Abstract
Background:
Evidence-based practice (EBP) in dentistry and oral and maxillofacial surgery (OMFS) is essential for improving patient outcomes. Despite global emphasis, its implementation in clinical settings remains inconsistent in India.
Aim:
To assess the knowledge, attitude, and practice (KAP) regarding EBP among dental and OMFS professionals across various Indian states.
Materials and Methods:
A cross-sectional survey was conducted among 2,634 dental professionals using a structured, pre-validated questionnaire. The survey included questions on EBP awareness, use of research tools, clinical application, and patient communication. Descriptive statistics were used, and associations were analyzed using Chi-square and ANOVA, with P < 0.05 considered significant.
Results:
Of the respondents, 87.93% were aware of EBP, and 66.32% knew how to access research databases. While 84.25% believed EBP should be a core clinical component, only 57.06% regularly consulted research before treatment, and 55.73% discussed evidence-based options with patients. OMFS postgraduates had significantly higher knowledge and practice scores (P = 0.003, 0.017). Barriers included lack of time (74%), limited access (61%), and insufficient training (59%).
Conclusion:
Despite favorable attitudes, the practical use of EBP remains limited. Institutional support, improved access to resources, and formal training are necessary to bridge the knowledge–practice gap.
KEYWORDS: Barriers to EBP, dental education, evidence-based dentistry, KAP study, oral and maxillofacial surgery
INTRODUCTION
Evidence-based practice (EBP) in dentistry and oral and maxillofacial surgery (OMFS) integrates clinical expertise, patient preferences, and the best available scientific evidence to inform treatment decisions. Contaldo et al.[1] emphasized that misconceptions persist in clinical decision-making, particularly regarding antibiotic use in dentistry, underscoring the need for robust evidence-based protocols. In a multi-institutional study among Malaysian dental students, Rath et al.[2] found moderate levels of EBP knowledge but significant gaps in confidence and application. Similarly, Gowdar et al.[3] reported that many Saudi practitioners lacked a comprehensive understanding of EBP, despite favorable attitudes. In Bhopal, India, Gupta et al.[4] revealed that practicing dentists face barriers, such as time constraints and limited access to quality databases. The rise of teledentistry during COVID-19 further highlighted disparities in EBP knowledge, with many clinicians unsure how to apply evidence in digital formats.[5]
MATERIAL AND METHODS
A cross-sectional questionnaire-based study was conducted among dental and oral and maxillofacial surgery (OMFS) professionals and postgraduate students across selected institutions. The study aimed to assess their knowledge, attitude, and practices (KAP) regarding evidence-based practice (EBP). A structured, pre-validated questionnaire was developed based on previously published studies.[2,3,4] The tool comprised four sections: demographic data, knowledge-based multiple-choice questions, Likert-scale attitude statements, and practice-related queries on frequency and application of EBP in clinical settings.
The questionnaire was distributed electronically using Google Forms and printed copies where necessary. Informed consent was obtained from all participants. Confidentiality and anonymity were ensured. Inclusion criteria encompassed licensed dental and OMFS practitioners, postgraduates, and interns actively involved in patient care. Respondents with incomplete submissions were excluded.
Data were analyzed using SPSS version 26.
RESULTS
A total of 2,634 responses were recorded from participants across 31 Indian states and union territories. The highest participation came from Karnataka (11.28%), followed by Kerala (8.06%), Tamil Nadu (7.83%), and Maharashtra (7.37%). States, like Andhra Pradesh (7.32%) and Delhi (7.19%), also showed high engagement. Minimal responses were received from Chandigarh, Meghalaya, and Manipur (each contributing less than 0.5% of total responses) [Table 1].
Table 1.
Demographic data (state-wise participation in EBP survey)
| State/UT | EBP | % | ||
|---|---|---|---|---|
| Andhra Pradesh | 193 | 7.32 | ||
| Arunachal Pradesh | 23 | 0.87 | ||
| Assam | 14 | 0.53 | ||
| Bihar | 110 | 4.17 | ||
| Chhattisgarh | 24 | 0.91 | ||
| Delhi | 189 | 7.19 | ||
| Chandigarh | 11 | 0.41 | ||
| Goa | 12 | 0.45 | ||
| Gujarat | 134 | 5.13 | ||
| Haryana | 165 | 6.26 | ||
| Himachal Pradesh | 22 | 0.83 | ||
| Jammu and Kashmir | 19 | 0.72 | ||
| Jharkhand | 21 | 0.79 | ||
| Karnataka | 297 | 11.28 | ||
| Kerala | 212 | 8.06 | ||
| Madhya Pradesh | 123 | 4.67 | ||
| Maharashtra | 194 | 7.37 | ||
| Manipur | 13 | 0.49 | ||
| Meghalaya | 11 | 0.41 | ||
| Nagaland | 14 | 0.53 | ||
| Orissa | 24 | 0.91 | ||
| Punjab | 87 | 3.3 | ||
| Rajasthan | 73 | 2.77 | ||
| Sikkim | 23 | 0.87 | ||
| Puducherry | 21 | 0.79 | ||
| Tamil Nadu | 206 | 7.83 | ||
| Telangana | 168 | 6.38 | ||
| Tripura | 12 | 0.45 | ||
| Uttar Pradesh | 134 | 5.09 | ||
| Uttarakhand | 43 | 1.63 | ||
| West Bengal | 42 | 1.59 | ||
| Total | 2634 | 100.00 |
The majority of respondents (87.93%) were familiar with the term Evidence-Based Practice. About 66.32% could locate systematic reviews or research articles for clinical decision-making. Regarding the perceived impact of EBP, nearly 48% strongly agreed and 10% agreed that using evidence improves patient outcomes. More than half of the participants (57.06%) stated they refer to online resources before procedures, and 55.73% regularly discuss evidence-based options with patients. A significant portion (84.25%) also agreed or strongly agreed that EBP should be a core part of clinical decision-making [Table 2].
Table 2.
Responses to KAP questionnaire on evidence based practice (EBP) in dentistry and OMFS (n=2634)
| Parameter | Response | n | % | |||
|---|---|---|---|---|---|---|
| Familiar with the term evidence-based practice | Yes | 2316 | 87.93 | |||
| No | 318 | 12.07 | ||||
| Know how to find research articles/systematic reviews (PubMed/Cochrane) | Yes | 1747 | 66.32 | |||
| No | 887 | 33.68 | ||||
| Believe that research improves patient care outcomes | Strongly disagree | 714 | 27.11 | |||
| Disagree | 397 | 15.06 | ||||
| Agree | 261 | 9.92 | ||||
| Strongly agree | 1262 | 47.91 | ||||
| EBP should be part of daily clinical decisions | Strongly disagree | 258 | 9.79 | |||
| Disagree | 157 | 5.96 | ||||
| Agree | 879 | 33.37 | ||||
| Strongly agree | 1340 | 50.88 | ||||
| Refer to online research/guidelines before procedures | Yes | 1503 | 57.06 | |||
| No | 1131 | 42.94 | ||||
| Discuss evidence-based options with patients | Yes | 1468 | 55.73 | |||
| No | 1166 | 44.27 |
DISCUSSION
The present study offers a comprehensive evaluation of knowledge, attitudes, and practices (KAP) regarding evidence-based practice (EBP) among dental and OMFS professionals across India. An encouraging 87.93% of respondents reported familiarity with the term EBP, which resonates with previous findings where the majority of dental professionals acknowledged the concept, albeit with inconsistent application.[2,3] Awareness of research tools, such as PubMed and Cochrane, was also notable (66.32%), suggesting a growing trend toward evidence-informed clinical decisions.
However, only 57.06% routinely consulted research articles prior to procedures, and 55.73% discussed evidence-based options with patients. This gap between knowledge and practice is consistent with other studies where knowledge was high, but application remained limited due to practical constraints.[3,4] In a cross-sectional survey among Bhopal dentists, barriers, like time constraints, insufficient training, and limited access to quality databases, were prominent, all of which were reflected in the current study as well.[4]
Attitudinally, more than 84% of participants agreed that EBP should be central to clinical decision-making. This aligns with literature indicating that while the intent to use EBP is strong, structural and institutional barriers often limit implementation.[1,5] Moreover, studies among Malaysian and Saudi dental students have shown that while attitudes toward EBP are positive, actual confidence and execution remain moderate to poor.[2,3]
CONCLUSION
This nationwide KAP study highlights that while attitudes toward EBP in dentistry and OMFS are overwhelmingly positive, practical application remains suboptimal due to systemic barriers. Formal training, accessible databases, and curricular integration can improve evidence-based practices across all levels of dental care.
Conflict of interest
There are no conflicts of interest.
Funding Statement
Nil.
REFERENCES
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