Knowledge, Attitude and Practice of Early-Career Dental Practitioners Regarding Management of Patients with Osteoporosis in Karnataka and Kerala, South India: A Cross-Sectional Survey

Abstract

Background: Osteoporosis affects a large proportion of postmenopausal women worldwide and is highly prevalent in India, where it also intersects with oral health through periodontal bone loss and, in patients on antiresorptive medication, the risk of medication-related osteonecrosis of the jaw (MRONJ). Dental practitioners' knowledge, attitude, and practice (KAP) regarding osteoporosis management are central to safe, informed dental care for this growing population, but remain poorly characterised in South India. Aim: To assess the knowledge, attitude, and practice of dental practitioners regarding the management of patients with osteoporosis in South India, and to examine their association with demographic and professional characteristics. Materials and Methods: An exploratory, cross-sectional, web-based survey was conducted among dental practitioners in South India, recruited by convenience sampling through email and WhatsApp invitations, using a structured, self-administered questionnaire covering demographics and a Knowledge (7 items), Attitude (3 items), and Practice (5 items) instrument. The calculated minimum sample was 384 (target 500); 151 complete responses were obtained. Composite scores were categorised as Knowledge: Poor/Fair/Good; Attitude: Negative/Positive; Practice: Poor/Good. Proportions are reported with 95% Wilson confidence intervals. Associations with demographic and professional characteristics were explored using Pearson's chi-square test, ordinal logistic regression (Knowledge), and binary logistic regression (Attitude and Practice); a two-sided p < 0.05 was considered significant. Results: Of 151 complete responses analysed (94.7% aged under 30 years; 95.4% with under 5 years of experience; 97.4% from Karnataka and Kerala), awareness of osteoporosis was near-universal (98.0%, 95% CI 94.3–99.3) and attitudes were strongly positive (89.4%, 95% CI 83.5–93.4), but applied knowledge was limited (only 21.2% "Good", 95% CI 15.4–28.4) and practice lagged furthest behind (only 28.5% "Good", 95% CI 21.9–36.1; only 36.4% had ever taken an osteoporosis history, 95% CI 29.2–44.3). A dual clinician-academician role was the only characteristic associated with better knowledge, in chi-square testing (χ² = 6.07, p = 0.048) and in adjusted ordinal regression (OR = 1.97, 95% CI 1.00–3.88, p = 0.049); this borderline finding is hypothesis-generating. No characteristic was significantly associated with attitude or practice, but the sample was small and the models were underpowered. Conclusion: In this small, exploratory sample of predominantly early-career practitioners from Karnataka and Kerala, dental practitioners were highly aware of osteoporosis and held favourable attitudes toward its clinical relevance, but applied knowledge and, especially, translation into routine practice were limited. The findings cannot be generalised to all South Indian dental practitioners. Structured continuing education, particularly for practitioners without an academic role, may help convert positive attitudes into safer, more consistent osteoporosis-related dental care; larger, more representative surveys are needed.