COMFORT ZONE: At your fingertips

Anytime soft tissue is repeatedly compressed or joints are forced into unnatural positions over and over, trouble may lie ahead.

Imagine a store that sold unisex clothing for dental offices with a "one size fits all" policy. That wouldn't work very well, would it?

If you were selecting a lab coat or jacket to wear every day, wouldn't you search for something that fits well? Imagine if you could barely button your lab jacket. Would you be comfortable in a jacket with sleeves that were three inches too long or shoulders big enough to fit a Green Bay Packers lineman? What about the fabric? Many synthetic fabrics irritate my sensitive skin, so I prefer natural fabrics like cotton.

From my point of view, the type of gloves we wear - patient after patient, procedure after procedure - is just as important as properly fitting clothes, yet many of us rarely give our gloves a second thought! So let's take a few minutes to evaluate whether the type of glove we wear is tailor-made for our needs. Remember, what is at our finger tips directly affects our tactile sensitivity as well as hand comfort.

Fabric: Latex and the options

First, consider the fabric. Do you prefer latex or nonlatex varieties? Latex gloves have the potential for creating the most "natural" fit. Latex sensitivity or a true latex allergy, however, is an issue for some clinicians and patients. Fortunately, alternative glove types are available for use in health-care facilities. In response to the "latex issue," many dental hygiene programs and a number of dental offices are creating latex-free environments.

Vinyl gloves are just one alternative to those who need to steer clear of latex, but the molecular structure of the vinyl begins to break down as soon as you start wearing the gloves. Microscopic fissures develop in the vinyl, which can allow blood-borne pathogens to pass through the gloves!

One major glove manufacturer no longer makes vinyl gloves for medical/dental use due to this concern. Another downside to vinyl is the very poor fit. So, if you have vinyl gloves sitting around the office, use them for other chores such as cleaning the X-ray processor or just toss them in the trash. Compromising someone's health is not worth the price of a box of gloves!

What if you're allergic to latex and vinyl is not a choice? Fortunately, there are two other options: the synthetic materials of nitrile and chloroprene. Nitrile gloves have high puncture resistance. But they also have limited flexibility or "give" and tend to be higher priced.

The newer chloroprene gloves also have high puncture resistance. They are much more flexible, and so provide a much better fit. They are priced somewhere between nitrile and latex varieties.

The one-size-fits-all syndrome

Just like my favorite clothes designer, gloves come in a wide range of sizes, ranging from extra small to extra large. Just like the clothing industry, though, a small size from one manufacturer may not be the same as a small glove from another company. Another thing to consider is the size of our hands. Some of us have petite, almost childlike hands, while others have hands so large that they can span two octaves on a piano keyboard. Also, look at the length of your fingers. If the glove is too long for your fingers, then you'll loose valuable tactile sensitivity. Conversely, if the fingers are too short, you'll loose freedom of movement.

It is also quite important that gloves fit properly in the palm and wrist. Constriction of the soft tissue in these areas can result in a very painful experience in either the thumb or the carpal tunnel area. Anytime soft tissue is repeatedly compressed or joints are forced into unnatural positions over and over, trouble may lie ahead. Remember, you don't want your hand to feel like it's stuffed inside a girdle any more than you want to put up with gloves that suffer from "panty hose creep."

Gloves come either in ambidextrous models or those that are individually fitted for the right and the left hands. While ambidextrous gloves do not bother most of us, some clinicians' hands are very sensitive to a less than optimal fit. The fitted right/left gloves are considerably more expensive than the ambidextrous models. But, if your hands hurt, it's difficult to perform quality procedures!

One option is to use the less expensive ambidextrous models for very short tasks, such as taking radiographs or brief exams, and the right/left gloves for longer, more exacting procedures such as a periodontal-debridement case. This strategy reduces the overall expense and still allows you to wear what you need when the fit is more critical.

Skin and the powder it rubs

Now let's talk about powder vs. powder-free. While powder makes the gloves easier to take on and off and helps absorb moisture, the powder can cause undue dryness in your skin and nails. Through the years, several different materials have been used to powder gloves. In the early days, many gloves used talc, which often created a contact dermatitis problem. More manufacturers now use corn starch to reduce this problem, but there is some concern that corn starch can pick up latex proteins, which can still present a problem for some clinicians. Many "latex allergies" are actually caused by the powder.

Switching to a powder-free glove may be all it takes to eliminate your skin irritation. Also, the amount of powder varies greatly in different brands of gloves, so consider selecting brands that are lightly powdered.

If you suffer from dry skin or dermatitis, be careful what you use on your hands before you don latex gloves. The integrity of latex can be compromised in the presence of petroleum-based products. In other words, do not use petroleum jelly on your hands before you put on latex gloves. Also avoid petroleum jelly on your patient's lips. You can still use hand lotions or creams that contain petroleum or other oils in the list of ingredients, since the concentration is so low in these products.

Oil-free hand products are also available from your dental supplier. One company manufactures gloves that contain aloe vera extract, which may provide relief for some clinicians.

Texture and other fun stuff

Textured gloves are one of the simplest ways to reduce hand fatigue and improve tactile sensitivity. When slick gloves get wet, it's like walking on ice. Texture gives you traction, just as it does on the bottom of your boots. Textured gloves allow you to hold on to your instruments with a feather-light grasp, which is critically important when using ultrasonic scalers, feeling for subgingival deposits, analyzing complex root morphology, or evaluating the integrity of a crown margin. Most clinicians find textured gloves improve their overall hand comfort and increase tactile sensitivity. However, just as in glove sizes, all "textures" are not the same. Latex, chloroprene, and nitrile gloves are all available in textured styles.

It is important to evaluate different brands of gloves so that you can select the perfect fit for your hands. Remember that "one size does not fit all!" Glove manufacturers are very happy to supply you with samples of their different types of gloves. Just give them a call!

Finally, we come to the fun stuff! You can now purchase gloves in a variety of scents, ranging from light peppermint to strawberry, bubble gum, and even grape. Some varieties are even flavored. Imagine aromatherapy from your gloves rather than the ever-pungent medical aroma of "eau de latex!" Gloves are available in fashion colors raging from pale pink to hot pink, lilac to purple passion, to mint green to all shades of blue. While I doubt it will ever become the talk of the town on the Paris runways, I wear only hot pink textured gloves to match my extensive collection of pink scrubs!

Here is my theory - it's hard to be in a bad mood wearing hot pink gloves!Well, I just love it! - comfort, fit, and a fashion statement - all available right at your fingertips while you're practicing in the comfort zone!

Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. She writes, speaks, and presents continuing- education courses on ergonomics and advanced ultrasonic instrumentation through her company, ErgoSonics (www.ergosonics.com). She can be reached by phone at (713) 974-4540 or by e-mail at anne@ergosonics.com.


Grasping for the clue

Susan Donnelly, RDH, a 22-year veteran, was experiencing pain in her right thumb. She received a brochure about a course in dental hygiene ergonomics in St. Louis that intrigued her. As she was driving back home to Kansas City, one topic stuck in her mind: The gloves she wore while working!

Susan remembered that her office changed to a new brand of gloves three months ago. She wondered if the new gloves were the culprit, since she had large hands and long fingers. When she examined her gloves carefully, she discovered that they were just a bit too tight across the palm, acting like a rubber band and constantly straining her thumb. Susan found a glove that fit her hand better, and did some special lower-arm massage.

Within one week, her thumb pain had nearly vanished! Several weeks later, she was pain-free. Sparked by some good information, Susan analyzed her problem and took immediate action that got rid of this potentially career-ending pain.

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