Oral and dental health problems constitute one of the most common health problems in the world and generally do not receive sufficient importance in medical education programs. Numerous studies have reported that doctors can make a significant contribution to improving the level of oral and dental health in the community
9-11. TDIs represent one of the important oral and dental health problems of childhood, which can cause pain and anxiety in children, and can cause negative consequences such as psychosocial and aesthetic problems if mistakes are made during the emergency treatment and referral phase. Given that prompt and accurate treatment management in TDI cases can improve both shortterm and longterm outcomes, it is important to raise awareness of this issue among emergency health professionals. It is expected that physicians working in emergency departments have sufficient knowledge about the emergency treatment of TDIs not only to increase treatment success rates, but also to reduce anxiety levels in children and their parents.
This study has revealed data that can provide information about the diagnosis, treatment and awareness of TDIs to physicians in all branches working in the emergency departments of hospitals in Diyarbakır city center. In our study, the average knowledge scores and the personal and demographic information of the participants were compared, and the attitudes and behaviors of the participants were evaluated. In this study, unlike other studies18-21, an educational brochure link was added to the end of the electronic questionnaire. By placing the brochure link at the end of the questionnaire, it was aimed to increase the awareness of physicians of this issue. Brochures were used in this study because of their advantages, such as being a method for personal information transfer and remembering the information by reaccessing it when necessary.
In this study, 53.95% of the physicians stated that their level of knowledge about TDIs was insufficient, 65.13% stated that it was important to learn about TDIs, 88.82% stated that they wanted to receive information about the emergency management of a tooth that had a dental avulsion, and 67.76% answered “no” to the question as to whether they had ever encountered dental avulsion before. In the light of all these findings, we think that physicians need more training on TDI diagnosis, treatment and the referral of these cases. For this reason, a short, colorful and catchy educational brochure link was added to the end of the questionnaire, explaining what physicians should do in such a situation. In addition, this subject should be included more in the medical education curriculum, and awareness of this issue should be increased through postgraduate training.
In the fourth part of the questionnaire, the participants were asked questions in order to evaluate their knowledge of and experience with dental avulsion. The highest score that the participating physicians could achieve was 25, while the average score in our study was 12,11 (48.44%, see Table 5). We believe that it is necessary to increase awareness of this issue with trainings, seminars and conferences on this subject, aimed at physicians.
According to the data obtained in this study, no significant difference was found between the dental avulsion knowledge and experience scores of the physicians based on their gender. Bahammam18, Aren et al.19, Kızıltan et al.20 reported in their studies, similar to our study, that there was no statistically significant difference between the genders.
According to the data of Aren et al.’s study (19), no significant difference was found between the dental avulsion knowledge and experience scores of physicians in terms of their age. There was no significant difference between the ages of the physicians and their correct answer rates. In the Bahammam study18, there was a statistically significant difference between all age groups, except between the (30-40) and (40-50) and between the (40-50) and (≥ 50) age groups. Yiğit et al.21 found that the age of physicians was significantly related to the level of knowledge, and Kızıltan et al.20 (20-30) found that the knowledge scores of the age group were lower than the other groups. Although our study concluded that the age of the physicians did not affect their knowledge and experience scores, we believe that, with increasing age, experience and exposure to avulsion cases will increase physicians’ knowledge about the treatment of these cases.
According to the data of this study, a statistically significant difference was found between the dental avulsion knowledge and experience scores of the physicians in terms of their branches (p <0,05). Intern doctors’ dental avulsion knowledge and experience scores were found to be significantly lower than those of emergency medicine specialists. Although there is no statistically significant difference between other branches and intern doctors, the mean knowledge scores of intern doctors were found to be lower than those of doctors from all other branches. Bahammam’s study18 indicated that there was a statistically significant difference between different specialties, where emergency department physicians had the highest aver-age knowledge scores, followed by pediatricians. Kızıltan et al.20, as a result of comparing the knowledge scores of the participants with their demographic characteristics, found that the total scores of general practitioners and emergency medicine assistants were lower than those of emergency medicine specialists. We believe that the many and frequent encounters of emergency medicine specialists with TDI cases, compared to other branches, positively affect their level of knowledge.
According to the data of the study, no significant difference was found between the dental avulsion knowledge and experience scores of the physicians and their length of service in the profession. Aren et al.19 found that there was no significant difference between the length of service of physicians in the profession and their correct response rates, while Ulusoy et al.22 found that the length of experience as an emergency physician did not have a statistically significant effect on physicians’ knowledge of the emergency treatment of dental avulsion. The study of Kızıltan et al.20, contrary to our study, found that the knowledge scores of physicians with 0-5 years of professional experience were lower than those of the other groups. Although our study indicates that the length of service in the profession does not affect the knowledge and experience scores, it should not be ignored that working in the profession for many years will add a great deal of experience, both in terms of theory and in practice.
According to the data of the study, no significant difference was found between the dental avulsion knowledge and experience scores of the physicians in terms of their previous TDI training and the presence of a TDI management protocol in their clinics. However, there is a statistically significant difference between physicians’ dental avulsion knowledge and experience scores and their awareness of the IADT trauma guide. The knowledge and experience scores of the physicians who were not aware of the IADT trauma guide were found to be significantly lower than those of the physicians who were aware of the IADT trauma guide. This finding demonstrates the importance of having knowledge about current literature and guidelines.
According to the data of the study, there is a statistically significant difference between the dental avulsion knowledge and experience scores of physicians who have a dentist among family members and those who do not. Among physicians with no dentist among family members, the dental avulsion knowledge and experience scores were found to be significantly lower than among physicians with a dentist among family members. Similarly, Yigit et al.21 found that having a dentist among family members was significantly related to doctors’ level of knowledge. Holan and Shmueli23 found in their study that the doctors most successful in treating avulsed teeth were those married to a dentist. The reason for this result may be the easy consultation opportunity provided by a family member who is a dentist or a previous awareness.