The practice of oral and maxillofacial radiology during COVID-19 outbreak

Abstract

The current coronavirus disease 2019 (COVID-19) outbreak has brought substantial challenges to the world health system, including the practice of dental and maxillofacial radiology (DMFR). DMFR will carry on an imperative role in healthcare during this crisis. This rapid communication has collected and evaluated all the best current evidence and published guidelines as well as professional recommendations to help maxillofacial radiologists and dental practitioners for safer radiological and imaging examinations on healthy, suspected, or confirmed COVID-19 patients during outbreak. Some strategies have been depicted including procedural indications, infection control, and correct employment of personal protection equipment along with evoking the proper practice environment during and after the COVID-19 outbreak.

Recommendations, Practices and Infrastructural Model for the Dental Radiology Set-up in Clinical and Academic Institutions in the COVID-19 Era

“…Although, some institutions/clinics are still practising paper. It is preferable to have a separate room outside the operatory room for the purpose of storing dental records [ 56 ]. Storage and strategic stockpiling: Researchers have stated that SARS CoV-2 can remain alive on environmental surfaces varying from few hours to days [ 57 ].…”

“…The dental radiology stock including radiographs and processing solutions are stored in an air-tight plastic container, which makes them easy for disinfection and storage. It has been reported that SARS CoV-2 can stay viable on plastic containers for up to three days, therefore it is advised to abstain from touching for the same number of days [ 56 ]. The consumption of stock should follow the concept of first-in, first-out, (FIFO), wherein the oldest stock is taken out first for consumption.…”

“…“No touch” technique has to be strictly adopted for this purpose [ 10 ]. Patients with serious gag-reflex needs to be managed before taking intraoral radiograph [ 10 , 56 ]. Alternatively, occlusal radiographs can be considered.…”

“…In a small scale dental clinical setup, where an isolated radiology setup is not feasible, it is advisable to use a hand-held dental radiology system can be used in compliance with current infection control protocol. Panoramic imaging–During this pandemic, panoramic imaging has emerged as the most preferred imaging modality as the probability of saliva contamination is minimal [ 56 ]. Despite being popular, demerits associated with this imaging technique such as metallic artifact, compromised resolution, and magnification of the image cannot be ignored.…”

“…The patient preparation in terms of removing the metallic objects needs to be completed before he/she enters the operatory room. As per the new protocol, patients should be encouraged to wear fresh piece of mask and gloves during the exposure [ 56 ]. Instead of bite peg and patient positioning device, an alternative approach should be adopted [ 10 , 56 ].…”