Knowledge, awareness, and perception of digital dentistry among Egyptian dentists: a cross-sectional study

The digital revolution is changing the world, without the exception of the dental field. It is important for dentists to have a better understanding and knowledge about the new trend. This study aimed to address the lack of literature regarding dentists’ knowledge, awareness, and perception of digital dentistry in Egypt, this would give us better information to be able to direct continuous dental education in this important field effectively. The findings of our study revealed a substantial difference among participants across specializations, regions of practice, and institutions, so the null hypothesis can be rejected.

In addition to the increased precision and comfort associated with the use of digital dentistry for practitioners, patient satisfaction has been reported in several studies. A survey conducted in Italy on patients’ and parents’ acceptance of clear orthodontic aligner therapy, showed more improvement in the patient’s social and school lives, increased overall satisfaction, and less painful to wear than traditional interceptive orthodontics [22]. While, according to the finding of a clinical trial conducted in Turkey (2014), the digital impression technique was more efficient, with a shortening of the treatment time, and more accepted from the patient’s point of view than the conventional impression technique [3]. Similar findings were also revealed by a survey conducted in the United States by Saponaro PC et al. [23] among a group of experienced complete denture wearers who confirmed a positive satisfaction rating with their digitally fabricated complete dentures in comparison with traditionally fabricated ones. Increased patient satisfaction with digital dentistry results, direct practicing dentists to be more knowledgeable and start adopting this technology.

In a survey conducted by Ramesh Nayakar et al. [16] in India (2022), 96.7% of the study participants were aware of CAD/CAM technology in dentistry. These findings are in disagreement with the results of the current study where 47.3% and 64.2% of participants had Moderate knowledge and awareness respectively, while 75.9% of them had a high perception of practicing digital dentistry. This may be due to the fact that more than half of the study participants in the Indian study were postgraduate students or the difference in the dental curriculum between the two countries. Furthermore, females had considerably lower awareness and perception scores in the current study as compared to males, which may be due to male practitioners’ preference for fixed prosthodontics as a specialization, according to a study conducted among dental students in Egypt [24]. This is inconsistent with a study conducted in Saudi Arabia which found that females showed higher results with most of the knowledge, awareness, and perception questions about digital dentistry [18]. Mostly, the high level of knowledge among Saudi Arabia’s interns and postgraduate students in India may be attributed to the use of digital education in conjunction with accessibility, collaboration, and communication between instructors and students, which support the transfer of theoretical and practical knowledge.

In Egypt, dental care is provided by three main sectors: governmental, private, and academic healthcare facilities, with most of the dentists practicing in the governmental sector [20]. When comparing dental practitioners in these sectors, the findings of the present study concluded that governmental clinics participants had significantly lower awareness scores, while faculty teaching staff had significantly higher awareness when compared with those who had their main practice in private clinics. Which highlights a significant gap in continued professional training among the participants that may be explained by the more equipped nature of the academic dental facilities and continuous education available to the academic staff. This is consistent with the findings of Ramesh Nayakar et al. [16] study which also revealed that the teaching faculty showed a better understanding of digital technology compared to private practitioners. In comparison with participants taking the Great Cairo region as governorate of practice, Alexandria and Delta/Suez Canal had significantly lower knowledge scores, while regarding perception scores, only Delta/Suez Canal showed a significant difference. This may be related to the knowledge of the more prevalent digital labs and clinics distributed in Cairo than the rest of the governorates, but, the insignificance between Upper Egypt and Great Cairo is not justified. Furthermore, participants who were practicing in rural areas had significantly lower knowledge, awareness, and perception when compared with those who were practicing in urban areas. This may be explained by the finding that there is still a significant urban–rural digital gap in digital practices [25]. Additionally, this difference between rural and urban dentists may be because dentists practicing in rural areas are not interested in digital dentistry because of its biggest obstacle, which is the product’s massive price and the unaffordable cost for patients in these areas.

Hegedus, T et al. [26] conducted an online survey on participants from 20 different countries with the most considerable numbers being from Hungary, the United States, and the United Kingdom, he concluded that the majority of dental practitioners depended on digital dentistry to fabricate their prostheses, casts, surgical guides, and clear aligners. In our study when different specialties were compared with general practitioner dentists, prosthodontists showed the highest level of knowledge and awareness among the participants, which is expected as CAD-CAM technology are mostly studied in the prosthodontics curriculum, with its main application in fabricating crown, veneers, bridges, implant prosthetics, and removable dentures [4, 5]. However, the current uses of digital dentistry are not limited to the prosthodontics field as it infiltrated almost all other specialties and it’s expected for other dental specialists to be also well informed and knowledgeable about this important technology. The lowest scores were related to pedodontists and preventive dentists, respectively. This may be because the use of digital dentistry in their practices is still not as prevalent as in the rest of the specialties. However, it demonstrates a deficiency in digital dental technology education, which needs to be addressed by the incorporation of courses and workshops in pediatric postgraduate studies, as pediatric dentistry can benefit from digital technology in fabricating various types of prostheses or orthodontic appliances. These technologies can provide pediatric patients with the best dental care possible. In addition, it has the power to encourage pediatric patients and foster a cooperative, positive attitude and behavior toward the profession [27]. Contrary to the findings of the study conducted in Switzerland [28] which concluded that younger dentists were more into digitalization, as well as a survey conducted in the United States among AirForce general dentists in 2020 [29], the current study found no differences in the level of knowledge, awareness, or perception based on the participant’s age or level of experience. This may be explained by the insufficient shift in the curriculum to integrate digital dentistry courses in Egyptian dental schools.

The current study revealed that with continuous dental education, availability of equipment, and incorporation of modern digital dental education at both the undergraduate and postgraduate levels, the overall knowledge and awareness of the practicing dentist would be improved, which would positively influence the quality of care and level of satisfaction offered to the patients. This is evident by the higher levels of knowledge and awareness among prosthodontists, academic staff, and dentists practicing in the more equipped regions compared with their colleagues. Additionally, to provide dentists with the skills they need to give their patients the best care possible, it is essential to address the knowledge gaps that exist between dentists with different specializations and work environments. This can be done by creating educational programs that are tailored to the needs of the least knowledgeable groups, whether at dental faculties or government healthcare facilities.

Strength and limitations

The current study has some limitations. It’s based on an online survey which is known for its lower response rate than paper-based surveys [30]. Although we used an anonymous questionnaire, there is a possibility of response bias because of social desirability that may lead participants to overestimate their knowledge, awareness, or perception of digital dentistry. There is also a possibility of recall bias, as participants may have difficulty accurately recalling past experiences or levels of knowledge. In addition, participants were recruited using snowball sampling methods since this study was the first to be done to assess digital dentistry KAP among Egyptian dentists, also participation may be reluctant to the participant’s interest in the topic or the time they spend on social media. On the other hand, this is the first study to investigate the dentist’s knowledge in this important field. Also, the study sample included dentists from both genders, with varying levels of experience and working in different health sectors and governorates in Egypt. This paper should be considered a reference for future paper-based studies with larger sample sizes to confirm the findings of this study. Furthermore, future studies should aim to assess the current state of digital dentistry in Egypt including its adaptation in the diagnosis and treatments among dental practitioners, and the barriers they face using this technology.

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