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Research Article
Open Access Peer-reviewed

Awareness of Role of Dentist-Patient Co-operation in Attainment of Ideal Dental Treatment among Dental Interns at DUHS Karachi

Besalat Hussain , Fatima Mushtaq, Asma Saher Ansari
International Journal of Dental Sciences and Research. 2017, 5(5), 116-121. DOI: 10.12691/ijdsr-5-5-1
Published online: November 17, 2017

Abstract

Aims: The study aimed to evaluate the Awareness of role of Dentist-Patient Co-operation in attainment of ideal Dental treatment among Dental interns at DUHS Karachi, Pakistan. Background: Safe and effective treatment of all Dental diseases requires mutual understanding and sound cooperation between a Dentist and his/her Patient. Material and Method: A cross-sectional study was conducted in Dental department of DUHS Karachi. Study included Dental interns from different designations i.e. Post-graduates, Graduates, Under-graduates and different sub-departments i.e. Orthodontics, Endodontics, Periodontics, Community Dentistry, Oral medicine, Oral surgery etc. The research tool was a paper based Questionnaire designed by running a pilot study based on 14 Questions evaluating the core aim, with an attached consent form. The sample size was about 250 Dental interns. Descriptive and Association tests were used for statistical analysis using SPSS 16.0. Results: 250 Questionnaires were filled. Gender and Qualification were the variables. Gender vice 32% were Males and 68% were Females Dental interns. Qualification vice 20% were Post-graduates, 40% were Graduates and 40% were Under-graduates. According to 68% Dental interns patients of 26-35 year age group are most cooperative during Dental treatment. 74% Dental interns chosen 2-12 year age group as least cooperative during Dental treatment.90% Dental interns agreed that Patients proper cooperation during chair-side treatment always saves valuable clinic/OPD time. About 60% Dental interns agreed that cooperative Dentist should be flexible enough to mold his/her treatment plans according to Patient’s longing/desire. 70% Dental interns agreed that with follow up appointments patient becomes more cooperative and trustworthy towards his/her Dentist. 66% Dental interns strongly agreed that patient’s phobia of dental treatment and dental instruments can drive him uncooperative during his/her treatment.55% Dental interns strongly agreed that Language barrier between Dentist and Patient can create un-cooperative environment and hence ideal treatment may become un-attainable. 75% Dental interns strongly agreed that Dentists busy schedule, engaged in routine appointments increases Dentist's anxiety level which can leads to uncooperative behavior and affect patient’s treatment.78% Dental interns agreed that if a Dentist is unable to handle patient's un-cooperative behavior or attitude, thus referring the patient to another Dentist for sake of ideal treatment can be a good option. Conclusion: The Dental interns at DUHS were found well aware of role of Dentist-Patient Co-operation in attainment of ideal Dental treatment. A positive relation is found out between Dentist-Patient’s Behavior and Treatment’s Results. A cooperative Dentist-Patient environment is found to be more time and effort saving. With the follow-up appointments the patients are found to be more comfortable and cooperative towards their Dentists. Patients of middle age group i.e. 26-35 year are found to be more cooperative in contrast to patient at extremes of ages specially 2-12 year are found to be least cooperative. Factors like Patients Dental-instrumental phobia and lingo-cultural differences are found to be among driving factors for patients uncooperative behavior. On the other hand Dentist’s hectic scheduling and tiresome work increases Dentist’s stress level and sometime trail them towards uncooperativeness. This study also well affirmed that Ethical Dentistry is of core value in Clinical Dental Practice.

1. Introduction

Dental care and treatment is medically necessary for preventing and eliminating the orofacial diseases, infections, and pains, it restores the form and function of the dentition, and also corrects the facial disfigurations or dysfunctions of Dental patients 1. Dentists are professionally trained in recognizing and effectively treating dental diseases. Dentist’s professional education system acknowledges that Dental student must acquire the complex socio-behavioral understanding of the population they are treating and also the sophisticated perceptual-motor skills of dentistry. Ethical Dental practice requires the commitment of graduates to apply their abilities with moral integrity and providing appropriate quality care in their patient’s interest 2. Safe and effective or ideal treatment of these diseases requires mutual understanding and sound cooperation between a Dentist and his/her Patient.

International Principles of Ethics for the Dental Profession states 3, “To satisfy the needs of the patient is the major concern during treatment and a good co-operative environment between a Dentist and Patient during treatment is of huge significance”. No doubt, successful Dental treatment is a “two-way street” that requires a consistent and cooperative effort by both the Dentist and the Patient 4.

Patients fears, general or situational anxiety, any previous unpleasant or painful dental experiences, failure to encounter the worse, and prevention of such practices can leads to uncooperative behavior by the Patient toward his/her Dentist 4. Socio-cultural and linguistic barriers also may play a role in attitudes and cooperation of a Patient towards his/her Dentist 5. These conditions can lead a patient to not to fallow the in-clinic or out-clinic instructions of his/her Dentist which can be taken as a serious act of un-cooperation by a Patient. On the other hand if a Dentist is under mental or physical stress because of his/her hectic appointments schedule 6, 7 then his/her attitude and professional capabilities to be ethical and cooperative with his/her patients are daunted. A good Dentist-Patient cooperation is quite significant not only because it’s an obligation of Ethical Dentistry 3, 12 but also it serves for the purpose of ideal treatment results which other vice will be jeopardized.

Ethically a good Dentist-Patient cooperation demands an equal share by both the Dentist and the Patient. It demands a Dentist to be gentle, well behaved, trust worthy and master in his/her field. It acquires a Dentist to give his/her patient the proper clinical time and care and to take complete responsibility for the patient’s safety 7, 13 and of making treatment plan successful. It also demands that a Dentist should respect patient’s autonomy 8 and comprehend and appreciate their patients' needs, and do their best to accommodate each patient's demands fairly 9. On the other hand a good Dentist-Patient cooperation demands a Patient to fallow the in-clinic and out-clinic instructions and precautions given by his/her Dentist and should fallow the treatment plain set up by his/her Dentist 10. Patient need to be punctual with his/her appointment schedules. It demands Patient to be trustworthy and honest towards his/her Dentist 8.

2. Methodology

2.1. Research Design

This research is a Cross sectional Survey planned to evaluate the awareness of importance of Dentist-Patient co-operation during treatment in attainment of ideal treatment results among Dental interns at DUHS Karachi.

2.2. Sampling Frame, Method and Size

In this Research the Sampling frame was Dental interns at DUHS including (a) Under-Graduates (b) Graduates (c) Post Graduates.

Sampling method was a Research based paper printed Questionnaire.

Sample size was (a) 100 Under-Graduates (b) 100 Graduates (c) 50 Post Graduates.

2.3. Data Collection

Data collection tool was the Research based Questionnaire which was filled by Dental interns of DUHS. There were about 250 Questionnaires. Each Questionnaire was filled by an individual Dental intern. A standardized Consent form 11 was signed by the participant before filling the Questionnaire. Questionnaire was in simple English language and contained 14 Research Questions each having 5 options (A-E). Participants were supposed to Tick/Mark the suitable option according to their knowledge and experience. Different Dental departments were approached and Questionnaires were presented to the Participants after taking their Consent. This Data collection process took about 50 Days.

Research Questions: 14 questions were asked in the form of a paper based Questionnaire. Answered by the Dental interns at DUHS and then Data is collected from their answers which served the purpose of deducing the results and conclusion. Questionnaire is attached as Annexure 2.

Annexure 2:
AWARENESS OF ROLE OF DENTIST- PATIENT CO-OPERATION IN ATTAINMENT OF IDEAL DENTAL TREATMENT AMONG DENTAL INTERNS OF DUHS.

3. Results

Data is collected through Questionnaires and then Result is deduced by using SPSS 16.0.

The Result is distributed into 3 categories on the basis of 3 different variables:

• Gender vice

• Frequency vice

• Qualification vice

Frequency, Gender and Qualification vice Result distribution chart

4. Discussion

This study is carried on the Dental interns of DUHS Ojha Hospital Karachi to evaluate role of Dentist-Patient Co-operation in attainment of ideal Dental treatment results. This study found that Dental interns at DUHS Ojha hospital are well aware of the importance of a cooperative environment and the role they have to play to build such treatment’s environment.

Pediatric dentistry is considered to be one of the most challenging field of Dentistry 18 and 74% of the Dental interns during this study thought that patients of 2-12 year age group are least cooperative during Dental treatment thus making the treatment job difficult.

A cooperative Dentist-Patient environment is found to be more time and effort saving and during this study 90% of the Dental interns agreed that less time is consumed if their patient is cooperative during treatment.

Follow-ups by the patients during treatment period is known to enhance patient’s trust, comfort and patient’s bonding with their Dentists, 70% Dental interns in this study agreed that with follow up appointments patient becomes more cooperative and trustworthy towards his/her Dentist.

Dental anxiety and behavior problems are common in the dental setting. Studies have been conducted in an effort to understand the relationship between the psychological factors of dental fear, dental anxiety and dental behavior 17 and leads patient uncooperative 20 during treatment. 66% research participant of this study are also found to have these experiences.

Studies have indicated that both anxiety and depressive disorders are observed frequently in Dentists 20. 75% Dental interns strongly agreed that Dentists busy schedule, engaged in routine appointments increases Dentist's anxiety level 6, 7 which can lead to uncooperative behavior and affects patient’s treatment.

40% Dental interns were found to think that they don’t have to change treatment plan according to patients logging to make them cooperative during treatment which is contrary to Dental Ethical code 10, 15.

Lingo-cultural difference can be a barrier to effective communication and a possible reason for the uncooperativeness of the patient 15 but during our study 45% Dental interns differed with this, they did not think that it can effects to such an extent that treatment will be jeopardized.

Dental Ethical principles states that the needs of the patient are the overriding concern during treatment 4 if a Dentist fails to do so ethically he should refer his patient to some other Dentist for sake of proper Dental treatment, 78% Dental interns affirmed this code during this study.

5. Conclusion

The Dental interns at DUHS were found well aware of role of Dentist-Patient Co-operation in attainment of ideal Dental treatment. A positive relation is found out between Dentist-Patient’s Behavior and Treatment’s Results.

Dentists firmly believed that a good Dentist-Patient cooperation not only makes diagnosis and treatment plan easy but also saves valuable Clinical/OPD time. According to Dentists “Pediatric Dentistry” is among the most challenging field in Dentistry as they have found the age group of 2-12 years among most uncooperative patients during Dental Treatment provision while patients of middle age group i.e. 26-35 year are found to be most cooperative during treatment

Factors like Patient’s Dental-instrumental phobia and lingo-cultural differences are found to be among driving factors for patients uncooperative behavior. Dentist’s hectic and tiresome schedule increases Dentist’s stress level and drives them towards un-cooperative behavior some time.

Through this study it is clearly highlighted that Treatment’s Results are directly affected by Dentist-Patient’s behavior, a cooperative Dentist-Patient Behavior yields ideal Treatment results while un-cooperative behavior may yields un-ideal Treatment Results. This study also well affirmed that Ethical Dentistry is of core value in clinical Dental Practice.

References

[1]  Policy on Medically Necessary Care. Council on clinical affairs. V 37 / NO 6 15 / 16.
In article      
 
[2]  David A. Nash, D.M.D. Ethics, Empathy, and the Education of Dentists. Journal of Dental Education June 1, 2010 vol. 74 no. 6 567-578.
In article      
 
[3]  FDI manual. Dental ethics manual 1st edition 2007.
In article      
 
[4]  Dr. Howell, whitehead Associates. Bay area smiles. FAQS.
In article      
 
[5]  William J. Gies. Ethics Hand book for Dentists. American College of Dentists.
In article      
 
[6]  Lang Randy, DDS, D. Ortho. Stress in dentistry-it could kill you, September 11-2017.
In article      
 
[7]  Gale EN. Stress in dentistry. N Y State Dent J 1998; 64(8): 30-4.
In article      PubMed
 
[8]  ADA Principles of Ethics and Code of Professional Conduct SECTION 1 — Principle: Patient Autonomy ("self-governance").
In article      
 
[9]  Jeremy Jacquot. Institution: UCLA. Article on Trust in the Dentist-Patient Relationship.
In article      
 
[10]  David B. Resnik, National Institute of Environmental Health Science.
In article      
 
[11]  WHO informed Consent form template.
In article      
 
[12]  CODE OF ETHICS FOR DENTISTS. Policy statement 6.5.1. ADA.
In article      
 
[13]  DALHOUSIE UNIVERSITY FACULTY OF DENTISTRY. CLINICAL POLICY AND PROCEDURES MANUAL. http://www.dal.ca/faculty/dentistry.html).
In article      View Article
 
[14]  Oxford Handbook of Clinical Dentistry By Laura Mitchell, David A. Mitchell, Lorna McCaul.
In article      
 
[15]  Schyve PM. Language Differences as a Barrier to Quality and Safety in Health Care: The Joint Commission Perspective. Journal of General Internal Medicine. 2007; 22 (Suppl 2): 360-361.
In article      View Article  PubMed
 
[16]  Kleinknecht R.A., Thorndike R.M., McGlynn F.D., Harkavy J., 1984; Getka E.J., Glass C.R., 1992; Milgrom P., Weinstein P., Getz T., 1995.
In article      
 
[17]  Klingberg G, Broberg A. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. International Journal of Paediatric Dentistry. 2007; 17(6):391-406.
In article      View Article  PubMed
 
[18]  Norris LJ. (2007). Testimony of Public Justice Center to Subcommittee on Domestic Policy, Committee on Oversight and Government Reform, U.S. House of Representatives on Ensuring Oral Health for Children Enrolled in Medicaid, Congressional Review.
In article      
 
[19]  Ellen Meye Meeting the Needs of Difficult Dental Patients Clear communication and careful preparation can help moderate stressful situations. Sept/Oct 2012. Volume 10, Issue 5.
In article      
 
[20]  Lang-Runtz H. Strees in dentistry: it can kill you. J Can Dent Assn 1984; 50: 539-41.
In article      
 

Published with license by Science and Education Publishing, Copyright © 2017 Besalat Hussain, Fatima Mushtaq and Asma Saher Ansari

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Cite this article:

Normal Style
Besalat Hussain, Fatima Mushtaq, Asma Saher Ansari. Awareness of Role of Dentist-Patient Co-operation in Attainment of Ideal Dental Treatment among Dental Interns at DUHS Karachi. International Journal of Dental Sciences and Research. Vol. 5, No. 5, 2017, pp 116-121. http://pubs.sciepub.com/ijdsr/5/5/1
MLA Style
Hussain, Besalat, Fatima Mushtaq, and Asma Saher Ansari. "Awareness of Role of Dentist-Patient Co-operation in Attainment of Ideal Dental Treatment among Dental Interns at DUHS Karachi." International Journal of Dental Sciences and Research 5.5 (2017): 116-121.
APA Style
Hussain, B. , Mushtaq, F. , & Ansari, A. S. (2017). Awareness of Role of Dentist-Patient Co-operation in Attainment of Ideal Dental Treatment among Dental Interns at DUHS Karachi. International Journal of Dental Sciences and Research, 5(5), 116-121.
Chicago Style
Hussain, Besalat, Fatima Mushtaq, and Asma Saher Ansari. "Awareness of Role of Dentist-Patient Co-operation in Attainment of Ideal Dental Treatment among Dental Interns at DUHS Karachi." International Journal of Dental Sciences and Research 5, no. 5 (2017): 116-121.
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[1]  Policy on Medically Necessary Care. Council on clinical affairs. V 37 / NO 6 15 / 16.
In article      
 
[2]  David A. Nash, D.M.D. Ethics, Empathy, and the Education of Dentists. Journal of Dental Education June 1, 2010 vol. 74 no. 6 567-578.
In article      
 
[3]  FDI manual. Dental ethics manual 1st edition 2007.
In article      
 
[4]  Dr. Howell, whitehead Associates. Bay area smiles. FAQS.
In article      
 
[5]  William J. Gies. Ethics Hand book for Dentists. American College of Dentists.
In article      
 
[6]  Lang Randy, DDS, D. Ortho. Stress in dentistry-it could kill you, September 11-2017.
In article      
 
[7]  Gale EN. Stress in dentistry. N Y State Dent J 1998; 64(8): 30-4.
In article      PubMed
 
[8]  ADA Principles of Ethics and Code of Professional Conduct SECTION 1 — Principle: Patient Autonomy ("self-governance").
In article      
 
[9]  Jeremy Jacquot. Institution: UCLA. Article on Trust in the Dentist-Patient Relationship.
In article      
 
[10]  David B. Resnik, National Institute of Environmental Health Science.
In article      
 
[11]  WHO informed Consent form template.
In article      
 
[12]  CODE OF ETHICS FOR DENTISTS. Policy statement 6.5.1. ADA.
In article      
 
[13]  DALHOUSIE UNIVERSITY FACULTY OF DENTISTRY. CLINICAL POLICY AND PROCEDURES MANUAL. http://www.dal.ca/faculty/dentistry.html).
In article      View Article
 
[14]  Oxford Handbook of Clinical Dentistry By Laura Mitchell, David A. Mitchell, Lorna McCaul.
In article      
 
[15]  Schyve PM. Language Differences as a Barrier to Quality and Safety in Health Care: The Joint Commission Perspective. Journal of General Internal Medicine. 2007; 22 (Suppl 2): 360-361.
In article      View Article  PubMed
 
[16]  Kleinknecht R.A., Thorndike R.M., McGlynn F.D., Harkavy J., 1984; Getka E.J., Glass C.R., 1992; Milgrom P., Weinstein P., Getz T., 1995.
In article      
 
[17]  Klingberg G, Broberg A. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. International Journal of Paediatric Dentistry. 2007; 17(6):391-406.
In article      View Article  PubMed
 
[18]  Norris LJ. (2007). Testimony of Public Justice Center to Subcommittee on Domestic Policy, Committee on Oversight and Government Reform, U.S. House of Representatives on Ensuring Oral Health for Children Enrolled in Medicaid, Congressional Review.
In article      
 
[19]  Ellen Meye Meeting the Needs of Difficult Dental Patients Clear communication and careful preparation can help moderate stressful situations. Sept/Oct 2012. Volume 10, Issue 5.
In article      
 
[20]  Lang-Runtz H. Strees in dentistry: it can kill you. J Can Dent Assn 1984; 50: 539-41.
In article