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ORIGINAL ARTICLE
Year : 2016  |  Volume : 14  |  Issue : 4  |  Page : 445-450

Evaluation of dentist-patient relationship toward the treatment of oral diseases after the usage of internet


1 Department of Public Health Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India
2 Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Wardha, Maharashtra, India

Date of Web Publication15-Dec-2016

Correspondence Address:
Sourav Sen
Department of Public Health Dentistry, Sharad Pawar Dental College, Paloti Road, Wardha - 442 004, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-5932.195833

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  Abstract 

Introduction: Among all innovative technologies, net is one among the recent and also the most innovative media by that one will keep connected with the remainder of the planet. This facility provides huge volume of oral health consciousness at the side of oral health info to net users who eventually have an effect on the dentist–patient relationship. Aim: The aim of this study is to evaluate the attitude of patients and dentists for the treatment of oral diseases after the use of internet by the patient. Materials and Methods: In a cross-sectional study, data were collected from 153 dentists and 449 patients. The data from the dentists were collected from hospitals and private practices. Data from the patients were collected in urban area. The questions asked to dentists and patients were such that each respective question in both the questionnaires gave the same conclusion. Results: Dentists (56.2%) agreed changes in patients thinking after the usage of internet. Within 21–40 years, 40.4% of dentists agreed that internet represents a threat to dentist–patient relationship. Conclusion: The usage of internet by the patients had brought about changes in patients thinking and the dentists had modified or guided patients in the use of oral health information obtained from the internet.

Keywords: Dental perception, dentist–patient relationship, internet, oral health


How to cite this article:
Sen S, Patel BS, Parekar A, Shrawagi NS, Deolia S, Sen RC. Evaluation of dentist-patient relationship toward the treatment of oral diseases after the usage of internet. J Indian Assoc Public Health Dent 2016;14:445-50

How to cite this URL:
Sen S, Patel BS, Parekar A, Shrawagi NS, Deolia S, Sen RC. Evaluation of dentist-patient relationship toward the treatment of oral diseases after the usage of internet. J Indian Assoc Public Health Dent [serial online] 2016 [cited 2020 Dec 4];14:445-50. Available from: https://www.jiaphd.org/text.asp?2016/14/4/445/195833


  Introduction Top


Advancement of technology is influencing the daily life of common people tremendously. Computers, electronic gadgets, and various social medias are requisites which people need on regular basis. Among all advanced technologies, internet is one of the most advanced media by which one can stay connected with rest of the world. This can be used at home, workplace as well as during leisure time for personal or professional usage. Internet usage provides easy access to the “global village.”[1] This facility provides massive volume of health consciousness along with oral health information to internet users. Patients as well as health-care providers, for example, dentists are not exceptions.[2]

Information provided by the internet on authentic sites of oral health services, educate, and empower the patients. Internet encourages the adoption of healthy behavior thereby improves the quality care. The appropriate uses of medicines along with better compliance with advices are the other useful aspects of internet usage.[3] Internet connects a large number of people who find themselves with identical medical problems, thus providing a strong base of support to those patients with similar health issues. Patients who are housebound due to their illness get benefit by such facilities.[4]

Contradictorily, oral health information obtained by the patient from the internet may be misleading or misinterpreted, resulting in inappropriate requests for clinical interventions.[5] Information obtained from the internet may not be discussed every time by the patients because searches may not directly raise issues but rather inform existing communications and decisions. Furthermore, the patients may overstep their role and appear to tell the dentists their job. Thus, dentists feel more stressed in their professional carrier. Hence, the dentists may feel the need to be protected from the “informed patients.” Ultimately, it depends on attitude of patient how they handle the information obtained from the internet and their views on the effect of this on their relationship with dentist.[6] Therefore, internet is also described as a transformative technology in relation to oral health care.[7]

Eventually, the way of internet use by the patient affects the frontline clinicians. The high-quality information gained from the internet proves to be beneficial for the patients. On the other hand, poor-quality information can mislead the patient leading to self-misdiagnosis and mistreatment. However, the misunderstanding and misinterpretation of high-quality information can also become a potential threat to dentist–patient relationship.[8] Probably, the dentist–patient relationship will change, and dentists will have to face challenges as patients obtain information from the internet.[9]

A patient entering dentist's clinic laden with internet printouts will demand more time and service by the dentists is a common disheartening scenario.[8] Thus, the impact of internet affects decision-making processes of patients offering new possibilities for dentist to patient recommendations.[10] In recent times, as patient satisfaction is receiving increasing attention, some dentists face emotional difficulty in interacting with those patients.[11] In this part of country, this type of study is less. Hence, the aim of this study is to evaluate the dentist–patient relationship after the usage of internet toward the treatment of oral diseases.


  Materials and Methods Top


This was a cross-sectional type of study. Data were collected from 153 dentists and 449 patients. Data from the dentists were collected from hospitals and private practices. Data regarding patients were collected in urban area. The time required for collecting all the data from dentists and patients was 3 months (from May to July 2016).

A pilot study was conducted on 15 dentists and 45 patients, who did not participate in the main study, to test the feasibility of the study, and to check the validity of questionnaire. The reliability was found to be acceptable (Cohen's kappa statistics = 0.82), along with the face, and content validity (Aiken's V index = 0.83).

A self-administered questionnaire was structured in English, regarding evaluation of the attitude of dentists' and patients toward the treatment of oral diseases after the usage of internet. Seven questions were asked to both. Each question had three possible answers (agree, no view, disagree). A score (1–3) was assigned to each answer (1-agree; 2-no view; 3-disagree).

The questions framed for dentists and patients were in such a manner that each respective question in both the questionnaires gave the same conclusion.

Data were analyzed using SPSS version 22 (IBM, Chicago, USA). Descriptive and inferential statistics (Chi-square test) were applied. Statistical significance was set at P < 0.05.


  Results Top


In this study, 153 dentists and 449 patients had participated [Figure 1]. Among all participants, 85 (55.5%) were male dentists and 68 (44.4%) were female dentists whereas 242 (53.9%) were male patients and 207 (46.1%) were female patients.
Figure 1: Distribution of dentists and patients in study

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Q2 depicts that 56.2% of dentists agreed changes in patients thinking whereas 48.6% of patients had no view for the same (P = 0.001). Q4 signifies 45.1% of dentists agreed that they had modified patients thinking while 51.7% of patients had no view on this (P = 0.017). In Q6, 45.8% of dentists and 51.4% of patients had no view on that patients followed their advice (P = 0.022). In Q7, 45.8% of dentists and 51.9% of patients had no view on that internet represents a threat to dentist–patient relationship (P = 0.000) [Table 1].
Table 1: Response-wise distribution among dentists and patients

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In Q2, the age group taken was between 41 and 60 years, out of which 58.6% of dentists “agreed” and 53.7% of patients had “no view” on changes in patients thinking (P = 0.000). In Q4, the age group considered was between 21 and 40 years, out of which 44.7% of dentists “agreed” that they had modified patients thinking and 54.2% of patients had “no view” on modified patients thinking (P = 0.004). In Q6, age group included was between 21 and 40 years, out of which 44.7% of dentists “agreed” that patients followed their advice and 51.8% of patients had “no view” on this (P = 0.034). In Q7, age group taken was 21–40 years, out of which 40.4% of dentists “agreed” that internet represents a threat to dentist–patient relationship and 53.7% of patients had “no view” on this pretext (P = 0.000), while 56.9% of dentists and 39.0% of patients within the age group of 41–60 had “no view” on the threat to dentist–patient relationship (P = 0.029) [Table 2].
Table 2: Age-wise distribution of response among dentists and patients

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  Discussion Top


This was a cross-sectional type of study, in which 25.41% were dentists and 74.58% were patients [Figure 1]. The study was carried out through questionnaires, in which seven questions were asked for dentists and patients in such a manner that it resulted in similar responses.

Majority of dentists and patients, i.e., 56.2% and 39.4%, respectively, agreed changes in patients thinking about oral health as a result of online information. Similar results were found in a study done by Yusuf and Alhaji [Table 1].[2]

Nowadays, there is increasing awareness among the patients about oral health, for which they make use of internet. There is wide range of information available on internet on oral health which brings about changes in patients thinking. Dentists (45.1%) approved that they had modified or guided patients in the use of oral health information obtained from the internet. A study done by Kuppersmith [12] gave the similar results [Table 1].

Vast information available on internet may sometimes mislead or misguide the patients. Such patients might end up in taking inappropriate decisions regarding treatment for their oral disease. They found that dentists have modified their thinking toward their disease and decision-making in choosing appropriate treatment plan for their oral disease. Maximum number of dentists (45.8%) and patients (51.4%) gave no view on whether patients followed their advice after they began using internet or not. Contradictory results were found in a study done by Murray et al.,[6] in which 85% of patients followed their physician's advice after they began using internet [Table 1].

Earlier as dentists were only the source of information regarding health for the patients, they used to have faith on their dentists and generally followed their advice. However, now the scenario has changed, patients can also use internet to get health-related information and can evaluate dentists for their advice regarding the disease. Dentists (45.8%) and patients (51.9%) gave no view on the fact that internet represents a threat to dentist–patient relationship. Similar results were found in a study done by Ball and Lillis [13] Dissimilar results were found in a study done by Chestnutt and Reynolds [3] In spite of internet usage, most patients trust their dentists as the most reliable source of oral health information. However, dentist–patient relationship might be on threat to those dentists who think that their patients should rely on them completely, avoiding the concern of such informed patients [Table 1].

In the age group of 41–60 years, 58.6% of dentists observed changes in patients thinking about oral health as a result of online information whereas 53.7% of patients had no view on this. Similar results were found in a study done by Iverson et al.[4] As we all know that internet is a modern technology which is getting popular recently, therefore the older population is not much accustomed with the usage of internet for different purposes. Hence, greater number of patients in older age group had no view on this [Table 2].

In the age group of 21–40 years, 44.7% of dentists think that they had modified patients thinking toward their health while 54.2% of patients had no view on this. Similar results were observed in a research done by Akerkar and Bichile et al.[14] Patients who had already searched web for their health-related information came with many questions for the dentists, and dentists who could give satisfactory answers to their questions can only be successful in modifying or guiding patients thinking toward their health [Table 2].

It was observed that 44.7% of dentists agreed that patients followed their advice, 51.8% of patients had no view. Similar results were found in a study done by Dickerson et al.[15] Greater part of dentists (40.4%) agreed that internet represents a threat to dentist–patient relationship while majority of patients (53.7%) had no. Dissimilar results were found in a study done by Iverson et al.[4] It becomes very difficult for the dentists to convince the patients for the treatment of their disease as patients came with a frame of ideas in their mind, and they want their treatment to be done in the same ideal manner as they have seen on the internet, irrespective of the limitations which the dentists may face in their case [Table 2].

In the age group of 41–60 years, 56.9% of dentists had no view on whether internet represents a threat to dentist–patient relationship while 39.0% of patients had no view as well as disagreed to this. Dissimilar results were found in a study done by Suzy A. Iverson et al. In older age group, patients who used internet for health-related information are more understanding than the younger population, and if they are not satisfied by their dentist regarding the same, they can go for second opinion to another dentist for the similar information. Thereby they can improve the quality of treatment, the patient will be getting [Table 2].

Limitation

The limitation of this study was the selection of dentists as well as patients on convenience basis from Wardha district only. As a result, this might not represent general population.

Recommendation

Further research is needed to determine the generalized dentist–patient relationship with larger sample size on multicentric trial basis.


  Conclusion Top


Nowadays, it is found that the usage of internet had increased among the young population so widely that internet has been reached in each and every house through not only computers and laptops but also through mobile phones. People are making the use of internet for various purposes including for getting health-related information. In this study, it was found that the usage of internet by the patients had brought about changes in patients thinking, and dentists had modified or guided patients in the use of oral health information obtained from the internet. In younger generation, dentists reported that patients followed dentists' advice after the usage of internet and also they considered internet as a threat to dentist–patient relationship.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Temmel M, Theuermann M, Ukowitz E, Vogrin T. The Impact of the Internet on our Daily Life. Available from: https://www.tru.ca/cpj/essay.html. [Last accessed on 2016 Sep 15].  Back to cited text no. 1
    
2.
Yusuf AA, Alhaji AA. Knowledge, attitude, and use of internet for medical information by patients attending specialist clinics in ABUTH Zaria-Nigeria. Sub-Saharan. Afr J Med 2015;2:160-4.  Back to cited text no. 2
    
3.
Chestnutt IG, Reynolds K. Perceptions of how the Internet has impacted on dentistry. Br Dent J 2006;200:161-5.  Back to cited text no. 3
    
4.
Iverson SA, Kristin DO, Howard B, Brian BA, Penney K. Impact of Internet use on health-related behaviors and the patient-physician relationship: A survey-based study and review. J Am Osteopath Assoc 2008;108:699-708.  Back to cited text no. 4
    
5.
Stevenson FA, Kerr C, Murray E, Nazareth I. Information from the Internet and the doctor-patient relationship: The patient perspective – A qualitative study. BMC Fam Pract 2007;8:47.  Back to cited text no. 5
    
6.
Murray E, Lo B, Pollack L, Donelan K, Catania J, Lee K, et al. The impact of health information on the Internet on health care and the physician-patient relationship: National U.S. Survey among 1.050 U.S. Physicians. Arch Intern Med 2003;163:1727-34.  Back to cited text no. 6
    
7.
Wyatt S, Henwood F, Hart A, Platzer H. Transforming health? The internet, health and everyday life. Science Soci Sante SocSci Med 2004;22:45-68.  Back to cited text no. 7
    
8.
Potts HW, Wyatt JC. Survey of doctors' experience of patients using the Internet. J Med Internet Res 2002;4:e5.  Back to cited text no. 8
    
9.
Diaz JA, Griffith RA, Ng JJ, Reinert SE, Friedmann PD, Moulton AW. Patients' use of the Internet for medical information. J Gen Intern Med 2002;17:180-5.  Back to cited text no. 9
    
10.
Gerber BS, Eiser AR. The patient physician relationship in the Internet age: Future prospects and the research agenda. J Med Internet Res 2001;3:E15.  Back to cited text no. 10
    
11.
Nili T, Moti M, Avner C. Dentists' attitudes toward discussing Internet health information with their patients – Does professional self-efficacy matter? J Public Health Dent 2011;71:102-5.  Back to cited text no. 11
    
12.
Kuppersmith RB. The physician-patient relationship and the Internet. Otolaryngol Clin North Am 2002;35:1143-7.  Back to cited text no. 12
    
13.
Ball MJ, Lillis J. E-health: Transforming the physician/patient relationship. Int J Med Inform 2001;61:1-10.  Back to cited text no. 13
    
14.
Akerkar SM, Bichile LS. Doctor patient relationship: Changing dynamics in the information age. J Postgrad Med 2004;50:120-2.  Back to cited text no. 14
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15.
Dickerson S, Reinhart AM, Feeley TH, Bidani R, Rich E, Garg VK, et al. Patient Internet use for health information at three urban primary care clinics. J Am Med Inform Assoc 2004;11:499-504.  Back to cited text no. 15
    


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