Knowledge Gaps and Age-related Misconception Among Prosthodontic Trainees: Findings from a Four-Year Cohort Study in Geriatric Dentistry

Manal R Alammari^1*

¹King Abdulaziz University; Faculty of Dentistry, Kingdom of Saudi Arabia

*Correspondence author: Manal R Alammari, Department of Oral and Maxillofacial Prosthodontics, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589, Kingdom of Saudi Arabia; E-mail: [email protected]

Citation: Alammari MR. Knowledge Gaps and Age-related Misconception Among Prosthodontic Trainees: Findings from a Four-Year Cohort Study in Geriatric Dentistry. J Dental Health Oral Res. 2025;6(2):1-9.

Copyright^© 2025 by Alammari MR. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Table 1: Participant Demographics.

Table 2: Item-level accuracy by gender.

Year-wise comparison using the Kruskal-Wallis H test found no significant difference in mean scores across cohorts (H = 2.98, p = 0.395). Table 3 shows the percentage of mean score through the years and 2022, 2023 and 2025 were below 60%. However, item-level accuracy comparison (Table 4) identified thirteen questions with <50% average accuracy. These reflected persistent misconceptions on matters including for example self-perceived health (Q39), personality change (Q4), adaptability (Q25), Health risk (Q8) and offering (Q26).

Table 3: Mean Scores by Cohort.

Table 4: Key misconceptions with clinical impact.

The misconception that personality changes significantly in older age may lead clinicians to underestimate older patients’ consistency in values, decision-making preferences or ability to engage meaningfully in treatment planning. This belief can reinforce paternalistic approaches and limit shared decision-making. This reflects a common stereotype that older individuals are rigid or incapable of coping with change. In dental care, such bias may cause practitioners to avoid recommending new prosthetic inter-ventions or treatment transitions based on perceived resistance, rather than patient preference or clinical need. Trainees’ belief in reduced societal engagement among older adults can translate into assumptions about compliance, motivation or rehabilitation potential, negatively influencing treatment expectations and long-term planning for prosthodontic care. Failure to recognize that many older adults self-report good health despite chronic conditions may lead clinicians to overemphasize deficits rather than strengths. This can skew risk assessment, underrepresent resilience and impact the tone of patient interaction.

An item-level gender analysis showed that females outperformed males on 24 ques-tions, while males scored higher on 13. Three items had equal scores. Fig. 1 illustrates this question-wise gender performance. Fig. 1 displays the total number of correct answers per gender by year. These visualizations further support the lack of significant overall differences while suggesting content-specific strengths by gender.

Figure 1: Item-level accuracy comparison by gender.

These statistical outcomes suggest that neither gender nor academic year significantly influenced the trainees’ overall knowledge about aging. Females slightly outperformed males, with an average score of 61.1% compared to 58.3% for males. Questions where females performed notably better in Q5, Q6, Q7, Q19, Q22, Q24, Q29, Q36, Q37. Differences in favor of females ranged from +14.6% to +33.3%. These items may reflect topics or formats where female trainees excel-possibly in areas requiring conceptual understanding, attention to detail or clinical reasoning. Questions where males performed notably better were Q17, Q20, Q26, Q30, Q35, Q39. Differences ranged from -14.6% to -43.7%. These may correspond to analytical or procedural questions where male participants showed stronger performance or where females faced greater difficulty Fig. 2.

Thus, while total performance appears equivalent, a closer examination of individual items suggests meaningful content-specific differences that may reflect underlying variations in perception or training emphasis. These nuanced disparities underscore the need for targeted educational interventions addressing commonly misunderstood domains of aging, regardless of cohort or gender.

Figure 2: The visual comparison of performance differences by question/gender (Green bars indicate questions where females scored higher; red bars indicate questions where males scored higher; labels highlight questions with a difference ≥15%, showing significant disparities).

Fig. 3 presents the total number of correct answers achieved by male and female postgraduate prosthodontic trainees across four academic cohorts (2022-2025). The visual data indicate relatively stable and comparable performance trends between genders. Males marginally outperformed females in 2022 and 2024, whereas females had higher scores in 2023 and 2025. These fluctuations are modest and align with the findings presented in Table 2, which details item-level accuracy percentages.

Figure 3: Total correct answers by gender per year.

Discussion

This four-year cohort study explored the extent and nature of age-related misconcep-tions among postgraduate prosthodontic trainees, with a focus on gender and co-hort-based differences in knowledge. Using the Facts on Aging Quiz (FAQ), the study sought to uncover not only general knowledge levels but also the presence of con-tent-specific misconceptions with potential clinical relevance in geriatric prosthodontics.

The findings suggest that postgraduate prosthodontic trainees, regardless of gender, share similar levels of knowledge about aging. However, a substantial number of incorrect responses on key items indicate persistent misconceptions-particularly re-garding cognitive ability, mental health and adaptability in older adults.

These knowledge gaps may translate into implicit ageist attitudes, affecting how care is planned and delivered to geriatric patients. Literature has shown that dental practitioners with limited knowledge of aging are more likely to:

Several FAQ items showed alarmingly low accuracy (<50%) across participants, revealing shared misconceptions that could adversely influence geriatric care. This raises concern in prosthodontics, where treatment planning heavily depends on clinician judgment. Failure to correct these biases may result in under-treatment or overtreat-ment, compromising geriatric care quality. These align with domains known to be susceptible to implicit ageist bias, particularly among healthcare professionals with insufficient geriatric training [12]. Importantly, female trainees demonstrated better awareness in these areas, which may reflect a more holistic or empathetic orientation in their approach to aging-related issues.

Despite stable overall knowledge, this study reveals significant attitudinal blind spots that could undermine equitable care. The misconceptions uncovered are not merely factual errors but signal the persistence of outdated narratives about aging. These can directly affect prosthodontic treatment planning by: Reducing the likelihood of shared decision-making. Limiting therapeutic options due to assumed frailty or disinterest. Hindering rapport-building and trust with older patients.

Therefore, the findings strongly support integrating gerodontology and ethical dis-course into postgraduate training, especially with modules focused on: Psychosocial dynamics of aging. Cognitive and behavioral adaptability. Intergenerational commu-nication. Reflective practice addressing bias.

These nuanced disparities underscore the need for targeted educational interventions addressing commonly misunderstood domains of aging, regardless of cohort or gender. The study’s findings echo prior research. Piaton and his team and Shenoy, also documented stereotypical views among dental students, especially around cognitive decline and perceived patient non-compliance [13,14]. In line with Karabulut Gençer, et al., our study found no significant statistical difference across gender or year but high-lighted persistent misconceptions, reinforcing the need for content-sensitive reform rather than broad-stroke training [15]. Interestingly, our gender analysis supports Shenoy et al.’s findings that female students may harbor fewer ageist views, particularly in psychosocial contexts a promising but underutilized trend in educational planning.

Conclusion

This four-year cohort study investigated the presence of knowledge gaps and potential ageist attitudes among postgraduate prosthodontic trainees using the Facts on Aging Quiz. While overall performance did not differ significantly by gender or academic year, the consistent presence of critical misconceptions-particularly in domains related to adaptability, personality change and self-perceived health underscores a concerning disconnect between general knowledge and the understanding of aging. Significant misconceptions remain, particularly in domains that affect how those prosthodontists interact with older adults. The study highlights the need for targeted educational reform aimed at addressing implicit biases and enhancing the delivery of geriatric dental care.

The gender-based analysis further revealed content-specific disparities, with female trainees outperforming males on several psychosocially relevant items. This indicates the need for more targeted curricular interventions that go beyond factual instruction to include reflective learning, intergenerational interaction and ethical discourse on aging.

As prosthodontists increasingly serve an aging population, ensuring trainees possess both the knowledge and attitudes necessary for equitable, person-centered care is vital. Addressing these gaps at the educational level is a critical step toward modifying un-spoken bias and improving outcomes in geriatric dental practice. This study tested two null hypotheses concerning knowledge of aging among postgraduate prosthodontic trainees: that no significant differences exist in FAQ scores based on gender or academic cohort. The results supported both null hypotheses. These findings suggest a consistent level of knowledge about aging among trainees, regardless of demographic or temporal variables.

Therefore, integrating gerodontology into postgraduate training as well as undergraduate education is essential for preparing prosthodontists to provide ethical, effective and customized dental care to the growing elderly population. Moreover, this improvement in gerodontology might positively influence student perceptions of age and aging.

Addressing these issues requires a dual-pronged educational approach: factual reinforcement and attitudinal awareness. Incorporating FAQ-like tools in formative assessments and reflective sessions can foster deeper engagement with the lived realities of older adults and improve patient-centered care outcomes. Future research should explore longitudinal impacts of such interventions on clinical behavior and patient outcomes.

Significance of the Study

This study provides valuable insight into the knowledge and attitudes of postgraduate prosthodontic trainees toward aging; a topic that remains underexplored in dental teaching. This study serves as a foundation for curriculum reform and further research into the integration of geriatric competencies in dental clinical teaching.

Conflict of Interest

There are no potential conflicts of interest to declare in this paper.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Declaration

This manuscript was not drafted with the assistance of an AI language model (ChatGPT). All content was reviewed and approved by the author.

Institutional Review Board Statement

Not applicable for studies not involving humans or animals.

Informed Consent Statement

Not applicable.

Acknowledgment
King Abdulaziz University Postgraduate trainees.

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