|Year : 2017 | Volume
| Issue : 2 | Page : 52-57
Determination of the awareness and the knowledge level in dental faculties regarding laser systems
Serdar Baglar, Ayse Tugba Ertürk Avunduk
Department of Restorative Dentistry, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey
|Date of Web Publication||29-Dec-2017|
Dr. Ayse Tugba Ertürk Avunduk
Department of Restorative Dentistry, Faculty of Dentistry, Kırıkkale University, Kırıkkale
Source of Support: None, Conflict of Interest: None
Aim of the Study: The aim of this present study is to evaluate the knowledge level about laser systems in dentistry of practitioners who educated/continuing education in dental faculties in Kırıkkale and Ankara, Turkey. Materials and Methods: This cross-sectional, descriptive study was carried out at the Faculty of Dentistry, Kırıkkale University, in Turkey. In this study, totally, 130 participants were evaluated. Seventy-six of them (17 males and 59 females) were in Ankara and 54 participants (18 males and 36 females) were in Kırıkkale. A survey which consists of 17 questions was conducted through face to face. The obtained data were statistically evaluated using the Chi-square test of SPSS program. Results: At the end of the study, it has been determined that 87.2% of the participants have knowledge about dental laser systems while 12.3% have no information on this subject. This percentage was 81.6% in Ankara and 96.3% in Kırıkkale separately. No statistically significant difference was found comparing the knowledge level of participants regarding cities educated. Conclusion: Since there is limited research available in the literature which investigated the education level on this subject, it can be claimed that the result of this study may be supported this field. This emphasizes that we need to focus more on this and that more research needs to be done.
Keywords: Dental laser, dental students, education, knowledge
|How to cite this article:|
Baglar S, Avunduk AT. Determination of the awareness and the knowledge level in dental faculties regarding laser systems. J Dent Lasers 2017;11:52-7
| Introduction|| |
Removal of decayed tissue is one of the main steps of restorative dental treatment and is an important determinant of the success of treatment. The change in the principles applied to cavity preparation today and the emergence of reliable adhesive materials have led to the development of alternative methods for the removal of decay. An inexpensive and easily available method that is easy to use in clinical conditions removes only infected dental tissue, is painless, quiet, requires minimal pressure for optimal use, and does not cause excessive vibration or heat buildup during operation.
New science and technologies are already making their way into all aspects of dental practice and have changed the traditional approaches, which require that students and practitioners receive the necessary knowledge. Dental laser is one of the most significant developments in the modern dentistry. Lasers were introduced into the field of dentistry in the 1960s, with the hope of overcoming some of the drawbacks posed by the conventional methods of dental procedures. Conventional methods of cavity preparation with low- and high-speed handpieces involve noise, uncomfortable vibrations, and stress for patients. These disadvantages have led to a search for new techniques as possible alternatives for dental hard and soft tissue removal. Different laser devices and different wavelengths opened up various treatment options for diverse indications. Today, many lasers have been investigated for the use in cavity preparation. Most effectively, erbium-based (erbium: yttrium-aluminum-garnet [Er:YAG] and erbium, chromium: yttrium-scandium-gallium-garnet [Er, Cr:YSGG]) lasers were found. This is why the application of Er: YAG and Er, Cr: YSGG lasers on tooth hard tissues is considered privileged.
To practice laser safely and effectively in different disciplines of dentistry, it is essential to have a good knowledge of laser physics, laser operation, different types of laser, and which type of laser is appropriate for each case.
In view of the increasing availability of new technologies in dental practices and the need for more education and training, this survey was conducted to assess the educational level and knowledge of the uses of laser in dentistry in Kırıkkale and Ankara.
| Materials and Methods|| |
Approval of the study was obtained from the Kırıkkale University Clinical Research Ethics Committee (Reg. No: 12/19-16.05.2017). This cross-sectional, descriptive study was carried out at the Faculty of Dentistry, Kırıkkale University in Turkey.
In this study, totally, 130 participants were evaluated. Seventy-six of them (17 males and 59 females) were in Ankara and 54 participants (18 males and 36 females) were in Kırıkkale. Questionnaires consisting of 17 questions were conducted through face to face to determine the level of knowledge of participants who responded to the questionnaire regarding dental lasers. The questionnaire was produced after extensive literature review of the dental laser types and common applications of laser in different dental specialties. The questionnaire was reviewed for content, clarity, bias, and the questions' adequacy to the study objective by a senior faculty. The obtained data were statistically evaluated using the Chi-square test of SPSS program.
| Results|| |
26.9% (35 people) of the participants in the study were male, and 73.1% (95 people) were females. Of the 76 people who participated from Ankara, 22.4% (17 people) were male anf 77.6% (59 people) were female, while of the 54 participants who participated in Kırıkkale, 33.3% (18 people) were male and 66.7% (36 people) were female.
9.2% of the participants were aged 21 years, 30% were 22 years, 40% were 23 years, 19.2% were 24 years, and 1.6% were 25 years. The majority of individuals participating in the study are those who were 23 years of age. 43.4% of the individuals participating from Ankara and 35.2% of the individuals participating from Kırıkkale were aged 23 years.
89.2% of participants have continued dental education, 7.7% 1-year graduate, and 1.5% 2 years and over. 1.5% (2 persons) of the participants did not give any answer to the question about graduation status and these individuals are from Kırıkkale province [Figure 1]. Education on both sides constitutes the majority of the ongoing living individuals. 84.2% of the individuals participating from Ankara and 96.3% of the individuals participating from Kırıkkale continue to be educated. In addition, the persons who participated in this study from Kırıkkale did not include graduates of 1 year and 2 years, while two persons did not specify graduation status.
While 87.2% of the participants stated that they had knowledge about dental laser systems, 12.3% reported that they did not have any information on this subject. 81.6% of individuals participating in Ankara and 96.3% of individuals participating in Kırıkkale have knowledge of laser systems.
6 participants did not answered the question of the most preferred laser systems in soft tissue applications. 62.1% of the responders gave the answer of diode laser, 3.2% of them gave the answer of excimer laser, 0.8% of them gave the answer of ruby laser, 20.2% of them gave the answer of argon laser and 13.7% of them gave the answer of Ho:YAG laser [Figure 2]. 60.0% of the participants from Ankara and 64.8% of the individuals from Kırıkkale constitute the majority by giving the diode laser answer. One person (1.4%) in the province of Ankara is given a ruby laser answer, whereas there is no person giving a ruby and excimer laser answer in the province of Kırıkkale.
|Figure 2: Knowledge level of laser types available in soft tissues according to cities|
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Eight of the most preferred laser questions were left unanswered in hard tissue applications in dentistry, The question of the most preferred laser systems in hard tissue applications in dentistry were left unanswered by 8 participants, while 54.9% of the respondents answered that the most preferred one in hard tissue applications is Nd:YAG, 5.7% of them stated diode laser, 0.8% of them stated excimer laser, 6.6% of them stated argon and 32.9% of them stated the erbium group lasers. In Ankara and Kırıkkale, respectively, 58.8% and 50.0% of the Nd: YAG laser responses were given. There were one participant (1.4%) in excimer laser in Ankara and two participants (3.7%) in Kırıkkale who gave a diode laser response. There are also no excimer and argon laser responders in Kırıkkale.
27.7% (36 people) of the participating individuals indicated that they preferred or could use laser to remove caries, while 72.3% (94 people) did not or did not prefer it [Figure 3]. While 90.8% of the people who participated from Ankara do not prefer laser to remove the caries, this rate is 46.3% in Kırıkkale. Participants stated that they could choose or prefer 39.5% Nd: YAG, 7.9% diode, 44.7% erbium group, 2.6% CO2 and 5.3% Ho: YAG dental laser species. Ninety-two participants did not specify which laser group they preferred or could do with. Individuals from Ankara and Kırıkkale stated that the Nd: YAG and erbium group laser are most preferred or will be preferred by 50%, respectively. There were no CO2 or Ho: YAG laser responders in Ankara. The reasons for choosing a laser system for caries removing were 84 respondents, and 47.6% of the respondents were minimally invasive, 9.5% had no harmful effects on surrounding tissues and pulp, 26.2% could selectively remove caries tissue, 10.7% anesthesia is not needed, and 5% for ease of anxious adult patients. Sixty-one percent of the individuals participating from Ankara were responded because they were most minimally invasive. The highest preference for the individuals who participated in Kırıkkale was 34.9%, which was minimally invasive, and the decayed tissue could be removed selectively.
|Figure 3: Classification of laser type information used in hard tissues according to cities|
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The question “What is your reason for not using the laser system” was left unanswered by eight of the participants. Thirty-two percent of the respondents did not have enough information about laser systems, 18.9% thought that the application had taken too much time, 46.7% was expensive, 0.8% was dissatisfied, and 1.6% was a harmful method or not [Table 1]. The number of people why do not prefer for laser systems is the majority with 39.1% in Ankara because they do not have enough knowledge about laser systems. In Kırıkkale, the answer is 62.3% because it is expensive. Moreover, as the reason for not choosing in Kırıkkale, there is no one who gives the answer “I think it is a harmful method because it creates dissatisfaction.”
Individuals who participate in the study were asked “whether this issue was adequately addressed during dental education” and 129 people answered the question. Individuals gave a response of 89.1% no and 10.9% yes. While 94.7% of the participants in Ankara think that the subject is adequately handled during education, this ratio is 81.5% in Kırıkkale.
A total of 129 participants answered the question that “Would you like to attend a training course/seminar on laser,” 91.5% answered yes and 8.5% answered no. In Ankara and Kırıkkale, 89.3% and 94.4%, respectively, of the participants answered yes.
There was no statistically significant difference in gender distribution in the data obtained in the study. No statistically significant difference was found when cities were compared in terms of age distribution of individuals. There was no statistically significant difference between the graduation status and the intercity relationship. No statistically significant difference was found when comparing the state of information about the use of individual laser systems with cities. When compare the answers given in the question “Do you prefer laser for caries removal,” there is a significant difference between the two cities. The proportion of those who answered yes in Kırıkkale was 53.7%, while in Ankara, this rate was 9.2%. A statistically significant difference was found when comparing the knowledge status of the soft tissue laser systems of participants with cities.
In Kırıkkale, the proportion of individuals who give argon laser is 31.5% and in Ankara 11.4%. The proportion of Ho: YAG laser responders in Ankara is 21.4% and this rate is 3.7% in Kırıkkale. There was no difference between the knowledge status of laser systems used for hard tissue and the statistical distribution in urban areas. When comparing the most common laser systems with cities, no statistically significant difference was found.
There was no statistically significant difference between the reasons for preferring laser for caries removal and cities. There was no statistically significant difference between the reasons for not using laser system and the comparison of cities. No statistically significant difference was found between the competence status of the dental laser practice taken during dental education and cities. There was no statistically significant result when comparing the dental laser education obtained after graduation to the beneficial status among the cities.
| Discussion|| |
Dentistry is not as indifferent to the innovations of the era as it is in many areas. With the advancement of technology and the increased scientific work done, new methods and tools are emerging in routine clinical practice in dentistry. Clinical use of dental laser devices is also increasing day by day. Therefore, it is important to find more places for this in the dental education curriculum.
In this study, it was researched whether there is any difference in knowledge and education level about dental laser systems between metropolitan and densely populated Ankara province and between dentists or graduated dentists trained in Kırıkkale province, which can be accepted as more rural and less crowded. 96.3% of the participants educated in Kırıkkale and 81.6% of the individuals participating in Ankara have knowledge of laser systems. The majority of respondents reported that they have knowledge about laser in both towns. In a similar study, Asma al Jobair et al., in King Saud University, 2013, located in Saudi Arabia, conducted similar inquiries about the students and investigated the level of knowledge and awareness of the laser. Similar to the present study, 87.2% of participants stated that they had knowledge about laser systems. In the same study, 91.5% of the participants reported that they needed more dental laser education.
Likewise, participants in Ankara and Kırıkkale, 94.7% and 81.5%, respectively, think that education is not handled in this respect. 89.3% and 94.3% of the participants from Ankara and Kırıkkale stated that they could participate in courses and training seminars for the use of dental laser after graduation. Asma al Jobair et al., similarly, revealed that the majority of students (76%) wanted to attend courses and training seminars in the future and preferred courses or seminars that provided the most training in laser surgery in the area of oral surgery and restorative therapy.
The most majority (87.7%) of the individuals participating in the study stated that they had knowledge of laser systems. However, when more specific questions about laser systems were asked to the participant, conflicting results emerged. For example, when asked about the most preferred soft tissue applications for participant laser systems, 62.1% of soft tissues were used in a high number of laser reactions, while 20.2% of those giving argon laser reactions for resin polymerization and biostimulation were not. Again, a similar question, the most common choice of hard tissue laser systems, gave a Nd: YAG laser response that was used in soft tissue interventions, with a majority of 54.9%. These results may lead us to believe that the participants in the study know the laser systems but do not have as much knowledge about the fields of use and laser types. The laser systems education may show that the institutions in which the study was conducted (Ankara and Kırıkkale) are in the curriculum for dental education institutions, but that this issue should be addressed more. Thirty-two percent of respondents (89.1%) say that they do not opt for laser systems because they find it insufficient and do not have as much knowledge as their competent staff.
In a study conducted in North America in 2013, surveys were delivered to 70 program managers in the field of orthodontics via e-mail to find out how much laser systems were used in the training curriculum, and in clinical use, and 37 (53%) of these training programs reported feedback. Forty percent of the surveys reported that they used laser in treatment, 11% did not provide training for laser use, and 1% did not use it in the treatment of illness, but 1% stated that they did not use it in their patients. This may make us believe that even in countries with higher levels of education and facilities, such as the United States and Canada, there is not as much training as a laser system in a licensed program. In addition, this situation can be considered as a necessity to increase the amount of education in many countries and institutions which are not unique to dental medicine faculties in Ankara and Kırıkkale which are our study fields.
In a study conducted in the United States in 2015, a questionnaire consisting of 19 questions prepared to learn how much space they have placed in the new technological development training curriculum, sent to 62 dental training schools, was issued and reported to school deans. Fifty-two percent (33 schools) were reported to have returned. In the study, technological innovations such as CAD-CAM, digital radiography devices, endodontic rotary instruments, and hard and soft tissue lasers were questioned about the amount of clinical and preclinical education involved. As a result of the study, it was reported that hard tissue lasers had a preclinical and clinical theoretical education rate of 36% and preclinical laboratory education and patient experience rate of 12%. It is stated that the difference between schools is affected not by geography and financial opportunities but by the fact that classroom and school are old or new. It has been reported that students who have >100 classmates or not >60 years have experience in clinical use on more patients. These results show us that in the developed countries such as the United States, laser education takes place in the curriculum, it is practiced (12%) and theoretical (36%) training and some faculties provide experience on the patient (12%). In addition, it was stated that the geographical position and financial support difference of the faculties did not make a significant difference between the schools, and in our study, there was no significant difference between the dental faculties with the same geographical position.
The lack of a sufficient number of large-scale research and studies that can constitute precedents in this respect reduces the possibility of a healthy comparison of the geographical and economic differences between the countries, in which the existing studies are conducted. This emphasizes that we need to focus more on this and that more research needs to be done.
| Conclusion|| |
In this study which includes Ankara and Kırıkkale illusions, it was found that there was no significant difference between the people who educated in two cities in general. On both sides, the knowledge level of the people about the laser systems is not sufficient and it is seen that education is inadequate in this regard. People have stated that they will be able to attend courses and training seminars after graduation. In this case, it shows us that more training is needed; in this regard, that individuals want to improve themselves and that further research and study should be done in this regard. With more extensive work, future steps in laser education and use can be better identified.
This research is supported by Kırıkkale University Clinical Research Ethics Committee (Reg. No. 12/19-16.05.2017).
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3]