Challenges of Oral Radiography Prescriptions During the COVID-19 Outbreak in Shiraz, Iran

Abstract
Background: Considering the severity of the COVID-19 outbreak and its rapid person-to-person transmission and the challenges it has brought about in dentistry, especially in intraoral radiography, following the established guidelines in prescribing radiographs is of great prominence. Objectives: We aimed to evaluate the necessity of prescribed intraoral radiographs and to estimate the number of unnecessary prescriptions during the COVID-19 pandemic. Methods: This cross-sectional study was conducted among 143 patients with a mean age of 29.36 ± 14.11 years who visited the Radiology Department of Shiraz Dental School during the peak of the COVID-19 outbreak. Information, including gender, age, systemic diseases, referring department, and type and urgency of radiography, was collected using a checklist. Chi-squared test and Fisher’s exact test were run to assess the relationships between variables. Results: Among all the patients referred to the Radiology Department, the endodontics and oral medicine departments accounted for the highest percentage of referrals. The relationship between the necessity of radiography prescriptions and dental departments was significant (P < 0.05). The lowest rate of unnecessary referrals was reported in the Department of Endodontics (13.3%), whereas the highest rate of unnecessary referrals was attributed to the aesthetic and restorative dentistry departments (73.3%). There was a significant association between dental department and the type of prescribed radiographs (extraoral/intraoral). The Orthodontics Department was the only department with more extraoral radiograph prescriptions than intraoral radiographs. One-third of the prescribed intraoral radiographs and half of the extraoral radiographs were unnecessary, with a significant difference during the pandemic (P = 0.019). Conclusions: Although there has been some success in the development of COVID-19 vaccines, this pandemic will not be easily eradicated. Therefore, it is crucial to follow the established guidelines and postpone unnecessary dental procedures to improve the safety of our community and the world in general.