KNOWLEDGE, ATTITUDE AND PRACTICE OF
HEALTH CARE ETHICS AND LAW AMONG
DENTAL PROFESSIONALS IN KARNATAKA
Research Scholar
Dr.Vanishree.M.K
Reader
Dept. Of Public Health Dentistry
AECS Maaruthi Dental College & Hospital
Bangalore-560076
[email protected]
Research Guide
Dr. Ganesh Shenoy Panchmal
Prof and HOD
Dept of Public Health Dentistry
Yenepoya Dental College,
Mangalore.
[email protected]
Bangalore
• Sample Size Determination
• Study population i.e. 1200 dental health
professionals,
• 5% marginal error,
• 90% confidence
• 10% dropout
• the sample size is determined to be 247
•
•
•
•
•
•
Bangalore
Dentist population – 11322
Confidence interval -5%
Confidence level-95%
Sample size-416
Response error 10%
Introduction
• Ethical challenges are not a universal phenomenon.
• Varies from person to person and country to country.
• Performing procedures without adequate competency, not
taking responsibility for one’s errors, over-treatment,
inappropriate manners towards patients, unprofessional
discussion of a colleague’s work, and unprincipled behaviors
towards disadvantaged patients were considered as relatively
more important topics.
• Assessment of ethical challenges gives the comparison for
different country.
Review of literature
• In a study done by prajna pramod nayak on Ethical Conventions:
A Study on Dental Practitioner’s Knowledge and Practice of Ethics
in their Line of Work in Bangalore.
• The results showed that Mean knowledge score among males
was 8.9 as compared to 9.43 among females
• mean practice scores among males was 8.25 as compared to 8.29
in females.
• statistically significant differences were found in the
mean knowledge and practice scores among
graduate dentists and specialists. (8.44 vs 9.36)
• Interestingly, dentists with least practice experience
had significantly lower knowledge scores (mean
score = 8.61) as compared to those with higher
practice experience which was statistically
significant. (Prajna Pramod Nayak, 2016)
• Cross-sectional survey was conducted among the dental
clinicians of Jodhpur city, Rajasthan, India by Mathur K et al to
assess awareness, attitude and practices about Consumer
protection Act. (Mathur K, 2014)
• Results showed that knowledge, attitude and practice
regarding CPA among 71.4%, 65.17% and 68.75% participants
was fair respectively
• A significant association was observed between knowledge
and behaviour of the study participants (P= 0.043).
• They concluded that the knowledge, attitude and practice
among the oral health professionals in Jodhpur, Rajasthan,
India is fair
• Enhanced by conducting various programmes related to CPA
which will further help in better clinical practice. (Mathur K,
2014)
Aim
• To Assess the “Knowledge, Attitudes and Practice of
Health Care Ethics and law among Dental Professionals in
Karnataka.”
Research questions (objectives)
• Identify the ethical issues in dentistry.
• To assess the knowledge of professional ethics and law
among the dental professionals in Karnataka.
• To explore their attitude towards ethics and law in dental
practice
• To assess how far the dental professionals’ have inculcated
the principles of ethics in their day to today practice
Identify the ethical issues in dentistry.
• This was done using a sample of Bioethicists,
subject experts and general dental
practitioners using qualitative methods like
interviews and focus group discussions
• Here we identified the following ethical issues
in dental practice in Indian scenarios
Final Analysis of phase I
Top10 issues of Ethical Issues in Dentistry: An Expert Opinion
1 Sterilization and Biomedical waste management
2
Poor knowledge and attitude towards ethics and law in health care
3
Overtreatment
4 Cost of oral health service
5 Informed consent
6 Consensus about the treatment procedures among dentists
7 Advertising
8 Justness in the distribution of care
9
Disagreement with treatment modalities among dentist and patient
10 Medical record maintenance
Phase 2 & 3
• To assess the knowledge, attitude and practice
of health care professionals in Karnataka
• As a preliminary stage a questionnaire was
developed from the existing review of
literature and validated using a sample of
dental professionals in Bangalore.
Development of questionnaire/items
Questions were constructed to
assess KAP
Patient Centered, Dentist centered,
Informed consent, Administrative
issue, Legal issues
Face validity (General Practitioners)
General dental practitioners
Content validity
panel of experts using Aiken Index >0.8
KAP was assessed using a randomly selected
participants of sample size 427 from Bangalore
95
KAP among the dental professionals in
Karnataka
(https://www.karnataka.com/districts/about-districts/ accessed on 03.02.2017)
Bijapur 48 (11%)
Gulbarga 42(9.7%)
Belgaum63(14.40%)
Bellary 69(15.8%)
Shivmoga 60 (13.7%)
Tumkur 48 (11.0%)
Mangalore 69(15.8%)
Mysore 39(8.90%)
(https://www.karnataka.com/districts/about-districts/ accessed on 03.02.2017)
Results
564 dental
professional
486 agreed
78 declined
to
participate
and 48
incomplete
filling
Total
available
data for
analysis was
of 438
participants.
Distribution of the study population according
to age and gender in Bangalore
Age
Frequency
Percent
20-30 Years
126
29.5
31-40 Years
238
55.7
41-50 Years
50
11.7
>50 Years
13
3
Total
Gender
427
Frequency
100
Percent
Male
252
59
Female
175
41
Total
427
100
Distribution of the study population according
to age and gender in Karnataka
Gender
Frequency
Percent
Male
276
63.0
Female
162
37.0
Total
438
100.0
The study participants age ranged from 22 to 63 year olds with a
mean age of 36.25+5.91.
Majority of the study participants were male
This shows that even though the admission for dental colleges is
more of girls the dental practice is mainly by male. Women were
younger participants compared to male
Distribution of the study population according to
Geographic location of the practice in Bangalore
no of participants
600
500
100
91.8
400
300
200
427
392
100
1.6
7
0
Urban
28
28
Rural
Semi urban
Geographical location
Total
Distribution of the study population according to Geographic
location of the practice in Karnataka
600
100
No. of Participants
500
400
67.1
300
200
100
294
14.4
63
18.5
81
438
0
Urban
Rural
Semi urban
Geographical location
Total
Distribution of study subjects according to
the years of experience in Bangalore
600
100
no of participants
500
400
300
200
65.6
427
280
100
0
01-10years
26.2
112
8.2
35
11-20 years
>20
Years of experience
Total
Distribution of the study population according to years of
practice in Karnataka
600
100
no.of participants
500
400
65.1
300
438
200
285
100
32.9
144
2.1
9
0
1-10 years
11-20 years
20 years and
above
Duration of practice
Total
no of dental practitioners
Distribution of study subjects according to type
of practice in Bangalore
180
160
140
120
100
80
60
40
20
0
32.8
140
13.1
56
14.8
63
8.2
35
6.6
28
3.3
14
6.6
28
Type of dental practice
6.6
28
4.9
21
3.3
14
Distribution of the study population according to type of
practice in Karnataka
no. of participants
150
26
100
16.4
50
0
15.1
114
72
4.8
21
8.2
66
2.1
9
3.4
15
36
Type of practice
4.8
21
9.6
9.6
42
42
Distribution of the study
population according to Nature of
dental practice in Karnataka
Nature of dental practice
in Bangalore
114,
26%
84,
20%
105,
25%
70,
16%
180,
41%
168,
39%
51, 12%
Solo
Group
Employee
Consultant
93, 21%
Mean distribution of knowledge and attitude of the
study population in Bangalore
Domain(N=427)
Minimum
Maximum
Mean
Std. Deviation
Patient centered
9
25
18.34
3.38
Dentist centered
10
20
15.51
1.95
Informed consent
12
24
19.25
2.54
Legal issues
10
25
19.07
2.45
Administrative issues
6
25
16.25
3.59
Total
70
112
88.41
9.05
Patient centered
6
14
10.25
1.85
Dentist centered
6
15
11.84
1.92
Informed consent
16
30
22.08
2.61
Legal issues
.0
5.0
2.770
1.17
Administrative issues
2
10
4.67
1.54
Total
40
68
51.61
5.43
Knowledge
Attitude
Mean distribution of knowledge and attitude of the study population in Karnataka
Domain (N+438)
Minimum
Maximum
Mean
Std.
Deviation
Knowledge
Patient centered
10.0
25.0
19.69
2.80
Dentist centered
5.0
20.0
15.21
2.65
Administrative issues
5.0
25.0
20.07
4.08
Informed consent
11
25
18.77
2.67
Legal issues
2.0
25.0
18.97
3.34
Total
63.00
114.00
92.73
9.26
Patient centered
6.0
15.0
11.19
1.90
Dentist centered
1
10
7.03
1.96
Informed consent
13.0
30.0
21.61
2.63
Legal issues
1.0
5.0
2.80
1.18
Administrative issues
2
10
4.86
1.79
Total
31.00
62.00
47.52
5.47
Attitude
Table : Comparison of mean and standard deviation scores of
Knowledge with the gender and age in Bangalore
GENDER
N
Patient
Dentist
Informed
Legal
Administrative
centered
centered
consent
aspect
issues
Male
252
18.58±3.44
15.78±1.83
19.64±2.27
19.61±1.99
16.39±3.94
Female
175
18.00±3.25
15.12±2.05
18.68±2.77
18.28±2.81
16.04±3.00
Age in
years
N
Patient
Dentist
Informed
Legal
Administrative
centered
centered
consent
aspect
issues
20-30
126
17.06+ 3.89
14.78 + 2.051
18.67+ 2.19
18.50+ 3.38
15.44+ 3.43
30-40
238
18.85+ 3.19
15.85+ 1.85
19.56+ 2.74
19.35+ 1.76
16.97+ 3.48
40-50
50
18.88 + 1.77
15.44+ 1.84
19.12+ 2.30
18.80+ 1.41
14.36+ 3.84
>50
13
21.08±1.03
16.54±0.51
19.62±1.55
20.31±4.15
18.00± 0.01
Table : Comparison of mean and standard deviation scores of Knowledge
with the gender and age in Karnataka
GENDER
N
Male
276
Female
162
Age in
years
N
20-30
90
30-40
Patient
centered
19.35 + 2.98
Dentist
centered
Informed
consent
Legal aspect
Administrati
ve issues
15.26 + 2.75
18.91 + 2.81
18.92 + 3.58
19.59 + 4.45
20.28 + 2.37
15.13 + 2.47
18.54 + 2.40
19.06 + 2.89
20.89 + 3.20
Patient
centered
Dentist
centered
Informed
consent
Legal aspect
Administrative
issues
20.17 + 2.26 15.13 + 2.95
18.83 + 2.96
19.56 + 3.99
20.03 + 3.72
249
19.84 + 2.80
15.19 + 2.65
18.65 + 2.68
18.55 + 3.42
19.95 + 4.34
40-50
99
18.88 + 3.11
15.33 + 2.36
19.03 + 2.37
19.48 + 2.14
20.42 + 3.69
Total
438
19.69 + 2.80
15.21 + 2.65
18.77 + 2.67
18.97 + 3.35
20.08 + 4.08
Table : Comparison of mean knowledge score with the type of practice in Bangalore
Specialist
GP
N
140
Patient
Dentist
Informed
Legal
Administrativ
centered
centered
consent
aspect
e issues
17.70±3.64
15.40 ±1.83
18.15 ±2.46
18.35±3.19
16.40±2.42
Total
86.00±7.97
Orthoddontics
56
19.00±3.67 15.00±2.141
20.62±1.95
18.50±1.236
14.88±5.006 88.00±11.42
Periodontics
63
18.00±2.96
16.33±1.34
19.33±3.25
19.00±0.67
17.33±2.01
90.00±6.14
Prosthodontics
35
17.20±1.18
14.20±1.34
17.80±2.34
20.00±0.64
16.20±3.29
85.40±3.66
Public Health
28
22.50±2.09
17.00±1.90
19.00±1.61
21.50±3.84
19.50±2.09 99.50±10.01
Oral Pathology
14
20.50±1.55
16.50±2.59
20.00±3.11
19.00±2.07
16.00±1.03
92.00±8.30
Endodontic
28
21.00±2.78
15.75±1.32
20.75±0.44
20.75±1.95
19.25±3.48
97.50±7.93
Oral Medicine
28
17.50±2.09
15.75±1.95
19.75±0.84
19.25±0.44
14.75±3.55
87.00±3.60
Oral Surgery
21
16.00±2.21
15.00±2.21
20.67±1.93
17.67±1.27
14.00±2.89
83.33±8.21
Pedodontics
14
16.00±0.00
14.00±2.07
21.50±0.51
20.00±0.00
9.50±3.63
81.00±6.22
Table : Comparison of mean knowledge score with the type of
practice in Karnataka
Specialist
Mean +S.D
N
Informed
consent
Legal aspect
Administrative
issues
General
Practitioners
114
18.66 +2.79
14.24 +2.39
17.79 +2.42
19.11 +2.96
18.68 +4.55
Orthodontists
72
19.83 +3.15
15.63 +2.30
19.50 +2.47
19.17 +2.86
20.25 +4.99
Periodontists
21
20.14 +2.92
16.86 +2.82 19.00 +1.45
20.14 +2.71
21.86 +2.01
Prosthodontists
66
20.27 +2.74
15.50 +2.33
18.95 +2.46
18.32 +2.97
19.82 +4.35
Public health
9
21.00 +3.00
16.00 +.87
17.33 +2.18
22.67 +2.18
18.33 +2.50
oral pathologists
15
20.60 +2.67
16.60 +2.59
22.20 +2.49
19.80 +2.18
22.40 +2.67
Endodontists
36
19.67 +1.87
15.83 +2.83
17.75 +2.23
18.67 +2.69
20.75 +3.54
oral medicine
21
17.14 +1.77
14.57 +2.50
17.14 +2.97
18.00 +2.95
21.00 +1.55
oral surgeons
42
20.79 +2.24
16.14 +2.23
20.43 +1.86
18.79 +3.87
22.00 +1.53
Pedodontists
42
20.71 +2.34
14.07 +3.47
18.93 +3.21
18.57 +4.95
19.64 +3.51
Total
438
19.69 +2.80
15.21 +2.65
18.77 +2.67
18.97 +3.34
20.08 +4.08
Patient centered Dentist centered
Table : Comparison of mean knowledge score with the hours
of practice in Karnataka
Hours of
N
practice
Patient
Dentist
Informed
centered
centered
consent
Legal aspect
Administrative
issues
<5hrs
324 19.78 +2.81
15.23 +2.75
19.04 +2.57
19.08 +3.46
20.13 +4.07
>5hrs
114 19.45 +2.77
15.16 +2.36
18.03 +2.83
18.66 +2.95
19.92 +4.11
Total
438 19.69 +2.80
15.21 +2.65
18.77 +2.67
18.97 +3.34
20.08 +4.08
Table : Comparison of mean knowledge score with the number of hours
of practice in Bangalore
Hours of
Practice
N
Patient
centered
Dentist
centered
Informed
consent
Legal
aspect
Administrative
issues
<5hrs
238
18.09±3.81
15.82±1.98
19.24±2.63
19.24±2.49
15.53±4.23
>5hrs
189
18.67±2.70
15.11±1.83
19.26±2.41
18.85±2.39
17.15±2.27
Table : Comparison of mean attitude score with the age in Karnataka
Age
in years
N
Patient
Centered
Dentist
Centered
Informed
Consent
Legal Issues
Administrative
issues
20-30
90
11.20 +1.77
6.50 +1.74
21.30 +2.95
2.67 +1.08
4.20 +1.59
31-40
249
11.37 +1.98
7.05 +2.16
21.69 +2.64
2.76 +1.21
4.84 +1.75
41-50
99
10.76 +1.73
7.45 +1.44
21.70 +2.27
3.06 +1.16
5.52 +1.84
Total
438
11.20 +1.90
7.03 +1.96
21.61 +2.63
2.81 +1.18
4.86 +1.79
Table : Comparison of mean attitude score with the Age in Bangalore
Age in
years
n
Patient
Dentist
Informed
Legal
Administrative
centered
centered
consent
aspect
issues
20-30
126
9.78 ±1.624
11.33 ±1.570
21.56 ±3.108
2.944±1.03
4.06 ±1.43
31-40
238
10.24 ±.820
12.00 ±2.105
22.59 ±2.370
2.61 ±1.1404
4.85 ±1.54
41-50
50
11.58 ±1.842
12.42 ±1.762
21.30 ±2.053
2.60±1.3093
5.16 ±1.46
>50 years
13
9.85 ±2.075
11.46 ±0.519
20.92 ±1.038
4.54 ±0.5189
5.46 ±0.52
Table : Comparison of mean attitude score with the gender in Karnataka
GENDER
N
Patient
Dentist
Informed
Legal
Administrativ
Centered
Centered
Consent
Issues
e issues
Male
276
11.22 + 1.92
7.18 +1.95
21.54 +2.67
2.79 +1.22
4.95 +1.81
Female
162
11.17 + 1.85
6.76 +1.95
21.72 +2.56
2.83 +1.10
4.72 +1.73
Total
438
11.20 + 1.90
7.03 +1.96
21.61 +2.63
2.80 +1.18
4.86 +1.79
Table : Comparison of mean attitude score with the gender in Bangalore
GENDER
n
Patient
Dentist
Informed
Legal
Administrativ
centered
centered
consent
aspect
e issues
Male
252
10.42±2.00
12.11±1.93
22.53±2.39
2.83±1.28
4.97±1.59
Female
175
10.00±1.55
11.44±1.84
21.44±2.78
2.68±0.97
4.24±1.33
Table : Comparison of mean attitude score with the geographical
location in Karnataka
Dentist
Centered
Informed
Consent
Legal
Issues
Administrative
issues
294 10.91 +1.76
7.41 +1.80
21.64 +2.82
2.91 +1.19
5.16 +1.79
Semi urban
81
11.41 +2.11
6.15 +2.04
21.82 +2.12
2.52 +1.17
4.48 +1.88
Rural
63
12.29 +1.79
6.38 +2.05
21.19 +2.26
2.71 +1.08
3.95 +1.18
Geographic
location
N
Urban
Patient
Centered
Table : Comparison of mean attitude score with the geographical
location in Bangalore
N Centered
Patient
Dentist
Centered
Informed
Consent
Legal
Issues
Administrat
ive issues
Urban
392
10.25±1.90
11.84±1.92
22.00±2.66
2.79±1.16
4.71±1.47
Rural
7
10.00±.00
13.00±.00
24.00±.00
2.00±.00
3.00±.00
Semi Urban
28
10.25±1.11
11.50±2.10
22.75±1.96
2.75±1.32
4.50±2.22
Geographic
Location
Table : Comparison of mean attitude score with the
type of practice in Bangalore
Specialist
n
Patient
Dentist
Informed
Legal
centered
centered
consent
aspect
Administra
tive
Total
issues
GP
140
10.30±1.31
11.55±1.75
21.30±2.50
3.050±1.12
3.80±1.08
50.00±4.72
Orthoddontics
56
11.12±2.33
11.50±2.31
23.88±1.77
2.500±.87
5.00±1.00
54.00±4.16
Periodontics
63
9.67±1.84
12.00±1.34
21.44±2.28
2.667±1.06
4.67±.82
50.44±5.35
Prosthodontics 35
9.60±1.98
11.20±1.74
22.60±1.21
2.400±.81
4.20±1.62
50.00±3.90
Public Health
28
11.75±0.44
13.2±1.32
24.50±3.91
4.250±0.44
6.75±2.20 60.50±7.36
Oral Pathology
14
10.00±0.10
13.50±1.55
24.00±2.07
2.500±0.51
6.50±0.51
56.50±2.59
Endodontics
28
11.00±2.16
12.25±1.11
20.75±0.84
3.000±1.61
5.25±1.66
52.25±1.95
Oral Medicine
28
9.00±1.01
13.00±1.01
21.25±2.53
2.500±.88
4.00±0.10
49.75±4.03
Oral Surgery
21
9.33±2.55
9.33±2.93
23.00±3.01
1.667±1.27
Pedodontics
14
10.00±2.07
13.00±0.10
20.50±0.51
1.500±0.51
5.00±1.44 48.33±3.95
7.00±1.03
52.00±2.07
Table : Comparison of mean attitude score with the
type of practice in Karnataka
Type of Practice
N
Patient
Centered
Dentist
Centered
Informed
Consent
Legal Issues
Administrative
issues
General
practitioner
114
10.92 +2.01
6.05 +1.85
21.03 +2.28
2.63 +1.21
4.45 +1.81
Orthodontists
72
11.04 +1.55
7.83 +1.61
22.79 +2.33
2.75 +1.14
4.83 +1.73
Periodontists
21
11.00 +1.64
8.57 +1.32
23.14 +2.01
2.86 +1.39
5.71 +1.71
Prosthodontists
66
11.77 +1.69
7.18 +2.08
22.18 +2.16
2.95 +1.23
4.59 +1.66
Public health
9
13.00 +.00
5.67 +.50
21.00 +1.50
2.67 +.50
5.00 +2.60
Oral pathathologist
15
10.00 +2.36
7.20 +2.57
23.60 +2.13
3.00 +1.31
7.00 +2.07
Endodontists
36
11.83 +1.98
6.75 +2.27
19.75 +2.75
2.50 +1.21
4.67 +1.51
Oral Physicians
21
11.29 +1.62
6.43 +1.54
20.57 +2.04
2.71 +.72
4.57 +1.43
Oral surgeons
42
10.57 +1.94
8.21 +1.28
22.21 +2.36
3.36 +1.25
5.93 +1.46
Pedodontists
42
11.50 +1.98
6.86 +1.57
20.43 +3.54
2.86 +1.00
4.50 +1.47
Total
438
11.20 +1.90
7.03 +1.96
21.61 +2.63
2.81 +1.18
4.86 +1.79
Table : Comparison of mean attitude score with the
hours of practice in Karnataka
HOURS OF
PRACTICE
N
Patient
Centered
Dentist
Centered
Informed
Consent
Legal
Issues
Administrative
issues
<5
324
11.41 +1.75
7.06 +1.96
21.58 +2.69
2.79 +1.13
4.86 +1.74
>5
114
10.60 +2.16
6.95 +1.97
21.68 +2.45
2.87 +1.31
4.87 +1.93
Total
438
11.20 +1.90
7.03 +1.96
21.61+2.63
2.80 +1.18
4.86 +1.79
Table : Comparison of mean attitude score with the
hours of practice in Bangalore
Hours
of
Practice
<5hrs
N
Patient
Centered
Dentist
Centered
Informed
Consent
Legal
Issues
Administrative
issues
238
10.18±2.02
12.03±1.93
21.91±2.9
2.91±1.17
4.79±1.51
>5hrs
189
10.33±1.59
11.59±1.9
22.30±2.21 2.59±1.13
4.52±1.55
Total
427
10.25±4.51
11.84±1.92
22.08±2.61 2.77±1.16
4.67±1.53
Comparison of overall knowledge score
(good fair, poor)
500
450
85.6
84.9
80.8
400
80.8
no. of participants
350
65.1
300
250
200
32.9
150
100
13.7
14.4
19.2
17.8
50
0
63
375
Fair Good
Patient centered
9
2.1
Poor
285
144
Fair Good
dentist centered
6
1.4
Poor
60
372
Fair Good
Informed consent
Knowledge scores
84
354
Fair Good
Legal aspect
6
1.4
Poor
78
354
Fair Good
Administrative
Comparison of overall attitude score
(good fair, poor)
400
350
70.5
69.2
61.6
300
no. of praticipants
54.8
52.1
250
200
42.5
39
38.4
309
150
30.8
303
270
240
100
171
168
228
186
17.8
11.6
50
78
6.2
135
5.5
51
27
24
0
Fair Good
Patient Centered
Poor
Fair Good
Dentist centered
Poor
Fair Good
Informed consent
Domains
Fair Good
Legal aspect
Poor
Fair Good
Administrative factors
The percentage distribution of dental professionals according to
preference for ethical consultation when confronted with ethical
or legal issues in Karnataka
300
55.5
no. of participants
250
40.4
200
150
30.1
243
19.2
100
177
132
50
84
8.9
39
0
0
Professional
colleague
Mentor
Spouse /family
Advocate
member
Preference for ethical consultation
Ethics
committee
Religious leader
The percentage distribution of dental professionals
according to preference for ethical consultation when
confronted with ethical or legal issues in Bangalore
250
No. of Participants
200
41
36.1
150
100
175
154
11.4
50
49
1.6
7
spouse
Lawyer
0
Professional
colleague
Dept Head
1.6
7
Ethics
Committee
Preference for ethical consultation
3.3
14
Religious
leader
The frequency distribution of dental professionals according to
reason for choosing or declining ethical consultations
600
no. of participants
500
86.9
89.7
95.8
400
60.3
300
200
380
393
420
43.8
264
192
100
0
Consultation
to solve the
problem
believe in
shared
decision
Gives other
perspective
Decision
It is my
differed from responsibility
mine
to resolve the
issue
uses ethical consultation
Does not use ethical consultations
Reason of using or not using ethical consultation
The frequency distribution of dental
professionals according to permissions obtained
from legal authorities in Karnataka
500
450
88.4
no. of participants
400
350
300
52.1
250
200
66.4
61.6
56.2
387
270
150
228
246
291
100
50
0
state dental
council
Medical
Corporation
Pollution
establishment
trade license
control board
act
Registration authorities for dental practice
Biomedical
waste
management
The frequency distribution of dental professionals
according to permissions obtained from legal
authorities in Bangalore
500
450
93.4
no of participants
400
350
67.2
300
49.2
250
200
50.8
50.8
399
287
150
210
100
217
217
50
0
State dental
Council
Medical
Corporation
Pollution
Establishment
License
control board
act
Registration authorities for dental practice
Biomedical
Waste
management
No. of participants
Practice of Biomedical waste
disposal methods in Bangalore
450
400
350
300
250
200
150
100
50
0
77
329
14.8
63
8.2
35
Dispose along with
other waste to
municipality
Attached to waste
management
company
Method of waste disposal
Both 1 and 2
Practice of Biomedical waste
disposal methods in Karnataka
300
52.7
no. of particiants
250
200
30.8
150
231
100
135
12.3
50
54
4.1
18
0
Municipality
Waste
management
Both
Did not
answer
Frequency distribution of obtaining written informed
consent among dental professionals in Bangalore
300
54.1
No of participants
250
200
42.6
150
100
231
182
50
3.3
14
0
Every patient
Only special cases
written informed consent
Not at all
Frequency distribution of obtaining written informed
consent among dental professionals in Bangalore
300
54.8
No Of participants
250
200
150
32.2
240
100
141
13.1
50
57
0
Every patient
Only special cases
Not at all
Type of maintenance of patient record in
Bangalore
350
No. of Participants
300
59
250
200
150
252
100
13.1
50
0
1.6
7
Do not
maintain
98
56
prescription
pad
23
3.3
14
Written
record
Digitalized
record
Demographic
details
Type of maintenance of patient record
in Karnataka
350
300
56.2
Number of participants
250
200
150
246
100
50
18.5
11.6
51
11.6
51
81
0
Do not maintain Prescription pad
Written record
Digital record
2.1
9
Only
demographic
records
Distribution of dental professionals according to accessibility of
patient records in the dental clinic in Bangalore
250
42.6
No. of participants
200
150
29.5
24.6
182
100
126
105
50
3.3
14
0
Dental surgeon
Dental surgeon Dental surgeon and
and secretary
spouse
Accessibility of patient's record
All the staff
Distribution of dental professionals according to
accessibility of patient records in the dental clinic in
Karnataka
200
180
Number of participants
160
34.2
31.5
31.5
140
120
100
80
138
150
138
60
40
2.7
12
20
0
Dental surgeon
Dental surgeon
secretary
Dental surgeon
and spouse
Accessibility patient records
All the staff in the
clinic
no. of participants
Distribution of dental professionals according to reporting
patients about treatment prognosis/failure/wrong in Bangalore
450
400
350
300
250
200
150
100
50
0
78.7
336
14.8
63
Report patient
0
6.6
28
if treatment Complete the
Not sure
fails
case
Reporting about the instrument breakage or wrong treatment
Distribution of dental professionals according to reporting
patients about treatment prognosis/failure/wrong in Karnataka
450
number of participants
400
77.4
350
300
250
200
339
150
100
13
57
50
0
Report the patient
Report if only
treatment fails
1.4
6
Do not report but
complete the case
8.2
36
Not sure
Reporting about the instrument breakage and wrong treatment
Distribution of dentists according to willingness
to modify the receipt in Bangalore
350
No of participants
300
57.4
250
200
150
100
50
245
14.8
16.4
11.5
49
63
70
0
0
Refuse no
explanation
Refuse and
legal reasons
explained
Refuse and
explain other
than legal
explanation
Agree to back
dated receipt
Patient asking back dated receipt
Not sure
Distribution of dentists according to willingness
to modify the receipt in Karnataka
300
Number of Participents
53.4
250
200
150
100
50
19.2
234
12.3
11.6
3.4
84
54
51
0
Refuse no
explanation
Refuse and
legal reasons
explained
Refuse and
explain other
than legal
explanation
Agree to back
dated receipt
Patient asking back dated receipt
15
Not sure
number of Participants
Frequency distribution of dental professional’s response to
patient failure of payment for the services received in Bangalore
200
180
160
140
120
100
80
60
40
20
0
36.1
34.4
23
154
147
98
6.6
28
Discontinue the
Perform only
treatment
emergency services
Complete the
treatment and
request for payment
of services
Dentist response for Patient failure to pay for the service
Not sure
Frequency distribution of dental professional’s response to
patient failure of payment for the services received in Karnataka
number of Participants
250
38.4
200
37
150
19.2
100
50
168
162
5.5
84
24
0
Discontinue the
Perform only
treatment
emergency services
Complete the
treatment and
request for payment
of services
Dentist response for Patient failure to pay for the service
Not sure
Frequency distribution of dentist response to patient
requesting for in appropriate treatment in Bangalore
no. of participants
300
52.5
250
200
150
100
50
224
13.1
56
23
11.5
49
98
0
Oblige patient Discontinue
services
Refer other
dentist
Not sure
Dentist response to patient request for in appropriate
treatment
Frequency distribution of dentist response to patient
requesting for in appropriate treatment in Karnataka
400
no. of participants
350
66.4
300
250
200
291
150
18.5
100
50
8.2
36
6.8
30
81
0
Oblige patient
Discontinue
services
Refer other
dentist
Not sure
Dentist response to patient request for in appropriate treatment
Frequency distribution of dentist response to poor
quality treatment of other dentist in Bangalore
No of participants
250
200
39.3
34.4
150
100
147
50
168
16.4
70
6.6
28
0
Report to the
patient
Report to the Report to the
Do nothing
concerned dentist himself
authority
Dentist response to poor work of other dentist
Frequency distribution of dentist response to poor
quality treatment of other dentist in Karnataka
250
No. of participants
200
38.4
150
100
50
27.4
19.2
15.1
84
168
120
66
0
Report to the
patient
Report to the
Report to the
Do nothing
concerned
dentist himself
authority
Dentist response to poor quality work of other dentist
Percentage distribution of dental professionals
Having Professionals indemnity insurance in Bangalore
No of participants
600
500
95.1
400
300
200
100
0
406
3.3
14
1.6
7
Yes
No
Don’t know
Dental professionals with professional indemnity insurance
Percentage distribution of dental professionals
Having Professionals indemnity insurance in Karnataka
400
71.9
no. of participants
350
300
250
200
150
100
50
0
27.4
315
120
0.7
3
Yes
No
Not sure
Dental professionals with professional indemnity insurance
Distribution of dental professionals according to
year of renewal of KSDC registration in Bangalore
No of participants
600
500
95.1
400
300
200
406
100
3.3
14
0
one year
back
2-3 years
back
1.6
7
3-4 years
back
>5 years
back
Year of KSDC registration
Not
renewed at
all
no of participants
Distribution of dental professionals according to
year of renewal of KSDC registration in Karnataka
500
450
400
350
300
250
200
150
100
50
0
89
390
2.7
12
One year
back
1.4
6
4.1
18
2-3 years
3-4 years
>5 years
back
back
Years of KSDC renewal
2.7
12
Not renewed
at all
Conclusion
• The study shows there is still a scope of incorporating biomedical
ethical principles in the dental practice. Even though the ethical
principles are not prima facie binding attention should be given to
the individual cases. Attempt should be made to analyze the ethical
importance in every day practice. We should attempt to integrate
and incorporate the ethical principles in our practice. Attempt
should be made by the individual dental professionals to improve
their competence by enrolling in continuing dental education such
as workshops and conferences on regular basis. Incorporating ethics
in every day practice helps to enhance the quality of dental care
delivered
• Development of moral judgment is a gradual process. Higher state
of moral reasoning is possible only if cognitive conflict is
stimulated. Moral reasoning at a stage higher than one’s own leads
increased moral thinking at the next higher stage, only if it
disagrees with or introduces uncertainty into the individual’s own
decision on moral dilemmas.
4-PUBLICATION -1
– Preparing 2 article for publication
5- OVER ALL PROGRESS
completed with data collection
6.PLAN OF WORK FOR THE NEXT SIX
MONTHS
– Review and discussion writing
REFERENCES
1.
Prajna Pramod Nayak, V. K. (2016). Ethical Conventions: A Study on Dental Practitioner’s
Knowledge and Practice of Ethics in their Line of Work in Bangalore, India. Journal of
Clinical and Diagnostic Research, 10 (8), ZC84-ZC87.
2.
Mathur K, D. S. (2014). Knowledge, Attitude and Behaviour of Consumer Protection Act
among Oral Health Professionals in Jodhpur, Rajasthan. International Journal of Preventive
& Clinical Dental Research, 1(3), 15-19.
3.
General Dental Council Standards of Conduct, Performance and Ethics. 2012
4.
Naidoo, S. (2015). Taking and making decisions forchildren in dentistry. SADJ, 70 (7), 308310.
5.
Giles, J. (2013, October 14). Ethical advertising in dentistry. Retrieved 21 2016, from
http://www.asdablog.com/ethical-advertising-in-dentistry/.
6.
An Introduction to Ethics, Professionalism, and Ethical Decision Making. (2012). Retrieved
21 August , 2016, from https://acd.org/PDF/Ethics_Handbook_for_Dentists_(s).pdf.
Thank you…