342 participants were included in the final analysis. The mean age was 37 years, with 12.4 years of practice as average. Female dentists represented 51.8% of the sample. Most participants were general dentists (61.1%), worked in private service (67%) and in an urban setting (93%). Regarding access to smartphones, 97.66% of dentists reported owning one. Demographic characteristics are presented in table 1.
Frequency of use of ICTs
WhatsApp was the most used ICT with 97.4% of participants using it to communicate with colleagues, and 93.6% with patients. Similarly, Facebook was used by 88.0% (n = 301) of dentists to interact with colleagues, while 67.8% did so with patients. The frequency of use of all ICTs is depicted in table 2. ICTs for academic purposes had lower usage rates compared to other categories. The most frequently used platform for academic purposes was PubMed, which was used by 42.7% (n = 146) of respondents, while UpToDate was only used with by 4.4% of surveyed participants.
The frequencies of use of ICTs for each studied purpose are depicted in Fig. 1. Almost all participants reported communicating with colleagues (99.7%) and with patients (96.2%) using ICTs. In contrast, academic information searching was the least used application, with 36.5% (n = 125) of respondents indicating no ICT use for this purpose. Similarly, 23.68% (n = 81) of respondents reported not interacting with patients through ICTs.
More than 90% (n = 308) of dentists agreed ICTs are useful for health and service promotion, getting involved in research projects, solving daily clinical cases, working in groups and finding new job opportunities.(Fig. 2). Regarding barriers, privacy was the biggest concern among dentists, with 65.2% (n = 223) agreeing that it is an issue concerning ICT use. The second most frequent barrier was time, with 48% (n = 164) of respondents considering not having enough time to use ICTs. A difficult internet connection and no internet connection were perceived as a barrier by less than a third of respondents (Fig. 3).
Chi Square testing was performed to identify relationships between demographic variables and the use, perceptions and barriers of ICTs. Variables with a p- value below a threshold of 0.05 were included for further analysis. Individual bivariate analysis results are recorded in the Supplemental Appendix. The findings of the multivariate analysis are summarized in Tables 4. 5 and 6 .
Regarding ICT uses, specialists were more likely (OR = 4.60, p < 0.01,95%CI: [CI 2.59–8.47]) to use ICTs for academic purposes. On the contrary, having more than 8 years of experience was related to the opposite trend (OR = 0.271, p = 0.010, 95% CI: [0.097–0.727]), it was also associated with a reduced likelihood of using ICTs for patient interaction ((OR = 0.38, p = 0.030, 95%CI: [0.154–0.912]). An increased likelihood of ICT use for patient communication was noted among female dentists (OR = 2.81, p < 0.01,95%CI: [1.46–5.65]) Specialists (OR = 3.14, p < 0.01, 95%CI: [1.47–7.32]) and those working in private institutions OR = 2.17, p = 0.02, 95%CI; [1.14–4.16])
Analysis of perceptions and barriers showed that dentists working in private institutions were more likely to agree that ICTs are useful to self promoting (OR = 5.48, p < 0.01, 95% CI: [2.05–16.9]), solving clinical cases (OR = 2.51, p = 0.01, 95%CI: [1.28–4.96]), and working in group (OR = 2.25, p = 0.04, 95%CI:[1.04–4.87]). The type of institution had no significant statistical association with any of the barriers presented.
Female dentists were more likely to agree that ICTs are useful for working in group (OR = 3.44, p = 0.01, 95% CI: [1.5–8.92]) and health promotion (OR = 5.74, p < 0.01, 95%CI: [2.32–17.4]). Concerning barriers, being female was associated with an increased likelihood of considering privacy a barrier for ICT use (OR = 1.89, p = 0.01, 95% CI: [1.19–3.03]), having no internet access (OR = 1.91, p = 0.02, 95%CI:[1.13–3.25]), and difficult internet access (OR = 2.1, p < 0.01, 95%CI: [1.28–3.49]).
Dentists older than 33 years of age had an overall less favourable perception of ICTs, represented by the reduced likelihood to preferring ICTs to Traditional channels (OR = 0.4 p < 0.01 [95%CI 0.215, 0.725]). Regarding barriers, this group was more likely to be concerned with privacy (OR = 1.84, p = 0.01, 95%CI: [1.16–2.94]), not having internet connection (OR = 2.14, p = 0.01, 95%CI: [1.22–3.8]), and not having enough time to use ICTs (OR = 1.94, p < 0.01, 95%CI: [1.24–3.05])