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 Table of Contents    
Year : 2014  |  Volume : 4  |  Issue : 1  |  Page : 8-11
Attitude and perception of undergraduate dental students toward endodontics as a specialty in India

1 Departments of Conservative Dentistry and Endodontics, Manipal College of Dental Science, Manipal University, Mangalore, Karnataka, India
2 Department of Public Health Dentistry, Manipal College of Dental Science, Manipal University, Mangalore, Karnataka, India

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Date of Web Publication17-Oct-2014


Introduction: Students' attitude toward choosing a specialty subject for post graduate studies is of great importance for the education system.
Aim: To evaluate the dental students' perception and attitude toward learning, in rendering treatment, choosing endodontics as a specialty for post-graduation.
Materials and Methods: A semi structured questionnaire study survey consisting of 10 multiple-choice questions was compiled and distributed among 400 undergraduate dental clinical students. The main domains appraised were preclinical and clinical training in endodontics, their opinion and interest in endodontics as post-graduate specialty. One sample chi-square test was done to see the association of subject response toward endodontic as a specialty response to each question.
Results: The response rate was 74.5%, the results showed 72% of the students preferred preclinical training on extracted human teeth. 71% of the students believed that intense preclinical training will help them to manage patients confidently.
Conclusion: The principal conclusion of the study revealed that majority of the students find endodontics an interesting subject to study and they would opt for endodontics as a postgraduate specialty subject.

Keywords: Dental students, endodontics, perception, preclinical, specialty

How to cite this article:
Shetty N, Kundabala M, Shenoy R. Attitude and perception of undergraduate dental students toward endodontics as a specialty in India . J Educ Ethics Dent 2014;4:8-11

How to cite this URL:
Shetty N, Kundabala M, Shenoy R. Attitude and perception of undergraduate dental students toward endodontics as a specialty in India . J Educ Ethics Dent [serial online] 2014 [cited 2020 Jun 5];4:8-11. Available from: http://www.jeed.in/text.asp?2014/4/1/8/143148

   Introduction Top

Presently the scope of endodontics has broadened vastly. Vital pulp therapy includes stem cell treatment, regeneration of pulpal and periradicular tissues. CBCT, MRI, Doppler's, PCR have changed scope of diagnosis and the treatment planning for oral lesions of pulp and periapical origin. Nonsurgical approach of root canal therapy, microsurgical procedures remove the pathological tissues optimally with minimal intervention. The specialty also encompasses endodontic implants; bleaching of discolored teeth, retreatment of previously endodontically treated teeth with special instruments, post-endodontic rehabilitation of teeth with more preservation of tissues and the management of traumatically injured teeth. [1] But unfortunately, endodontics is synonymous with root canal treatment among undergraduate students.

As a specialty, endodontics is at a crucial juncture with rapid changes seen in biosciences, biomaterials and instrumentation. One of the basic concerns as dental educators is to train students who are not only uncomfortable with techniques of clinical dentistry, but are also not very competent in diagnosis to improve the quality of life for their patients. [2] Endodontics is considered as a difficult and stressful discipline by students. The complex anatomical diversity and the inability to visualize the root canal, dependence on tactile feel, array of instruments and materials tends to make several students feel inadequately prepared to deal with endodontic treatment procedures. This insecurity may also reflect insufficient clinical and didactic teaching in the dental curriculum. [3] So, it is the responsibility of dental schools to prepare their students to undertake at least simple root canal treatments of predictable quality on graduation. [4] In India the undergraduate (UG) training in endodontics is limited to diagnosis of endodontic lesions, simple vital pulp therapy and root canal therapy for anterior teeth. The UG students and the interns are considered novice, so it is necessary that educators understand what should be the extent of endodontic training that has to be imparted to the students before they graduate, so that they will be able to render basic endodontic treatment. This study aimed to evaluate the fourth year students and intern's perception and attitude toward learning, in rendering endodontic treatment, choosing endodontics as a specialty for post-graduation and general opinion of the specialty.

   Materials and Methods Top

The present survey used semi structured, pretested, self-administered questionnaire composed with 10 multiple-choice questions was distributed among undergraduate dental students and interns of three dental college of Dakshina Kannada district, Karnataka in India. A pilot study was conducted to check the feasibility and reliability of the questionnaire. A total of 400 dental clinical students consisting of final year students and interns were included in the study. The students filled out the questions during a regular class session. All answers were kept confidential, and no individual students were identified. The students were not allowed to re-participate in the survey once completed. The questionnaire elicited information regarding demography and the 10 items assessing perception and attitude of undergraduate dental students toward endodontics as a specialty. Informed consent was obtained prior to questionnaire administration. The sample size was calculated using the formula.

n = 4pq



P = Perception of students to opt for endodontics is assumed to be 50%

q = (1-p)

l = Allowable error at 5%

n = 400

The final data of the survey results were compiled and submitted for statistical analysis. The data obtained from the study were subjected to statistical analysis using the Statistical Package for the Social Sciences (SPSS) version 16.0 to calculate the descriptive statistics. One sample chi-square test was done to see the association of subject response towards endodontic as a specialty response to each question.

   Results Top

A total of 400 students were invited to participate in the survey. 299 of the students returned the completed questionnaire. The overall response rate was 74.5%. The participant population sample consisted of 38.8% males and 61.2% percent females. 57.5%of the participants were final year students and 42.5% were interns [Table 1]. All the questions have shown statistically significant result with P-value less than 0.01 [Table 2]. The analysis for question no 1 showed that 53.3% of the students perceived they have been trained in preclinical endodontics. About 91% of the students responded that they found endodontics an interesting subject to study. 72.6% of the students favored preclinical training using extracted teeth. 70.6% of the students suggested that they can confidently do endodontic procedures after their preclinical training. 87.3% of the students suggested that root canal treatment is the most common endodontic procedure. 46.5% of the students agreed that third year of the academic course is the best time to start clinical endodontic training. Analysis of the question no 7 revealed that (23.4%) of the students were not sure though 52.5% responded "yes". 93% of the students suggested that endodontic educational aids such as models, 3-D interactive tooth atlas should be used as educational adjuvants .67.6 % of the students viewed the specialty of endodontics highly and 84.3% of the participants suggested that they would like to persuade it as post graduate specialty.
Table 1: Descriptive statistics of study subjects

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Table 2: Descriptive analysis of study questions

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   Discussion Top

With rapid changes taking place in treatment techniques and materials in the field of endodontics, it is important that UG students are equipped with understanding and preclinical experience while using these instruments and materials before treating patients. There is a wide variation in the way the endodontics is taught and the level of competencies developed in UGs in various institutions across the world. [5] According to Chambers, an improvement in performance occurs as a student progresses through a series of the learning process. [6] So educators during curriculum designing and evaluation need to recognize the problems and modify the curriculum. When learning new techniques, UG dental students require explicit directions and instructions in small steps, as they work toward achieving competence in performing more complex tasks in clinical settings. [7] The survey revealed that majority of the students (91%) find endodontics an interesting dental subject.

Cross infection control and ethical issues are reasons for replacing extracted human natural teeth with artificial teeth for preclinical endodontic training in some teaching institutions. According to Reader et al. difficulty of standardization of natural teeth could also be another drawback. [8] But this survey revealed that 72.6% students preferred extracted human natural teeth for preclinical training since it helps them to understand the complexities of the root canal anatomy better. Study by Nassri et al. evaluated five cloudy resin artificial teeth for their internal and external anatomy; coronal chambers for their size, shape and canal path; root canals for their size, shape and position; pulp chamber and root canals by considering their texture, quantity, color, and ease of handling; resin hardness and visualization of the radiographic image and concluded that the artificial teeth have potential to replace the natural teeth in endodontic teaching; however, improvements are still necessary to reach a better quality model. [9]

87% of students associated endodontics with root canal therapy. But there is a paradigm shift in management of pulpal and periapical diseases with emphasis on vital pulp therapy, regenerative endodontics, microsurgical procedures, post-endodontic restorations, non-vital bleaching for esthetics, endodontics as a part of interdisciplinary treatment modalities , thus suggesting need to emphasis on these treatment modalities during teaching of this specialty. 93% of the students suggested that there should be a change in the teaching methodology. Respondents also recommended that endodontic educational aids such as models, 3-D interactive tooth atlas which combines sound, text, stills and video with interactive learning should be used as educational adjuvants. Studies have suggested that endodontic computer simulation programs results in significant gain in knowledge and can successfully replace traditional learning strategies. [10],[11] According to Urbankova, eight hours of computerized dental simulator training conducted early in the preclinical operative dentistry improved student performance which could also be true for endodontic preclinical training. [12]

A systemic review by Al-Jewai et al. concluded that computer assisted learning is intended to support traditional learning methods, but not to replace them. [13] Only 53.2% of the respondents believe that they have been trained in preclinical endodontics using extracted teeth models. 71% of the students believed that intense preclinical training will help them to manage patients confidently. Dhima et al. evaluated dental students perception on dental specialties and factors that can play an important role in students decision to pursue specialty training or career choices and concluded that enjoyment of providing care in a specialty or field was identified as the single most important factor in choosing a specialty career. [14] 84.3% of the participants in the survey suggested that they would specialize in endodontics if given an opportunity, which is a positive sign for the specialty.

   Conclusion Top

This study concluded that most of the undergraduate students are interested in persuading endodontics as a specialty for post-graduation. Thus need of the hour is to emphasis on preclinical endodontic training and clinical training for management of all pulpal and periapical lesions with different modalities at the undergraduate level.

Endodontics is a vibrant, evolving and interesting clinical specialty. Intense endodontic training at UG level prepares the graduates to provide good basic patient care in clinical practice.

   References Top

Ingle JI, Bakland LK, Baumgartner JC. Ingle's Endodontics 6.6 th ed. Hamilton, Ontario: BC Decker; 2008.   Back to cited text no. 1
Pileggi R, O'Neill PN. Team-based learning using an audience response system: An innovative method of teaching diagnosis to undergraduate dental students. J Dent Educ 2008;72:1182-8.  Back to cited text no. 2
Rolland S, Hobson R, Hanwell S. Clinical competency exercises: Some student perceptions. Eur J Dent Educ 2007;11:184-91.   Back to cited text no. 3
Qualtrough AJ, Whitworth JM, Dummer PM. Preclinical endodontology: An international comparison. Int Endod J 1999;32:406-14.  Back to cited text no. 4
Friedlander L, Anderson V. A new predoctoral endodontic module: Evaluating learning and effectiveness. J Dent Educ 2011;75:351-9.  Back to cited text no. 5
Chambers DW. Toward a competency-based curriculum. J Dent Educ 1993;57:790-3.  Back to cited text no. 6
Guenzel PJ, Knight GW, Feil PH. Designing preclinical instruction for psychomotor skills (III) - instructional engineering: Design phase. J Dent Educ 1995;59:412-8.  Back to cited text no. 7
Reader CM, Kleier DJ, College C, Bujanda-Wagner S. Anatomical artificial teeth for teaching preclinical endodontics. J Dent Educ 1994; 58:229-32.  Back to cited text no. 8
Nassri MR, Carlik J, da Silva CR, Okagawa RE, Lin S. Critical analysis of artificial teeth for endodontic teaching. J Appl Oral Sci 2008;16:43-9.  Back to cited text no. 9
Fouad AF, Burleson JA. Effectiveness of an endodontic diagnosis computer simulation program. J Dent Educ 1997;61:289-95.  Back to cited text no. 10
Plasschaert AJ, Cailleteau JG, Verdonschot EH. The effect of a multimedia interactive tutorial on learning endodontic problem-solving. Eur J Dent Educ 1997;1:66-9.  Back to cited text no. 11
Urbankova A. Impact of computerized dental simulation training on preclinical operative dentistry examination scores. J Dent Educ 2010;74:402-9.  Back to cited text no. 12
Al-Jewair TS, Qutub AF, Malkhassian G, Dempster LJ. A systematic review of computer-assisted learning in endodontics education. J Dent Educ 2010;74:601-11.  Back to cited text no. 13
Dhima M, Petropoulos VC, Han RK, Kinnunen T, Wright RF. Dental students' perceptions of dental specialties and factors influencing specialty and career choices. J Dent Educ 2012;76:562-73.  Back to cited text no. 14

Correspondence Address:
Neeta Shetty
Department of Conservative Dentistry and Endodontics, Manipal College of Dental Science, Mangalore - 575 001, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-7761.143148

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