A survey based comparative study about dental clinical photography amongst intern and postgraduate students

Introduction

Photography has been utilized in dentistry for a considerable period of time, and is being used for various reasons in dentistry. Photographs are used to supervise the progress of various treatments and also to track the transition after the procedure. In the same way as radiography, study casts, and other investigations and testing are regarded as diagnostic tools, dental photography is considered at par.^[1] Photographs are predominantly used for recording various lesions pre and post treatments. Other places where photographs are utilized are in providing proof in MLC’s;^[2] supporting disease detection and in implementation of procedures.^[3] serving as a tool for dental education and guidance for staff and students.^[4] assisting in guiding the patient and inspiring them.^[5] Instruction to patients, laboratories, other physicians, and insurance providers.^[6] serving as a tool for tutor for case discussion.^[6] Photographs also help in distant consultation from specialists who live across the globe, specifically for cases such as pre-malignant one’s.^[7] Codes of conduct are established to manage risks and safeguard patients against potential harm, spanning from hazardous medical treatments to privacy violations. As a result, these codes outline the duties and account abilities of healthcare providers with the aim of minimizing risks.^[8] As a result, dental professionals must identify these risks and be judicious in their actions. The aim of our study was to gauge the knowledge perception and practices of interns and post-graduate in dental photography.

Materials and Methods

An online survey was conducted among dental interns and postgraduate students to gauge their awareness, perspective and related practices regarding the use of dental photography in clinical situations. The duration of our study was for 2.5 months and selection of the participants was on the following basis: (A) Interns (B) Postgraduate students, all the participants were willing to take part in the study as a consent was taken prior to start of the study. The exclusion criteria was (A) people unwilling to participate in the study (B) Staff of any college. A convenient sampling technique was used.

The sample size was calculated using G*Power software version 3.1.9.2 (Heinrich Heine University, Dusseldorf)^[9] was 250 with the power of study being 80%, alpha error 0.05, effect size being 0.5 and the Degree of Freedom of 5. A digital, self-administered, closed ended questionnaire was developed using pre-validated questions. The questionnaire consisted of twenty-seven questions further divided into four parts, 1) Demographic data 2.) Knowledge based questions 3.) Attitude based questions 4.) Practice based questions. The questionnaire was then distributed online on various online platforms such as Whatsapp, Instagram. The reliability statistics of the questionnaire calculated using Cronbach's alpha was 0.6. The participants were informed about the study and a consent was taken prior to the start of the study. All the collected data was then compiled in spreadsheets (Microsoft Excel 2016), and was statistically analyzed using descriptive statistics, where the P value was 0.5. The Statistical Package for the Social Sciences 23.0 version software (IBM, Chicago, Illinois, United States) was used for data analysis.

Results

A total of 250 participants from undergraduate and postgraduate programs took part in this study, out of which 48% were males and the remaining 52% were females. 78.4% of the participants had a BDS qualification and 21.6% had an MDS qualification.

In this study, 40% of the participants agreed that a doctor's recollection of memory was the best mode of reporting and documenting a case. Nonetheless, the use of a DSLR camera for the purpose of dental clinical photography was observed only in 7.3% of the aforementioned total population. The study also inferred mobile cameras as the most extensively used device (78.6%) in place of a DSLR for the same and was considered as the best method. Additionally, 78.6% of the study participants found it essential to document cases for marketing purposes, while only 10% believed in recording cases for outlining the treatment plan.

The high expense of equipment was specified as the primary reason for not demonstrating and storing information about the cases by 80% of the cohort. Moreover, a preponderance of the population was not well versed about the mirror required to take a quadrant/arch occlusal photograph used in dental photography. As a matter of fact, 52% of the cohort believed that no mirror was required in clinical photography. Likewise, 76% of the study population was unaware about the lens that is more often than not used in clinical photography. Conversely, the percentage of the study group that found it imperative to record cases was established at 51%.

With respect to maintenance of patient consent and confidentiality, informed consent was obtained from 73.2% of the study population before capturing their pictures in various forms. Additionally, 59.2% of the population covered their patient’s eyes to avoid breach of confidentiality.

Discussion

Our study had a near equal spread of participants between both the genders, and a vast difference in education levels, with excellent response rates from dental interns. While having a slight female predilection, the majority (78.4%) of participants were interns, while the minority (21.6%) were into a postgraduate course, which is in accordance with previously conducted studies by Alghulikah K et al.^[10] and Shaikh T et al.,^[11] This might be a reflection of the having fewer postgraduates students than interns.

Importance of recording the cases for marketing purposes was marked seen in our study as 78.6% of the study population agreed to it, analogous to research done by Harikrishnan R and Lakshmanan R,^[12] while only smaller number of the participants believe in the importance of dental records for treatment purposes, which refutes another study where the authors believed treatment planning was a common reason for using pictures of the patients pre and post-operative.^[13]

The study also found that 60% of participants disagree about the best method for recording and documenting cases being doctor's memory, in line with a study by Abouzeid HL et al.^[14] who observed that documenting cases in pictorial form was the most effective. In contrast, 78.6% of participants used mobile cameras to record cases, while only 7.3% used DSLR cameras, which conflicts with a study by Sharland MR et al.^[15] who found that dental photography was common among general practitioners in Great Britain.

80% of the cohort stated that the cost of the accessories was the particular reason they were not documenting cases, since most participants could not afford the price of a DSLR camera. This runs counter to research by Khaled A.^[10] and Shaikh T et al.^[11] but is in compliance with studies done by Rozan K. A. et al.^[15]

Regarding patient consent and confidentiality, According to our study, the majority of the participants (73.2%) obtained permission from the patient before taking photographs, and 59.2% ensure patient confidentiality by covering their eyes. This finding suggests that dentists are becoming more conscious about protecting patient privacy, which is an improvement compared to a previous study conducted by Hoda LA et al.^[16] in 2020 and is consistent with the results of a similar study by Rozan K A et al.^[17] in 2021.

Ultimately, 76% of the participants were not aware of the standard lens used in clinical photography, possibly because they did not utilize mirror less or DSLR cameras to document cases.

Conclusion

The study concluded with the literacy mark of dental clinical photography not being up to the par and the demand to learn more and figure out the working of digital cameras needs to be put forth in front of the students. The students also need to fully comprehend the medico-legal aspects of clinical photography. This will amend the shortcomings faced during documentation and application of efficient patient care. Pursuing dental photography more as a personal preference rather than a job will ensure promising outcome rate and will give them improved prospects for teaching, patient stimulation and follow up visits.

Source of Funding

None.

Conflict of Interest

None.