There are some books dealing specifically with the patient experience of disease or caring for others with an illness among the expanding body of graphic fiction. Many medical schools now recommend reading great literature to obtain insight into the human condition, in part due to the medical humanities movement. Even though some authors contend that graphic fiction is, in fact, a form of literature, and the medium of comics (the term is used in the plural to refer to both physical objects and the attendant philosophy and practice surrounding them) has not received much attention from health-care scholars until recently. Comics can depict a revealing medical tale that is just as valid as any other literature or art because they have their own special properties. The best examples provide uncommon insight into the human condition and are easily understandable and entertaining. An educational comic is one that “transmits information or communicates concepts, rather than telling a story or entertaining the reader”[3,4] The objective of the review was to investigate the importance of educational comics in dentistry and in educating pediatric patients, adults, and parents about oral health information and oral hygiene.
Visual storytelling that examines narratives about the body, health care, healing, and disability is known as “graphic medicine.” The “comics” genre has evolved over the past several decades to embrace themes formerly assumed to be exclusive to literature. In graphic medicine, the emotional and moral aspects of experience are explored. Which facts, disease theories, or medical procedures are correct or incorrect are determined by scientific medicine. Contrarily, graphic medicine demonstrates the complexity and humanity of both patients and providers. The reader is given the chance to consider how subjectivity, politics, culture, and society, as well as personal identity, power, and authority, influence medical practice within these narratives. Some health-care practitioners have started using visual storytelling for patient care and education, particularly those working in public health, with children, or with nonnative speakers.[6,7,8,9] This practice's lack of widespread adoption may be due in part to the fact that few doctors have given it serious consideration. Graphic narratives, in our opinion, play a significant part in patient care, medical education, and the social critique of the medical industry. The introduction to graphic storytelling that follows includes some examples of what they are, how and why they function, and how they might improve patient care and teaching.
Over the past 100 years, four comics have developed and are now seen as a distinct literary genre. Graphic novels are widely available in bookstores, movies, and television, and they have grown in popularity among adults with a genuine interest in learning more about a variety of important topics, from philosophy[9,10] to political upheavals.[9,11]
The field of “graphic medicine,” which was first described by British physician Ian Williams in 2007, examines the relationship between the comic book medium and the discourse surrounding health care. It is thriving at the intersection of the arts, literature, popular culture, and medicine.[9,12]
With cartoonists engaging in social and political polemics, the 18th century came to be known as the Golden Age of Cartoons. At that time, cartoons developed from more traditional styles of engraving, painting, and drawing. The most appropriate method seemed to be line drawing, and printmaking made them more widely available. The prints, which were frequently ornately finished and hand colored, were turned into collectibles. William Hogarth, Thomas Rowlandson, and James Gillray played significant roles in the genre's development in England.
With articles and projects on addiction, mental health treatment, health care in times of political unrest, and migrant health care, 2018, was a fruitful year for graphic medicine.
COMICS AND PANDEMIC
Comics have traditionally responded to pandemics and other tragedies by chronicling how we handle them. Recently, COVID-19 comics, an online collection of comics, editorial cartoons, autobiographical cartoons, and social media posts, have been published by graphic medicine, an interdisciplinary field of comics and medicine. These cartoons represent what we call covidity, a term we coined to describe both individual and group reactions to the COVID-19 pandemic in terms of philosophy, materiality, and a range of emotions. The way that comics have addressed previous pandemics such as H1N1 and Ebola is important since it helps to raise public awareness of the illness.
Comics' literary and visual qualities can convey the subtleties of the sickness experience with the immediate impact of visual involvement. Health-care professionals' comics regarding the COVID-19 epidemic currently pale in comparison to the nonmedical cartoonists' creations. On social media and webcomics websites, daily comics about the struggles of living under COVID-19 controls and the fear of a changing world are common. Health workers who produce comics and work on the front line of the epidemic are a rather small group, but they exist. Not unexpectedly, for some their creative productivity has been hampered by high clinical workloads during the COVID-19 pandemic.
COMICS AS AN EDUCATIONAL TOOL
Comics have been used to convey complex subjects in numerous scientific courses, such as human anatomy. According to teachers, reading instructional comics are linked to improvements in motor, visuospatial, writing, and course grades.[17,18,19,20]
During the informed consent procedure, graphic pathographies have also been employed as a tool to increase patient awareness. Furuno and Sasajima found that 93.8% of respondents preferred using comics in other medical situations, and 68.8% of 16 family members of patients who had experienced an intracerebral or subarachnoid hemorrhage thought reading comics about these conditions was helpful for understanding the doctor's explanation during the informed consent process.[20,21]
Educational comics may allow patients and their families to better understand the worries, anxieties, and expectations they can encounter by increasing empathy as the reader relates to the events and characters in the story and connects these to their experiences.
Graphic medicine communicates the health experience in a creative way that conventional texts are unable to, by highlighting the importance of art, relatability, and empathy in patient education materials. Graphic medicine resources are helpful for tackling health literacy, doctor–patient communication, and other difficulties within the medical setting, whether they are designed for patients, carers, or health-care providers.
EDUCATIONAL COMICS AND DENTISTRY
Children's dental anxiety is a serious social issue. It can be described as a generalized feeling of anxiety that does not require any prior knowledge of the circumstance being anticipated.[23,24,25] The study conducted by Alsaadoon, A. M., Sulimany, A. M., Hamdan, H. M., and Murshid, E. Z. concluded that the dental storybook can help kids feel less anxious about going to the dentist and behave better.
An epidemiological study of students at Kalijudan Elementary School received a direct distribution of educational comic books. Thirty kids and 13 teachers are involved in this initiative. Before learning about dental health from educational comics, the kids took a pretest. After obtaining the comic book-based health education materials, the participants took a posttest to gauge their level of health awareness. The paired t-test was used to assess the pre- and posttest data.
The empowerment program at Kalijudan 1 Elementary School produced pretest and posttest scores of 12.3 and 13.6, respectively. There was an increase of 1.3 points (P = 0.05). The significance level was set at 0.000. This indicates that there was a significant difference between the knowledge levels of the kids before and after reading the comic.
The goal of the study was to determine how oral hygiene values toward children with special needs changed as a result of dental health education utilizing a cartoon animation medium in 2017 at SLB NegeriBangli, Indonesia. The design was focused on one group (X) under a certain situation, and then observation and measurement were done. In comparison to the earlier stage, the study's findings demonstrate that the average value of oral hygiene increased by 0.84 after oral health education through cartoon animation (1.37). With a significant value of 0.00 and a correlation value of 0.84, this study concludes that there is a significant difference in oral hygiene between before and after an oral health education program employing cartoon animation for dental health.
Si Imut comic book media counseling activities were effective in increasing the knowledge of SDN 12 Kapoposang Island students. The data are backed up by analysis of Haq's 2015 research findings. The findings revealed that when respondents were provided with dental cartoons, their knowledge was significantly enhanced.[28,29]
Learning about dental and oral health is one way to avoid and treat dental and oral health issues. With SPSS 24 for Windows, a paired t-test was used to assess the pre- and posttest average value data. The data exhibit significant findings with a value of P (0.000) 0.05. The activity's conclusion is that the Comic Eksis Cermin Si Imut is effective in increasing students' knowledge of classes III, IV, and V SDN 12 Kapoposang Island.
A series of comics that analyze the effects of substance use on oral health were developed in collaboration with people who have firsthand experience with drugs by artists, dentists, public health experts, and addiction specialists. The Oral Health Improvement for People with Experience of Drugs initiative was developed by the University of Dundee in collaboration with NHS Fife and the Scottish Drugs Forum. The comics they created are a part of a collection of tools that will be used to teach addiction specialists in oral health mentorship and to promote awareness of the concerns raised to increase access to services.
To guarantee that the right oral hygiene habits are used for their children, parents must get oral health education. Following the use of the storybook, parents' oral health knowledge significantly improved, according to a study that examined the role of a dental storybook in enhancing parental oral health knowledge and evaluating parents' perceptions of the use of the storybook in enhancing parental oral health knowledge and lowering levels of dental anxiety in children.
Dentofacial malocclusions should be made more common among parents to prevent treatment delays. The purpose of the study was to determine how an instructional leaflet affected parents' knowledge and awareness of children's orthodontic malocclusion. A leaflet group that got an informative leaflet and a control group that received no leaflet were randomly assigned to the parents of 533 pupils aged 7–9 years. On a questionnaire about orthodontic issues, test results from before and after the intervention were compared. For both the overall score and the domain on general awareness of orthodontic issues, there were statistically significant greater differences between posttest and pretest scores in the leaflet group compared to the control group.Although there are limitations in presenting the message for a thorough understanding, a straightforward pamphlet might be a useful tool to boost knowledge about tooth avulsion and how parents should behave in such a case. A straightforward booklet is an effective tool for educating parents and raising awareness of tooth avulsion. The [Figure 1] below gives the information about the importance of educational comics in dentistry.
Thanks to the dental story, kids behave better and are less anxious when seeing the dentist. Oral hygiene improves in children as a result of a dental health education campaign that incorporates cartoon animation. Activities for media counseling related to comic books are effective in spreading awareness. Comics help in educating parents about oral health, dentofacial malocclusion, and tooth avulsion.
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Conflicts of interest
There are no conflicts of interest.
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