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assessments play a pivotal role in diagnosing periodontal and peri-implant osseous morphology and associated diseases ( Javed , 2007 ; ALHarthi et al ., 2018 ). The capacity of ionizing radiation ( IR ) to penetrate tissues and reveal non-visible images is significant in this context . However , it is imperative to exercise caution and implement safety measures during IR procedures , as uncontrolled exposure may potentially lead to adverse health effects ( Ribeiro et al ., 2008 ). Professionals must be cognizant of the criteria for accurate imaging while also considering a range of safety measures to mitigate the potential risks associated with dental and craniofacial radiography . Notably , IR has been reported to induce changes in DNA strands through the generation of free radicals , resulting in damage to living tissues ( Santivasi and Xia , 2014 ; Wdowiak , 2019 ). According to some researchers , exposure to dental radiography has been linked to an increased incidence of cancer in the head and neck area , as well as other health consequences ( Preston-Martin et al ., 1988 ; Preston-Martin and White , 1990 ; Hwang et al ., 2018 ). Dental radiography , while indispensable , necessitates adherence to radiation protection principles and guidelines to mitigate risks and ensure the safety of patients and dental healthcare providers .
Despite individual radiation doses in dental treatments appearing low , the cumulative exposure from repeated examinations raises concerns about potential adverse effects , including cancer ( Sudhakar and Kumar , 2011 ).
The well-established harmful effects of ionizing radiation on biological tissues , causing direct cellular damage or generating free radicals leading to various forms of DNA damage , underscore the importance of understanding these biological risks ( Ribeiro et al ., 2008 ).
These risks are categorized as stochastic and nonstochastic , with non-stochastic effects triggered by a specific dose threshold and stochastic effects having no predictable threshold , particularly evident at lower doses ( Asano et al ., 2001 ; Vii , 2005 ; Little et al ., 2009 ).
Each radiographic exposure during a patient ’ s examination must be clinically justified , ensuring a confirmed diagnostic benefit , as potential health risks from diagnostic X-rays have long been a focus of public health concerns ( Lee and Ludlow , 2013 ).
Factors influencing radiation exposure levels in dental radiography include film speed , exposure parameters , technique , collimation , and the use of protective barriers ( Okano and Sur , 2010 ). It is imperative for dental students and interns , especially those in their clinical years , to develop a comprehensive understanding of X-ray-related biological risks and protective strategies ( junior residential physicians and house surgeons ) ( Sudhakar and Kumar , 2011 ).
Few studies have been conducted among students at JU regarding MRI safety and radiation protection ( Abuhadi , 2019 ; Alyami et al ., 2023 , 2024 ). However , these studies have been conducted in different fields . To the best of our knowledge , there are no conducted studies examining the awareness and knowledge of dental students at JU . In light of these concerns surrounding radiographic exposure in dentistry , this study aims to assess the knowledge and practices of undergraduate dental students regarding the biological risks associated with dental X-rays . Additionally , the study seeks to compare knowledge , attitudes , and practices ( KAP ) between preclinical and clinical undergraduate students . The investigation aims to provide insights into the effectiveness of dental education in imparting crucial radiation safety awareness to future dental practitioners , promoting responsible use of radiographic procedures , and ensuring the safety of both patients and operators .
2 Materials and methods
2.1 Study design and population
A descriptive , cross-sectional survey was conducted among dental students enrolled in the dentistry program at Jazan University ( JU ) to evaluate awareness , knowledge , and practices concerning radiation protection . The inclusion criteria for participants in the study were dental students enrolled in the dentistry program at Jazan University ( JU ). All dentistry students were eligible to participate , resulting in a total of 82 participants out of 120 students in the college including 63 males ( 77 %) and 19 females ( 23 %). The level of study among the participants varied , as they were distributed across different academic years within the dentistry program at Jazan University . Demographic factors , such as gender and academic year , were analyzed to ascertain their potential influence on radiation protection awareness among dental students . To maintain confidentiality , the identity of participants was not disclosed , and all personal data were kept confidential .
Ethical approval for the study was obtained from the standing committee for scientific research on 3 January 2023 ( reference number REC-44 / 06 / 467 ). All dentistry students met the inclusion criteria , and a total of 82 participants engaged with radiography were included in the study .
2.2 Method of the questionnaire
The questionnaire utilized in the survey was structured to assess various aspects of radiation protection awareness , including knowledge of deterministic and stochastic effects of ionizing radiation , familiarity with radiation protection guidelines , and adherence to safety practices during radiographic procedures . The questionnaire , inspired by a study ( Sudhakar and Kumar , 2011 ), was constructed using Google Forms and comprised 16 items , including demographic inquiries . To facilitate participant responses , most questions were structured with close-ended options of ’ yes ’ or ’ no ’. The Google Form link to the questionnaire was distributed to a cohort of over 120 students officially enrolled in the full-time program at the Faculty of Dentistry at JU . This methodology aimed to ensure participant convenience , comprehensive data collection , and anonymity in responses .
2.3 Data analysis
In this study , data analysis was carried out using the Statistical Package for the Social Sciences ( SPSS ) v27 . Both descriptive statistics , which encompassed percentages and means , and inferential statistics , such as Pearson chi-square tests and associated P-values , were utilized . Pearson chisquare correlation was employed to assess the connection between participants ’ awareness levels and their demographic characteristics . Statistical significance was considered achieved when the P-value was less than 0.05 . Qualitative