Effect of a tele-orthodontics platform on knowledge, attitudes, and practices among orthodontic professionals in Yemen: a single-arm pretest–posttest intervention study

Abstract

Abstract Objectives To evaluate the effect of a tele-orthodontics platform on orthodontists’ and orthodontic residents’ knowledge, attitudes, and practices (KAP) in Yemen, as well as to assess the platform’s acknowledged benefits, obstacles, and consultants’ responsiveness. Methods This single-arm pretest, posttest quasi-experimental study initially identified 210 orthodontic professionals academically registered in Yemen; after exclusions and a pilot phase, 80 participants were recruited from January 2023 to March 2025. Participants completed a KAP questionnaire at baseline, after which they were given access to a custom-designed tele-orthodontics platform for one year, where they could receive asynchronous consultant feedback. Subsequently, they completed the post-intervention questionnaire. Normality of data was confirmed (Shapiro, Wilk, p > 0.05), and construct validity was supported by principal component analysis (KMO = 0.917, Bartlett’s p < 0.001), which identified three factors explaining 58.04% of variance. Paired-samples t-tests were used for primary analysis, while subgroups were compared using t-tests/ANOVA and chi-square tests. Effect sizes (Cohen’s d, η², Cramér’s V) were presented. Results The 80 participants (mean age 33.8 ± 4.5 years; females 61.25%; orthodontic residents 81.25%) demonstrated high baseline knowledge (2.70 ± 0.34), positive attitudes (3.71 ± 0.71), and moderate practice (3.35 ± 0.61). After the intervention, knowledge was significantly higher ( p = 0.007) with a small effect size (d = 0.43), however, attitudes and practices did not change ( p > 0.05). Within-group exploratory analyses showed modest knowledge gains, with females showing the largest improvement ( p < 0.001, d = 0.74, medium effect). Between-groups analyses only found a difference in knowledge improvement between genders in favor of females ( p = 0.025, d = 0.49, small-to-medium). Major barriers included technical problems (80%) and concerns about privacy (30%). Moreover, half rated the benefits of using the platform as good, and 45% rated the responsiveness of the consultant as good. Conclusion The tele-orthodontics platform provided a small increase in knowledge, although the high baseline scores and the limitation of the 3-point scale’s ceiling effect might have restricted this result. Attitudes and practices did not change, which points to a continuing disconnect between acquiring knowledge and clinical adaptation. Similar knowledge gains regardless of level of engagement indicate that even indirect exposure can help to strengthen knowledge.

The authors' abstract, as published at the source. BMC Oral Health, 2026 · DOI ↗