# Content Analysis of YouTube Videos That Demonstrate Periapical Radiography
## 4 Discussion
Due to this, soft foam attachments such as Edge-Ease (Strong Products, Corona, CA, USA) can be attached to the periphery of the receptor as cushions to make its corners and edges more rounded and comfortable to the patients. Alternatively, simply wrapping the receptor with a gauze may, to a lesser extent, serve the same purpose. However, none of the 21 analyzed videos showed the application of these attachments. Instead, several videos placed the receptor on the tongue surface when taking periapicals for the mandibular teeth to avoid hurting the lingual sulcus. It could be argued that a child patient might not be accustomed to (or even potentially reject) putting an object \"underneath\" his/her tongue. The only video with a child patient indeed placed the intraoral sensor onto the tongue. There were two other videos with an adult patient, one each with intraoral sensor and film. The former video instructed the patient to stick out her tongue and placed the intraoral sensor in the centre of her extended tongue ([[https://www.youtube.com/watch?v=nBrM_kNEPX0](https://www.youtube.com/watch?v=nBrM_kNEPX0)]([https://www.youtube.com/watch?v=nBrM_kNEPX0](https://www.youtube.com/watch?v=nBrM_kNEPX0)) (accessed on 26 July 2022)). The latter video placed the film in the centre of the patient's tongue within the oral cavity and exerted pressure on the tongue to ensure it would not displace the film ([[https://www.youtube.com/watch?v=H0](https://www.youtube.com/watch?v=H0) qZVv8 fl0E]([https://www.youtube.com/watch?v=H0](https://www.youtube.com/watch?v=H0) qZVv8 fl0E) (accessed on 26 July 2022)). This was different from conventional instructions from oral and maxillofacial radiology textbooks, which instructed students to place the receptor into the lingual sulcus lingual to the teeth to be imaged. Without placing cushions, the receptor could actually be causing discomfort to the tongue surface. Besides, if the receptor could not be placed on posterior tongue surface to avoid triggering the gag reflex, then the resultant image might not cover the posterior teeth such as the second molar. During the COVID-19 pandemic era, infection control should be heavily emphasized. The latest recommendation for the minimal PPE for dental radiology procedures should include head cap, goggles/face shield, surgical mask, gloves, and long-sleeved gown [22]. Surprisingly, the majority of the videos showed an operator without wearing a head cap, eye protection, or a mask. This alarming situation was comparable to the videos that demonstrated how to take panoramic radiographs [14]. Regardless of the rationales behind this lack of PPE, junior students may be misguided to think that it is the standard. The lack of a mask can be potentially harmful, as patients may cough during intraoral radiography, particularly for posterior periapicals that need to be positioned close to the throat or the back of the mouth. Hence, future videos produced should demonstrate proper usage of PPE. The oldest video, uploaded on 2/7/2009 but originally aired on 2 August 1972 ([[https://www.youtube.com/watch?v=TQZQCywto38](https://www.youtube.com/watch?v=TQZQCywto38)]([https://www.youtube.com/watch?v=TQZQCywto38](https://www.youtube.com/watch?v=TQZQCywto38)) (accessed on 26 July 2022)), showed an operator even without wearing gloves. The infection control standard 50 years ago certainly is not comparable to the standard nowadays, but the video has accumulated 165,424 views since it was uploaded in 2009. The video did not have any disclaimer or notice to remind the audience about this infection control issue. Only one out of the 31 comments made by the audience pointed out the lack of hand gloves. This comment received one \"like\" and one reply that \"gloves were not common practice nor required if you go back far enough\". This comment was not pinned or listed as top comments, so students might not easily recognize it. This survey has several limitations. Only YouTube videos narrated in English were considered.