Fears of an outbreak of enteroviral infections and seasonal flu are looming over students and faculty members of a junior-high school in Hualien County, after several dentists in charge of recent mass oral examinations at the school failed to change their surgical gloves after each check-up.
Hualien-based Tzu Chi General Hospital (TCGH) on Monday and Tuesday dispatched dentists to conduct examinations on the more than 600 seventh-grade students at Guo Feng Junior High School, which was suspended for a week after a confirmed case of enterovirus infection was reported at the school last week.
On the first day of the dental check-ups, school authorities were surprised to discover that some of the dentists responsible for oral check-ups did not change their gloves after each examination.
Despite being asked to do so, the dentists agreed only to avoid direct physical contact with students’ cheeks, chins and corners of their mouths the next day, contending that since their hands would not be inside the students’ oral cavities, there was no need for them to put on new gloves after every examination, considering the large number of examinees.
“A pair of surgical gloves costs only a few NT dollars. Does it [TCGH] really need to save that money?” asked Kuo Cheng-an (郭呈安), a member of the school’s Parents’ Association.
Kuo said that because each examined student paid a fee of NT$350, doctors should have conducted check-ups in accordance with the highest standards of disease prevention and changed their gloves regardless of the number of examinees.
“Doctors must take care when conducting such examinations. Otherwise, the good intention of maintaining students’ dental health could become an avenue of infection,” Kuo said.
The incident also drew ire among the examined students, with many of them saying they felt sick after learning of it.
One student, surnamed Chen (陳), expressed concern about the possibility of infection, saying it would be unsanitary if someone else’s saliva were spread by the dentists’ gloves.
Another student, surnamed Wang (王), said it would be “gross” and “nauseating” if doctors’ gloves were in contact with other students’ mouths before touching his.
Defending the practices of his peers and himself, TCGH dentist Huang Chih-hao (黃志浩), who is among the dentists in question, said they had conducted examinations in line with standard protocols, in which doctors first check for tooth decay and tooth alignment with a laryngeal mirror and a dental explorer and use a new set of sterilized equipment for each examination.
“It is unnecessary to change gloves each time because our hands do not come into contact with any bodily fluid or mucosa in the oral cavity during the processes,” Huang said.
Hualien County Health Bureau said standards for changing surgical gloves differ from place to place, with Taipei and New Taipei City (新北市) leaving the decision to the discretion of the doctors, and Greater Taichung opting to act in accordance with contracts between doctors and patients.
“As for [dentists in] Hsinchu and Hualien counties, they abide by regulations stipulated by local dental associations, which only mandate them to put on new gloves should they have contact with patients’ mouths or lips,” the bureau said.
While saying sanitary standards were important, the Hualien County Government’s Department of Education said the department has, after factoring in the professional opinions of the hospital, reached an agreement with the school and the concerned dental association that doctors are not required to change their gloves unless they have touched a patient’s mouth or lips.
“Such a practice is meant to save time, rather than money,” the department said.
Meanwhile, the hospital said the dentists concerned would not be disciplined because they had not been negligent and that the controversy was the result of a misunderstanding.