The study was approved by the Ethical Committee of King Saud University Riyadh Saudi Arabia under ethical number (E18-3360). The study was in accordance to STROBE statement of reporting cross-sectional surveys. The duration of the study was three months (from April 2019 to July 2019).

A literature review was performed to validate the present cross-sectional survey, which revealed that there was no available data on assessment of job satisfaction amongst endodontists. Contact details of registered endodontists were requested from the office of Saudi Dental Society. A questionnaire was formulated consisting of total 38 questions in seven domains. Research team of statistician along with authors reviewed the content of each question to make sure that the survey reflected appropriate phrasing and understanding and validation (Cronbach’s α=0.070). A total sample size of 100 endodontists was well thought out but since dropouts, invalid responses were anticipated so a sample size of 125 endodontists was considered appropriate. Using power calculation sample size was assessed from a study by Al-Kattan R and Al-Shibani N [12]. A link containing details of the questionnaire using survey monkey instrument was sent to endodontist from the office of Saudi Dental Society. Reminder e-mail was sent periodically to improve response rate.

The seven domains of the cross-sectional survey consisted of questions related to socio-demographic characteristics, academic, professional qualifications, and motivation behind choice of endodontist as a speciality, satisfaction as an endodontist, satisfaction with the workplace environment facilities and staff and their satisfaction with their relationship with patients. The questions of the survey were sourced from a study by Alqahtani N et al., and were included in the study with some modification [1]. The validity of modified questions was evaluated using Cronbach’s α=0.080) The responses were measured using a five-point Likert’s Scale coded as, 1 strongly disagree; 2 disagree; 3 fair; 4 agree; 5 strongly agree.

A single investigator to minimise bias evaluated all the responses. SPSS software version 21.0 (Chicago, IL, USA) was used for tabulation of descriptive analysis. Standard Deviation (SD), percentages and means were calculated. Comparison between the demographic, academic, professional qualification variables and other domains were explored by applying chi-square test.

Out of the total 125 emails sent to the endodontists, 110 (88%) responses were attained. The results of 110 respondents with mean age 45.54±5.24, revealed highly significant difference among responses to different included questions (p<0.05).

Demographic factors exhibited that 93.6% (103) were Saudi national whereas, 6.4% (7) were non-Saudis. Gender analysis indicated that 25 respondents (22.7%) were male, whereas 85 (77.3%) were females. Sixty-seven (60.9%) of the participants had age between 31-40 years [Table/Fig-1].

The [Table/Fig-2] presents the academic qualifications of the respondents. Around, 58 (52.7%) of the dentists had their qualification from Saudi Commission of Health Specialities, by completing the Endodontic Saudi board specialist training and examination. While 27 (24.5%) of the responders completed a master’s degree and certificate in endodontics; and only 11 (10.0%) had a doctorate degree. The results further revealed that amongst the total respondents, 61 (55.5%) completed their residency program within Kingdom of Saudi Arabia (KSA) while approximately 44 (40%) completed their residency program in a foreign country.

Majority (42-38.2%) of the participants fall within professional experience of 3-8 years, followed by 19 respondents who possessed 9-15 years of work experience and only 9 participants had professional experience between 16-25 years. Moreover, amongst 110 subjects, (44-40.0%) participants were engaged in academics-based practice, followed by 24 respondents (21.8%) employed by the Ministry of Health (MoH) and 23 (20.9%) were working in a private dental practice [Table/Fig-3].

Majority of the respondents, 78 (69.6%), reported “challenging profession” as the main reason for choosing endodontics. This was followed by “professional growth,” “financial gains,” “prestigious speciality,” and “family influence” [Table/Fig-4].

Majority of the participants, 77.3% stated that endodontics was their primary choice among all dental specialities, followed by 48.1% claiming to be satisfied with working quality of auxiliary staff. Furthermore, 63.7% of the subjects were pleased with overall, quality of life as an Endodontist. Moreover, 65.5% of the participants were gratified with facilities and resources in the clinics for adequate delivery of good quality oral health care. However, 27.3% of the respondents were not satisfied with the income from their endodontic practice. In addition, nearly 40% of the dentists were unhappy with medical facilities provided to them as job benefits [Table/Fig-5].

Regarding satisfaction of the dentists about their practice and workplace environment, 53.6% of the respondents stated that their responsibilities were well defined. Eighty-four percent of the participants affirmed that they are content with working environment within the practice team because it was conducive. Likewise, 81.8% of the participating subjects agreed that their professional senior colleagues were kind and they enjoyed working as team. Moreover, 51.8% of the participants stated that their organisation was supportive for professional development and quality of work [Table/Fig-6]. The results presented in [Table/Fig-7] show that 48.1% of the dentists were satisfied with practice management and care delivery system.

Analysis of the results presented in [Table/Fig-8] showed that 80.9% of the endodontist were of the view that they have good relations with their patients. Although, 27.3% of the respondents stated that amount of workload was too much on endodontist. Moreover, 31.8% of the participants agreed that their patients were not punctual and did not adhere to the appointment schedule. Likewise, 76.4% of the respondents agreed that overall they were satisfied with their job as an endodontist. In contrast, a significant percentage (24.5%) of their patients had unrealistic expectations regarding the outcome of their endodontic treatment [Table/Fig-8].

The present cross-sectional survey displayed a unique assessment of endodontist job satisfaction in the region of KSA. To the best of authors’ understanding this is one of the distinctive surveys done in KSA on endodontists job satisfaction. The response rate in the present study was 89%. A similar study type based on job satisfaction of orthodontics working in KSA was performed by Alqahtani N et al., which yielded a lower response rate [1]. A possible explanation to this low response rate was busy clinical settings and personal commitment. However, in the present study follow-up reminder emails exhibited a better response rate [13]. The reminder emails were sent periodically after every three weeks. The survey consisted of seven domains and 38 item questions. A cross-sectional type study design was used as it is easy, simple and cost-effective to perform, it may help in generating a hypothesis for a more complex investigation and possibilities of loss to follow-up are minimum [14]. Moreover, a survey monkey instrument was used making the results more accurate, less bias and convenient, compared to a manual survey [15]. When asked about qualifications, majority of the respondents did residency program in endodontics from KSA and qualification was Saudi Endodontic Board. This finding was in concurrence with the results of Al-Dlaigan YH et al., indicating that students were motivated, eager and enthusiastic in obtaining lifelong education [16].

When respondents were asked about motivation for choosing endodontics, 78 (69.6%) took endodontic as a challenging profession. These findings were in line with studies by Alqahtani N et al., and Noble J et al., signifying mature mental abilities and disciplined determination [1,17]. Overall, effect of QoL as an endodontist was 63.7%. Moreover, 77.3% of respondents proclaimed that choosing an endodontic speciality was their primary choice. Choosing profession and speciality of first choice helps a lot in balancing QoL and also may reduce occupational stress levels [18].

Moreover, when inquired about satisfaction with the workplace environment and staff, 84% were satisfied with working environment within the practice team because it was conducive and professional. These factors contribute to job gratification and organisational commitment. Henceforth, enhancing the success and progress of organisation and dental practice [19]. Furthermore, >50% of the endodontists were of view that ample time is available for family and personal life. A study by Rada RE and Johnson-Leong C, proclaims having no family or personal time have serious complication in a life of a dentist and risk of anxiety, stress, depression and burnout increases. Moreover, there is gradual erosion professionally resulting in serious implication both mentally and physically [20].

Most of the respondents were not satisfied and were unhappy with patients coming late to the dental practice i.e., being not punctual. These results are parallel to a study by Rada RE and Johnson-Leong C, indicating that such act by the patients causes high level of stress and anxiety among dentists [20]. In the present study, overall job satisfaction among endodontist was 76.3%. This satisfaction percentage is found to be worrying, as a study by Roth SF et al., shows that high satisfaction in job upsurges risk of occupational stress [21]. From the results of this study, it can be inferred, that job satisfaction among endodontist working in KSA was satisfying.

More studies with better study designs should be executed with comparison between different dental specialities. The study has limitation based on its small sample size. More studies with increased sample size and endodontist from other parts of KSA should be taken into account to get a better representation of the population. For future studies, a comparison between Saudis and Non-Saudis job satisfaction as an endodontist should be also performed.

Endodontists working in Kingdom of Saudi Arabia were found to be content and satisfied with their job. Moreover, policy should be directed in improving administrative responsibilities of endodontists for a better oral health care delivery. More studies should be performed to validate the findings of the present study.