LASERS RELATED KNOWLEDGE AND PRACTICES OF DENTISTS IN RIYADH CITY: A SURVEY-BASED STUDY
Meshari Abdulaziz AlHumaidi1*, Sultan Lafi AlJahdali1, Mohammed Khalid Mohammed AlGab1, Abdullah Ali Alrizqi1, Abdullah Nawaf AlShammeri1, Abdulaziz Abdullah AlQarni1
1 Internship Training Department, Faculty of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia. [email protected]
ABSTRACT
Use of lasers in health profession is not new as it dates back more than 100 years when this technology was first tested by Planck in 1900. Since then, there is no looking back, with these advancements being used in various sectors of health. The present study is a cross-sectional one, that utilized a close-ended questionnaire. The target of this study is the dental professionals of Riyadh city; hence, all dentists with the tendency to participate were required to complete the questionnaire.
After comparison of the responses based on designation, it was indicated that 47% of general practitioners were unsatisfied with their level of knowledge (p-value: 0.023), use of lasers increased with designations (p-value: 0.008), and 55% of consultants believed that not using anesthesia is one of the important reasons to use lasers (p-value: 0.007). Rest of the questions did not result in any significant comparison. Overall knowledge of dental practitioners on laser use was found to be on the lower side.
Key words: Knowledge, Dental professionals, Lasers, Dentistry, Practices.
Introduction
Use of lasers in health profession is not new as it dates back more than 100 years when this technology was first tested by Planck in 1900. Since then, there is no looking back, with these advancements being used in various sectors of health. These include removal of kidney stones in 1960s, tumor ablation, and for the treatment of benign prostate hyperplasia [1, 2].
Dentistry is evolving with the increased incorporation of lasers in this field, with dental specialties such as restorative, endodontics implantology, periodontics and pediatrics being benefited mainly [3]. Several investigations in different parts of the world have been conducted in order to acquire the level of awareness and perception of dentists as far as the application of lasers is concerned. Adequate amount of knowledge was observed among the Indian dental professionals when inquired about the use of various types of lasers and they supported its use in several dental procedures. However, there was a significant difference in the knowledge level among low and high experienced dentists and an overall need of improved training was demanded by some of these study participants [4, 5]. On the other hand, the attitude of Iranian dentists was found to be mixed, as they were more inclined towards the traditional procedures as compared to laser technology [6].
A few other studies have been done to assess the knowledge of dental professionals regarding specific dental procedures. It was noted in one of these studies that the dental professionals although being highly aware of laser use, showed lower level of attitude towards the use in endodontics. It is now a documented fact that the use of lasers in disinfecting root canals using laser photodynamic therapy is found to be affective [7, 8]. Finally, Brazilian dentists have also supported the efficiency of dental lasers used in detecting caries. Although the use of these measures is restricted to trained dental professionals only, the readiness of these dentists seem to be on the positive side [9].
Study hypotheses
Dentists in Riyadh have a limited exposure to dental lasers and their knowledge is inadequate as well.
Aims of the study
Materials and Methods
Study design
The present study is a cross-sectional one, that applied a close-ended questionnaire.
Questionnaire design
The researchers constructed the questionnaire online by Google forms. The questionnaire started with questions about demographics, such as gender, educational level, professional designation etc. Moreover, about knowledge level of dental lasers questions were asked, that included various kinds of lasers and their clinical uses, factors influencing using or not using lasers in dental procedures etc.
Research sample
The target of this study is the dental professionals of Riyadh city; hence, all dentists with the tendency to participate were required to complete the questionnaire. Totally, 500 Riyadh dentists were aimed to be involved in the present research. The survey was mainly sent by online communication such as social media.
Validity and reliability of questionnaire
The experts in research, that included a few faculty members of REU received the questionnaire to confirm its validity. Considering the reliability, a pilot study was performed using 20 online questionnaires completed haphazardly by university students. Cronbach’s coefficient alpha in the Statistical Package for Social Sciences (SPSS) version 19 was used to test the reliability.
Statistical analysis
After collection, the data was transferred to SPSS version 19 from Google sheets, where inferential as well as descriptive statistics were carried out. With the significance value kept under 0.05, comparisons were made between the groups .
Results and Discussion
A total of 344 participants filled up the online survey. Grouping of the participants was done based on their gender, which indicated that 62% (n=214) were males and 38% (n=130) were females (Figure 1). The participants were also grouped on the basis of their designation, which demonstrated that 68% (n=233) are general practitioners, 29% (n=100) are specialists and 3% (n=10) are consultants (Figure 2). Grouping of the participants was also performed based on their experience, which showed that 78% (n=266) have 1-3 years of experience, 16% (n=54) have 4-6 years of experience, 5% (n=16) have 7-10 years of experience and 2% (n=13) have more than 10 years of experience (Figure 3). Table 1 shows the comparison on the basis of gender, Table 2 compares the specialties and Table 3 the work experience.
Validity and reliability of the questionnaire
According to the experts in REU, we made minor changes to our questionnaire before we distributed it to the study participants. As far as the reliability is concerned, we performed Cronbach’s coefficient alpha in SPSS and the value retrieved was 0.80, which is acceptable to carry out the data collection after pilot study.
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Figure 1. Distribution of Study Participants on the Basis of Gender |
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Figure 2. Distribution of Study Participants on the Basis of Designation |
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Figure 3. Distribution of Study Participants on the Basis of Work Experience |
Table 1. Comparing the Research Participants Based on Gender
Item |
Male |
Female |
P- Value |
How do you rate your overall knowledge about dental lasers? |
Highly Unsatisfactory 17%
Unsatisfactory 41%
Neutral 32%
Satisfactory 7%
Highly Satisfactory 3% |
Highly Unsatisfactory 11%
Unsatisfactory 76%
Neutral 27%
Satisfactory 7%
Highly Satisfactory 2% |
0.217 |
Have you been using dental lasers in your practice? |
Never Used 80%
Occasionally Used 14%
Very Commonly Used 6% |
Never Used 82%
Occasionally Used 15%
Very Commonly Used 3% |
0.337 |
Have you received proper training to use dental lasers? |
Yes 15% |
Yes 5% |
0.009 |
Are you aware of the functions of different types of lasers? |
Highly Unaware 15%
Unaware 43%
Neutral 30%
Aware 11%
Highly Aware 1% |
Highly Unaware 11%
Unaware 54%
Neutral 26%
Aware 7%
Highly Aware 2% |
0.200 |
Which laser can be used for soft tissues? |
GAALAS (Diode) 40%
Excimer 17%
Ruby 16%
Argon 17%
HO: YAG 10% |
GAALAS (Diode) 45%
Excimer 7%
Ruby 16%
Argon 15%
HO: YAG 16% |
0.048 |
Which laser can be used for hard tissues? |
GAALAS (Diode) 34%
Excimer 18%
Erbium 6%
Argon 20%
Nd: YAG 22% |
GAALAS (Diode) 29%
Excimer 19%
Erbium 6%
Argon 26%
Nd: YAG 20% |
0.764 |
Lasers can remove caries better and conservatively than hand piece. |
Strongly Disagree 10%
Disagree 12%
Neutral 20%
Agree 53%
Strongly Agree 5% |
Strongly Disagree 3%
Disagree 12%
Neutral 18%
Agree 64%
Strongly Agree 3% |
0.104 |
Lasers can be used as endodontic irrigation better than conventional methods. |
Strongly Disagree 12%
Disagree 60%
Neutral 15%
Agree 11%
Strongly Agree 2% |
Strongly Disagree 4%
Disagree 65%
Neutral 21%
Agree 9%
Strongly Agree 1% |
0.061 |
Which of the following is a BEST REASON TO USE laser in dentistry? |
Minimally Invasive 56%
Not Harmful for Surrounding Tissues 23%
No anesthesia Needed 21% |
Minimally Invasive 46%
Not Harmful for Surrounding Tissues 21%
No anesthesia Needed 33% |
0.053 |
Which of the following is the REASON NOT TO USE laser in dentistry? |
Not Enough Information 29%
Procedure is Time Consuming 9%
Expensive 62% |
Not Enough Information 16%
Procedure is Time Consuming 8%
Expensive 76% |
0.020 |
Are you interested in receiving proper training of dental lasers? |
Definitely, Yes 47%
May Be 51%
Definitely, No 2% |
Definitely, Yes 49%
May Be 49%
Definitely, No 2% |
0.893 |
Table 2. Comparing the Research Participants based on Specialty
Item |
General Practitioner |
Specialist |
Consultant |
P- Value |
How do you rate your overall knowledge about dental lasers? |
Highly Unsatisfactory 15%
Unsatisfactory 47%
Neutral 30%
Satisfactory 6%
Highly Satisfactory 2% |
Highly Unsatisfactory 17%
Unsatisfactory 42%
Neutral 29%
Satisfactory 9%
Highly Satisfactory 3% |
Highly Unsatisfactory 0%
Unsatisfactory 30%
Neutral 50%
Satisfactory 0%
Highly Satisfactory 2% |
0.023 |
Have you been using dental lasers in your practice? |
Never Used 86%
Occasionally Used 10%
Very Commonly Used 4% |
Never Used 70%
Occasionally Used 25%
Very Commonly Used 5% |
Never Used 80%
Occasionally Used 20%
Very Commonly Used 0% |
0.008 |
Have you received proper training to use dental lasers? |
Yes 9% |
Yes 18% |
Yes 10% |
0.068 |
Are you aware of the functions of different types of lasers? |
Highly Unaware 14%
Unaware 49%
Neutral 28%
Aware 8%
Highly Aware 1% |
Highly Unaware 13%
Unaware 43%
Neutral 27%
Aware 13%
Highly Aware 4% |
Highly Unaware 10%
Unaware 30%
Neutral 50%
Aware 10%
Highly Aware 0% |
0.520 |
Which laser can be used for soft tissues? |
GAALAS (Diode) 45%
Excimer 13%
Ruby 15%
Argon 15%
HO: YAG 14% |
GAALAS (Diode) 35%
Excimer 15%
Ruby 20%
Argon 19%
HO: YAG 11% |
GAALAS (Diode) 60%
Excimer 0%
Ruby 10%
Argon 30%
HO: YAG 0% |
0.372 |
Which laser can be used for hard tissues? |
GAALAS (Diode) 34%
Excimer 15%
Erbium 6%
Argon 21%
Nd: YAG 24% |
GAALAS (Diode) 28%
Excimer 25%
Erbium 7%
Argon 24%
Nd: YAG 16% |
GAALAS (Diode) 30%
Excimer 20%
Erbium 0%
Argon 50%
Nd: YAG 0% |
0.104 |
Lasers can remove caries better and conservatively than hand piece. |
Strongly Disagree 8%
Disagree 11%
Neutral 18%
Agree 59%
Strongly Agree 4% |
Strongly Disagree 7%
Disagree 14%
Neutral 25%
Agree 49%
Strongly Agree 5% |
Strongly Disagree 0%
Disagree 10%
Neutral 0%
Agree 90%
Strongly Agree 0% |
0.351 |
Lasers can be used as endodontic irrigation better than conventional methods. |
Strongly Disagree 10%
Disagree 63%
Neutral 18%
Agree 9%
Strongly Agree 1% |
Strongly Disagree 8%
Disagree 61%
Neutral 17%
Agree 11%
Strongly Agree 3% |
Strongly Disagree 10%
Disagree 40%
Neutral 20%
Agree 30%
Strongly Agree 0% |
0.474 |
Which of the following is a BEST REASON TO USE laser in dentistry? |
Minimally Invasive 53%
Not Harmful for Surrounding Tissues 20%
No anesthesia Needed 27% |
Minimally Invasive 55%
Not Harmful for Surrounding Tissues 27%
No anesthesia Needed 18% |
Minimally Invasive 0%
Not Harmful for Surrounding Tissues 45%
No anesthesia Needed 55% |
0.007 |
Which of the following is the REASON NOT TO USE laser in dentistry? |
Not Enough Information 23%
Procedure is Time Consuming 7%
Expensive 70% |
Not Enough Information 27%
Procedure is Time Consuming 12%
Expensive 61% |
Not Enough Information 10%
Procedure is Time Consuming 10%
Expensive 80% |
0.322 |
Are you interested in receiving proper training of dental lasers? |
Definitely, Yes 52%
May Be 47%
Definitely, No 1% |
Definitely, Yes 40%
May Be 58%
Definitely, No 2% |
Definitely, Yes 40%
May Be 50%
Definitely, No 10% |
0.135 |
Table 3. Comparing the Research Participants based on Years of Experience
Item |
1-3 Years |
4-6 Years |
7-10 Years |
10+ Years |
P- Value |
How do you rate your overall knowledge about dental lasers? |
Highly Unsatisfactory 18%
Unsatisfactory 49%
Neutral 26%
Satisfactory 5%
Highly Satisfactory 2% |
Highly Unsatisfactory 4%
Unsatisfactory 39%
Neutral 46%
Satisfactory 9%
Highly Satisfactory 2% |
Highly Unsatisfactory 13%
Unsatisfactory 19%
Neutral 26%
Satisfactory 31%
Highly Satisfactory 13% |
Highly Unsatisfactory 0%
Unsatisfactory 0%
Neutral 56%
Satisfactory 14%
Highly Satisfactory 30% |
0.000 |
Have you been using dental lasers in your practice? |
Never Used 88%
Occasionally Used 9%
Very Commonly Used 3% |
Never Used 60%
Occasionally Used 34%
Very Commonly Used 6% |
Never Used 56%
Occasionally Used 25%
Very Commonly Used 19% |
Never Used 30%
Occasionally Used 70%
Very Commonly Used 0% |
0.000 |
Have you received proper training to use dental lasers? |
Yes 8% |
Yes 19% |
Yes 38% |
Yes 33% |
0.000 |
Are you aware of the functions of different types of lasers? |
Highly Unaware 15%
Unaware 52%
Neutral 25%
Aware 7%
Highly Aware 1% |
Highly Unaware 8%
Unaware 38%
Neutral 40%
Aware 12%
Highly Aware 4% |
Highly Unaware 6%
Unaware 18%
Neutral 36%
Aware 30%
Highly Aware 6% |
Highly Unaware 0%
Unaware 0%
Neutral 43%
Aware 43%
Highly Aware 14% |
0.000 |
Which laser can be used for soft tissues? |
GAALAS (Diode) 45%
Excimer 13%
Ruby 15%
Argon 17%
HO: YAG 13% |
GAALAS (Diode) 33%
Excimer 21%
Ruby 23%
Argon 15%
HO: YAG 8% |
GAALAS (Diode) 36%
Excimer 0%
Ruby 21%
Argon 7%
HO: YAG 36% |
GAALAS (Diode) 29%
Excimer 0%
Ruby 4%
Argon 58%
HO: YAG 14% |
0.014 |
Which laser can be used for hard tissues? |
GAALAS (Diode) 36%
Excimer 16%
Erbium 5%
Argon 21%
Nd: YAG 23% |
GAALAS (Diode) 25%
Excimer 25%
Erbium 6%
Argon 28%
Nd: YAG 16% |
GAALAS (Diode) 0%
Excimer 29%
Erbium 21%
Argon 43%
Nd: YAG 7% |
GAALAS (Diode) 0%
Excimer 33%
Erbium 33%
Argon 17%
Nd: YAG 17% |
0.003 |
Lasers can remove caries better and conservatively than hand piece. |
Strongly Disagree 8%
Disagree 11%
Neutral 18%
Agree 59%
Strongly Agree 4% |
Strongly Disagree 7%
Disagree 19%
Neutral 22%
Agree 48%
Strongly Agree 4% |
Strongly Disagree 6%
Disagree 12%
Neutral 31%
Agree 44%
Strongly Agree 6% |
Strongly Disagree 0%
Disagree 0%
Neutral 15%
Agree 70%
Strongly Agree 15% |
0.712 |
Lasers can be used as endodontic irrigation better than conventional methods. |
Strongly Disagree 8%
Disagree 67%
Neutral 16%
Agree 7%
Strongly Agree 1% |
Strongly Disagree 9%
Disagree 52%
Neutral 20%
Agree 19%
Strongly Agree 0% |
Strongly Disagree 25%
Disagree 25%
Neutral 25%
Agree 13%
Strongly Agree 12% |
Strongly Disagree 0%
Disagree 17%
Neutral 17%
Agree 66%
Strongly Agree 0% |
0.000 |
Which of the following is a BEST REASON TO USE laser in dentistry? |
Minimally Invasive 52%
Not Harmful for Surrounding Tissues 21%
No anesthesia Needed 27% |
Minimally Invasive 56%
Not Harmful for Surrounding Tissues 26%
No anesthesia Needed 18% |
Minimally Invasive 40%
Not Harmful for Surrounding Tissues 33%
No anesthesia Needed 27% |
Minimally Invasive 43%
Not Harmful for Surrounding Tissues 29%
No anesthesia Needed 29% |
0.723 |
Which of the following is the REASON NOT TO USE laser in dentistry? |
Not Enough Information 23%
Procedure is Time Consuming 5%
Expensive 72% |
Not Enough Information 26%
Procedure is Time Consuming 22%
Expensive 52% |
Not Enough Information 31%
Procedure is Time Consuming 13%
Expensive 56% |
Not Enough Information 14%
Procedure is Time Consuming 29%
Expensive 57% |
0.001 |
Are you interested in receiving proper training of dental lasers? |
Definitely, Yes 49%
May Be 50%
Definitely, No 1% |
Definitely, Yes 41%
May Be 56%
Definitely, No 3% |
Definitely, Yes 63%
May Be 32%
Definitely, No 5% |
Definitely, Yes 33%
May Be 67%
Definitely, No 0% |
0.426 |
The present research targeted to determine the knowledge and use of laser technology among dentists in Riyadh city. We divided the study population on the basis of gender, designation and work experience. As far as gender comparison was concerned, statistically significant differences were found when inquired about receiving proper training to use dental lasers (p-value: 0.009), type of laser used for soft tissues (p-value: 0.048) and reason for not using lasers in dentistry (p-value: 0.020). All other responses were not statistically significant; therefore, overall no association of gender with laser use and knowledge can be determined. Similar findings were reported by Al-Jobair (2014) who observed no statistically significant relationship between gender and laser-related knowledge [10].
Furthermore, 12% of the study participants reported that they received training for the use of dental lasers. A study conducted by Yadav et al. (2018) revealed that 21% of Indian dental practitioners had received laser treatment training [11]. Another investigation in Iran reported a small percentage of 3% dentists receiving training to use dental lasers [12].
After comparison of the responses based on designation, it was indicated that 47% of general practitioners were unsatisfied with their level of knowledge (p-value: 0.023), use of lasers increased with designations (p-value: 0.008) and 55% of consultants believed that not using anesthesia is one of the important reasons to use lasers (p-value: 0.007). Rest of the questions did not result in any significant comparison.
Finally, the work experience showed some significant differences when inquired about rating their own level of knowledge (p-value: 0.000), current usage of dental lasers (p-value: 0.000), receiving proper training (p-value: 0.000), being aware of different lasers (p-value: 0.000), lasers for soft tissues (p-value: 0.014), lasers for hard tissues (p-value: 0.003), lasers being used for endodontic treatment (p-value: 0.000) and reason for not using (p-value: 0.001). Varying responses were noted from dentists having less and high work experience.
There is a need to increase the sample size of this study, which is the limitation as well.
Conclusion
Acknowledgments: Authors of this study would like to acknowledge the support and cooperation of the research center of Riyadh Elm University.
Conflict of interest: None
Financial support: None
Ethics statement: None
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