UV Awareness Month

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  Posted by: Dental Design      19th July 2023

July is Ultraviolet (UV) awareness month- I am sure we have all heard of UV rays but what exactly are they and why should we be aware?

Well, ultraviolet radiation (UV) is a form of ionizing radiation, which produces rays that have an elevated level of energy. This energy is released naturally by the sun, artificially from sunbeds/lights and has enough momentum to remove an electron from an atom or molecule-impressive, eh? This power is capable of damaging the genetic material in our body’s cells, and although, the risk is usually only skin-deep (they tend not to infiltrate further than that) it can still lead to skin damage, including skin cancer.

Types of UV rays

There are three main types of ultraviolet rays, and they are as follows:

Ultraviolet A (UVA) rays-these make up most of the sun’s rays and when they reach the skin, they are known to cause premature aging including wrinkles and more worryingly some skin cancers.

Ultraviolet B (UVB) rays are thought to damage the DNA fabric of the skin cells. (1) Transmitting a bit more energy than UVA rays, they play a role in most skin cancers and comprise about 5% of the sun’s rays that reach the skin.

Ultraviolet C (UVC) rays, these are the most dangerous, but luckily, they are mostly absorbed by the ozone layer and do not reach the Earth’s surface-HOWEVER, as we all know the ozone layer is depleting meaning we could be getting greater exposure to ‘C’ rays.

Why are they dangerous?

Well, they are alarming because the temperature outside is not indicative of whether we will burn or not so even if its chilly UVB rays can stimulate calls in our skin known as melanocytes to produce melanin, causing us to either burn or get a tan, both of which are signs of damage. Indeed, almost 90% of melanomas are thought to be caused by UV exposure, and two of the most common skin cancers; basal & squamous cell are found on parts of the body that have been exposed to the sun-suggesting an aetiological role.

But why is all of this of concern to the dental team?

After all UV rays have historically been used for decontamination, inactivating viruses, bacteria, and fungi. In dentistry, their diagnostic uses are related to radiography with low dose exposure to small areas and, blue light has also become indispensable for many forms of treatment-so why should we worry? Well, obviously, prevention is always better than cure & although it now plays a key role in dentistry, we need to remember that almost 90% of skin cancers are preventable too. However, early detection is key and that is where we come in! Because we can see bits our patients cannot e.g., the back of their head and behind their ears. Also, how many of them are aware that abnormalities on their face & lips could be suspicious? Therefore, we need to be reinforcing the fact that UV rays from the sun can cause cancer.

So, what should we be advising our patients?

Well, I am sure we often chat about holidays with our patients so maybe we should discuss sun protection too! We particularly need to advise those patients who are considered to be most at risk e.g., people with fair skin tend to be more susceptible to sunburns and the damage that leads to skin cancer although those with darker skin still need to be vigilant.

Risk factors include:

  • Light skin that burns and is prone to freckles or moles.
  • Light eyes-remember blue & green should never be seen so cover them with shades!
  • Fair hair-natural blondes & redheads are particularly prone to burning.
  • Previous skin cancer diagnosis or a family history of the condition
  • Age-the older they are-the greater the risk.

Other factors to consider:

  • Remember-lips burn too and need protection-so all patients should be advised to wear SPF lip balm on a daily basis.
  • Since we cannot feel the UV rays it is important to check the UV index and keep in mind that if its 3 or more, we are still at risk of burning even if it is cool or cloudy.
  • In the UK, the suns UV rays are strongest from 11am to 3pm between march & October but it is a good idea to check the UV index before venturing out.
  • Exposure to UV rays at an early age can be particularly damaging. Evidence suggests that historical sunburn increases skin cancer risk.
  • Use of sunbeds/lamps before the age of thirty also increases the risk of developing melanoma by 75 percent. So much so that the World Health Organisation has declared that use of UV-emitting tanning devices is “carcinogenic to humans.”

We also, need to advise against the current Tik Tok trend of dousing yourself in beer before lying in the sun-far better to drink it although that poses another health risk!

But our discussion should not be limited to the sun and SPF we also need to discuss what affects both UV rays from the sun as well as synthetic rays.

Clouds: Although clouds do block day light, they are not as good at blocking UV rays. In fact, some research suggests that UV rays are stronger on overcast days, so it is still important to wear sunscreen even if it is cloudy outside.

Windows: although most types of glass, including windows, are effective at blocking UVB rays they are not so good with UVA rays, so it is a clever idea to sit a few feet away from windows and always wear sunscreen.

Clothes: UV rays can often penetrate clothing, so it is important to wear clothes with high UPF (Ultraviolet Protection Factor) ratings when outdoors for a prolonged period of time.

Man-made UV rays

These UV rays often come from sources of light e.g.:

  • Phototherapy, also called UV light therapy, uses UVA or UVB light in a controlled setting to treat skin conditions, such as psoriasis.
  • Mercury vapor lighting-I’m sure we all associate mercury with amalgam restorations, but lighting is also one of its many uses. The bulbs usually have an outer layer to filter the UV light, but if this fractures intense UV radiation can cause burns-which is a worry as they are often used in gyms and stadiums (reassuringly most are designed to switch off if they break).
  • Halogen, fluorescent and incandescent lightbulbs, as well as some specialty xenon lights, can emit UV rays as can UV drying devices used in nail salons.

It is clear that UV rays are cause for concern-if you are really interested in their harmful effects, it may be worth familiarising yourself with the Fitzpatrick scale (a way to assess the response of different types of skin to ultraviolet (UV) light).and completing the Skcin course online-it is really worthwhile and you never know you might just save a life.

About the Author:
Ali Lowe is an award-winning dental hygienist based in Cardiff and has worked in both private & NHS practice as well as the Orthodontic department of Cardiff Dental School. Her interest in helping patients both before and after cancer diagnosis began following enrolment on Victoria Wilsons Smile Revolution course and the development of Fit Lip UK – a campaign aimed at encouraging people to wear SPF lip balm in order to protect their lips, prevent lip cancer & keep their mouth healthy. Ali volunteers for the Mouth Cancer Foundation, has had several articles published in both the dental and public press, is actively involved in the BSDHT and is on the publications committee of Dental Health (the hygienist & therapist journal). Ali is fervent about raising awareness of mouth cancer (in particular lip cancer), its side effects and the importance of continuing care.

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