This study was used to evaluate the attitude and knowledge of medical students towards collaboration of medical and dental practice. We included only medical students in the survey as it would suffer a response bias from dental students as participants may simply have positive disposition towards the study objective, as shown by a study which was conducted by Zhang in 20157.
Overall, the medical students showed fairly good attitude and knowledge towards medical and dental collaboration in congruence with the results obtained in the study by Zhang.7But analysis of groups within each parameter showed a significant difference. Based on year of study, it was found that student from third and final year had more positive attitude,than the Interns, unlike results obtained by Zhang.7 More than half the number of participants, particularly the interns did not agree to attend compulsory rotation in dentistry with p value of 0.017, contrary to finding in which Hendricson and Cohen8 concluded this rotationship not only beneficial but essential.
Although nearly 50% participants had fair knowledge regarding the oral-systemic link, many participants were confused when asked if it was mandatory to undergo an oral check-up before pregnancy. Sufficient research has shown that severe periodontal disease in pregnant women predisposes her to a higher risk to deliver preterm and/or low-birth weight new born10. Offenbacher11found mothers with periodontal disease are at a risk seven times more than the normal. When asked about diabetes and oral health link students seemed to have some vague knowledge regardless of year of study. In addition, previous investigations have established an association between either type 1 or type 2 diabetes and periodontal diseases to the extent that Periodontitis has been called the ‘‘sixth complication of diabetes’’ 12,13. Interestingly analysis among gender revealed statistically significant difference with more knowledge among females with regard to questions pertaining to criteria to undergo treatment among HIV patients. Though it does not provide any supporting evidence to prove poor knowledge, but it indicates the level of confusion among the medical students about HIV patients and dental treatment.
While assessing the attitude, we found significant data that junior students advised and motivated their patients to undergo dental check-up regularly, compared to senior students who gave a more of neutral response. One of the reasons for such an attitude from senior students can be because of the concept of social hierarchy which can be due to lack of interprofessional communication and patient management4.
In the United States, utilization of oral health care services and the incidence of oral disease are strongly linked to dental insurance coverage14.In India though the dental insurance sector has not yet taken off, 40-50% of the medical students strongly feel that dental check-up and some part of treatment must be covered in general health packages.
Around 50-60% participants on average responded positively towards the integral collaboration and interprofessional communication, although 25-30% students were not sure and the rest disagreed to it. Analysis showed that the third and final year students were more positive than interns which is in contrary to result obtained from study by Zhang et al7. The exposure at clinics along with the interest of students affect the perception of oral health and its importance among the medical students, which when applied to Indian scenario the egocentric power relations among healthcare workers which instead of creating new ways, is threatening this interprofessional collaboration15.
Student’s attitude is associated with factors such as gender, regular dental check-up, and curriculum. Results of a previous study reported that gender could affect a student’s attitude towards medical dental collaboration9. Questions pertaining to the attitude towards collaboration such as insurance benefits for dental treatments received positive response from females than males. When asked about importance of interprofessional communication for exchange of knowledge and better patient care, females gave a greater positive response than males, which can be attributed to higher ego among males15.
In clinical practice, Interprofessional continuing education is a useful means of regulating and stabilizing a professional’s identity and improving teamwork 4. Guidelines must be set to improve confidence in provider’s ability with regard to cases pertaining to both the fields and have access to updated knowledge about the collaboration between medical and dental practice. Medical and Dental professional body plays an important role here. They can lay guidelines for the indications, timing, protocols, and responsibilities of referral and consultation among physicians and dentists. Patients and the community should be made to understand the relationship between oral and systemic health by means of awareness campaigns. In doing so, National health goals can be achieved only by reducing these kinds of healthcare disparities.