Sir, we wish to comment on the article recently published in the BDJ suggesting that there are no logical reasons for using gloves in non-surgical procedures.1

Research focussing on blood-borne viruses has shown that the risk of their transmission in the dental setting is very low, although dental treatment is still considered to be a risk factor for HBV and HCV infection.2 Additionally, the number of emerging viral diseases with repercussion in dentistry has increased dramatically in recent decades.3 The risk of transmission can be reduced by taking routine precautionary measures such as glove wearing, as this practice significantly reduces the blood volume transferred during needlestick injuries.

Restricting glove use to surgical dental procedures underestimates the potential of saliva as a vehicle for the transmission of infectious diseases. Glove wearing prevents the transmission, via saliva, of infectious agents previously considered of lesser importance, such as herpetic whitlow,4 though it is now known that some of these viruses may have oncogenic potential. Although this field has received little attention to date, we have shown, for example, that over 50% of HCV-infected patients have detectable levels of HCV-RNA in their saliva and that culture of the saliva from patients with confirmed tuberculosis is positive in almost 90% of cases.

Continuous stimulation of the immune system with small quantities of antigens to favour natural immunity is a delicate issue. The most radical proponents are the antivaccination movements, particularly active since Wakefield's study, linking vaccination and autism. Recently, in Spain, a 6-year-old child who had not been vaccinated against diphtheria died from this disease, which for the past 28 years has been considered to have been eradicated in that country. In an ever more global society, the arrival of refugees and immigrants (United Nations stated that in 2013 the United Kingdom was among the top 10 destinations for international migrants) requires us to maximise universal barrier measures, in particular to avoid the transmission of pathogenic organisms not recognised by our immune system.

In summary, we consider that glove wearing is a barrier measure of confirmed efficacy and that furthermore, the use of gloves only in the context of surgical procedures could be of medico-legal importance.