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Allergies To Dental Materials

Suspected allergies in dentistry should be confirmed by an allergy test conducted by a dermatologist or allergist, due to the potential for a life threatening allergic reaction or the development of a long-term occupational disability. When an allergy test to a certain dental material is found to be positive, the dental team should take appropriate precautions to eliminate the use of the offending allergen by using alternative materials, for example, latex-free gloves or nickel-free alloys.

Research demonstrates that there are numerous potential allergens in everyday dental practice. However, currently there is not enough evidence to indicate that use of popular dental materials should be discontinued. Nevertheless, the dental team should remain vigilant and acutely aware of the potential of the many available dental materials and products to cause allergic hypersensitivity within the mild to severe range, both intra-orally and at unrelated parts of the body. Materials that warrant particular awareness include latex, nickel, methacrylate, eugenol and polyether impression materials.

References available from the author on wiltshir@cc.Umanitoba.Ca.

Box 1: Test yourself

1. What proportion of orthodontic patients with pierced ears is allergic to nickel?

A. 60% B. 20% C. 30%

2. When did latex allergy become more common?

A. 21st century B. 1980s C. 1940s

3. A Type IV reaction is:

A. Delayed B. Immediate C. Fatal

ANSWERS: 1C, 2B, 3A.

Latex Allergy: 'A Balloon Could Kill Me'

Liz Knight can no longer read a newspaper or touch the buttons on her remote controls, because they both contain latex

Balloons are a common sight at children's birthdays, weddings, restaurants and shops. But Liz Knight has spent most of her life avoiding them because coming into contact with one could kill her.

As a child, Liz was allergic to dust, animal hair and feathers. By the age of 12, doctors found she was also allergic to human hair. Her long blonde ponytail was duly cut off into a short, cropped style that wouldn't cause any irritation.

It didn't stop there - the extent of her allergies only grew and some of her earliest memories involve being isolated because of them.

"We went to visit a relative when I was four; I think it was an aunt or a great-aunt of mine. She had a budgie - everyone seemed to have them in the 60s and 70s - and I was really bad with any type of feathers.

"I can remember we parked up in the drive, my parents went in with my two sisters, and I couldn't go in. The budgie meant I had to stay in the car on my own. It made me feel very left out - I couldn't do what normal people do."

Liz had to have her long blonde hair chopped off

Liz, from Paignton in Devon, has suffered with irritated skin her whole life. In her 20s, her eczema got infected and led to septicaemia, which left her hospitalised for weeks. But it wasn't until the 1990s, when she was at a fair with her family, that she suspected a latex allergy.

"One of my daughters handed me a handful of these great, big, thick helium balloons and asked me if I could hold them while she ran off to do something. I must have touched my face after holding them because that's when this dramatic swelling started."

Liz, now 56, believes she developed the allergy by repeated exposure to latex from going to the doctors so much, which exposed her already fragile skin to the material.

Her everyday life has been impacted in a multitude of ways. She can no longer read a newspaper, because the ink contains latex. It is the same with the buttons on remote controls, the handle of her carving knife, her blender, mixer and hairdryer, all of which are covered with cling film so she can still use them.

Whenever there are road-works nearby, Liz has to keep her doors and windows closed because the road surface also contains latex. She says she often feels like a prisoner in her own home.

"I often feel trapped. Sometimes I stay at home for up to a week, just because it's safe."

She has to cover her remote controls with cling film because the buttons contain latex

Then four years ago, Liz got confirmation of what she was dreading: her latex allergy had gone airborne. She had walked into a shop with her husband during the winter and her lips instantly swelled and she broke out in hives.

"I went straight back outside and said, 'I don't know what's in there, but something's making me feel really bad'."

They looked back and saw six balloons tied around a stand at the back of the shop. In that case, the latex proteins had been circulating through the heating system. But Liz's allergy is so severe that even if a room has had a balloon in it in the past 48 hours - especially if it has popped - she might have a severe reaction because the latex proteins could still be in the air.

Most reactions cause her to start sweating, her lips swell and she has a feeling of "impending doom". She can normally handle the symptoms by leaving the area, going outside and letting herself recover - although it can take hours to get back to normal.

What is a latex allergy?

Latex is a milky sap from plants like the tropical rubber tree and is collected by drilling into the trunk

It is used to make rubber items such as household and medical gloves, shoes, tyres, balloons and condoms

Allergies are caused by your immune system overreacting to something it perceives as a threat, with symptoms ranging from a mild rash to anaphylaxis

Up to 5% of people could have an allergy to latex, according to the NHS, although not all will show symptoms

A tendency to develop allergies can be hereditary, although conditions like asthma and eczema also make people more susceptible

The only way for sufferers to avoid reactions is to avoid latex as much as possible

Regular contact with latex, such as the gloves sometimes used in healthcare professions, will lead to higher chances of a latex allergy, with repeated exposure often making reactions worse

There are experimental treatments to desensitise people from latex, but they are not yet widely available

Source: NHS, British Association of Dermatologists, Globalaai

One recent reaction at her home, however, was more extreme, and left her in serious trouble.

"A few months ago I made a sweet and sour dish using a sachet that had 2% pineapple juice. Within about 15 minutes of eating it I could feel my tongue swelling, and then my throat started going a bit funny. My tongue was getting worse and worse."

Tropical fruits have proteins that are almost identical to the latex protein, and often produce a very similar reaction. She used her Epipen, a self-administered injection of adrenaline which slows the effects of allergic reactions.

Liz was monitored in hospital for several hours to make sure she didn't have a biphasic reaction - a delayed reaction comparable to the aftershocks following an earthquake - and ultimately the symptoms died down.

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Liz's allergies have had an effect on many aspects of her mental health. Her social circle has "drastically shrunk" and she had to quit an exercise group she attended for years because of the latex in mats, trainers and aerosol sprays.

She has also had to give up her work at a pharmacy due to repeated reactions which were endangering her health, and now feels guilty that she can't contribute financially at home.

Despite all of this, Liz says she's determined not to let her latex allergy completely take over her life. "I can walk, I can do and see things, and I've got to be grateful for the things I do have."

Liz regularly breaks out in hives when she has a reaction

Globalaai was formed in 2016 after its founder, Dr Pooja Newman, had an anaphylactic shock at a concert in Melbourne. A surprise balloon drop left her in intensive care for nearly a week and inspired her to raise awareness of latex allergies around the world.

While recovering, she made a Facebook page to tell her story and the non-profit organisation was founded.

"Part of the reason for this charity is to recognise the trauma people suffer as a result of an anaphylactic event and the issues around feeling discriminated or not included in everyday life," said Dr Newman.

The organisation has developed Epipen stations in public places and has supported the ban of latex gloves in food preparation in several US states, as well as a proposed restriction of balloons in public spaces in Australia.

Liz's work with the group has seen progress in Paignton, with many shops changing their practices on her advice. While recognising the many ways in which her allergies limit her life, Liz's outlook remains positive.

"When it feels really unfair I get a bit depressed about it I suppose, but there's always that feeling that it could be worse. I try to talk to as many people as possible about latex allergies. The more people that know about it, the more things can change.

"I'm determined not to let allergies take away everything in my life, and I'll work to improve things, not just for me, but for other people as well."

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Our Expert Guide To Dunlop Vs. Talalay Latex: What's The Difference?

Shopping for mattresses and other sleep products can make you feel a bit like Goldilocks. Everything is too firm or too soft and then—hopefully–eventually, just right. Along the way, you'll encounter numerous fabric and material names, some of which you might not have heard before, along with a slew of marketing terms competing for your attention. If you're interested in sleep products made with latex, such as the Avocado Green Mattress, you need to decide between Dunlop vs. Talalay latex—which is right for you?

The Sijo CloudSupport Pillow is made with Talalay latex foam.

Illustration: Forbes / Photo: Retailer

Many people opt for mattresses made with latex foam, which is known for its eco-friendliness. But there are multiple options for what makes up the best latex mattresses, including Dunlop and Talalay. Here's what to consider before you shop to ensure you choose products for the best sleep for your budget and specific needs.

What Is Latex Foam?

Latex foam is divided into three types: all-natural latex, synthetic latex or a mixture of both. All-natural latex comes from a rubber tree, whereas synthetic latex typically is made from synthetic materials like styrene-butadiene rubber.

For consumers entertaining latex foam for their good night's sleep, Dunlop and Talalay latex are the two most popular choices. The terms refer to the manufacturing process for the way the latex is poured and the foam is produced.

The Differences Between Dunlop Vs. Talalay Latex

"Dunlop latex is going to be a bit firmer, but the softest you can get there is medium-soft," says Tasha Stoiber, senior scientist at Environmental Working Group. According to Stoiber, latex of either variety is better when it comes to off-gassing and VOCs than polyurethane foam is, so people who want to steer away from petroleum-based products choose latex. "Latex mattresses usually have better materials overall," she explains.

Purchasers tend to report that Talalay latex mattresses have a bouncier feel, while Dunlop works best for people who like a more mild springy feel. The key differences between the two lie in the production process. "It's just a different recipe for baking Talalay, and that's why it turns out softer," Stoiber says.

Myths About Dunlop Vs. Talalay

One is superior to the other. Sleep On Latex shares that retailers selling latex sleep products tend to "exaggerate" benefits of one and deficiencies of the other, when in reality they simply have different traits and firmnesses.

One is "softer" than the other. Both types of latex can be produced in a wide range of firmness feels. The Dunlop process typically creates denser foam with more weight to it, but that doesn't always equate to being firmer.

The process of making the two types of latex is mostly the same. Not only are the processes not alike, but there are other variances as well. Techniques can differ between factories and equipment, for example. Also, each type of natural latex foam can be made with or without synthetic latex included.

You shouldn't use this type of mattress if you have a latex allergy. "Latex is a 'touch' allergy. In the case of latex mattresses, the sleeper will never make skin-to-skin contact with the latex. So, people with latex allergy can still enjoy the benefits," says Bailee Nebeker, former vice president of Salt Lake City's Wallaroo's Furniture and Mattresses and CEO of the company's manufacturing line, American Homestead Furniture.

Illustration: Forbes / Photos: Retailers

How Talalay Latex Is Made

According to Talalay Global, the process to create Talalay latex includes eight steps, including some of the following:

First, the latex is poured into a mold.

This mold is only filled partway, to allow for air to be added by vacuum and the latex to be dispersed through the mold.

The mold is then placed in the freezer at -22 degrees Fahrenheit.

After its flash freeze, the mattress is heated to 220 degrees Fahrenheit, in a process called "gelling."

The latex is then purified through various washes.

The final step is "vulcanization," during which any remaining moisture is removed and the mattress is considered cured.

Wallaroo's Furniture & Mattresses

Type: FoamFirmness: Not statedTrial period: 2 weeksWarranty: NoneHeight: 11 inches

Nebeker has personal and professional experience with Talalay latex. "We have been sleeping on the King Koil Pure Bliss mattress, which is 12 inches of pure Talalay, for two months now, and we are so glad," she says. "The feel is unlike anything on the market; it has a bouncy feel with absolutely no motion transfer—think mattress+bowling ball+wine glass. You feel absolutely no movement."

She chooses to offer it in her store because she admires the craftsmanship "at prices normal people can afford." She also mentions how sturdy it is, pointing out that a queen-size King Koil Pure Bliss mattress weighs 250 pounds, whereas the average queen mattress weight only around 120 pounds.

How Dunlop Latex Is Made

Dunlop latex also starts out by being poured into a mold but, unlike Talalay, the latex is poured in layers. Because of the various pours, settling can occur, which is why the foam tends to have various densities from the bottom to the top of the mattress or even on the sides.

"Dunlop is less consistent; each layer has different properties and densities because of the way it is poured. Air bubbles that form during that process are part of the reason for the inconsistencies," says Nebeker.

Top latex mattresses, such as the Avocado Green Mattress, use GOLS-certified organic Dunlop latex. The pillowtop and standard models of this highly rated mattress are made with Dunlop latex, using more than 95% certified organic material. The plush box-top model includes additional FSC-certified pure Talalay latex as well.

Type: HybridFirmness: Plush (4), medium (6) or firm (7)Trial period: 1 yearWarranty: 25-year limited warrantyHeight: 15.5 inches (plush), 13 inches (medium) or 11 inches (firm)

Why Trust Forbes Vetted

Forbes Vetted sleep writers, contributors, and editors have extensively researched the best products, tested numerous must-have sleep items, and interviewed leading experts in sleep to bring readers the knowledge they need to find the best products for them. From mattresses and bedding to products to help you sleep better, Forbes Vetted has essential information and a trustworthy reputation.

This article was written by Alexandra Frost, a veteran product journalist with 18 years of professional experience lying (and bouncing) on dozens of mattresses. She has interviewed sleep doctors and coaches, brand leaders and scientists to build her knowledge of the sleep industry to bring clear and helpful advice to readers.

Sleep editors Bridget Chapman and McKenzie Dillon, are certified sleep science coaches and experienced sleep journalists who have tested hundreds of mattresses between them.

We tapped expert knowledge including industry insider and brand leader Bailee Nebeker, the former vice president of Wallaroo's Furniture and Mattresses and CEO of Wallaroo's manufacturing line, American Homestead Furniture, in Salt Lake City.

We also talked to Tasha Stoiber, senior scientist at Environmental Working Group to learn more about the science behind the two types of latex.

We routinely revisit our content to ensure that it's accurate and up-to-date. This article was last reviewed in August 2024.

Frequently Asked Questions (FAQs)

Is Dunlop Or Talalay Latex Better?

Nebeker says she has asked many mattress-industry leaders this very question over the years. "Nine times out of ten, they tell me a Talalay latex mattress [is better] and expound on the reasons shared above." However, the answer is more accurately based on your personal preference for a bouncy or less bouncy mattress.

Why Is Talalay More Expensive?

The raw materials used to make Talalay latex mattresses come from rubber tree sap, collected by hand, which is "labor intensive," Nebeker says. "Talalay latex, by its nature, requires a more costly manufacturing process."

Does Talalay Latex Soften Over Time?

Latex mattresses generally have more elasticity and compression than a memory foam mattress does. Dunlop latex mattresses tend to have a firmer feel when compared with Talalay latex. But most latex mattresses don't soften the same way memory foam mattresses do, which is why you might see longer warranties on some latex mattresses, such as 20 to 25 years.

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