Knowledge and Attitude about Evidence-Based Dental Practice among Dentists in Al-Kharj, Saudi Arabia

ABSTRACT

Background:

Quality of patient care will improve when dental professional practices are based on evidence. The present study was aimed at assessing the knowledge and attitude of private dental practitioners in Al-Kharj regarding evidence-based dentistry.

Methodology:

The study sample consisted of 180 private dental practitioners in Al-Kharj, Saudi Arabia. A pretested questionnaire was used to collect information regarding knowledge and attitude toward evidence-based dental practice (EBDP). Data were collected by direct personal contact and information was collected on the same day.

Results:

Awareness of EBDP among private dental practitioners was 67.8%. Also, 31.1% of subjects told that they practice EBD in decision-making about patient treatment. Only 16.7% of study subjects were aware of the Cochrane database, whereas 34.1% were aware of the evidence-based pyramid. Also, 91.7% thought that they needed to be trained regarding EBD.

Conclusion:

Awareness of EBDP is low among private dental practitioners but the majority of dentists think they need training regarding evidence-based dentistry.

INTRODUCTION

Most dentists would probably agree that the rationale for good dental practice is a blend of science and art, and both are important for quality care.[1] According to Susan in 2001, with the advances in dentistry along with patient expectations with complex needs and demand, which is a challenge for practicing dentists[2] now, another 20 years of progress has resulted in many more advancements and newer treatments. As a professional, it is our responsibility to deliver the best possible care to the patients.[3] Even though every dentist acquires skills that come with practice experience, there is a possibility that expertise and effectiveness in some areas begin to deteriorate. Also, changes in treatment modalities and the availability of newer materials in the market make dental practitioners difficult to keep track of and update themselves.[4]

Also, in recent years, there have been changes in doctor–patient relationships. The main challenge is the patient’s involvement in clinical decision-making.[5] Hence, it becomes necessary for the practitioner to get updated about recent advancements in materials, treatments, and procedures related to dentistry. One possible way of keeping updated is through evidence-based dental practice (EBDP).

Evidence-based practice (EBP) is the conscientious and judicious use of current best evidence along with clinical expertise and giving respect to patient values and guiding health care decisions.[6-9]

EBDP helps the practitioner to search for scientific research findings to decide on treatment.[10] That kind of practice is considered the best approach to providing safe, methodologically proven, efficient, cost-effective interventions or treatments.[3]

EBDP helps practitioners about deciding treatment after assessing the available evidence, which in turn may improve dentist–patient relationship by increasing patient trust in dental services.

There are very few studies conducted on the knowledge and attitude of dentists about EBDP. A previous study from the Riyadh region concluded that there was inadequate knowledge of evidence-based dentistry among dentists.[11,12] With this background, the current study was conducted with the aim to assess the knowledge and attitude of dental practitioners in Al-Kharj city, Saudi Arabia about EBDP.

OBJECTIVES

To assess knowledge and attitude about EBDP among dental practitioners in Al-Kharj, Saudi Arabia.

MATERIALS AND METHODS

A cross-sectional study was planned to assess dentists’ knowledge and attitude about EBDP among a total of 180 dentists practicing in the Al-Kharj region of Saudi Arabia. This questionnaire study was planned by collecting information through direct interviews.

The need for the study was explained and participation consent was obtained before the study. The study was approved by the Institutional Review Board of Prince Sattam Bin Abdul-Aziz University, Al-Kharj. A thorough review of the literature was conducted and a structured questionnaire was framed with the assistance and guidance of a panel of academic experts. The questionnaire was initially prepared in Arabic, which is translated into English.

A total of 180 dental professionals were involved in the study. Informed consent was obtained from all participants. The questionnaire was structured and had a total of 10 questions emphasizing the assessment of general awareness, level of understanding, and application of EBDP. Each dentist was personally consulted and explained about the study. After obtaining the consent, the questionnaire was provided and sufficient time was given to fill out the questionnaire and it was collected back on the same day. The consent form was included in the questionnaire. A total of 180 dental practitioners provided responses about EBDP.

Statistical analysis

SPSS version 23 was used for statistical analysis. The Chi-square test was used for comparing awareness and practice of probiotics according to gender and year of practice. Results are expressed as numbers and percentages.

RESULTS

Table 1 shows the distribution of study participants. A total of 180 dentists were practiced in the present study, out of which 122 (67.8%) were males and 58 (32.2%) were females [Table 1].

Table 1.

Distribution of study subjects according to gender

Gender	Frequency	Percentage
Males	132	67.8
Females	48	32.2

Table 2 shows the response of study subjects to various questions related to EBDP. When a question was asked regarding the awareness of EBDP, 132 (67.8%) responded as they are aware of the word. Further, these 132 subjects were considered for analysis, and 48 subjects who told they were not aware were excluded from the study. Further, 31.1% of subjects told that they practiced EBP in decision-making about their patient’s treatment. Only 16.7% of study subjects were aware of the Cochrane database of systematic reviews, whereas 34.1% of subjects told they know about the evidence-based pyramid. The major constraints for practicing EBP were lack of time (40.9%), followed by difficulty to understand (36.4%), and low knowledge (22.7%). The majority of the study participants (85.6%) thought EBD improved patient care at the same time; only 32.6% of participants thought that without EBD practice is inefficient. Only 28.0% told that they read journals and only 16.7% of subjects told they had ever used EBD in practice. The majority of the study subjects (91.7%) thought that they needed to be trained regarding EBD.

Table 2.

Response of study subjects to various questions related to evidence-based dental practice

Questions	Response	Frequency	Percentage
Are you aware of the term evidence-based dental practice	Yes	132	67.8
	No	58	32.2
Do you practice EBP in your decision-making about your patients	Yes	41	31.1
	No	91	68.9
Do you think without EBD your practice is inefficient	Yes	43	32.6
	No	89	67.4
Are you aware of the Cochrane database of systematic reviews	Yes	22	16.7
	No	110	83.3
Are you aware of evidence-based pyramid	Yes	45	34.1
	No	87	65.9
Barriers for practicing evidence-based dental practice	Lack of time	54	40.9
	Difficult to understand	48	36.4
	Less knowledge	30	22.7
Do you think EBD improves patient care	Yes	113	85.6
	No	19	14.4
Do you regularly read journal	Yes	37	28.0
	No	95	72.0
Have you ever used the EBD approach in ordering tests or treatment	Yes	22	16.7
	No	110	83.3
Do you think you need to be trained regarding EBD	Yes	114	81.7
	No	30	18.3

DISCUSSION

The level of knowledge and attitude toward EBDP was assessed using this study among private dental practitioners in Al-Kharj city, Saudi Arabia. Only 67.8% of dentists were aware of the term EBP. This is less compared to the study by ALmalki[12] who reported an awareness of 91.8% in Riyadh, Saudi Arabia. However, the author has considered dentists working in academics also. Therefore, this may be the reason for the increase in awareness about EBP. Results are in line with those of Gupta et al.[1] (70.5%) and more than that of Pratap et al.[13] (50.7%); these two are Indian studies. Those dentists working in the institution were excluded from the study due to their ease of access to educational resources in comparison to the majority of private practitioners.

In the present study, 31.1% of private dentists who were aware of EBDP told they practiced it on patients for clinical decision-making. This is in contrast to the study by ALmalki et al.,[12] where 84.8% of participants told they practiced evidence-based dentistry in clinical decision-making. In this study, 32.6% of study subjects thought that without EBD practice is inefficient, which is less than that reported by Bhate et al.[14](56.4%).

In this study, only 16.7% of subjects knew about the Cochrane database. This finding is in line with the study performed by Sudhanshu et al.,[15] where the author found only 10.64% of study participants were aware of the Cochrane database. When asked about information on the evidence-based pyramid, 34.1% of subjects told they are aware of it, which is in accordance with the study by Bhate et al.[14] who reported 38.5% awareness.

Lack of time (40.9%), difficulty to understand (36.4%), and also low knowledge (22.7%) were barriers to using EBDP, which were in terms with previous studies.[16-18] Lack of time could be traced to the business of practice.

The majority of dentists (85.6%) thought that EBD would improve patient care by helping in making accurate diagnoses and treatment plans for the patient. A similar observation was made by Rajagopalachari et al. (76%).[19]

Less than 30% of the practitioners told that they regularly read journals. Only 16.7% told they had practiced the EBD approach. Reading journals is one of the important criteria, which a practitioner should know to practice evidence-based dentistry. Also, they must be familiar with study designs to understand the research.

Further, 81.7% of participants agreed that they needed to be trained in EBD, which shows that the majority of participants were having a positive attitude toward knowing about EBDP.

Limitations of the study

Some of the limitations of the study were the small sample size, only private dental practitioners, and a small area of study.

CONCLUSION

In the present study, a moderate percentage of awareness about EBD was observed among private dental practitioners. Most practitioners were aware that EBDP improves the quality of dental care. Only a few dental practitioners had a habit of reading journals and knew about the Cochrane database. The majority of the dental practitioners had a positive attitude to learn EBDP. Workshops can be made to train EBD to practicing dentists.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.