Asking patients to lower their face masks below the mouth may not be enough to prevent artifacts from ruining oral radiograph images, experts cautioned Thursday in Academic Radiology.
Individuals typically remove their masks before undergoing 2D dental X-ray exams but it has become common practice to pull the covering down below the chin when masking isn’t required. The aluminum nosepiece, however, can still create noticeable artifacts.
Due to the surge in the omicron variant, the authors still recommend healthcare providers promote mask-wearing to minimize transmission risk. But they suggest using alternatives, when possible. The FDA has also warned radiologists to ensure their patients are not wearing face masks with metal during MRI scans due to potentially serious injury.
“The use of metal-free face masks may reduce the risk of extraoral radiologic artifact formation within the oral and maxillofacial region and possibly avoid the need for repeat imaging studies,” John K. Brooks, DDS, a clinical professor in the Department of Oncology and Diagnostic Sciences at the University of Maryland School of Dentistry, and co-authors wrote Jan. 6.
The authors drafted their letter to the editor after reading a correspondence published by Academic Radiology in September that discussed the possibility of obtaining oral X-rays in patients wearing masks. That investigation used phantom studies to outline specific protocols (outside of removing masks) that would retain safety measures while still producing quality images.
In their Thursday letter, Brooks et al. shared real-world images of patients inadvertently wearing masks during exams.
The group noted metallic nosepiece artifacts may appear as smooth “V-shaped radiopaque” structures or “wavy” radiopaque patterns on exams. Other cases may give off bilateral sharp linear structures depicting the nosepiece.
Additionally, positioning a mask below the mouth can resemble broken surgical needles, wig clips and other foreign objects on X-ray images, the group noted.
Brooks and co-investigators again underscored that face masks should be worn during exams, where possible, but encouraged the use of the metal-free variety. If not available, providers should try removing the metal nose strip and place tape over the patient's nose bridge to keep the mask in place, they wrote.
Read more from the group here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.