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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 20
| Issue : 4 | Page : 393-397 |
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Teledentistry: Knowledge, attitude, and perception among undergraduate and postgraduate dental students
Boddeda Suma Priyanka, L Vamsi Krishna Reddy, Vineela Parlapalli, Siva Kumar Pydi, Nagarjuna Pottem, Yaswanth Sai Rachuru
Department of Public Health Dentistry, Anil Neerukonda Institute of Dental Sciences, Visakhapatnam, Andhra Pradesh, India
| Date of Submission | 17-Jul-2021 |
| Date of Decision | 22-Jun-2022 |
| Date of Acceptance | 27-Aug-2022 |
| Date of Web Publication | 19-Dec-2022 |
Correspondence Address:
Boddeda Suma Priyanka
Department of Public Health Dentistry, Anil Neerukonda Institute of Dental Sciences, Sangivalasa, Visakhapatnam - 531 162, Andhra Pradesh
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jiaphd.jiaphd_133_21
Background: In India, improper access to health services, particularly oral health care, is the main concern. As a result, teledentistry is a novel technique of practicing that ensures an exponential increase in clinical practice and public health-care delivery. Aim: The aim of the study was to assess the knowledge, attitude, and perception regarding teledentistry among dental students of Andhra Pradesh, India. Materials and Methodology: A descriptive cross-sectional study was conducted. Two hundred and fifty dental students are selected through a random sampling technique, including 3rd year Bachelor of Dental Surgery (BDS), 4th year Bachelor of Dental Surgery, interns, and Master of Dental Surgery (MDS) students studying in Andhra Pradesh. Dental students' knowledge, attitude, and perception regarding teledentistry was recorded using a self-administered, structured, pretested, and validated questionnaire administered through Google Forms, and the completed questionnaires were statistically analyzed using Statistical software (SPSS 25). Descriptive statistics included the computation of percentages and inferential statistics; the Chi-square test was used for intergroup comparisons. Statistical significance was set at P ≤ 0.05. Results: A total of 250 (100%) participants participated in the study. Sociodemographic data indicates that most respondents were between 20 and 23 years of age [n = 153 (61.2%)]. Most of the respondents accounted are females [n = 184 (73.6%)], and the remaining were males [n = 66 (26.4%)]. Majority of the participants were BDS [n = 193 (77.2%)] and the remaining were MDS [n = 57 (22.8%)]. The majority of postgraduate students, 77.2% (P = 0.022), were found to be familiar with the definition of teledentistry. It was observed that the majority of postgraduate students, 78.9% (P = 0.02) had knowledge about teledentistry and how to improve the health education of the masses. It shows that 61.4% (P = 0.002) of postgraduates believe that teledentistry can save time in dental practice. The overall study results uncovered that the postgraduates had a greater mean knowledge score than undergraduates. Conclusion: Most dental students were aware of teledentistry, its benefits, drawbacks, and how to use it. As teledentistry is still a nascent technology, this topic should be included in dental education.
Keywords: Dentistry, informatics, telecommunications, teledentistry
How to cite this article:
Priyanka BS, Reddy L V, Parlapalli V, Pydi SK, Pottem N, Rachuru YS. Teledentistry: Knowledge, attitude, and perception among undergraduate and postgraduate dental students. J Indian Assoc Public Health Dent 2022;20:393-7 |
| Introduction | |  |
Improper access to health services is a major concern internationally, and access to oral health care is challenging.[1] In the age of telecommunications and computers, health care has been radically transformed. Dental treatment is also increasingly transformed due to the opportunities created by technology.[2] There are several telecommunication implementations for hospitals, and a new word for it has come with time, i.e., telemedicine.[3]
Telehealth has a wide range of purposes, including continuing education, research, and sharing of information essential for diagnosis, treatment, epidemic detection, and prevention of diseases.[4] Teledentistry is a burgeoning branch of dentistry that combines telecommunications and dentistry. Teledentistry is now included in telemedicine. It is originated from the Greek word “Tele,” which means distance, and the Latin word “Mederi” which means to heal.[2]
Cook in 1997 defined teledentistry as “The practice of using video conferencing technologies to diagnose and provide advice about treatment over a distance.” Teledentistry, a new arena of dentistry, delivers dental care services to community citizens through different information technology. It helps to provide patients with basic knowledge about dental health care by enhancing oral care services. It is also helpful for engaging with health practitioners and also for educating dental students.[5]
Teledentistry is a new way of practicing that assures enormous prospective clinical practice and public health-care delivery.[5] The Association of American Medical Colleges states that “Telemedicine is the use of telecommunications technology to send data, graphics, audio, and video images between participants who are physically separated for clinical care.”[3] It is a useful tool used in different specialties in dentistry by both patients and clinicians.
In oral medicine and radiology, it helps to diagnose and frame a treatment plan for complicated cases by making it easier to reach multiple specialists and transmit radiological images of lesions. In maxillofacial surgery, evaluating specialized dental imaging techniques (such as cone-beam computed tomography) that are often not accessible in one center can help accurately treat complicated cases. Taking multiple standard cephalometric analysis views helps a lot of orthodontics for a more profound clinical experience. It may also be used to improve patient compliance and comfort by sharing pre- and posttreatment images. In endodontics, for accurate diagnosis of periapical lesions and the presence of any supplementary root canal, this might be applicable. It can also be effective in prosthodontics for inlay, onlay, and crown preparation, as well as various computer-aided diagnostic approaches such as computer-aided design and computer-aided manufacturing.[6] In periodontics, teledentistry has been proven helpful in diagnosing and monitoring patients who undergo periodontal surgery.[7],[8] In pediatrics and preventive dentistry, there is a need for schools and child care centers to use teledentistry for early screening of dental problems before they become emergencies to ensure safe oral hygiene for children, to provide immediate care to emerging oral problems, and link children and their parents to adequate health and social services.[9] Teledentistry is particularly useful for evaluating early childhood caries and categorizing patients who are at high or low risk. The intraoral camera aids in the rapid detection and analysis of caries.[7]
Teledentistry may be a useful guide for undergraduate and postgraduate students and dental professionals who want to keep their knowledge up to date. Students and educators will collaborate and receive input from patient data evaluations due to video conferencing technologies.[10]
Teledentistry decreases the time taken by different doctors for various opinions and thereby works out more economically for the patient and the doctor. It enables the avoidance and early diagnosis of any carious lesion or soft-tissue lesion.[6] There is little literature based on the knowledge, attitude, and perception of dental students toward teledentistry. This study is conducted to evaluate the understanding levels of dental students' knowledge, attitude, and perception toward teledentistry.
The aim of this study was to assess the knowledge, attitude, and perception among dental students about teledentistry in Andhra Pradesh.
The objectives of this study were to assess the knowledge, attitude, and perception using a pretested questionnaire and to compare the knowledge, attitude, and perception of Bachelor of Dental Surgery (BDS) and Master of Dental Surgery (MDS) students.
| Materials and Methodology | | |
The study design was a cross-sectional questionnaire survey conducted among 250 dental students, including BDS – 3rd year, 4th year, interns, and Master of Dental Surgery (MDS) students, to investigate the knowledge, attitude, and perception in January–February 2021. Participation was voluntary. The study was online-based, in which the questionnaire was sent in the form of Google Forms. Before giving the questionnaire, consent which explained the study objectives were obtained from the study participants. This study protocol was reviewed and approved by the institutional ethical committee (IEC No.-ANIDS/IEC/202106001).
The sample size was assessed using the formula N = z2pq/L2, considering the prevalence of knowledge in the previous study as 82%.[5] Hence, a sample size of 236 was obtained, which was rounded off to 250. A simple random sampling technique was employed. Out of 16 dental colleges in Andhra Pradesh, three colleges chosen randomly using the lottery method were included in the study.
Students pursuing BDS – 3rd year, 4th year, and interns, and MDS of the selected dental colleges in Andhra Pradesh and who gave informed consent were included in the study. Students who have submitted incomplete questionnaires and who did not give informed consent were excluded from the study.
Data collection
A modified self-administered closed-ended questionnaire used to assess the knowledge, attitude, and perception with questions compiled from previous studies[2],[4],[5] about teledentistry was used in this study which was pretested and validated. The study was conducted entirely online, and the questionnaire was distributed through Google Forms. Since the study population was students, the questionnaire was written in English; four sections of the questionnaire are
Section 1 Recording sociodemographic characteristics
The list of questions included was the study participant's age, gender, college name, and year of study.
Section 2 recording students' knowledge about teledentistry
It comprised 12 questions to assess the student's knowledge of teledentistry.
Section 3 recording attitude of students toward teledentistry
It comprised five questions to assess the student's attitude toward teledentistry.
Section 4 recording students' perception about teledentistry
It comprised six questions to assess the student's perception of teledentistry.
Each participant's score average was taken, which was later converted to a percentage to get an overview of their general knowledge, attitude, and perception toward teledentistry.
The responses of the participants were ranked according to how well they agreed with each statement, using a five-point Likert scale with the following options: strongly agree, agree, neutral, disagree, and strongly disagree.
Statistical analysis
The collected data was coded, compiled, and entered into Microsoft Word Excel Sheet 2019 version and was analyzed using statistical software SPSS software version 25.0. IBM Corp. (Armonk, NY, USA). Descriptive statistics included computation of percentages, and Chi-square test was used for intergroup comparisons with a confidence interval, and statistical significance was set at P ≤ 0.05.
| Results | | |
A total of 250 (100%) participants participated in the study. Sociodemographic data indicates that most respondents were between 20 and 23 years of age [n = 153 (61.2%)]. Most of the respondents accounted are females [n = 184 (73.6%)], and the remaining were males [n = 66 (26.4%)]. Majority of the participants were BDS [n = 193 (77.2%)] and remaining were MDS [n = 57 (22.8%)].
The knowledge of the study participants regarding teledentistry showed that the majority of postgraduate students, 77.2%, were more familiar with the definition of teledentistry than BDS students. It was observed that the majority of postgraduate students knew how teledentistry could help to improve access to oral health care more than BDS students. It was observed that the majority of postgraduate students, 78.9% had knowledge about teledentistry and how to improve the health education of the masses. It was also observed that 59.6% of postgraduates agreed on how teledentistry can be applied in every branch of dentistry [Table 1].
The attitude of the study participants showed that 61.4% of postgraduates believe that teledentistry can save time in dental practice. It was observed that 52.6% of postgraduates think that teledentistry can better understand the patient's oral health problem over the Internet. It also shows that 49.2% of BDS students agreed that the dental examination done through teledentistry is as accurate as face-to-face consultations [Table 2].
The perception of the study participants on teledentistry showed that 40.9% of BDS students agreed on how teledentistry equipment is difficult for them to use. The majority of postgraduates, 61.4%, think in India, the major challenges in teledentistry are illiterates, population below the poverty line, and lack of infrastructure. The majority of postgraduates, 63.2%, think that there is a lack of awareness about teledentistry benefits and applications by dental professionals, this becomes a barrier to its use [Table 3].
| Discussion | | |
Owing to advancing technology, there has been a significant shift in how oral health care is delivered to patients. Teledentistry is currently stashed under the wing of telemedicine and is yet to be recognized as a distinct entity. Data and advanced technologies in varying Internet technologies, such as telecommunications, video conferencing, and e-data, have led to substantial improvements in health-care services.[11] The combination of dentistry and information technology has the capacity to evolve how clinical and primary health care is delivered in our country.[12],[13] Within its drawbacks, this modern approach promises happier days for both patients and practitioners.
The present study results uncovered that the postgraduates practicing dentists had a greater mean knowledge score than dental practicing undergraduates. In the present study, the knowledge and awareness among the postgraduate students depicted that majority of the participants agreed that teledentistry is the practice of the use of computers, the Internet, and intraoral camera technologies to diagnose and provide advice about treatment over a distance, which is in accordance with several studies such as Pradhan et al.,[2] Singh et al.,[3] Sen et al.,[5] Ramesh et al.,[10] Bhambal et al.,[14]. The justification for this may be that postgraduate students are more familiar with computers, the Internet, and other technology forms. The use of computers and the Internet is common in the health-care sector nowadays. Teledentistry connects dental health-care services through dental health records, telecommunications technology, digital imaging, and the Internet to enhance communication and information sharing.
In the present study, the knowledge among postgraduate students, the majority of the participants (78.9%) agreed that teledentistry could improve the health education of the masses, contrary to other studies such as Sen et al.,[5] and Boring et al.,[6]. The disparity of opinion may be due to postgraduates being informed about the value of public health education and its interventions, allowing them to correlate teledentistry and how it can help public health education.
In the present study, the knowledge among postgraduate students, the majority of the participants (78.9%) agreed that teledentistry helps in training better oral hygiene practices, which is in accordance with other studies such as Aboalshamat[1] Pradhan et al.,[2] Singh et al.,[3] Sen et al.,[5]. This is attributed to the recent advancements and developments in dentistry, such as teledentistry, which can increase training in better oral hygiene practices.
In the present study, the knowledge among postgraduate students, the majority of the participants (68.4%) agreed that teledentistry is good for dental education over the Internet and for training primary health-care dentists, which is in accordance with other studies such as Aboalshamat[1] Pradhan et al.,[2] Singh et al.,[3] Sen et al.,[5]. It reveals that our study participants had a healthier and more optimistic outlook about teledentistry.
In the present study, the knowledge among postgraduate students, the majority of the participants (80.7%) agreed that teledentistry could improve access to oral health care, which is in accordance with other studies such as Aboalshamat[1] Pradhan et al.,[2] Singh et al.,[3] in contrary with a study like Sen et al.,[5]. This is because postgraduates have a higher level of academic expertise and are more knowledgeable about recent advancements and developments in dentistry, such as teledentistry than undergraduates, like how it can increase rural people's chance of accessing dental care.
It is not difficult to foresee teledentistry being yet another way to see an oral health-care provider in the not-too-distant future. In future, in teledentistry, dentists may be assigned to Primary Health Centers and Regional Health Centers to consult with experts on diagnosing and treating difficult patients.[15] Dental colleges with a predetermined catchment area could be perfect locations for teledentistry consulting hubs since they house all of the experts under one roof.
Teledentistry has the potential to increase access to oral health care, improve delivery, and eliminate oral health inequalities between rural and urban regions.[16],[17],[18] Teledentistry can empower dentists in connecting with a variety of communities. New technologies such as this enhance oral health education in schools and communities easier and effectively.[19]
Long-distance health care, clinical training, and continuing education for dentists may all be delivered through telehealth, which is a unique method to overcome geographic constraints.[20] Its use is extremely beneficial in underserved rural and urban regions. This technology improves interprofessional communication, allowing dentistry to better integrate into the wider health-care delivery system.[21]
With the utilization of real-time clinical pictures, referrals, preauthorizations, and other insurance obligations may be completed rapidly online, resulting in cost savings for dental practices and patients.[22] Professionals' knowledge may be improved by tele-education and teleassistance, allowing for the early diagnosis of oral diseases such as dental caries, oral cancers, and periodontal disease. Teledentistry has the potential to help reduce morbidity and mortality by encouraging preventive and health promotion practices by offering remote diagnostics to do the initial examination of a dental problem and to propose a treatment plan.[23]
Limitations
Since the research was undertaken at an academic college and a hospital, the results cannot be generalized to the whole dental population.
| Conclusion | | |
This study shows that dental students have adequate knowledge, attitude, and awareness regarding teledentistry. Most dental students were aware of teledentistry, its benefits, drawbacks, and how to use it as teledentistry is still a nascent technology; this topic should be included in dental education.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Aboalshamat KT. Awareness of, beliefs about, practices of, and barriers to teledentistry among dental students and the implications for Saudi Arabia vision 2030 and coronavirus pandemic. J Int Soc Prev Community Dent 2020;10:431-7.  |
| 2. | Pradhan D, Verma P, Sharma L, Khaitan T. Knowledge, awareness, and attitude regarding teledentistry among postgraduate dental students of Kanpur city, India: A questionnaire study. J Educ Health Promot 2019;8:104. |
| 3. | Singh P, Suma BS. Knowledge, attitude & practices regarding teledentistry amongst dental practitioners of Patna, Eastern India. Int J Dent Health Sci 2016;3:1095-106. |
| 4. | Murererehe J, Uwambaye P, Isyagi M, Nyandwi T, Njunwa K. Knowledge, attitude and practices of dental professionals in Rwanda towards the benefits and applications of teledentistry. Rwanda J Ser Filol Med Health Sci 2017;4:39-47. |
| 5. | Sen N, Bhat N, Mandal A. Knowledge, attitude and awareness among dental students about teledentistry in Kolkata, West Bengal, India – A cross sectional study. Int J Recent Sci Res 2017;8:15952-6. |
| 6. | Boringi M, Waghray S, Lavanya R, Babu DB, Badam RK, Harsha N, et al. Knowledge and awareness of teledentistry among dental professionals – A cross sectional study. J Clin Diagn Res 2015;9:C41-4. |
| 7. | Panat S, Chakarvarty A, Aggarwal A, Teledentistry: A new revolution. J Dent Sci Oral Rehabil 2012;3;1-4. |
| 8. | Sanjeev M, Shushant GK. Teledentistry: A new trend in oral health. Int J Clin Cases Inves 2011;2:49-53. |
| 9. | Chhabra N, Chhabra A, Jain RL, Kaur H, Bansal S. Role of teledentistry in dental education: Need of the Era. J Clin Diagn Res 2011;5:1486-8. |
| 10. | Ramesh N, Pankaj A, Archana JS, Kailash A, Mridula T, Piyush P, et al. Teledentistry: Knowledge and attitudes among dentists in Udaipur, India. Oral Health Dent Manag 2013;12:138-44. |
| 11. | Shirolkar R, RuparellaKP, More C, Ruparella P. Teledentistry: An art and science of healing. J Indian Acad Oral Med Radiol 2011;23:108-11. [Full text] |
| 12. | |
| 13. | Gopi VV, Daryani D, Uthkal MP, Zehra F. Teledentistry – The Indian perspective. Int J Oral Health Dent 2019;5:59-62. |
| 14. | Bhambal A, Saxena S, Balsaraf SV. Teledentistry: Potentials unexplored. J Int Oral Health 2010;2:1-6. |
| 15. | Kharbanda O, Priya H, Balachandran R, Khurana C. Current scenario of teledentistry in public healthcare in India. J Int Soc Telemed EHealth 2019;7:e10 1-8. |
| 16. | Jampani ND, Nutalapati R, Dontula BS, Boyapati R. Applications of teledentistry: A literature review and update. J Int Soc Prev Community Dent 2011;1:37-44. |
| 17. | Martin AB, Nelson JD, Bhavsar GP, McElligott J, Garr D, Leite RS. Feasibility assessment for using telehealth technology to improve access to dental care for rural and underserved populations. J Evid Based Dent Pract 2016;16:228-35. |
| 18. | Reddy KV. Using teledentistry for providing the specialist access to rural Indians. Indian J Dent Res 2011;22:189. [ PUBMED] [Full text] |
| 19. | Estai M, Kanagasingam Y, Mehdizadeh M, Vignarajan J, Norman R, Huang B, et al. Teledentistry as a novel pathway to improve dental health in school children: A research protocol for a randomised controlled trial. BMC Oral Health 2020;20:11. |
| 20. | Marcoux RM, Vogenberg FR. Telehealth: Applications from a legal and regulatory perspective. P T 2016;41:567-70. |
| 21. | Irving M, Stewart R, Spallek H, Blinkhorn A. Using teledentistry in clinical practice as an enabler to improve access to clinical care: A qualitative systematic review. J Telemed Telecare 2018;24:129-46. |
| 22. | Daniel SJ, Kumar S. Teledentistry: A key component in access to care. J Evid Based Dent Pract 2014;14 Suppl: 201-8. |
| 23. | da Costa CB, Peralta FD, Ferreira de Mello AL. How has teledentistry been applied in public dental health services? An integrative review. Telemed J E Health 2020;26:945-54. |
[Table 1], [Table 2], [Table 3]
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