Exploring patient perceptions of dentist demeanour in Pakistan: a mixed methods analysis using the Urdu translated dental belief survey

Oral health in Pakistan faces challenges due to infrequent, symptom-driven dental visits and negative patient perceptions of dentist demeanour, often leading to care avoidance. This study aimed to explore these perceptions using the Dental Belief Survey (DBS) and to identify the influencing factors. The objectives of this study were to (1) validate the Urdu translation of the DBS (2), compare DBS scores among patients in dental outpatient departments, and (3) conduct qualitative interviews to gain deeper insights into the views of patients who exhibited moderate to high negative perceptions of dentist demeanour. A sequential mixed-methods study was conducted in the three affiliated dental colleges of Dow University of Health Sciences situated in different localities of Karachi. The quantitative phase involved a cross-sectional survey of 273 patients using the Urdu-translated DBS. Descriptive statistics, chi-square tests, and independent-sample t-tests were employed to analyse the data. The qualitative phase involved semi-structured interviews with 15 purposively selected patients based on their DBS scores, which were analysed using thematic content analysis. The Urdu DBS demonstrated strong internal consistency (Cronbach’s alpha = 0.86). The overall mean DBS score was 26.30 ± 10.05, with most participants exhibiting moderate negative perceptions. No significant gender differences were found in DBS scores across communication, belittlement, lack of control, trust, and fear domains. Qualitative findings identified key themes: dentist-patient communication and professionalism, patient trust and satisfaction, hygiene and environmental factors, and gender bias and preferences. This study provided a comprehensive understanding of patient perceptions of dentist demeanour in Pakistan, confirming the reliability of the Urdu DBS. Addressing communication, transparency, and hygiene issues can enhance patient satisfaction and reduce care avoidance. These findings offer valuable implications for improving dental practices globally, particularly in culturally diverse settings.