Knowledge and Perception of Artificial Intelligence Among Dental Students: A Cross-Sectional Study in Chennai, India

Background: Artificial Intelligence (AI) is rapidly transforming healthcare, including dentistry. While AI offers potential benefits and its integration is still emerging, research on dental students' understanding of AI remains limited, especially in developing nations like India. This study aims to assess dental students' knowledge and perception regarding AI. Methods: A cross-sectional study was conducted among a representative sample of undergraduate and postgraduate dental students from a private dental institution. A structured questionnaire was administered to assess participants' knowledge and perception of artificial intelligence. Descriptive and inferential statistics were used to analyze the data. Results: The study findings reveal that 63.8% of participants demonstrated moderate knowledge of artificial intelligence, while only 19.1% had received formal training in the subject. Participants perceived improved diagnostic accuracy (47.9%) as a primary benefit of AI integration, yet identified lack of awareness (43.9%) and associated costs (45.1%) as significant barriers to adoption. Dental professionals exhibited a neutral stance toward AI adoption (46.5%) and its integration into the curriculum (46.7%). A gender disparity was evident, with males demonstrating higher AI knowledge levels (19.8%) and expressing greater concern for patient data privacy (32.7%) than female counterparts. Conclusion: As AI continues to evolve and integrated into healthcare, ongoing assessment of educational needs and knowledge gaps among dental students is essential. This will ensure that future practitioners are not only aware of AI's capabilities but also equipped to leverage them for improving patient care and advancing dental practice.


INTRODUCTION
Artificial intelligence (AI) is revolutionizing the field of medicine and dentistry, driven by advancements in science and technology (1).This technology has its roots in the 1956 Dartmouth Conference, where researchers like John McCarthy and Marvin Minsky laid the groundwork for AI's exploration (2).AI has enhanced efficiency and quality across various fields, including games, car driving, medical image analysis (MRI, brain tumors), financial analysis, and more (3).Dentistry is no exception.From a dental perspective, AI applications can be categorized into diagnosis, decision-making, treatment planning, and predicting treatment outcomes.Additionally, AI automates tasks, freeing up dentists' time for patient interaction and reducing paperwork (3).Recent years have seen a surge in AI applications for dentistry, particularly in radiology.These applications range from diagnosing caries and detecting various pathologies to planning orthodontic treatment for crowded teeth (3).Image processing techniques have significantly impacted dental radiology studies, with AI aiding in areas like gingival diseases, automatic anatomical structure marking, cephalometric analysis, and even diagnosing osteoporosis from jaw radiographs (3).This technology improves surgical accuracy and optimizes treatment outcomes.AI-powered systems can also educate patients about periodontal health and proper oral hygiene.Virtual assistants and mobile apps powered by AI can provide personalized recommendations, reminders for oral care routines, and monitor patient adherence to treatment plans (3).Digital dentistry, encompassing technologies like CAD/CAM, intraoral scanners, and 3D printing, are all examples of AI's influence (5).The COVID-19 pandemic further highlighted the crucial role of telemedicine and AI in patient care and disease prediction (6).AI-based applications will fundamentally change patient care.They will relieve dental professionals of tedious routine tasks, improve overall health outcomes at lower costs for a broader population, and ultimately contribute to the advancement of prognostic, preventive, and participatory dentistry.AI utilizes specialized algorithms and computational techniques to analyze vast amounts of data quickly and efficiently.Studies have shown that many doctors, dentists, and dental students lack a comprehensive understanding of AI concepts (3,4).A thorough understanding of AI is crucial for developing plans to integrate this technology into dental practice and education effectively.Medical and dental students, future dental professionals, will practice in a world heavily reliant on information technology.Although India is a rapidly developing nation in the technological sphere, it has yet to fully unlock the potential of AI and its impact on personal and professional lives (4).This study aims to assess the knowledge, attitude, and perception of artificial intelligence among dental students in Chennai, India.

MATERIALS AND METHODS
This study employed a cross-sectional/descriptive research design to evaluate the level of awareness regarding artificial intelligence among dental students in Chennai, India.Spanning from January 2024 to June 2024, the study encompassed comprehensive phases of data collection, rigorous analysis, and meticulous compilation of findings.Ethical clearance for the research was obtained from the Dr MGR Educational and Research Institute in Chennai, ensuring adherence to ethical standards throughout the study.The target population consisted of dental students enrolled in various years of study from a private dental college in Chennai, India.A sample size of 398 participants was determined using continuous random sampling techniques to ensure a representative cross-section of the student community.Demographic details gathered included gender and educational qualifications, including specialization in post-graduate studies.Data collection was facilitated through the distribution of a structured questionnaire via Google Forms.Prior permission was secured from the institutional authorities, emphasizing the non-intrusive nature of data collection to respect participants' academic commitments.Each participant provided informed consent before participating in the study, ensuring transparency and voluntary participation.Anonymity and confidentiality were strictly maintained throughout the research process to safeguard participant privacy and encourage candid responses.Statistical analysis: To analyse the data SPSS (IBM SPSS Statistics for Windows, Version 23.0, Armonk, NY: IBM Corp. Released 2015) was used to calculate frequency and percentage of the variables.The level of significance was fixed as 5% (α = 0.05).

RESULTS
In this cross-sectional study conducted at a private dental college, we investigated 398 participants aged between 18 to 30 years.The mean age of the cohort was 23.40(+3.93)years.The gender distribution revealed that 25.4% (101) were male and 74.6% (297) were female, reflecting a predominance of female participants in the study.Regarding educational qualifications, undergraduate students comprised the majority, with 21.1% (84) in their first year and 3.3% (13) postgraduate students specializing in prosthodontics.(Table 1) This study surveyed dental students to assess their perceptions and readiness regarding the integration of artificial intelligence (AI) in dentistry.Out of 398 respondents, only 76(19.1%) reported having received formal education or training on AI.Participants rated their general knowledge about AI variably, with majority 63.8% (254) rating moderate knowledge; less than quarter of the population, 95(23.9%),having personally used AI-based tools or technologies.Regarding perceived benefits of AI in dentistry, respondents highlighted improved accuracy in diagnosis 191(47.9%)and enhanced treatment planning 187(46.9).The participants felt Lack of awareness and understanding among practitioners, 175(43.9%),and cost of implementing AI technologies, 180(45.1%),as the major limitations and risk associated with integrating AI in Dentistry.Privacy and confidentiality of patient data, 96(24.1%),was considered as the major ethical consideration that needed to be implemented.Respondents emphasized the need for training and education programs 171(43.0%),access to reliable AI tools 80(20.1%),and clear regulatory guidelines 9624.1%) to support AI implementation in dental practice.Views on AI's impact varied, with 133(33.4%)expecting it to reduce routine tasks.Regarding future developments, 145(36.4%)anticipated incremental improvements from AI, while 87(21.9%)believed in its revolutionary potential for dentistry.The majority 184(46.2%)perceived dentistry as on par with other healthcare fields in AI integration.To stay informed, professionals primarily relied on social media platforms 188(47.2%).Regarding willingness to adopt AI-assisted tools and its integration into dental curriculum, 185(46.5%)and 186(46.7%)expressed neutrality respectively and factors influencing adoption included accuracy 130(32.7%),ease of integration 91(22.9%),and cost-effectiveness 94(23.6%).A notable proportion of participants, specifically 186 (46.7%), acknowledged the moderate importance of collaboration between dental professionals and AI experts.Similarly, 177 participants (44.5%) expressed moderate concerns regarding the potential for AI to replace traditional roles within dentistry.
A gender disparity emerged in the study of knowledge, attitudes, and practices regarding artificial intelligence.Males reported a higher self-rated knowledge of AI (19.8%) and a greater preference for prioritizing patient data privacy and confidentiality (32.7%) as an ethical consideration.Additionally, males were more likely to utilize online forums and discussion groups (35.6%) to stay updated on AI advancements, reported a higher personal use rate of AI-based technologies (36.6%) and believed AI will reduce certain routine tasks of dental practitioners (36.6).

DISCUSSION
In the present study, a significant majority of dental students had not received formal education or training on AI; 80.9%.This suggests a gap in the curriculum where AI education is concerned, potentially leaving students underprepared for its integration into dental practice.In the present study, 25.1% of the surveyed students assessed their overall understanding of AI as limited, while 74.9% considered it to be moderate to advanced.This contrasts with findings from a study involving dental undergraduates in Chennai by Ganta L et al (7) where 73.43% demonstrated awareness of Artificial Intelligence in dentistry, suggesting a generally average level of knowledge and awareness regarding AI.In the present study males reported higher levels of knowledge about AI compared to females.males rated their knowledge as high (19.8%)while only 8.1% of females did so.This disparity suggests that there may be factors influencing how AI information is accessed or perceived differently by genders within the dental student population.In our study, privacy and confidentiality of patient data emerged as a concern for 24.1% of the respondents.Interestingly, a higher proportion of males (32.7%) expressed apprehension regarding this issue, indicating a heightened concern among male participants towards safeguarding patient information.Furthermore, bias in AI algorithms and the potential for resulting inequalities in treatment were identified as ethical concerns by 12.8% of the female respondents.Among males, this concern was notably higher, with 22.8% highlighting these issues.This suggests that male participants are more attuned to the ethical implications of AI technologies in dental practice, particularly regarding fairness and bias in algorithmic decisionmaking.Additionally, a significant segment of the respondents (26.6%) expressed uncertainty about ethical considerations surrounding AI in dentistry.However, males (10.9%) were less likely than the females (32.0%) to report uncertainty, indicating a clearer stance or better understanding among males regarding the ethical complexities associated with AI use in dental settings.Karan-Romero M et al ( 8) study revealed a strong sense of optimism and positive outlook among dental students regarding the influence of AI in dentistry.According to the study (8), a substantial majority of surveyed dental students, 86%, expressed agreement that AI will lead to significant advancements within their field which is almost similar to the present study.This indicates a widespread belief among the participants that AI holds substantial promise for transforming various aspects of dental practice, potentially enhancing diagnostics, treatment planning, patient care, and administrative processes.12), it was noted that dental students required fundamental knowledge of AI due to its significant impact on the field of dentistry.The research suggests that many educators currently lack proficiency in AI, underscoring the need for curriculum revisions to integrate AI principles and applications to prepare future dental professionals effectively.
In this study, 177 participants (44.5%) expressed moderate concerns regarding the potential for AI to replace traditional roles within dentistry.These findings underscore the nuanced perspectives and readiness of dental professionals towards AI integration, highlighting opportunities and challenges for future implementation in dental practice.

CONCLUSION
As artificial intelligence continues to integrate into the healthcare landscape, including dentistry, it is imperative to continually assess the knowledge and educational needs of dental students.This ongoing evaluation will ensure that future dental practitioners are not only cognizant of AI's capabilities but also proficient in leveraging them to enhance patient care and advance the field of dentistry.
Similarly in a study by Dinesh T et al.(9) dental students demonstrated positive attitudes towards Artificial Intelligence (AI) in dentistry despite lacking sufficient knowledge.The research emphasizes the necessity for increased awareness and education to effectively implement AI in dental practice.Additionally, a study by Yüzbaşıoğlu E et al.(10) indicates that dental students exhibit a willingness to learn about AI, even though their current knowledge is limited.Approximately 48.4% possess basic AI knowledge, and a significant 85.7% believe AI has the potential to revolutionize dentistry.The majority of surveyed also support the integration of AI into dental education.Ghorbanifarajzadeh M et al.(11) emphasize the importance of AI awareness among dental students, highlighting that integrating AI into dental education can enhance learning outcomes, aid in clinical decision-making, improve the interpretation of radiographs, and ultimately elevate the quality of patient care.In a study byThurzo A et al. (