Perception and Behavior of PIDC Patients Towards Online Dental Health Information

Background: The Internet represents an increasingly common source of dental health related information, and it has facilitated a wide range of interactions between patient and the oral health care providers. Aim: To evaluate the perception and behaviour of Penang International Dental College (PIDC), Penang, Malaysia patients towards online dental health information. Methodology: A pre validated questionnaire was randomly distributed to 365 new and existing patients of PIDC attending treatment at the facility during the years 2019-2020. Convenience sampling was carried out for patients attending PIDC for their treatment. Statistical analysis: T-test was used to find the significant difference between the younger users (<35) and the older users (36-75) pertaining to using the internet for seeking dental health information. Furthermore, Pearson’s correlation was applied to correlate the relationship between age and the frequency of internet use for seeking dental information. Result: PIDC has a satisfactory number of patients (268) who use the internet for seeking dental health information. The patients have a positive perception towards the online dental health information gathered with a mean score of 28.7. There is a significant difference between the younger users (<35) and the older users (36-75) pertaining to using the internet for seeking dental health information (ρ<0.05). There is a significant relationship between age and the frequency of internet use for seeking dental information (ρ<0.05). Conclusion: PIDC does have a satisfactory number of patients who use the internet for seeking dental health information with a positive perception towards the information gathered.


Introduction
The Internet represents an increasingly common source of dental health related information, and it has facilitated a wide range of interactions between patients and oral health care providers. With easy access to the Internet these days, patients are able to gain an insight of their dental related signs & symptoms as well as information on maintaining good oral health. Information seeking behavior has an impact on the provider-patient communication, patient health status and quality of care remains an area of further inquiry, particularly in dentistry. Dental practice-based research networks (PBRNs) offers an ideal setting to assimilate dental advances and treatment decisions into practice as well as improving patient care altogether. The advantages include PBRN practitioner-investigators bringing practice relevant topics into the research agenda and engaging in the study development process.
Information seeking refers to the "purposeful seeking for information as a consequence of a need to satisfy some goal." Since 2000, Internet popularity for seeking health information has Copyright © Philip Pradeep MRD.000649. 6(5).2021 widely increased. A Pew survey in 2000 showed that 55 percent of American adults use the Internet to acquire health information [1]. Dental health information sought online by patients is not intended to replace dentists, but rather, to support it. Using the Internet to search for health information has many advantages: easy access, availability of a wide range of illustrated and audiovisual health resources, as well as providing an opportunity to ask experts' opinion [2]. Reasons for dental health seeking include the following: to know the dental pattern practiced by dentists, using personal judgment to make decisions regarding the treatment, and gathering information and experience from others [3].

Material and Method
A cross sectional study was designed and conducted in the form of questionnaire. The questionnaire we have used in our research was adapted from a previous study done in Scotland.
Before distribution of the questionnaire, validation was done. The sample size was set at 365 participants seeking treatment at PIDC in the time frame of 2019-2020. Convenience sampling was carried out for patients attending PIDC for their treatment. The questions are closed response and participants were asked to select one response from a range of categorical options. Patients had a choice to participate in the physical copy or our online questionnaire version which was conducted on Google Form at their convenience. The questionnaire was also available in Bahasa Malaysia for participants who preferred to answer questions in the local language. The data collected was entered into SPSS 16 and analyzed. The characteristics of the sample were analyzed and illustrated by descriptive means. T-test was used to find the significant difference between the younger users (<35) and the older users (36-75) pertaining to using the internet for seeking dental health information. Furthermore, Pearson's correlation was applied to correlate the relationship between age and the frequency of internet use for seeking dental information.

Result
According to the Table 1, 268 or 73% of the respondents have used the internet to seek dental information whereas 96 or 26.2% of them have not used the internet to search for dental information. According to the Table 2, majority of the patients, 142 or 38.7%, went online because they had developed some dental problems.
Only 33 or 9% of the respondents appeared to be checking out on the new medicines prescribed and treatment suggested. Table 2: Reasons for seeking health information online.

Reason Total
Noticing new symptoms or change in my mouth 142 Finding/ selecting a dentist or dental clinic 49 Preparing for a dentist's consultation 62 Being diagnosed with a dental condition not familiar to me 42 Being prescribed with a new medication, test, or treatment 33 Having doubts about information given by my dentist 49 Dealing with an ongoing dental problem 88 Deciding to change my behaviors/ daily routine (e.g. diet, quit smoking) 43 Hearing or seeing something in the news that you wanted to learn more about 91 For knowledge or curiosity 110 Others (please specify): 2 As found in our study, a total of 131 or 35.7% of the respondents did discuss with their dentist, the information that they found online. Whereas 191 or 52% of the respondents did not discuss with their dentist regarding the online information they found (Table 3). Based on the Table 4, the respondents have a mean score of 28.7 in terms of the positivity of their perception towards online dental health information.  According to the Table 5b, the ρ value obtained is 0.000. It is evident that there is a clear significant difference between the two age groups.

Discussion
Number of patients who use the internet for seeking dental health information.
From our study`s findings it is indicated that 73% of patients used the internet for seeking online dental information. It is noteworthy that such a high percentage of PIDC patients are internet savvy. This implies that there is a great potential of the Internet as an important channel for health information and support for the general population.  [4] found that an increasing number of people (especially women) turned to the Internet for health advice, and then combined online advice with offline advice from friends, family and doctors in order to be confident in their final decision.

Reasons for seeking health information online
In fact, according to Sillence [4], women believe that the Internet influences their decision-making and improves communication with doctors [5].
Discussing dental health information with dentist Table 3 shows that a total of 131 or 35.7% of the respondents did discuss with their dentist, the information that they found online. In the early days, because dentists were only a source of information about the health of patients, they used to have confidence in dentists and usually followed their recommendations. However, the situation has now changed, and patients can also use the

Patient's perception towards online dental information
Based on Table 4 above, the respondents have a mean score of 28.7 in terms of the positivity of their perception towards online dental health information. The mean score of 28.7 works out to 64.1% when computed against the maximum possible mean. Thus, the respondents' perception towards online health information is sufficiently positivity. According to Chestnutt, Ivor and Reynolds, K. in their examination, discovered that patients who looked for online data were generally better informed and in fact information on the Internet has influenced and enhanced the delivery of oral care. They also found that the internet was an asset and not a threat to the dentist-patient relationship. The internet information had actually led to patients demanding inappropriate care or more complex treatment. Table 5 shows the existence of a significant difference between the use of internet for online dental health information seeking aged less than 35 and those aged between 36-75 years old. The age group of less than 35 have a higher online dental information seeking score. It was established that, age certainly impacts the online dental information seeking score clearly indicating that advancing age may mean a reduced inclination of searching dental health information online. The difference between the younger and the older group was subject to a t-Test, to find out if the difference was minimal and negligible. However, the results indicated that the difference was significant.

Relationship between age and the frequency of internet use
As shown in Table 6 there is a strong negative correlation between the frequency of use of the internet to seek online dental information and the age, (r=-0.524, ρ<0.05). This means that the frequency of use of the internet to seek online dental information has an inverse relationship with age. Higher age corresponds with lower frequency of internet use and vice versa. Clearly the younger respondents have a higher frequency of internet use and this would certainly translate into a higher rate of online dental information seeking.

Copyright © Philip Pradeep
MRD.000649. 6(5).2021 As can be seen from the table above, alpha (ρ value) is less than 0.05, and the Pearson 'r' value is -0.524.

Conclusion
The Internet has great potential to affect health and wellness.
By providing information about health and wellness services and supporting self-help and patient choice, it can and most definitely will increasingly be used to educate and enhance public capabilities. Overall, participants showed awareness of potential issues related to online health information searches.

Perception & behavior of PIDC patients towards Online Dental Health Information Seeking
We would like to ask for your opinion and your experience of using the Internet for health-related information. There are no right or wrong answers, choose an answer that suits you the most.
Please check the appropriate answers, or write your answers in the spaces provided: Can you tell us some basic information about yourself? If NO, Thank you, this is the end of the survey.