Assessment of Allergic and Non-Allergic (Irritant/Toxic) Reactions to Acrylates in Dentistry

Background and Objectives: To examine the potential association between acrylate exposure, skin condition, and allergic and non-allergic (irritant/toxic) skin and mucosal reactions among dental professionals and students. Materials and Methods: A total of 136 dental personnel (dental technicians, dentists, dental assistants/nurses, and students) completed a questionnaire on dentistry-related unwanted reactions to acrylates, and 53 additionally agreed to a dermatologic examination, including assessment of hand skin condition using the Osnabrück Hand Eczema Severity Index (OHSI) and allergy testing. Patch testing for acrylates and common dentistry-related substances, as well as prick testing for inhalant allergens, was performed. Results: In the total sample, 88/136 participants (64.7%) reported work- or study-related skin changes, with the highest prevalence among dental technicians and dental assistants/nurses (78.3% and 76.9%, respectively). Among dermatologically examined participants, dental technicians had the highest OHSI scores, indicating the most severe hand skin changes. The most commonly reported manifestations in the total sample were hand eczema and fingertip skin fissuring (29.4%), followed by facial eczema (14.7%), periungual dermatitis (11.8%), nail dystrophy (7.4%), generalized dermatitis (6.6%), mucosal symptoms (6.6%), and other reactions. Among dermatologically examined participants, those reporting reactions to acrylates had higher OHSI scores than those without such reactions (median 2 vs. 1; p = 0.005; r = 0.384). OHSI scores differed significantly across categories of work-related skin changes (p = 0.048; ε = 0.117). In total, 6/53 (11.3%) positive allergic reactions to acrylates were found, which were present in 4/53 (7.5%) of tested participants. Positive reactions to methyl methacrylate (MMA), 2-hydroxyethyl methacrylate (2-HEMA), and ethylene glycol dimethacrylate (EGDMA) were observed in 2/53 (3.8%) participants each. Conclusions: The low prevalence of confirmed acrylate allergy in patch testing compared with the high frequency of reported work-related skin and mucosal changes suggests that allergies to acrylates are uncommon and that other factors may cause or contribute to these lesions. Preventive measures are particularly important for dental technicians, who show the greatest severity of hand skin changes.