The final research sample consisted of 204 responding professionals registered in the three Official Colleges of Dentists and Stomatologists of the Valencian Community who answered the survey. Regarding the background of the respondents, 57.3% were registered in Valencia, 31.4% in Alicante and 11.3% in Castellón.
Of these, 64 were male (32.7%) and 132 were female (67.3%). The mean age (± standard deviation) was 39.8 ± 11.1 years, with a range between 23 and 67 years. The most common level of qualification was licensed dentist (pre-1999 [Bologna declaration qualification]; 71.1%), but there were also dental graduates (post-1999 [Bologna declaration qualification]; 18.6%) and those graduates in medicine with specialization in Dentistry (10.3%). 89.2% received this training entirely in Spain or shared with another country, as in the case of 4.2% of the respondents. 85.3% of the sample had acquired additional academic training, usually a Master's degree.
Analysis by college (geographical)
Analysing the results obtained from the survey in the three colleges of the Valencian Community, based on the percentage of correct questions by college, it was found that dentists or stomatologists who took the survey, correctly scored an average of 61.9% of the questions in the first section on ethical knowledge, 65.3% of the questions in the second section on legislative knowledge and 62.2% of the questions in the third section on dental-legal documentation, which meant that 63.4% of all the questions in the questionnaire were answered correctly, as can be seen in Figure 1.
The overall score was 6.34 out of 10. Therefore, it can be concluded that dentists' and stomatologists' general level of knowledge of forensic dentistry and current health legislation and regulations was average in the Valencian Community and similar for each of the three sections considered.
Question 17 about the offences for which the dentist may be criminally liable and question 25 about fundamental rights related to consent were the most successfully answered questions, both with 93.1% correct answers. However, question 31, on expert examinations, was the question with the highest percentage of unfamiliarity of the whole test, with 7.4% not knowing or not answering. And question 20, which dealt with the question of what to do if a patient refuses to pay the dentist's fee, was the one where the respondents failed the most, with the highest percentage of incorrect answers of the whole test, 90.2%, as it can be seen in Figure 2.
In order to measure the relationship between level of education, specialisation, work experience, place and status at work and degree of knowledge, the level of knowledge was analysed according to the result of the Chi-squared test of independence and the F-test of the 1-way ANOVA model and/or the t-test for independent samples, depending on each variable.
Analysis by level of training/education
With regard to the specialisation of the professionals, as can be seen in Figure 3, 60.3% practised General Dentistry and to a lesser extent other specialisations (as this was a question where the professional could tick several options, the sum of the percentages exceeds 100%), followed by other specialisations. In second place, Endodontics was selected by 36.8% of the respondents and in third place, Prosthodontics, with 30.4%.
59.8% of the respondents had more than 10 years of work experience and 85.3% of them worked in urban areas. With regard to where they practised their professional activity, the majority, 52.2%, did so in their own private dental clinic and 51.7% in another private dental clinic, and with regard to the professional category that defined the interviewee, the majority, 52.9%, were self-employed.
Thus, with regard to the level of education, only the results of two questions were statistically significant: question 16, where, when faced with evidence of unqualified practice, it was found that those licensed dentists were those who failed the most (11%), and question 14, about the principles on which the dentist-patient relationship is based, where 48.3% of those with the most education were correct compared to 30% of those with the least education. It can thus be concluded that no higher level of knowledge was observed in either compulsory or additional academic education, and it can be concluded that there seems to be no relationship between level of education and level of knowledge, these figures are represented in Table 1.
Analysis by specialization
With regard to the specialisation, the group of respondents who had mentioned General Dentistry as their specialisation showed significant differences in the average score in the ethical knowledge group, where they obtained 65.9%, the second highest average score of all the specialisations, behind that obtained by the specialists in Aesthetics who obtained 69.5%, but both were much higher than the total average score of all specialisations for this section, which was 61.9%, and by extension, of all the questions answered in the questionnaire, obtaining a total average of 64.9% for the 3 sections, the second highest of all the specialisations, information represented in Table 2.
Survey respondents working as general dentists showed greater knowledge on some questions, such as question 13, which dealt with experimentation in the field of pharmacological therapeutics, where this group obtained 81.3% correct answers, compared to 73% of the overall sample, and also question 29, on informed consent, about which this group seemed more knowledgeable, obtaining 92.7% correct answers, again higher than the total for the rest of the specialisations, which was 89.25%. The results obtained in these individual questions and others, although not reaching the level of significance, accumulated and raised the mean level of knowledge for the total questionnaire for the specialisation of General Dentistry.
Another interesting set of results related to the group of respondents specialising in Aesthetics compared to the rest of the respondents. Up to 3 questions were reported where there were significant differences (13, 16 and 29) that respectively dealt with experimentation, the crime of unqualified practice and informed consent. It was observed that the group of professionals practising this specialisation got these questions right more than those who did not work in this field (the rates exceeded 93%), the total percentage of correct answers to question 13 was 73% and this specialisation obtained 93.1%, being also the specialisation that obtained the best results. As with question 16, in which the percentage of correct answers was 91.7% and this specialisation obtained 98.3%, or question 29, in which the total percentage of correct answers was 89.2%, and this specialisation obtained 98.3%, and as with question 13, this was the specialisation that obtained the best result, these figures can be seen in Table 3.
In the light of these results, certain differences can be seen depending on the specialisation in which the professional works, with those working in General Dentistry and Aesthetics Dentistry indicating that they are more knowledgeable about the aspects of the ethical knowledge section.
Analysis by work experience
With regard to work experience and level of knowledge, it could be seen that there were no major differences in terms of how long they had worked. The only question with a notable result was question 26, which referred to the importance of informed consent. Interestingly, with regard to knowledge based on work experience, 63.8% of those who had been working for 5-10 years were much more likely to get this question right, compared to the beginners, who got 31.4%, and to the more veteran ones, who got 37.7%, represented in Table 4.
Analysis by place of work
With regard to the workplace and level of knowledge, it could be seen that the university teacher was the most heterogeneous background in terms of knowledge with respect to the overall sample, as significant differences were observed in up to three questions. Firstly, they had a lower level of knowledge for question 18, concerning professional secrecy, obtaining an incorrect answer rate of 26.4%, when the percentage of incorrect answers in the whole column was 17.2%, thus obtaining the highest percentage of incorrect answers by far in comparison with the values obtained by all the other workplaces, which had values of 13.3% or 18.9%, among others.
However, a higher level of knowledge was obtained for questions 23 and 24, relating to the medical history of patients, with 84.9% correct answers for question 23, whereas the percentage of correct answers for the total column was 71.9%, thus obtaining the highest percentage of correct answers by far in comparison with the values obtained by all other workplaces. Something similar to what happened with question 24, which obtained 88.7% correct answers, when the percentage of correct answers in the total column was 74.9%, obtaining a value much higher than this, as it be seen in the Table 5.
Analysis by position at work (professional category)
And finally, with regard to the results of the relationship between the professional category and the degree of knowledge, it could be observed that the score in the section on legislation for the self-employed and employees as a whole was different from the rest. In order to better visualise it, Figure 4, was drawn up, that shows that knowledge of this professional category was somewhat lower in the section on legislation (grey boxes).
One of the questions contributing most to this result was question 22, which dealt with professional secrecy, which only 58.8% of this professional category of self-employed and employees got right, compared to 73% overall, being also the professional category that obtained the lowest percentage of correct answers to this question. Question 30, which dealt with the expert's requirements, was also interesting, with knowledge dropping to 44.1%, compared to 62.7% overall, again with the lowest percentage of correct answers. It concludes that only one background, that of the self-employed and employees as a whole, demonstrates a lower level of knowledge than the rest of the sample.