tack, tough shell surrounding the glove, while also reducing the surface tack over the glove.
Myth #2: Exam Gloves’ safety remains constant with prolonged use
Reality: When in use, gloves may undergo wear and develop holes. It has been shown that the defect rate of gloves increases with prolonged use. In addition, if the curing and cross-linking is not adequate, dental nitrile gloves can swell and gradually develop defects or holes or defects over time. Defects frequently occur in the part in between the forefinger and thumb.
Myth #3: Gloves can be 100% single material composition
Reality: It is frequently claimed by glove suppliers that the composition of their gloves is "100%" pure, containing only the specified material. However, practically it is not possible to manufacture usable gloves of any material including nitrile, NRL, or latex without additives. Incorporating cross-linking agents, curatives, and accelerators to natural latex and nitrile exam gloves is important to produce strong and durable gloves. As for vinyl, plasticizers and activation agents are needed for strength. Additionally, most gloves also contain surfactants that support film formulation.
Myth #4: Fillers reduce glove performance
Reality: Fillers are added in gloves in significant amounts. While fillers reduce the cost of the gloves, they also help to improve certain glove characteristics such as tear strength in natural latex gloves, improved via calcium carbonate fillers. However, the key is moderation, and up to 15% filler content can be added. Beyond this can negatively impact the glove’s performance.
Myth #5: Nitrile or vinyl gloves can address allergy issues
Reality: Allergies caused by glove use is a great concern for users. It is generally thought that glove-related allergies only occur due to natural latex material but this perception is not always true. What’s true, however, is that allergies caused by latex gloves are the most common and serious ones. These allergies can have systemic effects and can lead to anaphylactic shock.
Components found in both vinyl and nitrile gloves can provoke a chemical allergy. For instance, dental nitrile gloves and natural latex gloves mostly have carbamates or thiazoles that may lead to skin allergy. Several vinyl gloves use activation agents which may also cause skin allergies.
Myth #6: The term ‘powder-free’ denotes clean gloves
Reality: The procedure used to make a glove "powder-free" does leave residual chemicals on the surface of the gloves. The process of removing powder from the glove is done commonly by their surface treatment. The types of surface treatments include chlorination and adding of a polymer coating or wax. The gloves are washed before packing in the traditional process of chlorination. The purpose of washing the gloves is to remove any residues from them.
Myth #7: All disposable gloves are the same
Reality: the general perception that all disposable gloves are the same stands false, as studies, already talked about above (Ker et al.) have shown that the leakage rates of different materials are different, each glove material comes with different physical characteristics, therefore, different prices. Typically, nitrile exam gloves are considered superior to latex, and latex are considered superior to vinyl.
In actuality, all the materials have diverse properties. For example, nitrile has a higher resistance to puncture and can comparatively withstand more chemicals including solvents and oils. Likewise, latex has improved tear resistance, typically has a better fit, and has superior dexterity. Vinyl, on the other hand, has the finest electrostatic dissipation and can resist sulfuric acid better than latex or nitrile.
There is a slight difference in the glove properties from one brand to another as well. This reflects the different composition and standards of manufacturing processes used by the specific manufacturers.
Myth #8: Low-cost gloves save you money
Reality: Choosing gloves entirely based on their price is a great mistake one would make. The value of the glove lies in more than just its cost. Other than price, durability, productivity, and safety risks also play an important part. [6]
Our Top Pick Dental Gloves Online
Aurelia transform
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The quality and durability that most dentists desire, comes in Aurelia Transform Powder-Free Nitrile Gloves.
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100% latex-free, can be used by practitioners with skin sensitivity to latex.
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It offers improved barrier protection alongside impersonating the comfort of latex gloves.
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They are ergonomic-friendly thus, preventing hand fatigue.
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They deliver the right comfort and fit your hands.
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Aurelia Transform glove comes with 2.8 mil thickness that retains the right sensitivity.
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Their variety of colors offers something that meets every dentist’s choice. You can now get excellent quality gloves at an affordable price.
Aurelia Sonic
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The innovative personal protective gloves, the Aurelia Sonic are the best blend of durability and tactility.
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They are nitrile exam gloves that are 100% latex-free.
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This ultra-thin formulation (2.2 mil) provides seamless fit to your hands whilst maintaining an excellent tactile sensation.
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Automated packing offers the convenience of single glove dispensing
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These come in indigo blue color and allow smooth use for prolonged periods without tearing. The color contrast also increases visibility in case there is a tear or puncture.
Aurelia Amazing
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Aurelia Amazing meets the needs of dentists desiring the highest level of comfort and sensitivity.
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These nitrile disposable gloves are 100% latex-free, ideal for those allergic to latex.
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This unique formulation offers durability for high-stress procedures.
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They come in transblue color in 5 different sizes that offer a great fit for all hand-sizes.
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Its 2.0 mil thickness provides the ultimate tactile sensation that sets them apart.
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They have an ambidextrous and finger-textured design.
Emerald powder-free Nitrile Dental Gloves
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Emerald Powder-Free Nitrile Dental Gloves offer great comfort at an affordable price.
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This latex-free formulation is best for sensitive skin.
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These nitrile exam gloves are textured and exhibit outstanding tactile sensitivity.
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Its ergonomic-friendly design protects against hand fatigue.
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Emerald nitrile gloves provide superior tensile strength and chemical resistance.
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What’s unique? They come with a beaded cuff that allows convenient donning.
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Emerald disposable medical gloves meet FDA recognized as Class 1 Medical Devices.
Protocols to follow when using gloves
Handwashing should be done every time the gloves are worn and removed, prior to exiting the operatory, with visible soiling of hands, and after contacting potentially contaminated objects. According to the Organization for Safety and Asepsis Procedures (OSAP), the handwashing protocols to be followed pre and post every procedure include:
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Wetting the hands with water
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Applying soap to hands and rubbing hands to create lather
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Rubbing hands for at least 15 seconds, ensuring all surfaces are covered
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Rinsing hands with water
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Drying hands with a disposable towel
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The towel should be used to turn off the faucet
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For surgical procedures, the protocols to be followed are as under:
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Remove any bracelets, watches or rings.
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Wash off fingernails under running water with the help of a nail cleaner.
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Scrub forearms and hands according to the manufacturer’s recommended time.
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Dry hands before wearing surgical gloves. [7]
Hand Hygiene is Must
The major part of adequate PPE product usage and cross-contamination control is donning of gloves. However, practicing routine hand washing and hygiene maintenance is crucial to implement complete asepsis protocols.
Regular hand-washing coupled with gloving will deliver adequate protection to both clinicians and patients from infection dissemination. Hand hygiene holds immense importance as an effective tool to prevent disease transmission and must be prudently implemented for optimum defense and safety.
Steps for glove donning
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Take out a glove from its box
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Touch only the restricted surface of the glove that corresponds to the wrist (at the top edge of the cuff)
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Wear the first glove
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Use the bare hand to hold the second glove and grasp the restricted surface as done before.
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While wearing the second glove, avoid touching the skin or the forearm with the first glove. To do so, turn the external surface of the first-donned glove.
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Once both gloves are worn, the gloved hands should not touch anything that is not indicated for the procedural glove use.
Dental Exam Gloves Frequently Asked Questions (FAQs)
When should dental assistants change gloves?
Gloves should be donned when the clinician comes in contact with the patient’s mucous membrane for examination or task performance. However, they should also be changed in the following circumstances.
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When they come in contact with other surfaces
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When contact occurs with potentially contaminated objects not indicated for the treatment procedure.
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When visible soiling occurs with something.
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When tear or damage occurs during the procedure when donned for prolonged periods.
What are nitrile gloves?
Utilized as a disposable glove compound, nitrile is a synthetic rubber. Whilst nitrile has been long available, its price was higher previously and has reduced only recently to be more affordable. Besides their physical characteristics including strength and durability, its cost is the reason why nitrile gloves are gaining more acceptability in the medical and dental industries. Other merits of nitrile gloves include higher puncture resistance and improved chemical resistance than other glove materials.
What are nitrile gloves made of?
Dental nitrile gloves are made for use by medical and dental professionals. They are made from a compound called nitrile. This compound is essentially a synthetic reprocessed form of latex. Nitrile is a co-polymer, designed by a combination of butadiene and acrylonitrile. Formerly, nitrile gloves begin as rubber obtained from trees. Next, they are converted into latex rubber after which they are reprocessed until a nitrile compound is formed. The latex proteins are removed by additional processing removes all latex proteins.
Can you wash nitrile gloves?
No gloves in the medical or dental fields cannot be reused or washed. More widely used gloves in the medical field are disposable ones and are intended only for single use. After use, these can be donned off and disposed of without hassle.
Can you be allergic to nitrile gloves?
While skin allergies are mostly associated with latex gloves, nitrile gloves contain components such as thiazoles and carbamates that may also cause skin sensitivity or allergy. In case you are allergic to nitrile or any of the components present in it, consider using other materials for daily use in your clinical practice.
Where to buy nitrile gloves?
You can easily buy nitrile gloves online. When buying nitrile gloves, ask several questions about the vendor and assess the following features.
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Settle for a reputable vendor.
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Take opinion from fellow dentists who have experience in using gloves, or search from social media forums talking about various topics such as Reddit.
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It’s better to purchase gloves from brands that are tested and authorized for their quality.
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Prefer brands that meet FDA standards of manufacturing and composition.
Are utility gloves mandatory for dental offices?
Nitrile utility gloves are suggested to be worn in the dental clinic while performing instrument processing or on-patient procedures. Considered puncture-resistant and heavy-duty the utility gloves provide greater protection to the hands as compared to thinner gloves. Hence, the CDC and Occupational Health and Safety Administration (OSHA) recommends the use of nitrile utility gloves. According to OSHA’s recommendation, every individual in the dental office should have a personal pair of gloves.
Are nitrile gloves chemical resistant?
Dental nitrile gloves have excellent overall chemical resistance and are typically less costly than other types of gloves. This is why they are more commonly used for diverse task performance than other materials. Nitrile exam gloves can resist kerosene, gasoline, and other petroleum solvents. Medical-use gloves are made from nitrile to prevent latex allergies, it is resistant to fats and oils as well.
However, nitrile gloves are not advised to be used with organic chemicals containing nitrogen, ketones, and strong oxidizing acids.
Do nitrile gloves cause cancer?
Nitrile gloves may comprise bis(2-ethylhexyl)phthalate (DEHP) that are considered carcinogenic. However, there is a lack of research confirming whether nitrile gloves can cause skin cancer and long-term longitudinal studies are warranted.
Akin to other glove materials, nitrile gloves are also sensitive to alcohol degradation. They are also shown to be ozone degradation sensitive. In case of a breach, nitrile gloves can easily tear leading to breaks. As a result, the glove pieces may end up in the food that may have carcinogenic potential in the long run.
Are nitrile gloves BPA-free?
Nitrile exam gloves are BPA-free, phthalate-free, latex-free, vinyl-free, MBT-free, and powder-free.
Are nitrile gloves heat resistant?
Nitrile glove material is highly heat resistant and has a great 250°C contact heat resistance. Coupled with high dexterity and great grip that is exhibited by the nitrile coat, these gloves outshine in industries including mouldings, panel handling, and oven use. Nitrile’s outstanding mechanical protection, flexibility, and dexterous design make them ideal for handling hot objects.
Chloroprene gloves vs nitrile
Chloroprene is also called Neoprene which was the first synthetic rubber. It exhibits high abrasion resistance and improved cut resistance. It combats degradation brought about by aging, exposure to sunlight, ozone, weather, and oxidation. Chloroprene also offers flame resistance with heat stability of up to 93°C (200°F). It delivers outstanding resistance to a variety of chemicals such as acids, fats, alcohols, refrigerants, caustics, ketones, detergents, and fertilizers. Neoprene® is also combined with natural rubber in some glove coating formulations.
Nitrile is the copolymer of acrylonitrile and butadiene. It exhibits remarkable resistance to physical threats including cuts, punctures, snags, and abrasion. Although nitrile is not flame-resistant, it’s good for temperature ranges between -4 and 149°C (25 to 300°F). Nitrile provides substantial resistance to fuels, oils, and certain organic solvents. Nitrile and chloroprene are rubbers that have similar characteristics but some differences in properties. Both glove materials have elasticity and can return to their former shape after being stretched. In a nutshell, nitrile is acceptable due to its chemical, heat, and abrasion resistance while chloroprene is known for its durability and weather resistance.
Disposable gloves vinyl vs latex
Latex gloves offer excellent barrier protection. They are comfortable, cost-effective, and provide great levels of tactile sensitivity. They have remarkable durability and flexibility which makes them perfect for most medical and dental procedures. However, allergies is a common concern caused by latex. In that case, latex gloves cannot be used and an alternative material such as nitrile is to be chosen.
PVC, a petroleum-based film is used to manufacture vinyl gloves. These are inexpensive but are less durable when compared to nitrile and latex. In addition, they provide inadequate protection against contaminants or chemical agents. Stretching vinyl gloves cause separation between the individual molecules compromising their integrity and impeding their barrier protection. Their reduced price and low barrier protection allow their use for low infection and non-hazardous environments.
Are all nitrile gloves powder-free?
As powdered nitrile gloves were banned by the FDA, all nitrile gloves are powder-free.
What are the best quality disposable gloves?
The best quality disposable gloves have:
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High strength and durability
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High tear and puncture resistance
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Good flexibility
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Excellent chemical and heat resistance
References: Stoessel K, Smith S M. Dental Supplement | Medical Glove Selection for Dental Professionals. The clinical issue. Issue 5. Kimberly-Clark Healthcare Education. 2008.
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Kerr LN, Chaput MP, Cash LD, et al. 2004 Sep. Assessment of the Durability of Medical Examination Gloves. Journal of Occupational and Environmental Hygiene 1: 607-612.
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Kerr LN, Boivin WS, Chaput MP, et al. 2002 Sep. The Effect of Simulated Clinical Use on Vinyl and Latex Exam Glove Durability. Journal of Testing and Evaluation 30(5): 415-420.
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Siegel JD, Rhinehart E, Jackson M, Chiarello L, HICPAC. 2007 Jun. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Online: www.cdc.gov. Accessed 6/2/2008.
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Pereira M. The Importance of Glove Ergonomics to Dentistry. CDA. DECC, 2015.
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Baker J. & Wagner M. Nine Myths About Disposable Safety Gloves. Occupational Health & Safety. Apr, 2010.
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Olk M J. Infection Control In Practice. Organization for Safety & Asepsis Procedures. Jan, 2003. Vol. 2(1).
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