Treating Patients with Food

Allergies in the Dental Office

Holli Schexnider, Dental Hygiene Student
Katelyn Crouch, Dental Hygiene Student

What is a food allergy?

A food allergy is a serious medical condition affecting up to 15 million people in
the United States, including 1 in 13 children. Thats roughly two children per
classroom.
A food allergy results when the immune system mistakenly targets a harmless
food protein an allergen as a threat and attacks it.
Actual food allergies differ from food intolerances; food allergies are IgE
mediated. This means that your immune system produces abnormally large
amounts of an antibody called immunoglobulin E (IgE). IgE antibodies fight the
enemy food allergens by releasing histamine and other chemicals, which
trigger the symptoms of an allergic reaction. These reactions can range from mild
to severe.

Allergic Reactions
Allergic reactions can vary from mild to severe.
Reactions may begin immediately, or may be delayed.
Mild reactions can include hives, GI discomfort, or itching.

Severe reactions include anaphylaxis shock.

Mild to moderate reactions may be treated with an antihistamine such as
Benadryl, with more severe reactions requiring epinephrine.
If epinephrine is required, 911 should be called, as the patient may need
additional care.

Top 8 Food Allergens

These are the most common food allergens,
causing about 90% of all reactions. Although,
any food could potentially cause a food
allergy.
Dairy
Eggs
Wheat

Soy
Peanuts

Tree Nuts
Fish
Shellfish

Peanut or Tree Nut Allergy

Peanut allergies are the least likely to be
outgrown.
In the past, fluoride varnish has been

suspected of causing a reaction due to

the pine sap rosin. Recent research shows

this to not be true.

Other dental materials that may contain
traces of peanut or tree nut protein

include: dental cements, polishing pastes,

and some impression materials.
Alternative materials

Dairy (Milk Protein) Allergy

A dairy allergy is the most common
childhood allergy, but also the most likely
to be outgrown. Milk is the third most
common allergen to cause anaphylaxis
shock, after peanuts and tree nuts.
In dentistry, dairy or milk protein is in
several products.
Recaldent (Calcium Phosphate)

Trident Gum
Some toothpastes
These products may contain casein (a
milk protein) that may trigger a reaction.
A true dairy allergy should not be
confused with lactose intolerance.

Egg Allergy
Egg allergies are also more common in
children, but may also be present in
adolescents and adults.
Nitrous Oxide is molecularly similar to
egg protein and has been known to
cause a reaction in some patients.
Propofol is usually received by patients
who are undergoing orofacial surgery,
also contain egg lecithin and egg yolk
phospholipids. In most cases, propofol
is tolerated safely.
Sulfonamides may be used in RCT
materials, and may cause a crossreaction with egg sensitive patients.

Questions?

References

University of Nebraska-Lincoln (March 10, 2014) Retrieved from http://farrp.unl.edu/allergenic-foods-and-their-allergens-links-informall

Fagan, Michelle A. (February 12, 2016). Food Allergy Awareness. Retrieved from http://www.rdhmag.com/articles/print/volume32/issue-08/features/food-%20allergy-awareness.html

Food Allergy Research & Education (2015). Egg Allergy. Retrieved from http://www.foodallergy.org/allergens/egg-allergy

Goldie, Maria Perno. (May 11, 2015). Food Allergies and Anaphylaxis Practice Parameters. Retrieved from
http://www.dentistryiq.com/articles/2015/05/food-allergies-and-anaphylaxis-practice-parameters.html

Hsu, Deborah C. Cravero, Joseph P. (October 6, 2014). Up To Date. Retrieved from http://www.uptodate.com/contents/selection-ofmedications-for-pediatric-procedural-sedation-outside-of-the-operating-room

Ludman, S. Neil, S. Fox, Adam T. (September 16, 2013). BMJ. Retrieved from http://www.bmj.com/content/347/bmj.f5424

Mattana, Durinda. (July 29, 2015). Is Fluoride Varnish a Risk for Patients With Nut Allergies? Retrieved from Dimensions Of Dental Hygiene
70.

Mayo Clinic Staff. (August 7, 2014). Disease and Conditions Milk Allergy. Retrieved from http://www.mayoclinic.org/diseasesconditions/milk-

VOCO Fluorid Varnish (July 10, 2014) Retrieved from email from Dr. LeAnn McQuade; Aug 2016.