|Year : 2021 | Volume
| Issue : 5 | Page : 846-850
Knowledge, awareness, and attitude among practicing orthodontist on teledentistry during COVID pandemic in Kerala: A cross-sectional survey
Pradeep Philip George1, Terry Thomas Edathotty2, S Gopikrishnan1, PS Prasanth3, Sandeep Mathew4, AA Mohammed Ameen5
1 Professor, Department of Orthodontics, Annoor Dental College, Muvattupuzha, Kerala, India
2 Reader, Department of Orthodontics, Mar Baselious Dental College, Kothamangalam, Kerala, India
3 Professor, Department of Orthodontics, Indira Gandhi Institute of Dental Sciences, Kothamangalam, Kerala, India
4 Professor, Department of Orthodontics, Al Azhar Dental College, Thodupuzha, Kerala, India
5 Assistant Professor, Department of Orthodontics, Al Azhar Dental College, Thodupuzha, Kerala, India
|Date of Submission||16-Dec-2020|
|Date of Decision||28-Dec-2020|
|Date of Acceptance||11-Jan-2021|
|Date of Web Publication||05-Jun-2021|
Pradeep Philip George
Department of Orthodontics, Annoor Dental College, Muvattupuzha, Kerala
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Considering the gravity of coronavirus disease 2019 (COVID-19) and its potential to unfold within the dental workplace or institutions, a shift from traditional dental practice to a newer method is needed. Teledentistry is widely being practiced in this pandemic era for the diagnosis and to give instructions to the patients. Hence, an attempt has been made to explore the knowledge, attitude, and awareness of practicing orthodontists regarding the usage of teledentistry during COVID lockdown, in Kerala. Materials and Methods: A cross-sectional, descriptive study was done on about 150 orthodontic professionals. A pretested, self-organized, close-ended survey was managed through online stages that comprised of 15 questions. The information gathered was assembled in a systematic way and investigated regarding recurrence and Chi-square test was utilized for the examination of frequencies. Results: It was observed that 93.3% orthodontic practitioners had knowledge regarding teledentistry and a positive attitude toward teledentistry was shown by younger age group practitioners and those who were working in institutions (P < 0.05). 77.3% believed that teledentistry can save dentist's time and 71.3% responded that the new technology can be helpful in reducing the cost of treatment for patients. Conclusion: The knowledge, awareness, and attitudes were discovered to be acceptable among the orthodontic practitioners. Younger practitioners had more positive attitude toward teledentistry, and there was an overall positive attitude for using teledentistry as a temporary alternate for direct patient contact in COVID-19 pandemic time.
Keywords: Awareness, COVID 19, knowledge, orthodontists, teledentistry
|How to cite this article:|
George PP, Edathotty TT, Gopikrishnan S, Prasanth P S, Mathew S, Mohammed Ameen A A. Knowledge, awareness, and attitude among practicing orthodontist on teledentistry during COVID pandemic in Kerala: A cross-sectional survey. J Pharm Bioall Sci 2021;13, Suppl S1:846-50
|How to cite this URL:|
George PP, Edathotty TT, Gopikrishnan S, Prasanth P S, Mathew S, Mohammed Ameen A A. Knowledge, awareness, and attitude among practicing orthodontist on teledentistry during COVID pandemic in Kerala: A cross-sectional survey. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Jun 29];13, Suppl S1:846-50. Available from: https://www.jpbsonline.org/text.asp?2021/13/5/846/317710
| Introduction|| |
Coronavirus disease 2019 (COVID-19) is a contagion caused by severe acute respiratory syndrome coronavirus which affects largely the vulnerable population together with older folks with compromised immunity and comorbidities such as coronary heart diseases, diabetes mellitus, and hypertension. It is transmitted through oral or nasal secretions once an infected individual sneezes or coughs. The pandemic eruption of (COVID-19) has become a major public health burden globally. Considering the gravity of COVID-19 and its potential to unfold within the dental workplace or institutions, a shift from traditional dental practice to a newer method is needed.
Teledentistry is a field that has arisen with the beginning of data technology. It is outlined as “the phase of the science of telemedicine involved with dentistry that deals with the whole method of networking, sharing digital information, distant consultations, workup, and analysis.” Teledentistry uses two approaches: Real-time and store-and-forward strategies. Real-time consultation includes a videoconference during which dental experts and their patients, at entirely unexpected areas, may see, hear, and speak with one another really utilizing progressed data innovation and super high transfer speed network communications.,, Store-and-forward alludes to the social affair and secure transmission of encoded data along with understanding reports and pictures (intraoral photographs, radiographs, and extraoral photographs) which are used for review by the dental professional or expert sometime in the not too distant future for discussion and treatment designing.,,,
In India, there is no documented information on teledentistry per se from any of the 29 states, six union territories and one national capital region. Three states are specifically operating within the field of teleconsultation, of which Maharashtra has implemented teleconsultation for dental-related issues as well. In Kerala state, The “Tele-Oncology Network” was the primary telemedicine service developed for early detection, follow-up, and pain relief for cancer patients from the rural areas. There is moderately less independent foundations for teledentistry. As of now, these administrations work underneath the umbrella of telemedicine services in Bharat.
Teledentistry tools can be used for remote specialist superintendence of orthodontic treatments and interventions undertaken by native dentists, and studies have proven that it is a helpful approach. While there is no chance for face-to-face consultations, professionals and patients have the opportunity to use technology to supply and receive virtual help, using photo, video, or video call applications, thereby permitting the orthodontist to judge the requirement to be seen at dental workplace., Hence, an attempt has been made to explore the knowledge, attitude, and awareness of practicing orthodontists regarding the usage of teledentistry during COVID lockdown in South Kerala.
- To assess the knowledge, awareness, and attitudes of orthodontic practitioners on using teledentistry in COVID pandemic time.
| Methodology|| |
| Study design and study population|| |
The current investigation is a clear cross-sectional survey. A pretested, self-directed, close-ended questionnaire comprising of 15 inquiries were incorporated to assess knowledge, attitudes, and awareness among the orthodontic practitioners. A structured online questionnaire along with informed consent was prepared and sent through social media platforms to practicing orthodontist. The study population comprised of 150 practicing orthodontist in Kerala.
Inclusion and exclusion criteria
All the practicing orthodontists willing to participate in the study were considered in the inclusion criteria. The exclusion criteria included were orthodontists who are not practicing and who were above 60 years.
Pilot study and pretesting of the questionnaire
The pilot study was directed among 10 orthodontic practitioners to decide the attainability of the investigation. Cronbach's coefficient was discovered to be 0.79 which implies an adequate inside unwavering quality of the survey. For testing the legitimacy, the substance legitimacy proportion was likewise determined by utilizing item-rated content validity indices. This was accomplished by taking the responses on the dichotomous scales where the academician showed whether a thing is favorable (score of +1) or unfavorable (score of 0). The content legitimacy proportion was discovered to be as 0.86 by the board of four academicians. Furthermore, there were no progressions needed in the survey because of pretest.
Ethical approval and informed consent
The protocol for the survey was approved by the Institutional Review Board, and ethical approval was obtained. An online consent form was also obtained from all the participants.
Data collection and analysis
The questionnaire was distributed through online portal. The questionnaire comprised of two parts which includes a first part which consists of sociodemographic details and the second part consists of questions to assess the knowledge, awareness, and attitudes of clinical practitioners on using teledentistry in COVID pandemic time. The study was conducted between the time period of May 2020 and July 2020. The data were assembled, organized, and arranged in a systematic manner and analyzed in terms of frequencies (yes/no), and Chi-square test was used for inferential statistics. Statistical analysis was done using the SPSS software version 17.0 (SPSS Inc., Chicago, IL, USA).
| Results|| |
A total of 150 participants participated in the study. 42.6% participants were below 35 years of age, 38.6% between 35 and 45 years of age, and 18.6% was above 45 years of age. There were 108 males and 42 female orthodontists in the study. Majority of the participants were sole clinical practitioners (68.6%) and not into academics [Table 1].
93.3% heard of teledentistry while 82% felt that orthodontic diagnosis can be done through teledentistry. 83.3% think that the patient can share their radiographs digitally for diagnostic purpose. More than 50% responded positively for giving instructions for fixed and removable orthodontic appliance through teledentistry. 69.3% patients were willing to practice teledentistry in future also [Table 2].
|Table 2: Responses in knowledge, awareness, and attitude-related questions|
Click here to view
43.5% participants who responded positively were of the age group of 25–35 years. There was a statistically significant association between knowledge question with age group, P < 0.032 and mode of practice [Table 3]. There was no significant relation with knowledge question and gender.
|Table 3: Association of knowledge and attitude-related question with baseline parameters|
Click here to view
48.07% participants of age group of 25–35 years responded positively, whereas 43.47% responded negatively to the question “in the future, will you practice teledentistry?” There was a statistically significant relation between this question with age group P < 0.002 and mode of practice P < 0.014 [Table 3].
| Discussion|| |
In the present study, the knowledge and awareness regarding teledentistry was assessed among 150 orthodontic practitioners. 93.3% of the study participants were aware about teledentistry. A similar study by Pradhan et al. on postgraduate students showed that there were 96.1% participants who were aware of teledentistry. Knowledge level about the teledentistry approach was higher among younger practitioners than experienced practitioners in our present study and was statistically significant. Teledentistry is an ongoing origination and requires contraptions, for example, cell phones and media, which is clearly utilized more by younger generation in contrast with the older folks.,,,
Ninety-two percent participants had a positive attitude toward this method and believed it to be a decent apparatus for oral hygiene training in orthodontic patients. In addition, 71.3% respondents believed that teledentistry helps in reducing costs for the dental practices. A study done in Bristol highlighted that there is a significant reduction in travel expenses for dental treatment with the usage of teledentistry.,
Most of the responses for consultation regarding instructions for patients on the usage and maintenance of removable and fixed orthodontic treatment were positive. 75.3% positively responded for the question “does teledentistry help to monitor the fixed or removable orthodontic appliance?” 63.3% responded on “teledentistry be used to instruct patient to activate removable orthodontic appliance? (expansion screw and Hawley appliance).” A low percentage of positive response was observed when it came to fixed orthodontic treatment and myofunctional appliances compared to the removable orthodontic appliance. Fifty-eight percent of the participants felt that teledentistry can be used to instruct patient to replace removable components (elastics) in fixed orthodontic treatment and 54.6% believed that teledentistry can be used to give instructions to help them fix a broken or damaged orthodontic appliance. A study by Saccomanno et al. on instructions for activation of expansion screw and monitoring of aligners showed a positive result and were considered time saving and economical for both dentists and patients.
Is significant on the grounds that clinical dynamic through electronic methods may fall beneath set up principles of care dental assessments through PCs and intraoral camera when contrasted with the customary office setting.
The validity of telemedicine significant on the grounds that clinical dynamic through electronic methods may fall beneath set up principles of care. Furthermore, there is a lack of research investigating the validity of telemedicine applications., Only half of the population in our present study had doubt about the accuracy of the dental assessments through PCs and intraoral camera when contrasted with the customary office setting.
There was a statistically significant association between attitude with the age of the respondents and mode of practice. Positive attitude was seen in the practitioners of younger age group and in those who were working in teaching institutions. As mentioned before this may be due to an increased usage of electronic gadgets by younger practitioners.
Although there are many merits associated with the usage of teledentistry, certain disadvantages do exist. It is a tedious procedure to ensure data security, collection, and storage. For instance, information encryption, password protection, and client access logs can help in preventing the greater part of individuals and in ensuring quiet privacy. Dental specialists should know about the legitimate necessities in their conditions of training and stay cautious about the parliamentary changes in this quickly creating field.
In spite of receiving all the feasible strides to decrease predisposition, the investigation was as yet helpless to certain impediments. The significant impediment was brief length for information assortment which might have brought about more modest than anticipated example. Utilizing online media for information assortment would have wiped out the experts who were inexperienced with web-based media or the individuals who were caught up with dealing with individual issues. A few states or areas the nation over were more influenced than others which may impact the organization and medical care preventive estimates actualized by a specific state that could impact the result of the study.
| Conclusion|| |
The knowledge, awareness, and attitudes were discovered to be acceptable among the orthodontic practitioners. Younger practitioners had more positive attitude toward teledentistry, and there was an overall positive attitude for using teledentistry as a temporary alternate to avoid direct patient contact in COVID-19 pandemic time. There was no gender wise difference in knowledge, attitude, and awareness.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Shrivastava R, Mishra N, Shrivastava R, Sharma R. Epidemiology of dental health: A guidance to manage dental problems in novel coronavirus (COVID-19) pandemic outbreak in India. Int J Oral Health Dent 2020;6:122-5.
Mathews MA, Kathavate RN, Tewary S, Pawashe K. Teledentistry: A new frontier. Int J Oral Care Res 2015;3:52-7.
Mihailovic B, Miladinovic M, Vujicic B. Telemedicine in dentistry (teledentistry). In: Graschew G, Roelofs TA, editors. Advances in Telemedicine: Applications in Various Medical Disciplines and Geographical Areas 2011. Rijeka (Croatia): InTech; 2011. p. 215-30.
Kumar S. Teledentistry. Switzerland: Springer Publications; 2015.
Sanjeev M, Shushant GK. Teledentistry: A new trend in oral health. Int J Clin Cases Investig 2011;2:49-53.
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.
Bhambal A, Saxena S, Balsaraf SV. Teledentistry: Potentials unexplored. J Int Oral Health 2010;2:1-6.
Sudhamony S, Nandakumar K, Binu PJ, Niwas SI. Telemedicine and tele-health services for cancer-care delivery in India. IET Commun 2008;2:231-6.
Berndt J, Leone P, King G. Using teledentistry to provide interceptive orthodontic services to disadvantaged children. Am J Orthod Dentofacial Orthop 2008;134:700-6.
Mishra SK, Kapoor L, Singh IP. Telemedicine in India: Present and future. Telemed Health 2009;15:568-75.
Suri S, Vandersluis YR, Kochhar AS, Bhasin R, Abdallah MN. Clinical orthodontic management during the COVID-19 pandemic. Angle Orthod 2020;90:473-84.
Martina S, Amato A, Rongo R, Caggiano M, Amato M. The perception of COVID-19 among Italian dentists: An orthodontic point of view. Int J Environ Res Public Health 2020;17:4384.
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.
Cooper BR, Engeswick LM. Knowledge, attitudes, and confidence levels of dental hygiene students regarding teledentistry: A pilot study. Internet J Allied Health Sci Pract 2007;5:1-4.
Purohit BM, Singh A, Dwivedi A. Utilization of teledentistry as a tool to screen for dental caries among 12-year-old school children in a rural region of India. J Public Health Dent 2017;77:174-80.
Tomar D, Menon I, Tyagi U, Singh A, Goyal J, Singh RP, et al
. Assessment of awareness about teledentistry among dentists in a private dental college of Muradnagar, Ghaziabad. J Dent Spec 2018;6:8-12.
Murererehe J, Uwambaye1 P, Isyagi M, Nyandwi T, Njunwa K. Knowledge, attitude and practices of dental professionals in Rwanda towards the benefits and applications of teledentistry. Med Health Sci 2017;4:39-47.
Cook J, Austen G, Stephens C. Videoconferencing: what are the benefits for dental practice? Br Dent J 2000;188:67-70.
Ata SO, Ozkan S. Information Technology in Oral Health Care: attitudes of Dental Professionals on the Use of Teledentistry in Turkey. European and Mediterranean Conference on Information Systems. [Last accessed 2020 Nov 20]. Available from: http://www.sid.ir/fa/VEWSSID/Jpdf/61613930110.pdf
Saccomanno S, Quinzi V, Sarhan S, Laganà D, Marzo G. Perspectives of tele-orthodontics in the COVID-19 emergency and as a future tool in daily practice. Eur J Paediatr Dent 2020;21:157-62.
Jerrold L. Litigation, legislation and ethics. The problem, electronic data transmission and the law. Am J Orthod Dentofacial Orthop 1998;113:175-8.
Wallace S, Wyatt J, Taylor P. Telemedicine in the NHS for the millennium and beyond. Postgrad Med J 1998;74:721-8.
[Table 1], [Table 2], [Table 3]