The purpose of this study was to assess the use, perceptions, and barriers of ICTs among a sample of Ecuadorian dentists. Overall, we found that virtually all surveyed participants used at least one ICT platform on their daily practice. This shows that dentistry has adopted the use of ICTs to share deals and promotions, networking, providing customer service, and advertising dental practice with patients. Previous studies assessing the use of social media among dentists, have found that between 51% to 76% of individuals used ICTs for professional purposes . In our study, 95.3% of respondents stated they used ICTs for this end. On the other hand, previous publications have reported that patients tend to give higher satisfaction scores when dental care providers use ICTs for patient communication. In this regard, our study found that most dentists (96.2%) already used ICTs to communicate with patients, with WhatsApp cited as the most used application for this purpose (83.9%). The latter finding agrees with a previous study in which roughly 70% of surveyed health professionals perceived this application as beneficial during practice.
Currently, Facebook is considered as the biggest social media platform, allowing for complex social interactions between individuals with similar interests . In agreement with recent studies, we found that this platform was the most used ICT for interacting with both patients (67.8%), and colleagues (88%) . The widespread adoption of this platform makes it an attractive mean of interacting with patients and efficiently sharing dental care information. However, Facebook has been widely criticized recently for mismanaging user information, which should be of concern considering that more than two thirds of those surveyed in our study had privacy or security concerns about personal and/or patient information related to the use of ICTs for the dental practice.
The internet has become an essential tool for healthcare professionals to improve their knowledge and to acquire updated information about health care and their profession. In our study, roughly two-thirds of respondents used ICTs to search for academic information. Still, there are important questions regarding the quality of online information that ends up being transformed into practice. Systematic reviews and metanalysis provide the strongest evidence for assessing original works, however only 7% of the participants in our study were found to frequently use them, a finding that relates to a previous study among physicians . On the other hand, most dentists surveyed considered that ICTs can be useful for health promotion, and for self-promoting professional services. ICT platforms allow for an ever-increasing amount of data to be shared, transforming the way patients approach and manage their care. This in turn leads to changes in patient’s expectations, which dentists must be able to identify and adapt in order to be able to leverage them into an increased patient satisfaction.
On the subject of barriers, privacy and patient confidentiality have been regarded as the most significant difficulties to m-Health implementation in regions such as Europe and America. Similarly, we found that privacy and security concerns related to personal and or patient information were the biggest concerns related to ICTs in more than two-thirds of the Ecuadorian dentists surveyed. The issue of patient privacy expands well beyond the domain of the dentistry practice, this is why it is essential for both ICT providers and healthcare practitioners to work together in order to ensure that patient information is only accessed by authorised individuals. Furthermore, possible solutions for securing many aspects of patient-related information are currently being explored by researchers to ensure privacy and confidentiality.
In a previous study conducted in 2013 among Latin American dentists, around 80% of participants reported lacking a reliable internet connection. In contrast, we found that less than a third of Ecuadorian dentists considered the lack of a reliable mobile connection and internet at work as barriers for ICT implementation. A possible explanation might be attributed to the ongoing expansion of wireless technology infrastructure across Latin American countries. Still, there is a considerable proportion of dentists that could miss potential interventions through ICTs due to a lack of widespread access to the internet. In developing societies, the adoption of new technologies often yields increased benefits by leapfrogging the need to implement infrastructure and enabling the distributed implementation of new strategies[26, 27].
Finally, we found several associations between demographic variables and the perception towards ICTs. For instance, dentists working at private practices were more likely to agree on the usefulness of ICTs to promote their professional services, collaborate with other colleagues, and for solving clinical cases than their counterpart. This can be related to the need of private dentists to adapt to evolving patient preferences, and the potential of ICTs to offer tools which provide a competitive advantage to peers. In contrast, older dentists had a less favourable view to most of the perceptions studied and were more likely to report barriers related to the use of ICTs. A possible explanation can be attributed to what is known as the digital divide.This concept relates to the observation that users born in the digital era are more familiar with the internet and computers in general, therefore they tend to adopt technologies at a faster rate than their older peers.
In conclusion, our study found a high use of ICTs among Ecuadorian dentists, a finding that compares to previous reports among physicians and nurses in the country[13, 31]. But despite the potential benefits of these technologies, there are many barriers and factors that need to be accounted when implementing ICTs. In particular, it is necessary to improve and increase the use of evidence-based resources among dentists, and the implementation of these resources in postgraduate and continuing dental education.
Strengths and Limitations
One of the main strengths of this study was that it covered a relatively large sample size of dentists, with participants of different age, gender, and practice. However, in light of our findings there are several limitations worth mentioning. First, this study was not conducted in all Latin American countries, as such the preferences and usage of ICTs could differ, limiting the ability to generalize our results to all Spanish-speaking dentists. Second, due to the cross-sectional nature of the study, cause and effect relationships cannot be made. Third, the original validation of the survey used in this study was conducted among physicians, it should be noted that validity and reliability coefficients have not been calculated yet specifically for dentists. Fourth, although sources of bias were minimized wherever possible in the study design, the frequencies, perceptions and barriers may be influenced by confounding variables not accounted for in this study. Finally, participants knew the purpose of the study, which could have affected the answers some of them gave. To the best of our knowledge, this is the first study to assess the use, preferences, and perceptions related to ICTs among Ecuadorian dentists.