Introduction

Artificial intelligence (AI) refers to the intelligence displayed by machines or software, due to its mimicking cognitive function for real-world problems and developing systems that think like people1. Artificial Intelligence has had a profound impact on various aspects of life, addressing complex challenges across scientific, engineering, business, medical, meteorological, and media domains2,3,4,5,6. The advancement of AI technology has stirred both aspirations and concerns, particularly within the healthcare sector, including the detection of radiographs, viewing histopathological slides, detecting diabetic eye diseases, and many more applications in medicine7. Artificial intelligence also has a great impact on the field of dentistry8. Artificial Intelligence methodologies have great capability to detect and diagnose the lesions of the oral cavity, which may usually go undetected by the human eye, therefore making their way towards dental practice9. The potential of advanced A.I. in orthodontics has been explored particularly for applications such as CBCT diagnosis and assessment, evaluation, and treatment progress, ensuring the solidity of outcomes during the follow-up stage10. Using artificial intelligence (AI) in dental practice can face challenges like getting data, interpreting it, and ethical concerns. Still, AI is considered a worthy addition to dental procedures8.

In November 2022, ‘Open AI,’ a notable artificial intelligence company, unveiled a widely recognized chatbot named ‘ChatGPT’11. This versatile chatbot has multifaceted applications, ranging from educational and entertainment purposes to predicting queries, drafting applications, conducting research, managing schedules, making appointments, and assisting in debugging codes12. Notably, it has found valuable applications in the healthcare sector, providing medical guidance and information, such as responding to medical inquiries, offering recommendations for drugs and treatments, and aiding in the diagnostic process13. Lately, ChatGPT has played an essential role in creating discharge summaries, which can drastically reduce the workload of documentation in the healthcare sector14. Furthermore, ChatGPT could enhance service efficiency by maximizing clinical output and reducing work costs. ChatGPT has the potential to play a major role in breast cancer screening, evaluating pain and identifying necessary imaging steps15.

ChatGPT possesses the potential to significantly bolster clinical applications and research within the field of dentistry. It can also be used as an educational tool for students and professionals in the field of dentistry by offering an immense amount of knowledge and information16. Large Language Model AI Chatbot has the capability of strengthening clinical application and research in dentistry. It is positioned to enhance dental diagnosis and treatment planning by surmounting dental practitioners in the accuracy and efficiency of diagnostic procedures, therefore decreasing the occurrence of missed findings and preventing overtreatment17. AI algorithms can be trained to evaluate CBCT images for dental conditions by examining the alignment, location of teeth, and assessing bone quality for placing implants, thereby resulting in AI-assisted image processing and analysis. ChatGPT can offer patients accurate and reliable information tailored to their specific dental health and hygienic needs18. ChatGPT can provide prompt feedback, address doubts, and provide additional resources to readers.

As artificial intelligence (AI) continues to evolve, tools like ChatGPT are gaining significant attention across various sectors. Globally, individuals are leveraging ChatGPT for diverse applications, ranging from education to healthcare. In Pakistan, recent studies have highlighted a growing awareness and utilization of ChatGPT among the general population. One such study reported that approximately 76% of respondents were aware of ChatGPT, with 30% of this group comprising healthcare providers19.

Building upon these findings, the current research focuses specifically on the dental community in Pakistan. It aims to assess the level of awareness, attitudes, and practices related to ChatGPT among dental professionals and students. Understanding how this AI tool influences their daily professional routines and their perspectives on its future applications is crucial. Given the potential of ChatGPT to transform educational methodologies, clinical decision-making, and patient communication, this study seeks to provide insights into its current impact and future implications within the field of dentistry in Pakistan.

The objective of the study

The objective of the study is to assess the knowledge, attitudes, and practices (KAP) related to ChatGPT among undergraduate and graduate dental students and professionals in Karachi, Pakistan, and to analyze an association with sociodemographic factors.

Methodology

A questionnaire-based cross-sectional study was conducted over a period of three months across various dental institutes in Karachi, Pakistan. The target population included:

  • Students currently enrolled in Bachelor of Dental Surgery (BDS) programs.

  • Dental graduates holding a BDS degree.

  • Postgraduate students or dentists pursuing further professional education after obtaining their BDS degree.

Ethical approval for the study was obtained from the institutional review board. The study was conducted in accordance with the Declaration of Helsinki and its 2013 revision. A non-probability convenience sampling technique was employed. The questionnaire was disseminated via internet-based platforms, including WhatsApp, and email using generalized invitations to maximize reach. Participation was voluntary and anonymous. No names or identifying information were collected, and all data were stored securely on a password-protected device accessible only to the core research team.

The sample size was determined using the RAOSOFT sample size calculator. Based on a confidence interval of 95%, a margin of error of 5%, and an assumed response distribution of 65%, the required sample size was calculated to be 347 participants.

A self-administered questionnaire was developed using Google forms and structured into four sections. Demographics include age, gender, professional status, and work sector. Participants were also asked to indicate their years of clinical experience after receiving their BDS degree. This variable was categorized into the following groups: 0 years (current students), 1–3 years, and more than 3 years. Knowledge-based items to assess awareness and understanding of ChatGPT and items specific to assess the Attitudes i.e., participants’ opinions on ChatGPT’s role in dentistry. Additionally, the questionnaire also had a section to collect data about practices of the participants or usage patterns of ChatGPT in academic or clinical settings. (Supplementary file 1).

The questionnaire underwent Pre-testing for face and content validation on 30 participants once, including heads of departments (HODs), assistant professors, research specialists, and research managers. Their feedback was used to refine the questionnaire in terms of clarity, structure, and relevance. To assess internal consistency, the Cronbach’s alpha coefficient was calculated, yielding a value of α = 0.71, indicating acceptable reliability.

Statistical analysis

Data was analyzed using SPSS software version 26. Descriptive statistics, including frequencies and means, were used to summarize the demographic characteristics of the participants. Multiple linear regression analysis was performed to evaluate the association between participants’ knowledge, attitude, and perception of ChatGPT and their sociodemographic variables. For the purpose of regression analysis, all binary response variables (e.g., ‘Yes’/‘No’) were coded as 1 and 2, respectively, to convert nominal data into numeric format suitable for analysis. A p-value of ≤ 0.05 was considered statistically significant.

Results

The majority of participants were female (74.6%, n = 258), among whom 74.4% reported familiarity with ChatGPT. Among male participants (n = 89), an even higher proportion (82%) were familiar with the platform. Overall, 76.4% of all participants (n = 347) reported awareness and use of ChatGPT (Table 1). In this study most of the participants belonged to the age group of 18–25 (78%), while (19.6%) were 26–35 years whereas, the remaining (2.3%) belonged to the age range of 36–50 years respectively. The study included 153 (44.1%) dental students, 140 (40.3%) general dentists, 47 (13.5%) postgraduate students, and seven (2%) consultants. In terms of clinical experience, dental students had no professional experience, general dentists and postgraduates primarily had 1–3 years of experience, while consultants typically had more than 3 years of clinical experience. Seventy (20.2%) participants belonged to the public sector, 236 (68%) to the private sector, and 41 (11.8%) to both sectors.

Table 1 Gender distribution and familiarity with ChatGPT.
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News and social media emerged as the most common source of information about ChatGPT, cited by over 40% of respondents. Friends accounted for about a quarter, while fewer participants learned about ChatGPT through their workplace or educational institutions. Family was the least cited source, indicating minimal influence from home environments on ChatGPT awareness (Fig. 1).

Fig. 1
Fig. 1
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Source of information regarding ChatGPT.

A significant proportion of participants, more than 45%, believed ChatGPT would have a positive effect on future learning and creativity. Conversely, around 20% perceived a negative impact, while a smaller segment (10%) expressed a neutral approach. This indicates a largely optimistic outlook on the educational and creative potential of ChatGPT (Fig. 2).

Fig. 2
Fig. 2
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The impact of ChatGPT on learning and creative performance.

Among those aware of ChatGPT (n = 265), about one-fourth (26%) had sought external help to learn its usage, while just over half (49.9%) had not. Routine use was reported by 25.6% of respondents. A majority found it easier to use compared to other sources (64%) and considered it helpful (62.8%). However, only 23.3% reported prior use of other AI tools during their dental training (Table 2).

Table 2 The percentage distribution of knowledge among the participants regarding ChatGPT. (23.6%, who are not aware of chat-GPT were excluded).
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The attitude of participants varied across usage contexts. ChatGPT was most commonly used as an educational tool (47%), followed by research assistance (36.3%) and answering dental questions (32.3%). A relatively smaller number of participants reported using it for administrative tasks (21%) or patient counseling (7.5%), indicating limited clinical or managerial application among dental students and professionals (Table 3). Although the questionnaire did not include direct measures of clinical or managerial competence, responses to items such as “Use of ChatGPT for patient counseling” and “Use for administrative tasks” were interpreted as indicative of participants’ perceptions of ChatGPT’s potential in these domains.

Table 3 The percentage distribution of attitude among the participants regarding ChatGPT Participants and Knowledge (n = 265) (23.6%, who are not aware of chat-GPT were excluded).
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Moreover, half of the participants (50.1%) viewed ChatGPT as a superior knowledge source. Nearly half (48.7%) believed it could replace certain academic roles in the future. Opinions on the ethical use of AI were divided almost evenly. Over half (53.3%) expressed concern that AI use may impact future dental professionals’ skills, although fewer (33.1%) anticipated AI overtaking dentists’ roles. Nonetheless, (31.4%) supported restrictions or bans on ChatGPT use in dental education (Table 4).

Table 4 The percentage distribution of perception among the participants regarding ChatGPT (23.6%, who are not aware of chat-GPT are excluded).
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The regression analysis revealed that professional designation and years of experience were significant predictors of knowledge about ChatGPT (p = 0.001), while gender significantly influenced both attitude (p = 0.04) and perception (p = 0.021). Age showed a borderline significance in influencing attitude (p = 0.03) but not knowledge or perception. Other variables, such as sector, were not significantly associated with any of the outcomes (Table 5).

Table 5 Regression analysis for knowledge, attitude, and perception showing predictors of knowledge, attitude, and perception toward ChatGPT among dental students and professionals.
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Discussion

The rapid evolution of artificial intelligence in healthcare, understanding how emerging tools like ChatGPT are perceived and utilized by future dental professionals is both timely and critical14. This study aimed to bridge that knowledge gap by exploring the awareness, attitudes, and practices related to ChatGPT among dental students and practitioners in Karachi, Pakistan.

Our findings indicate that over 75% of participants were aware of ChatGPT; however, its application in clinical practice remains limited. This trend aligns with a study conducted in Islamabad, where 61% of medical and dental students had utilized ChatGPT primarily for academic purposes, such as case-based and problem-based learning20. Similarly, research from Rawalpindi highlighted that while students recognized ChatGPT’s potential, its usage was predominantly for academic assistance rather than clinical application21.

The user-friendly nature of ChatGPT was acknowledged by participants, with many finding it accessible through various platforms, notably social media. This aligns with studies indicating that social media serves as a primary conduit for disseminating information about AI tools among students22,23. Regarding the perceived accuracy of ChatGPT, most participants considered its responses moderately accurate. This perception is consistent with findings from a study in Saudi Arabia, where dental students expressed moderate confidence in AI tools, emphasizing the need for enhanced AI literacy and training24. It is noteworthy that this study did not directly assess clinical or managerial skills; rather, the interpretations were based on participants’ reported contexts of ChatGPT use, such as patient counselling and administrative assistance.

When exploring the potential of ChatGPT to replace certain academic roles, nearly half of the participants believed it could substitute junior faculty positions. This sentiment resonates with international discussions on AI’s role in education, where concerns about job displacement coexist with recognition of AI’s supportive capabilities25.

Ethical considerations emerged as a significant concern. Participants were divided on the appropriateness of using AI in healthcare, reflecting global debates on the ethical implications of AI integration in clinical settings. A study by Wei Q et al. highlighted potential ethical challenges from legal, humanistic, algorithmic, and informational perspectives, emphasizing the need for clear rules and legal boundaries to properly allocate liability and protect users26.

The reliability of ChatGPT’s responses has been tested in various scenarios, with developers presenting both simple commands and more complex, profession-related queries to assess its functionality. In our study, 54.8% of participants suggested the software was moderately accurate. The findings are well supported by other studies that indicated satisfactory performance of ChatGPT when handling complex commands27,28.

Despite the intelligent capabilities of ChatGPT, some participants remained unconvinced about its ability to independently perform tasks traditionally conducted by humans. Concerns were raised about the ethical acceptability of deploying such software in the healthcare industry. In our study, 38.3% of participants agreed that it was ethically acceptable to use ChatGPT in healthcare, while a similar proportion disagreed. This uncertainty arises due to accountability dilemmas, particularly if the software provides incorrect outputs leading to adverse patient outcomes. Establishing responsibility and taking appropriate medicolegal action in such situations could be challenging.

Furthermore, the study by Alammari et al.29 in Saudi Arabia revealed that 42.5% of medical students were concerned about AI-induced job displacement, and 34.4% believed AI might eventually replace traditional doctor roles. Despite these concerns, there was a unanimous recognition of the potential for AI to collaborate with human healthcare professionals, indicating a shift towards a synergistic model in clinical practice. In contrast, our study involving dental professionals and students in Karachi, Pakistan, found that 53.3% believed ChatGPT could affect the performance and abilities of dental health providers, while 43.2% did not believe it would replace dentists in their professional roles.

These findings underscore the importance of integrating AI education into medical and dental curricula to prepare students for the evolving technological landscape. Addressing ethical concerns and promoting collaborative models can alleviate fears about job displacement. Continuous professional development through workshops and training sessions can keep current practitioners informed about AI advancements and applications. By implementing these strategies, educational institutions can better equip future healthcare professionals to navigate and embrace the integration of AI in their fields.

Limitations

This study was conducted solely in Karachi, Pakistan, which limits the generalizability of the findings. A more comprehensive approach would involve conducting similar studies across different regions or countries to better assess the knowledge, attitudes, and practices related to ChatGPT on an international scale. Since ChatGPT is a relatively new and rapidly evolving platform, its ongoing updates may significantly influence user perceptions and usability over time. As a cross-sectional study, this research captures a snapshot of participant opinions at a single point in time and does not account for potential changes in perception as the software continues to develop. A longitudinal study would be more appropriate to assess how attitudes, knowledge, and practices evolve over time.

While a pre-test of the sample was conducted to evaluate face and content validity, it involved only academic experts. Including members of the target population (undergraduate and postgraduate dental students) in this pilot phase would have enhanced the representativeness and reliability of measures such as the Cronbach’s alpha. One limitation of this study is the combination of undergraduate and graduate dental students within a single convenience sample, without stratified analysis. While this approach allowed for a broader perspective on ChatGPT usage across different educational levels, it may have obscured group-specific differences. Future studies should consider stratified sampling or separate analysis of educational subgroups to provide more targeted insights. Additionally, the study focused exclusively on individuals from a dental background. This may include participants who are less familiar with or less supportive of AI technologies. Moreover, younger individuals who are not currently enrolled in a dental program were excluded from the study. Including a broader age range and educational backgrounds might provide more diverse perspectives and strengthen the findings. Although years of experience was included as a variable to assess the impact of professional exposure on ChatGPT familiarity, we acknowledge that the majority of our sample consisted of students and early-career professionals. Therefore, the influence of this variable may be limited and not generalizable to experienced clinicians. Future studies should include a more diverse range of clinical experience levels to better evaluate this factor.

Despite these limitations, this study provides valuable preliminary insights into the knowledge, attitudes, and practices regarding the use of AI software like ChatGPT among dental students and graduates. It sets the foundation for future, more extensive research exploring the integration of AI technologies in healthcare education and practice.

Conclusion

This study highlights a generally positive awareness and acceptance of ChatGPT among dental students and professionals, with the majority recognizing its potential educational and research utility. While knowledge about the platform was influenced by professional designation and years of experience, gender played a notable role in shaping attitudes and perceptions. Despite concerns regarding ethical implications and job displacement, a substantial proportion of participants believed in the constructive role of ChatGPT in enhancing learning and creative performance. These findings highlight the need to integrate AI literacy into dental education while also fostering critical discourse on its ethical and professional implications.