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Preclinical dental students’ awareness and integration of pulp biology knowledge: a cross-sectional study assessing the understanding of pulpal functions and implications for clinical endodontic competency and practice

BMC Med Educ. 2026 May 25. doi: 10.1186/s12909-026-09437-8. Online ahead of print.

ABSTRACT

BACKGROUND: The dental pulp is a vital tissue integral to tooth vitality and endodontic health. However, awareness and comprehension of pulpal functions among preclinical dental students remain inadequately characterized. Understanding baseline knowledge and attitudes in early dental education can inform pedagogical improvements in oral histology and foundational endodontic instruction. The study evaluates the awareness, knowledge, attitudes, and learning practices related to dental pulp and its functions among preclinical undergraduate dental students.

METHODS: A descriptive cross-sectional study was conducted among 225 preclinical (first and second-year) undergraduate dental students from multiple dental institutions. A validated 20-item structured questionnaire comprising four sections; demographics, knowledge assessment with 6 multiple-choice items, attitude evaluation using 5-point Likert scale with 6 items, and learning practice assessment with 5 items was administered via Google Forms. Data were analyzed using descriptive statistics, frequency distributions, percentages, and comparative analysis between academic years using chi-square and independent t-tests.

RESULTS: Second-year students demonstrated significantly higher knowledge accuracy (61.8%) compared to first-year students (38.2%, p < 0.05). The majority of students (92.4%) correctly identified mastication as a non-function of pulp, and 67.6% recognized A-delta fibers as responsible for sharp, localized pain. However, knowledge gaps were identified: 29.3% of students incorrectly attributed odontoblast function to enamel formation, and only 61.9% understood the physiological constraints limiting pulpal healing capacity. Attitude assessment revealed strong positive perception (mean Likert scores 3.16-4.37), with highest endorsement for understanding pulp structure (4.37) and learning pulp for endodontics (4.25). Exam-driven learning behavior was predominant (57.3%), while visual learning modalities were preferred (33.3% favored videos/3D models and 32.9% preferred textbook reading).

CONCLUSIONS: While preclinical students demonstrate commendable foundational understanding of pulpal anatomy and core functions, specific knowledge gaps and exam-centric learning patterns point the need for enhanced pedagogical approaches. Integration of visual aids, clinically relevant case-based learning, active learning modalities, and structured early clinical correlation could strengthen conceptual understanding and foster deeper engagement with pulp biology, ultimately enhancing preparedness for clinical endodontic practice.

PMID:42178531 | DOI:10.1186/s12909-026-09437-8

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