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ORIGINAL ARTICLE
Year : 2022  |  Volume : 20  |  Issue : 1  |  Page : 100-105

Assessment of knowledge and practice of lasers among dental professionals of Central India – An online questionnaire-based survey


1 Department of Periodontology, Government Dental College, Raipur, Chhattisgarh, India
2 Department of Preventive and Social Medicine, JIPMER, Puducherry, India

Date of Submission16-May-2021
Date of Decision16-Aug-2021
Date of Acceptance30-Dec-2021
Date of Web Publication25-Feb-2022

Correspondence Address:
Waheda Rahman
Department of Periodontology, Government Dental College, Raipur, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_76_21

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  Abstract 


Introduction: The invention of the laser has sparked the interest of many people throughout history. It is critical to have a thorough understanding of laser use, different types of lasers, and which type of laser is suitable for each case to use laser safely and effectively in various dental fields. Aim: The objective of the study is to assess the knowledge and understanding of the application of lasers and their preferred choices among different procedures in dentistry among dental professionals of Central India. Materials and Methods: An online questionnaire-based survey was carried out among dental professionals of Central India. A questionnaire was developed using Google Forms and shared with respondents via WhatsApp and mail. Collected data were analyzed using Stata Version 16 software. The relevance of study parameters on a categorical scale was determined using Chi-square analysis. P value was set at 0.05 as the level of significance. Results: Out of 350 respondents, about 15.4% of dental surgeons were currently using lasers and 75.7% of participants were interested in using lasers. Potential barriers reported were: High cost, procedure sensitivity, and health risks. Conclusion: Lasers need comprehensive training in both theoretical and applied. Incorporating laser education into undergraduate courses may provide students with an early opportunity to learn about and practising with lasers.

Keywords: Awareness, Central India, dental lasers, knowledge, questionnaire, understanding


How to cite this article:
Gupta V, Mishra S, Sangha KS, Rahman W, Goswami V, Thakkar V. Assessment of knowledge and practice of lasers among dental professionals of Central India – An online questionnaire-based survey. J Indian Assoc Public Health Dent 2022;20:100-5

How to cite this URL:
Gupta V, Mishra S, Sangha KS, Rahman W, Goswami V, Thakkar V. Assessment of knowledge and practice of lasers among dental professionals of Central India – An online questionnaire-based survey. J Indian Assoc Public Health Dent [serial online] 2022 [cited 2022 May 23];20:100-5. Available from: https://www.jiaphd.org/text.asp?2022/20/1/100/338525




  Introduction Top


Since the turn of the twentieth century, there has been a steady increase in the number of dental devices that depend on photomechanical interactions.[1] Lasers are one such technology that has emerged as a high-tech instrument and a very useful tool in all areas of our lives.[2] The word LASER is an abbreviated term for light amplification by stimulated emission of radiation. Theodore Maiman was the first to build it in 1960.[3] Lasers have been used for soft-tissue procedures such as gingivectomy, frenectomy, and biopsies for several years.[4] With the exception of nonscientific studies, their efficacy versus traditional strategies is uncertain in many instances. Surgical lasers are used in dentistry as an adjunct to treat the efficient cutting of dental hard tissue, hemostatic ablation of soft tissue, and sterilization by bacterial removal.[2] The standard of dental treatment has risen dramatically as a result of the emergence of lasers.[5] It is essential to have a thorough understanding of laser physics, laser operation, different types of lasers, and which type of laser is suitable for each case to use laser safely and effectively in various dental disciplines.[6]

Many dental surgeons lack clinical and theoretical expertise in this area due to the dynamic nature of lasers in dental practice. According to Bordea et al., students' experience of laser use in dentistry needs to be upgraded and integrated.[7] According to Bagheri and Purkhamene general dentists in Ardabil have a low level of laser awareness, so raising awareness and informing about laser application is critical.[8] Undergraduate dental students from Mumbai and Pune city dental colleges had insufficient laser knowledge and training about dental lasers, according to Kadam et al.[9] In a recent survey in India, there is a need to educate and train dental professionals about dental lasers to fully leverage this new technology in future.[5]

Hence, with the widespread use of lasers in dentistry and the requisite knowledge, the aim of the present study was to assess the knowledge, extent of training about dental lasers and understanding of the application of lasers and their preferred choices among different procedures in dentistry among dental professionals in Central India.


  Materials and Methods Top


An online questionnaire-based survey was carried out among dental professionals of Central India. The study was approved by the scientific committee (No/3618/GDC/Scientific Committee/2020). The present study was scheduled to extend for 2 months (i.e., October–November 2020).

This study included both undergraduate and postgraduate dental professionals. Considering the knowledge about dental laser systems among dental professionals to be 87.2%, absolute precision at 5% level (adding a nonresponse rate of 20%), the sample size was calculated to be 209 study participants using Open Epi version 3.01.[6] The questions were formulated after reviewing similar studies and papers about dental lasers that had been published in academic journals.[5],[6],[10] The questionnaire was developed using Google Forms with a consent form displayed on the first page to assess dental laser knowledge and practices among dental professionals in Central India. Before data collection, the questionnaire was piloted among 30 dentists and the internal consistency reliability coefficient Cronbach's alpha was found to be 0.78.

The questionnaire was divided into four sections: the first included questions about the respondents' general information; the second section consisted of nine questions (Q1 to Q9) that assessed the respondents' level of knowledge and extent of training about dental lasers, the third and fourth section comprised 13 and 11 questions, respectively, that assessed respondents' understanding of the application of lasers and their preferred choices among different procedures in general dentistry and periodontics.

In third and fourth sections, each response received a score, which was used to assess their preferred mode of treatment. If the respondents prefer the use of lasers over conventional techniques for a specific procedure, then score 1 was assigned. If the score was ≥6 for a particular respondent, then the response was considered as aware of applications of lasers. Similarly, in section four, a score of ≥5 determines adequate awareness of the application of lasers in periodontics.

Using the snowball sampling recruitment method, generated Google Form link was disseminated via WhatsApp and mail and shared with the personal contacts of the research group members and among the dental professionals. The reminder survey link was sent to them if a response was not received within 2 weeks. Internet Protocol addresses of the participant's computer or smartphone are used to identify potential duplicate entries from the same user. The spreadsheet used for Google forms was password encrypted to maintain the confidentiality of data. Collected data were analyzed using Stata (16.1, StataCorp LLC, College Station, TX ). In this study, descriptive and inferential statistical analyses were performed. Categorical variables summarized as the frequency with proportion. P value was set at 0.05 as the level of significance, and any value less than that was considered statistically significant. The relevance of study parameters on a categorical scale was determined using Chi-square analysis.


  Results Top


Out of 350 participants, 88% were under the age of 30 years, 11% were between the ages of 30–50 years, and the remaining were over the age of 50 years. The majority of those who took part were under the age of 30 years. Around 79% of the dental professionals were undergraduates, while 21% were postgraduates. Furthermore, 49% of the participants were academicians, while the remainder were private practitioners, government-affiliated institutes, or both [Table 1].
Table 1: General information of dental professionals in Central India (n=350)

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About 84.6% of dental professionals were not currently using lasers, according to this survey, in which 88.67% of participants belong to <30 years of age (P < 0.0001). 93.17% of participants were undergraduates (P < 0.0001) and all of the individuals were government affiliated with private practice (P < 0.0001). About 75.7% of participants were interested in using lasers of which considerably 94.44% of participants are postgraduates (P < 0.0001). Diode lasers were used by 8.3% of the participants, followed by Nd: YAG lasers (5.1%) and CO2 lasers (0.9%) were 54.29% of postgraduates (P = 0.024) made up a significant portion of the participants. About 7.1% of them were self-taught, while 5.4% received training from another institution. 60% of participants were postgraduates (P < 0.0001). Lasers were favored by 76% of participants because they decreased noise, improved efficiency, and reduced bacterial infection. Owing to the high cost, procedure sensitivity, and health risks, approximately 46.9% of participants did not favor dental lasers in use, in which 59.07% of participants were undergraduates (P < 0.0001). About 66.9% of respondents had preferred to recommend other dentist to use lasers and 69.4% suggested that a laser training program be included in the undergraduate curriculum, in which 77.49% of individuals under 30 years old (P = 0.002) and 78.06% of undergraduates (P < 0.0001) was significantly higher. Around 54.3% of patients were satisfied with the laser treatment, while 28.9% were neutral and 14.9% were highly satisfied. The description is mentioned in [Table 2] and [Table 3].
Table 2: Knowledge and training about dental laser among dental professionals in Central India (n=350)

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Table 3: Comparison of responses to the questions (Q1 to Q9) on the basis of age, qualification, and job description

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In this survey, 68.9% of dentists chose conventional treatment for caries removal. For enamel etching, 55.4% favored the traditional method. For smear layer removal, 58.6% preferred conventional treatment. For dentin desensitization, 54% chose laser therapy. For bleaching of teeth, 54.6% chose conventional treatment. For surgical treatment of large vascular lesions, 63.7% chose laser treatment. For cystic lesion, epulis, and wart elimination, 66.3% chose laser therapy. For bone recontouring, 53.7% chose laser therapy. For root canal disinfection, 60.6% preferred conventional treatment, and 56.6% preferred conventional treatment for pulp vitality diagnosis. About 54.3% of respondents believed that laser could reduce the need for local anesthesia, while 34% were unaware of this. Lasers, according to 63.7% of respondents, can be used to reduce swelling and pain as well as accelerate wound healing (58.9%). When age-wise, qualification- and job description-wise comparisons were made regarding awareness of lasers in different procedures in general dentistry among dental professionals, no significant differences were reported [Table 4] and [Table 5].
Table 4: Awareness of application of lasers and their preferred choices among different procedures in general dentistry among dental professionals in Central India (n=350)

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Table 5: Comparison of scores for awareness of application of lasers and their preferred choices among different procedures in general dentistry among dental professionals in Central India on the basis of age, qualification, and job description

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It was observed that 62.9% of dentists favored traditional therapy over laser treatment for periodontal pocket disinfection (37.1%). For soft-tissue curettage, 50.6% preferred laser treatment, while 49.4% preferred conventional treatment. For implant surgery, 53.7% chose laser treatment. For implant maintenance, 50.9% favored laser treatment, while 49.1% preferred conventional treatment. For peri-implantitis or peri-mucositis, 57.4% chose laser treatment. About 65.1% of respondents favored a visual approach to detect calculus, and 58.6% preferred conventional therapy to remove calculus. For gingivectomy and crown lengthening, 47.1% chose laser therapy. For frenectomy, 53.7% preferred laser treatment, and for gingival depigmentation, 63.4% preferred laser treatment. For operculectomy, 52.6% chose laser therapy. When age-wise, qualification, and job description-wise comparisons were made regarding awareness of lasers in different procedures in periodontics among dental professionals, no significant differences were found [Table 6] and [Table 7].
Table 6: Awareness of application of lasers and their preferred choices among different procedures in periodontics among dental professionals in Central India (n=350)

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Table 7: Comparison of scores for awareness of application of lasers and their preferred choices among different procedures in periodontics among dental professionals in central India on the basis of age, qualification, and job description

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  Discussion Top


The invention of lasers marked a watershed moment in dentistry, and various forms of lasers are now used in a variety of procedures. The aim of this study was to assess the knowledge, awareness, and practices of dental lasers among dental professionals in Central India. In addition, the respondents' preferred choices of various procedures were accessed in this survey.

Since lasers are being a part of postgraduate curriculum, postgraduate students were very much interested in using lasers. In this survey, only a limited number of dental professionals used lasers. Lack of proper training and knowledge of lasers is one of the reasons behind the limited usage of lasers among the younger age group and undergraduates. Dental students should be trained in the latest technologies accessible since technological improvements assist dentists and patients, and training at their institution can only aid them in their profession.[9] The other explanation for this for government affiliated with private practice may be the high cost, delicate operation, or health risk. This supports a study by Bagheri and Purkhamene, which found that a lack of training, new technologies, and high equipment costs are the reasons for lower dental laser knowledge.[8] Approximately 3.5% of dentists in private practices used lasers, according to a survey conducted by the American Dental Academy in 2000. They speculated that it was because they were able to achieve similar results using traditional methods.[11] In a survey in North America in 2013, 40% said that they used laser in treatment, 11% said that they did not have laser education, and 1% said that they did not use it in the treatment of illness, but 1% of respondents said they did not use it for their patients.[12] This may lead us to believe that, even in countries with higher levels of education and services, such as the United States and Canada, there is not as much training as there is with a laser device in a licensed program.[6]

Since the wavelength of the diode laser is absorbed by pigmentation in soft tissue, making it an outstanding hemostatic agent, it was most commonly used by dental professionals.[13] The ability to use this instrument in a continuous wave or pulse mode significantly expands its soft-tissue surgery applications.[14] Majority of participants who are postgraduates were using diode laser, which is cost-effective and technically insensitive. Many colleges have laser units; however, they are solely available to faculty and postgraduate students;[9] therefore, postgraduates were trained from their institutions. The younger age group recommended that laser training be included in undergraduate courses. According to a survey conducted by Yadav et al., a significant number of respondents (60%) expressed a strong interest in laser education, and that integrating laser education into undergraduate courses could help broaden the knowledge and understanding of dental lasers.[5] Since most students rely on the knowledge and training they receive during their undergraduate studies, including a laser program in the undergraduate curriculum may enhance the success of this novel technology.

Patients were fairly satisfied with laser treatment, according to the majority of practitioners in this survey. However, patients were highly satisfied with laser therapy, according to a survey conducted by Yadav et al.[5] Wigdor studied patients' perceptions of lasers in dentistry and found that when lasers were used instead of a high-speed handpiece, patients felt more at ease.[15]

The majority of those who took part in the study said they were interested in using lasers. However, we asked them to choose between traditional and laser treatment for a variety of dental procedures and found that the majority of respondents chose laser therapy over conventional treatment for soft-tissue curettage, dentin desensitization, surgical treatment of massive vesicular lesions, cystic lesion, bone recontouring, implant treatment, gingivectomy, frenectomy, gingival depigmentation, and operculectomy. Nonetheless, some applications of lasers, such as pocket disinfection, bleaching of teeth, caries removal, enamel etching, detection and removal of calculus, root canal disinfection, and diagnosis of pulp vitality, were unfamiliar to the participants, and they favored traditional treatment. While lasers cannot replace all traditional dental procedures, they can be used to perform certain procedures differently than before.[16]

Dental pain is ranked in the top ten phobias in the world. The use of laser therapy can make a significant difference in a patient's life by reducing stress and anxiety.[2] A great number of respondents thought that laser surgery could eliminate the need for local anesthesia, minimize swelling and pain, and speed wound healing. Lasers have been shown to have anti-inflammatory and analgesic effects by blocking nerves.[2]

The limitation of our study was the self-reporting bias. The study was limited to dental professionals in central India. Another of the survey's drawback is the selection bias introduced by the voluntary aspect of the survey. More research is needed to assist in the more effective and rapid integration of this technology into dental college curricula. Follow-up surveys may track the adoption of these innovations and the benefits that come with them.


  Conclusion Top


Lasers in dentistry are still a new technology; therefore, experience and understanding are minimal. However, although the majority of participants in this study are interested in using lasers, only a few dental professionals use this equipment. Lasers need comprehensive training in both theoretical and applied. Furthermore, incorporating laser education into undergraduate courses may provide students with an early opportunity to learn about and practising with lasers.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Maiman T. Stimulated optical radiation in ruby. Nature 1960;187:493-4.  Back to cited text no. 3
    
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Pick RM, Colvard MD. Current status of lasers in soft tissue dental surgery. J Periodontol 1993;64:589-602.  Back to cited text no. 4
    
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Yadav S, Chaudhry S, Talwar S, Verma M. Knowledge and practices of dental lasers among dental professionals in India: A survey-based study. J Dent Lasers 2018;12:50-5.  Back to cited text no. 5
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Baglar S, Avunduk AT. Determination of the awareness and the knowledge level in dental faculties regarding laser systems. J Dent Lasers 2017;11:52-7.  Back to cited text no. 6
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Bordea R, Lucaciu O, Câmpian RS. Student's knowledge and opinion regarding the need of implementation of lasers in dental faculty curriculum. HVM Bioflux 2016;8:157-60.  Back to cited text no. 7
    
8.
Bagheri A, Purkhamene S. General dentist's awareness of laser application in dentistry. Int J Curr Res Rev 2015;7:35.  Back to cited text no. 8
    
9.
Kadam SR, Naviwala GA, Panchal AM, Shastri Nishtala SS, Pardeshi VR. Dental laser education and knowledge among students from dental colleges of Mumbai and Pune City: A questionnaire study. J Indian Assoc Public Health Dent 2017;15:368-72.  Back to cited text no. 9
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Amanthi G, Jeevanandan G. Awareness of laser dentistry among dentists in Chennai – A survey. Drug Invention Today 2020;11:3128-33.  Back to cited text no. 10
    
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Dansie CO, Park JH, Makin IR. Training and use of lasers in postgraduate orthodontic programs in the United States and Canada. J Dent Educ 2013;77:773-81.  Back to cited text no. 12
    
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Whitters CJ, Strang R. Preliminary investigation of a novel carbon dioxide laser for applications in dentistry. Lasers Surg Med 2000;26:262-9.  Back to cited text no. 13
    
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Dederich DN, Bushick RD; ADA Council on Scientific Affairs and Division of Science; Journal of the American Dental Association. Lasers in dentistry: Separating science from hype. J Am Dent Assoc 2004;135:204-12.  Back to cited text no. 14
    
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Wigdor H. Patients' perception of lasers in dentistry. Lasers Surg Med 1997;20:47-50.  Back to cited text no. 15
    
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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