|Year : 2017 | Volume
| Issue : 5 | Page : 398-402
Awareness, Attitude, and Prevalence of usage of magnification devices among the dental practitioners in the state of Andhra Pradesh – A questionnaire-based study
Gautami Subhadra Penmetsa1, Loda Princee Mani1, Gadde Praveen2, Chini Dorai Dwarakanath1, S Suresh2
1 Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
2 Department of Public Health Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
|Date of Submission||25-Oct-2017|
|Date of Acceptance||20-Nov-2017|
|Date of Web Publication||9-Feb-2018|
Gautami Subhadra Penmetsa
Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram - 534 202, West Godavari, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Dentistry, dealing with teeth and supporting tissues in the oral cavity is not only an ever-evolving science but also an art combined with good eye-hand coordination. It not only encompasses clinical and theoretical skills which play a crucial role in the success of therapy but also a lot of intrinsic work is accomplished in dentistry. In a journey to fulfill the above accomplishments and for facilitating early diagnosis of pathologies which usually go unnoticed, a clearer and magnified field of vision are also essential. The purpose of this study is to evaluate the awareness, attitude, and prevalence of the usage of magnification devices among the dental practitioners in the state of Andhra Pradesh. Materials and Methods: A questionnaire-based study was conducted to assess the awareness, attitude, and prevalence of magnification devices among the 370 dental practitioners in Andhra Pradesh. All the participants were provided with a prestructured questionnaire comprising of 24 questions and answering was completely self-based. Results: Among the participants, majority were aware about magnification in dentistry (91.1%), and also of the different types of magnification devices available (90.5%). On the other hand, when the reason for not using magnification devices was taken into consideration, 32.7% attributed that they have not experienced the devices and 32.4% felt that devices were too expensive. Moreover, when regarding the usage of devices was taken into account, only 23.8% of the total participants were exposed to the usage of magnification aids. Conclusion: Among the selected group of participants, even though majority were aware of magnification in dentistry its application in practice was very less.
Keywords: Ergonomics, magnification, magnification devices, magnification loupes, precision
|How to cite this article:|
Penmetsa GS, Mani LP, Praveen G, Dwarakanath CD, Suresh S. Awareness, Attitude, and Prevalence of usage of magnification devices among the dental practitioners in the state of Andhra Pradesh – A questionnaire-based study. J Indian Soc Periodontol 2017;21:398-402
|How to cite this URL:|
Penmetsa GS, Mani LP, Praveen G, Dwarakanath CD, Suresh S. Awareness, Attitude, and Prevalence of usage of magnification devices among the dental practitioners in the state of Andhra Pradesh – A questionnaire-based study. J Indian Soc Periodontol [serial online] 2017 [cited 2019 Nov 13];21:398-402. Available from: http://www.jisponline.com/text.asp?2017/21/5/398/225139
| Introduction|| |
Critical visual assessment is an integral function of oral health care. The ability to perceive fine detail is relevant in all aspects of dentistry and represents an important first step in clinical decision-making which can be achieved by the usage of magnification devices. Dental surgeons who deal with dental procedures day in and day out are at risk for musculoskeletal disorders due to their nature of work and wherein the subject of ergonomics arises. The usage of magnification devices promotes good posture, and thereby reduces musculoskeletal stress.
As dental professionals are subjected to prolonged excursion of hands, efficiency and high level of clinical treatment can be maintained throughout their working life if good ergonomics are incorporated. In an attempt to overcome these limitations, any device which enhances or improves the clinicians resolving power is extremely important in producing precision in dentistry.
In this journey of enhancing improved vision and acuity of the dental practitioners, magnifying loupes were devised. As dental professionals spend a day working in a small oral cavity, clear vision plays a major role in producing accurate benefits. This led to the introduction of enhanced magnification devices wherein magnification was considered to be one of the greatest revolutions in science and more specifically in dentistry.
Even though scientific evidence supporting the impact of magnification on the dentist's performance is weak, few studies in the literature do show predictable results when magnification was incorporated and integrated into the clinical scenario. Hence, the present questionnaire-based study was attempted to assess the awareness, attitude, and prevalence of use of magnification devices among the dental practitioners in the state of Andhra Pradesh.
| Materials and Methods|| |
This questionnaire-based study was conducted from January 2017 to May 2017, wherein the questionnaire was given to 370 registered dental practitioners from 13 districts of Andhra Pradesh. This study was approved by the institutional ethical committee.
A prestructured questionnaire comprising of 24 questions was prepared, out of which 8 questions were related to awareness, 8 questions were related to the attitude, and 8 questions were formulated to assess the usage of magnification devices among the participants. A few of the questions were taken from previously published studies which were modified and included in our questionnaire.,,
Registered dental practitioners practicing with a qualification of BDS or MDS were included in the study, and practitioners who were not willing to participate in the study and practitioners who did not respond in the stipulated time were excluded. All the participants were provided with the questionnaire, and wherein, the answering is completely self-based.
The data were collected, entered into MS Excel spreadsheet and analyzed through the statistical package for the social sciences package v. 20 software (SPSS Inc. Chicago, IL, USA).
Simple descriptive statistics were used to define characteristics of the variables using numbers and percentages for categorical variables. To establish relationships between categorical variables, Chi-square test was used, and statistical significance was recognized when P < 0.001.
| Results|| |
The questionnaire employed for our study procedure comprised of 3 sets of questions, wherein each set constituted 8 questions. The first set of questions in the questionnaire focused on awareness, whereas the second set focused on attitude, and the third set on the prevalence respectively.
Among the dental practitioners participated in our study who accounted to 370 in toto, 331 (91.1%) constituted the group that was aware of magnification in dentistry. On the other hand, 59.5% of the participants attributed their awareness to magnification in the course of pursuing their BDS/MDS degree, whereas 24.9% through colleagues and friends, 13.5% through demonstrations, 12.5% through social network sites, and 10% have gained awareness through attending workshops. A statistically significant difference of P < 0.001 was evidenced in the group that attributed their learning during BDS/MDS which accounted to their highest response (59.5%) as depicted in [Figure 1].
In the present study, 90.5% were aware that there are different types of magnification systems and 85.4% were aware about various ranges of magnifications available in different magnification devices, 72.7% were aware that various dental procedures are to be done at specific magnifications. When the participants were asked to score their knowledge about loupes, 42.5% opted as poor, 52.4% as good, whereas 5.1% as reasonably good. On the other hand, when surgical microscopes were taken into consideration, 70.8% depicted poor knowledge, 16.2% showed good knowledge and 3% had reasonably good knowledge.
A next of eight questions focusing on assessing the attitude of the participants toward magnification devices in dentistry were included. 32.7% of the participants have never experienced the devices physically, 32.4% did not use magnification devices in their practice wherein they attributed the reason to be expensive, 24.9% of the participants believed that there would be no difference in using or without using magnification devices, 5.7% of the participants believed that they could view better without magnification and magnification was not necessary. About 10.5% of the participants believed that the use of magnification resulted in health issues, for which they had to discard their further use, and this was statistically significant as depicted in [Figure 2].
When the question of magnification devices improving the accuracy of work was put forth, 40.3% believed that improvement does occur, whereas 50% believed that they do not improve the accuracy and 4.9% were not sure whether magnification devices would improve the accuracy of their work or not.
When a question on whether magnification devices should be reinforced in clinical practice or not was asked 55.1% of the participants believed that the devices should be reinforced in practice. When a question of the use of magnification devices at various levels was posed in the questionnaire-46.5% believed that devices should be reinforced in undergraduation, 17.6% in clinical practice, whereas 15.9% believed that devices should be reinforced in postgraduation which was statistically significant (P < 0.001).
When the question of whether there would be any advantage of using magnification devices in their work was posed in the questionnaire, 56.7% believed that there would be an added advantage in using the magnification devices. For next question which focused on whether magnification devices should be used only by specialty dentists or not, 53.5% responded that they should be used only by specialty dentists. When the opinion regarding the usage of magnification devices in various branches was asked, the majority of the participants (71.6%) agreed that magnification devices are worthy to be used in endodontics followed by oral surgery (61.9%) and the difference was statistically significant (P < 0.001) as depicted in [Figure 3].
While the first two sets of questions focused on awareness and attitude, the third set of questions focused on the prevalence and usage of magnification devices. Out of 370 participants, only 88 members responded to this set of questions, as these set of questions can be answered only by the participants who were exposed to the usage of magnification devices. Among these 88 members – 13% constituted academicians, 7% of clinicians, whereas 4% of them were both academicians and clinicians.
Among the 88 members who experienced the usage of magnification devices, 14.9% have opted that they are comfortable with the usage of magnification devices, whereas 0.5% opted that they were not comfortable. On the other hand, 8.9% owed the comfortability of the usage of devices to the type of procedure being performed. On questioned about experience and comfortability of the type of magnification device, out of 22.7% of the participants who had experience in using loupes, 8.6% were exposed to ×2.5 to ×3.5 magnification while 14.1% to using ×3.5 to ×4 magnification. When questioned regarding the use of surgical microscope, 7.3% were exposed to using ×2 to ×10 magnification and 1.4% in using ×10 to ×20 magnification. Among the participants exposed to using loupes, 17% opted that they are using headlight while doing procedures and regarding the comfortability of the operator pertaining to the use of headlight during the procedures 22% felt that they are comfortable with using a headlight for the procedure.
Regarding the advantage of using the magnification device, 4.1% stated that they are comfortable during the procedure with the device, 7.6% felt that there is increase in quality of treatment while 1.1% stated that it saves time. Cross-tabulation was done for the above question, and 9.5% believed that there is comfort in vision, whereas 22.6% thought that there is improvement in quality of treatment, 3.6% believed that it saves the treatment time while 53.6% stated that there is comfort, increase in quality of treatment as well as time-saving and the difference was statistically significant (P < 0.001) as depicted in [Table 1].
When the question on health issues during the usage of magnification devices was posed, 4% stated that they suffer from vision problems, 5.9%, 1.1%, and 6.2% stated that they suffered from neck, wrist, and lower back pain, respectively, on the other hand, 11.1% agreed that the usage of magnification devices do not lead to health problems. A cross-tabulation was performed for this question as depicted in [Table 2].
|Table 2: Type of magnification device and problems faced 1-loupes 2-microscopes|
Click here to view
| Discussion|| |
In dentistry, manual dexterity and skill are of extreme importance to achieve accurate results. Along with manual dexterity and skill, vision also plays a very important role. In dentistry, the work is done on teeth and soft tissues which need good visual acuteness that can be enhanced using magnification devices. Magnification devices are indeed an evolution from the conventional method of macrodentistry to a high precision microdentistry. Modern-day dentist has numerous magnification systems to choose from, which range from simple to compound prismatic telescopic loupes and a vast variety of surgical microscopes. The use of magnification devices along with the microsurgical instruments and techniques can lead to improved surgical outcomes, thereby resulting in a higher quality of care. It is evident that the application of magnification to dentistry gives more predictable results with procedures being less invasive, reduced patient discomfort, superior approximation of wounds, more rapid healing, improved cosmetic results, and greater patient acceptance compared to conventional macrosurgical approach.
Magnification devices can be used in diagnosing the diseases such as lesions in the oral cavity, and ulcers, analyzing the radiographs, endodontic treatments, surgical procedures, periodontal procedures from simple scaling to periodontal plastic procedures, in prosthodontics, and also in placement of the brackets in orthodontics. Magnification devices, therefore, encompasses all disciplines in dentistry to visualize the minor details and smaller structures clearly and thereby work accurately.
The main motto behind conducting this study is to analyze the awareness, attitude of the dentists toward the dental magnification devices, and also to know how well they are applying in their routine practice, as they were limited studies available on the usage of magnification devices in the dental specialty. In our study, we have identified that overall routine use of magnification devices is very less in spite of having awareness.
Most of the participants in our study were clinicians, wherein their awareness regarding the magnification devices was on a positive note. Regarding the source of knowledge about magnification in dentistry, majority of the participants gained their knowledge during pursuing their professional degree (59.5%), followed by suggestions from colleagues and friends (24.9%). These results were in accordance with the results of the study conducted by Eichenberger et al., in which the decision to buy magnification aids was mainly influenced by colleagues (34%), and wherein the less important reasons were mentioned as courses (16%), exhibitions (11%), and scientific studies (38%), respectively.
When questions regarding the use of magnification devices at different magnifications, different types of dental procedures that need to be done at specific magnifications and whether they were aware of the inbuilt illumination system in the magnification devices were posed, majority of the participants reported that they were well aware.
When participants in our study were asked to self-assess their knowledge about magnification, majority of the participants rated as poor which was in accordance with the study conducted by Eichenberger et al.
When the reasons for avoiding the magnification in their work were elicited in the questionnaire, 32.7% of the participants have never experienced the devices physically and 32.4% thought that the magnification devices were too expensive which was in accordance with the studies done by Farook et al. (2013), and Meraner and Nase. About 24.9% of participants in our study also believed that there is no difference in the accuracy and outcome of the procedure with or without using the magnification devices. Majority of the participants in our study gave an opinion that magnification aids should be reinforced in clinical practice and their introduction should begin from the level of undergraduation which was in accordance with the study done by Alhazzazi et al. (2016).
In our study, many of the participants thought that using the magnification devices the quality and accuracy of the work was improved which is an added advantage in clinical practice which was in accordance with studies conducted by Farook et al. (2013) and Alhazzazi et al. (2016).
The last part of the questionnaire which consisted of 8 questions was designed to assess the prevalence of the use of magnification devices, wherein 88 participants out of 370 were eligible which included both academicians and clinicians.
The degree of comfortability in the usage of the magnification devices was owed to the procedure that was involved. In our study, loupes were being used by majority and was considered to be the most common magnification system, as it was less cumbersome and easier to use initially when compared to surgical microscopes.
Many of the participants have experienced ×2.5 to ×3.5 magnification loupes for routine dental procedures and >×4 loupes for the surgical procedures. When the use of surgical microscope was taken into consideration magnification levels up to ×20 has been shown as a significant aid in improving the quality of treatment. Usage of headlight was more comfortable compared to light emitted by the dental chair as stated by most of the participants.
Many of the participants have also felt comfortable with the use of magnification devices as they have shown improvement in quality of treatment, thereby saving the time of the procedure. It goes without saying that improving the quality of treatment occurs by the use of microsurgical instruments as an aid in decreasing the tissue trauma, thereby hastening the healing process. Even though musculoskeletal diseases are an occupational hazard to the dentists,,, majority of the participants in our study stated that they did not suffer from those diseases as stated in the literature by Valachi and Valachi, which stated that static forced posture adopted for prolonged time by dental students caused physical alterations and musculoskeletal disorders generating neck, back, hand, wrist, and shoulder pains. As ergonomics is one of the most important principles that need to be implicated in dental practice, the use of magnification devices definitely surpasses the limitations encountered in performing the procedures in a conventional way. Apart from the various advantages elicited in the literature regarding the use of magnification devices, as ergonomics also plays a very important role in the day-to-day clinical practice, magnification devices should definitely be advocated in dental practice.
| Conclusion|| |
This questionnaire based study was conducted in an attempt to assess the awareness, attitude and prevalence of usage of magnification devices especially among dental practitioners in Andhra Pradesh and results revealed that even though majority of the practitioners were aware of magnification in dentistry, it is unfortunate to state that their application into clinical practice was not phenomenal
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2