The COVID-19 pandemic has changed the way many of us go about our daily lives. This is especially true for dental practices and how they deliver care to their patients. Renew Digital, the leader in certified pre-owned dental X-ray machines and cone beam systems, has gathered some information on how to provide safe and effective care to your patients, especially as they apply to dental imaging.
Those with COVID-19 may be asymptomatic or pre-symptomatic but they are still capable of spreading the virus. Therefore, they could inadvertently affect other patients and staff within your dental practice. Both the ADA and CDC have released detailed guidelines to aid dental practices in providing safe and effective dental care during this pandemic.
Good hand hygiene and thorough disinfection of surfaces should always be part of your dental practice operations. What’s new is the addition of personal protective equipment including masks, gloves, gowns, and goggles or face shields. These items help to protect the skin and mucosa from coming into contact with potentially infected blood or other secretions. Because respiratory droplets are the main route of COVID-19 transmission, particulate respirators like the N-95 masks are recommended for routine dental care.
To keep dental radiography as simple and least invasive as possible, experts recommend utilizing extraoral dental X-ray machines, when appropriate. Several experts suggest using panoramic X-rays as the first option of preventative or emergency care. Extraoral X-rays are often adequate for initial diagnoses, especially in emergency situations. Sectional panoramic or extraoral bitewings are recommended for localized dental pain that occurs around one or two teeth or within a single quadrant.
Additionally, small volume CBCT dental X-ray machines may be considered for more complex cases or If panoramic X-rays were not able to provide the necessary diagnostic information.
Panoramic and CBCT units should be barrier-wrapped on the control panel and any region that has contact with the patient, including the bite stick and any head and face positioners. If necessary, a pano X-ray or CBCT image can be taken while the patient remains wearing a face mask. They can use the chin rest instead of a bite stick and align the canine by palpating through the mask and marking the mask with a pen.
After the exam is complete, the barrier wrapping should be removed and all areas should be wiped down with disinfectant.
We have received questions from several customers about how to properly bill extraoral bitewings to insurance companies when captured with a panoramic dental X-ray machine. Code D0251, extraoral posterior dental radiographic image, was added to the CDT 2016 code updates. D0251 is listed as an “Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that is not derived from another image.” You should always confirm with any dental insurance carrier or Medicaid provider if extraoral bitewings are covered and which procedure code is recommended for billing.
It is wise to carefully consider intraoral radiographs after an appropriate risk assessment. Pay special attention to whether a patient reports a strong gag-reflex or has previously struggled to obtain intraoral radiographs. It is recommended to limit the use of periapical radiographs to avoid irritating the patient’s airway and inducing coughing or retching. A safer alternative may be occlusal radiographs.
In cases where intraoral imaging is deemed necessary, an antimicrobial oral rinse should be taken before the imaging. The mouth rinse should contain oxidative agents such as 0.2% povidone or 1% hydrogen peroxide.
Utilize dirty and clean zones for intraoral film/sensors and holders. Process imaging films or sensors in a touch-free way, if possible. Disinfect all dirty zones following ADA and CDC infection control protocols.
Renew Digital offers a broad selection of dental X-ray machines and dental cone beam machines featuring extraoral bitewings to help prevent the spread of COVID-19 in your practice. Contact us today or call 888-246-5611 to learn more!