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Guidelines for the Safe Practice of Oral and Maxillofacial Radiology During the COVID-19 Pandemic
TAKE-HOME MESSAGE
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While recommendations for the safe return to dental practice have been issued and promulgated by the CDC and ADA, guidelines are limited with regards to radiography. This article, written by leaders in the oral and maxillofacial radiology community, provides detailed guidance to reduce the risk of disease transmission during radiographic procedures, and is accompanied by a flowchart for use in dental practices. Strict adherence to selection criteria for radiographic orders is stressed; prescription of every radiograph must arise from a specific clinical indication.
- Gagging and coughing during intraoral radiographic procedures is a potential source of aerosol generation, perturbed most frequently in the maxillary molar areas. The utility and limitations of the judicious use of dental panoramic radiographs, extraoral bitewing imaging, and focused or small field-of-view cone beam computed tomography as alternatives to intraoral radiography are discussed. Finally, guidance is provided on post imaging-room cleaning, including concerns inherent to digital dental intraoral radiographic equipment, and alternative methods of sterilization.
abstract
This abstract is available on the publisher's site.
Access this abstract nowSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing the current coronavirus disease 2019 (COVID-19) pandemic, is not only highly infectious but can induce serious outcomes in vulnerable individuals including dental patients and dental health care personnel (DHCPs). Responses to COVID-19 have been published by the Centers for Disease Control and Prevention and the American Dental Association, but a more specific response is required for the safe practice of oral and maxillofacial radiology. We aim to review the current knowledge of how the disease threatens patients and DHCPs and how to determine which patients are likely to be SARS-CoV-2 infected; consider how the use of personal protective equipment and infection control measures based on current best practices and science can reduce the risk of disease transmission during radiologic procedures; and examine how intraoral radiography, with its potentially greater risk of spreading the disease, might be replaced by extraoral radiographic techniques for certain diagnostic tasks. This is complemented by a flowchart that can be displayed in all dental offices.
Additional Info
Guidelines for Oral and Maxillofacial Imaging: COVID-19 Considerations
Oral Surg Oral Med Oral Pathol Oral Radiol 2021 Jan 01;131(1)99-110, DS MacDonald, DC Colosi, M Mupparapu, V Kumar, WH Shintaku, M AhmadFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Clinical Dentistry
This is a timely review of oral and maxillofacial radiography (OMR) in the age of COVID-19, dealing with imaging techniques and technology, assessment of COVID-19 risks and asepsis, and how these relate to dental practice, generalists, and specialists. After a brief review of SARS-CoV-2, the authors, who are all respected radiologists, make recommendations for management of OMR and discuss pros and cons of each imaging technology, intra- and extraoral, with respect to which images provide specific information and which are more likely to cause aerosols with virus. They deal with management of patients who have or are being investigated for COVID-19, as well as patients who do not appear to be infected. The authors consider various aspects of managing patient imaging that dental practitioners may have wondered about and draw attention to things that may not have been considered. They use the literature and recommendations of professional organizations as the basis for their recommendations. The article is useful both as an overview of most aspects of OMR in the age of COVID-19 and as a resource for practitioners and dental staff who wish to find answers to specific imaging concerns related to COVID-19. As such, it is a valuable resource that should be in every practitioner’s office.