Background
Disasters, both natural (earthquakes, floods, pandemics) and man-made (biological or radiological attacks), overwhelm health care systems, necessitating expanded roles for non-traditional health care providers, such as dentists.Reference Li, Chang, Li and Wang1-Reference Psoter, Herman and More3 Dentists’ skills including infection control, suturing, and forensic identification are invaluable in disaster response.Reference More, Phelan and Boylan2, Reference Dutta, Singh and Passi4 Despite its vulnerability to disasters, Iran lacks a structured framework to integrate dentists into disaster management.5
This study evaluates the knowledge, attitude, and self-reported practice of senior dental students in Tehran regarding their role in disaster management, aiming to inform curriculum development and policymaking.
Methods
This cross-sectional study surveyed senior dental students from 3 reputable dental schools in Tehran, representing an optimistic model for other Iranian institutions. A minimum sample size of 246 students was calculated. The students completed an anonymous online questionnaire that assessed demographics (age, gender, and history of disaster experience), knowledge (9 questions), attitude (8 questions), and self-reported practice (3 questions) related to disaster management. Responses were scored (0-18 for knowledge, 0-16 for attitude, and 0-6 for practice).
The questionnaire, based on prior studies,Reference Chhabra, Rajesh and Shetty6, Reference Villa, Chmieliauskaite and Patton7 was validated by experts and achieved a Kappa coefficient >0.7 for reliability. Statistical analysis was conducted using t tests and Pearson correlation, with significance set at P<0.05. Ethical approval was obtained from Tehran University of Medical Sciences (IR.TUMS.DENTISTRY.REC.1398.156).
Results
Of the 240 respondents (mean age of 24.7±2.3 years, 61.7% female), 20.8% reported prior disaster experience. Mean scores were 7.1±3.0 for knowledge, 13.1±3.0 for attitude, and 1.9±1.3 for self-reported practice. While participants demonstrated moderate knowledge of “triage” (59.6%) and “using dental records for victim identification” (59.2%), most were unaware of national disaster management policies (Table 1). The attitude scores were notably higher, with 92.5% agreeing on the necessity of disaster training. However, self-reported practice was low; only 37.9% had prior training in CPR or disaster-specific skills.
Distribution of students’ answers regarding the role of dentists in disaster management (n = 240)
Female students exhibited significantly higher attitude scores than male students (13.66±2.47 vs. 12.16±3.50, P<0.001). However, knowledge and practice scores showed no gender differences (Table 2). Women were more familiar with certain disaster concepts, such as management preparedness and identifying disaster risks (P<0.05).
Knowledge, attitude, and self-reported practice scores of dental students on the role of dentists in disaster management (n = 240) based on t test analysis
There were no significant differences in scores between students with or without prior disaster experience (Table 2).
Knowledge correlated with attitude (r = 0.27, P<0.001) and self-reported practice (r = 0.33, P<0.001), but no significant correlation found between attitude and practice (P = 0.40).
Discussion
This study highlights a significant gap in disaster management knowledge and practice among Iranian dental students, despite their positive attitudes. Similar trends have been reported in Nigeria,Reference Odai, Azodo and Chhabra8 India,Reference Chhabra, Rajesh and Shetty6, Reference Rajesh, Chhabra and Shetty9 and the US,Reference Bhoopathi, Mashabi and Scott10 where the absence of formal training limits preparedness. In contrast, initiatives by the American Dental Association (ADA) following the September 11 attacks have successfully integrated dental professionals into disaster response frameworks through training and policy advocacy.Reference More, Phelan and Boylan2, 11 The findings emphasize the potential of incorporating disaster management topics—such as triage, forensic identification, and crisis policies—into the dental curriculum.Reference Li, Chang, Li and Wang1, Reference More, Phelan and Boylan2 Current courses, like emergency medicine and forensic dentistry, provide a foundation but lack specificity in disaster scenarios.Reference More, Phelan and Boylan2, Reference Psoter, Herman and More3
Higher attitude scores among women may reflect cultural factors or greater engagement in training-related activities, reflecting greater interest in disaster management training. However, the lack of significant gender differences in knowledge and practice suggests that despite higher motivation, female students have not had greater access to disaster education or hands-on experience. This finding aligns with previous studies where interest in disaster management did not necessarily translate into better preparedness without structured training.Reference Chhabra, Rajesh and Shetty6, Reference Rajesh, Chhabra and Shetty9 Therefore, rather than relying on individual motivation, integrating disaster management into formal education is essential to ensure all students, regardless of gender, acquire the necessary competencies.
Furthermore, the absence of significant differences in knowledge and practice between students with and without prior disaster experience suggests that experiential learning alone does not enhance preparedness. This highlights the need for structured educational interventions rather than relying solely on exposure to disasters.
This study is limited by its cross-sectional design and convenience sampling from Tehran’s dental schools, which may not fully represent other regions. Social desirability bias could also have influenced responses.
Conclusions
Iranian dental students lack sufficient disaster management knowledge and practice, despite strong willingness to learn. Structured curriculum changes, emphasizing disaster preparedness and practical training, are essential to equip dentists for critical roles in emergencies.
Integrating disaster management training into dental education could significantly enhance national disaster response capabilities. Policymakers must address potential legal barriers to expanding dentists’ roles in emergencies while considering regional disaster profiles.
Competing interests
All authors declare none.
