COVID-19 and beyond: implications for dental radiography

Area of Science:

• Dentistry
• Radiology
• Public Health

Background:

• Routine dental care in the UK halted during the COVID-19 pandemic.
• Liverpool University Dental Hospital (LUDH) established an emergency dental service on March 25, 2020.
• Staff redeployment, including within the radiology department, was necessary to support the emergency service.

Purpose of the Study:

• To summarize changes in radiography practices at LUDH in response to the COVID-19 pandemic.
• To evaluate the diagnostic quality and radiation dose of alternative radiographic techniques.
• To identify lessons learned for improving future dental radiography practices.

Main Methods:

• Transitioned from intraoral to extraoral radiographs, following Royal College recommendations to minimize aerosol generation.
• Addressed diagnostic challenges with sectional panoramic radiographs by introducing extraoral bitewings.
• Conducted a quality assurance audit to assess image quality, diagnostic accuracy, and radiation dose.

Main Results:

• Extraoral bitewings were found to provide excellent quality images.
• Diagnostic accuracy was improved with the new extraoral radiography techniques.
• A substantially lower radiation dose was achieved compared to previous methods.

Conclusions:

• The shift to extraoral radiography during the pandemic yielded significant improvements in image quality and diagnostic accuracy.
• The reduced radiation dose associated with extraoral bitewings presents an opportunity for enhanced patient safety.
• Lessons learned from this adaptation can inform and improve future dental radiography protocols, even post-pandemic.