Patient safety attitudes among dentists and clinical dental students: a multivariable cross-sectional analysis

BACKGROUND: Patient safety is a cornerstone of high-quality dental care; however, evidence regarding factors associated with safety and ethical attitudes in dentistry remains limited. This study assessed self-reported patient safety and ethical attitudes among Turkish dentists and clinical-stage dental students, examining demographic and professional correlates. METHODS: In this cross-sectional study, 427 participants (232 students; 195 dentists) completed the Patient Safety Attitude Scale in Dentistry (PSASD), including the Risk Management and Ethical Attitude subscales. Data were collected on age, gender, professional role, prior patient safety training, incident history, and reporting status. Robust multivariable regression models were fitted to estimate covariate-adjusted associations, given the correlation between age and professional role. RESULTS: The mean PSASD total score was 60.03 ± 7.57. While bivariate analyses suggested higher unadjusted scores among students (p < 0.001), covariate-adjusted models revealed a role reversal: compared with students, general dentists (B = 3.354, p = 0.030) and specialist dentists (B = 6.452, p < 0.001) had higher adjusted total scores. Older age categories were independently associated with lower scores (p < 0.001), with the largest decrement in the 36–40 group (B = − 11.296). Gender associations were domain-specific: female gender was positively associated with Risk Management (B = 1.018, p = 0.026) but negatively associated with Ethical Attitude (B = − 1.050, p = 0.012). Self-reported incident history was consistently associated with lower scores (p < 0.001). Among participants with an incident history, reporting was positively associated with Risk Management (B = 2.128, p = 0.012). CONCLUSION: Patient safety attitudes were generally favorable but varied by age, professional role, and incident experience. The reversal of the apparent student advantage after covariate adjustment underscores the importance of accounting for age-related confounding in mixed dental cohorts. The consistent negative association between incident history and safety attitudes highlights the potential need for post-incident support. The coexistence of favorable ethical endorsement with infrequent reporting suggests that reporting behavior may be shaped more by organizational context than by individual attitudes, warranting direct assessment in longitudinal studies.