April 1997 Newsletter

President's Message | Sy Symanski's Page

MCDS Board of Trustees Report | Treasurer's Report Detail

NJDA State Board of Trustees Report | Articles | Announcements | Dates to Remember

President's Message

Latex Gloves: Just the tip of the finger

More frequently, patients with latex allergies are being seen in the dental office. Latex allergy in Dentistry is important not only because of the problems in creating a latex free environment to treat allergic patients, but we as health care providers can develop these allergies as well. After the introduction of universal precautions, use of natural rubber latex gloves increased. Respectively the increased demand may have altered the manufacturing procedures which resulted in poor quality, highly allergenic gloves.

Natural rubber latex is derived from the sap of the Hevea brasiliensis plant known as the rubber tree. Reactions to products containing latex can be triggered by either the latex protein or by an additive used in the manufacturing process which gives the product its final shape, color, and texture.

The latex protein can also bind to the powder in gloves and becomes airborne after each glove removal.


1) The prevalence of latex allergy in the general non-atopic population is less than 1%.

2) The prevalence in health care workers is 7 - 10%.

3) Children with cogenital neutral tube defects like spina bifida have late allergy rates from 12-64%. These patients undergo many surgeries, as well as frequent catherizations and enemas resulting in mucosal absorption of latex.

The populace with latex allergies can also be allergic to other plant proteins with similar structures like avocado, banana, chestnuts and kiwi.

Reactions to latex can vary and become more severe over time with continued exposure.

1) An irritant contact dermatitis is a non-allergic cutaneous response to latex that can cause papular and ulcerative lesions.

2) Allergic contact dermatitis is a Type IV (delayed hypersensitivity) reaction which is a T-cell mediated response to the manufacturing additives to latex. Vesicular skin lesions appear on the dorsum of the hands.

3) A Type I (immediate hypersensitivity) reaction is IgE mediated and is triggered by the latex proteins themselves. Symptoms are more severe with rhino conjunctivitis, urticaria, wheezing, and bronchospasm. Anaphylaxis is most often caused by exposure to surgeons gloves in the abdomen or mucosal exposure from a barium enema and dental procedures.

There are five routes of exposure to latex proteins: cutaneous, mucous membrane, inhalation, internal tissue, and intravascular. All can be encountered in a dental appointment. When a patient enters an office they are exposed to particulate latex in the air from powdered gloves. Latex is in the blood pressure cuff tubing and stethscope tubing. Latex can leach out of the rubber stoppers in local anesthetic cartridges or multidose vials of drugs and be injected. Also containing latex are prophy cups, rubber dams, orthodontic elastics, endodontic filling material, face mask straps, and adhesive tape.

Treatment Considerations

1) Preventing problems starts with a good patient history. Latex allergies can be suspected in anyone with spina bifida, congenital urinary tract anomalies and/or frequent catherizations. Questions can be asked about food allergies (banana, kiwi, chestnuts, and avocado) or facial swelling after blowing up a balloon or exposure to a rubber dam.

2) When treating a patient with latex allergy an allergist can be called for consultation. Although anaphylactic reactions cannot be prevented, premedication regimens including hydroxyzine, prednisone, and rantitdine can reduce symptoms.

3) The patient should be given the first appointment of the day when there is less particulate latex in the air and no latex on your hands or clothes.

4) Local anesthetic can be ordered in glass ampules and drawn into a syringe with a plastic plunger.

5) Plastic sleeves can be placed over all latex tubing.

6) Anything being used on a patient needs to be handled with vinyl gloves.

7) Have emergency drugs, especially epinephrine readily available (patient will usually carry their own).

8) Latex-free products can be ordered. Since labeling is not always accurate, the manufacturer can be called to confirm.

1) Holzman, RR. Latex Allergy: An

Emerging Operating Room Problem.

Anesh Analg 1993; 76:635-41

2) Sussman, G. Allergy To Latex Rubber.

Ann Intern Med. 122:43-46

See you at the next meeting.

­ Phil Engel

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Sy Symanski's Page


The leadership of our state government stopped all activities on March 13, 1997 as Assemblyman Arnone lead a ceremonial program to honor our own Dr. Theodore 'Sy' Symanski.

Sy was honored, in this unique fashion, for distinguished service in the field of dentistry and to his country.

We at MCDS have known for years about Sy's

commitment to Dentistry and his many years of

service to our local dental society.

Congratulations Sy!



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MCDS Board of Trustees Report

­ MARCH 11, 1997 ­

Attendance: Bloom, Brunsden, Engel, Fertig, Fromkin, Glickman, Krantz, Leizer, Perlmutter, Weiner.

Acceptance of Minutes last meeting - Feb. 2, 1997 - vote unanimous.

 Treasurer's Report:

 Previous Balance

$ 29,176.44
 M. Schambra,  Treasurer

 Income / Expenses

$ 3,341.04

 Current Balance

$ 32,517.48



There have been 15 applications received for membership in MCDS for the 1997 year. Six of the 15 are dental residents. An induction ceremony will be scheduled for either the April or May meeting and Certificates will be distributed at that time.

We need to encourage nonmember dentists to attend MCDS meetings. This is probably the best way that we can spread the word about how valuable membership really is. Last month's newsletter was mailed out to the "New Dentist" group of nonmembers.


An evening of continuing education lectures is scheduled with Marcy Dental Laboratory for April 17, 1997 from 6:15 - 9:30 pm. Three CEU credits will be awarded for this free seminar, however, a reservation is required as seating is limited. This program is restricted to doctors only.

Two computer courses are scheduled with Loris Enterprises for both novice and intermediate users. Internet topics will be discussed in each course. The program is scheduled for Thursday, May 1, 1997, 6:30 - 8:00 pm for novice computer users, and 8:00 - 9:30 pm for intermediate users. CEU credits are pending for each seminar. Staff members are invited to attend this course.


This year's theme for CDHM is "Uncover the Secrets to a Healthy Smile". A county wide poster contest is being held, ending March 26th. Savings bonds will be awarded to the winners on April 7th at the Dental Health Show in the East Brunswick H.S. auditorium.

The Nurse's Continuing Education Program will be held Wednesday, March 26th at NJDA Headquarters at 7:00 pm. "Behavioral Management in Children" will be presented by Dr. Stephen Schwartz.


The Trenton Thunder trip is scheduled for Wednesday, June 4th. A block of tickets have been reserved for MCDS. Contact Dr. Philip Engel to make a reservation.


Dr. Peter DeScissio was selected to be next year's Program Chairman.

Dr. Daniel Krantz was nominated for NJDA Trustee, Dr. Joseph Perlmutter was nomin-ated for Alternate.

Dr. Joel Leizer was nominated for ADA Delegate, Dr. Peter Clemente was nominated for Alternate.

Dr. Joseph Fertig has arranged for the St. Peter's Library to be available for all MCDS members. An extensive dental videotape collection already exists at St. Peter's, and can now be loaned out by presenting a valid ADA membership card with MCDS listed as your component. The library requests a $300 flat fee from MCDS for the first six month's use for all members. This fee will be used to purchase dental related materials for the library. A motion was made to pay $300 for a trial MCDS library membership, after which time further membership will be re-evaluated. Vote unanimous.

Respectfully submitted.

Ira S. Rosen, DMD

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Treasurer's Report

February 28, 1997

Treasurer: Mark Schambra, D.D.S.

Previous Balance

(1/31/97) $29,176.44

Income / Expenses

(11/97/97) $ 3,341.04

Current Balance

(1/31/97) $32,517.48



2/1/97 Through 2/28/97


Dinner Payments 110.00

Dues 8,551.25

TOTAL-INCOME $8,661.25


Dinner Meetings 2,374.55

Donations 1,000.00

Lecture Fees 500.00

Newsletter 1,079.66

Secretarial 48.00

Uncategorized Expenses 0.00



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NJDA State Board of Trustees Report

February 26, 1997

NJ DPAC - Dr. Fred Sterritt

­ NJ is printing a federal PAC to enable NJDA to contribute to our federal legislators.

This will create two separate PACs, one state and one federal, that work cooperatively.

­ Night at the Races - May 7, 1997, will be used to fund the NJ Federal Dental PAC.


­ Dental consultants working for insurance companies must hold a current NJ license.

­ RN's may not perform oral examinations under the supervision of an M.D.


The board authorized the solicitations of proposals on sponsorship programs for electronic claims processing, gloves, and group purchasing of office supplies as a source of 'non-dues' income.


The ADA President Elect's Conference focused on Direct Reimbursement, Continuing Competency, and National Marketing.


NEBCO has proposed the payment of royalties on non-endorsed products sold as a result of the NEBCO/NJDA Association.

LEGAL-REPORT - Mr. Art Meisel

­ The board approved legal action to assure prompt publications of regulations in the NJ register. (5 state board proposals are awaiting publication).

­ BC/BS 'termination without cause' clause is in trial court. Legal services are available if you have been harmed by this action.

­ Professional management companies that require a percentage of revenue as payment is ongoing, in 'fee splitting' and this is prohibited.

COUNCIL ON-ANNUAL-SESSIONS: The annual session on June 6 & 7 has limited rooms available.

COUNCIL ON-DENTAL-BENEFITS: Senate Bill 438, the NJDA-sponsored Assignment of benefits legislation would require all dental benefit plans to send payments directly to den-

tists, regardless of participation status, as long as the patient executes the authorization.

Respectfully submitted ­ Dr. Cavan Brunsden
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No articles in this issue.
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MCDS Nominations: 1997-98

President: Dr. Cavan Brunsden

President Elect: Dr. Ira Rosen

Vice President: Dr. Mark Schambra

Secretary: Dr. Theodore Symanski

Treasurer: Dr. Charles Bloom

ADA Delegate: Joel Leizer

ADA Alternate

Delegate: Peter Clemente

NJDA Trustee: Daniel Krantz

NJDA Alternate

Trustee: Joseph Perlmutter

These positions will be voted on at the general membership meeting in May.

GOOD & WELFARE: Dr. Daniel Krantz is happy to open his new office over one year since his old office was destroyed

MCDS wishes a warm welcome to the following new members for 1997:

Dr. Daniel Armento

Dr. Daniel Boden

Dr. Cynthia Butcofski

Dr. Lynda Chen

Dr. Michael Conte

Dr. Paul Ferguson

Dr. Edwin Galkin

Dr. Wael Ibrahim

Dr. Salim Nathoo

Dr. David Pipitone

Dr. Jacqueline Reid

Dr. Vivian Rivelo

Dr. Paul Szott

Dr. Wonhi Yoo

*Nonmember dentists are always welcome to attend our continuing education programs as guests.


A valid ADA membership card from a MCDS member is all that is needed to access the extensive video collection located at St. Peter's Hospital Library. (Hundreds of current dental videos are available).

Dr. Joseph Fertig has arranged for this additional membership benefit that should provide all of our members with videotapes on subject matter ranging from 'Current Bonding Techniques' to 'Staff Management and Benefit Determination.'

Additional information and a listing of available titles is available by contacting the St./ Peter's Library or Dr. Joseph Fertig.


Thursday, April 17, 1997

St. Peter's Hospital

I. Impression Taking

II. Precision Partials

III. Shade Verification

6:15 - 9:30

Three one hour video/live seminars

Three C.E.U.

Presenter: Marcy Dental, Perth Amboy

Thursday, May 1, 1997


St. Peter's Hospital

II. Introduction to Computer Use

7:00 - 8:00

II. Application of Computers

8:30 - 9:30


Each seminar costs $15.00

One C.E.U. per seminar

Presenter: Loris Enterprises, Edison



Contact: Dr. Ethan Glickman ­

Chairman Mentor Committee

Call 572-4244


· Want to swing a bat?

· Need to throw a ball?

· How about having some fun?


Who will accept the CHALLENGE!




Cavan Brunsden


A Middlesex County Dental Society Special Event!

... You can fight bumper-to-bumper traffic into New York!

... You can even park your car in the Bronx (and pray that it is

there when you get back)!

... Or you can ...


Wednesday, June 4th, 1997






Contact: Dr. Philip Engel

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Dates to Remember

March 9 - NJDA Day at the Circus
March 19 - 'Nothing But Net' - N.B. Hyatt
March 26 - 'Nurses Night' - NJDA: 7:00 pm
April 6 - CDHM Awards EBHS Auditorium: 1:00 pm
May 21 - NJDA House of Delegates
June 4 - Trenton Thunder Baseball
June 6&7 - Annual Session: Atlantic City

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