Evaluation of dentists' malpractice fears and defensive dentistry attitudes: a scale development.

OBJECTIVES

To develop and design the Defensive Dentistry Attitude Scale (DDAS) to evaluate the relationship between defensive dentistry and fear of malpractice among dentists in Türkiye.

METHODS

The Defensive Dentistry Assessment Scale (DDAS) questions were determined based on expert opinions and a literature review. Based on these results, a questionnaire including the 13-item DDAS and the malpractice fear scale was sent to 3513 dentists in Türkiye by email between 3.11.2023 and 10.1.2024. A total of 369 dentists returned. The questionnaire consisted of 26 questions with two VAS scales related to the frequency of complications and detailed anamnesis. During the development of DDAS, the Content Validity Index (CVI), Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were utilized. The Mann-Whitney U and Kruskal-Wallis tests were employed for group comparisons. In examining the relationships between variables, path analysis within the structural equation modeling (SEM) framework was conducted.

RESULTS

The DDAS developed in the study was a valid and reliable measure with two dimensions and eight items. DDAS (Median = 29) and malpractice fear scores (Median = 21) were high in dentists. Malpractice fear scores of dentists aged 29-35 years (Median = 21) were found to be statistically significantly higher than those of dentists aged 36 years and older (p < 0.05). The levels of malpractice fears (Median = 22) and defensive dentistry attitudes (Median = 31) of dentists with 6-10 years of experience were statistically significantly higher than those of dentists with 11 years of experience and over (respectively (Median = 20), (Median = 28), p < 0.05). A statistically significant and high-level positive correlation was found between dentists' fear of malpractice and their tendency to adopt defensive dentistry practices (β = 0.56, p < 0.001).

CONCLUSIONS

According to the results of this study, the DDAS was found to be a valid and reliable measure of negative and positive defensive dentistry. Specifically, a significant and strong positive correlation was identified between dentists' fear of malpractice and their engagement in defensive dentistry practices. This finding indicates that the tendency to adopt defensive dental behaviors increases as malpractice fear increases.