Publication: Implementación del diagnóstico de riesgo de patología oral como método de aprendizaje del control, manejo y mantenimiento en salud del paciente odontológico en la asignatura Odontología Preventiva y Comunitaria
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2021-05
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Abstract
El diagnóstico de riesgo de caries, de enfermedad periodontal, y de patología de mucosa oral, supone un avance muy importante para el diagnóstico, siendo un elemento fundamental en la odontología moderna, por lo que se pretende diseñar una herramienta que facilite el aprendizaje en este ámbito a los alumnos de Grado de Odontología. Es importante señalar que manejamos en nuestro día a día dos de las enfermedades más prevalentes en el mundo, ocupando la caries la primera posición y la enfermedad periodontal la sexta. Para su prevención es importante conocer el riesgo de dichas patologías de cada paciente e implantar, según su riesgo, un protocolo de actuación tanto en clínica como en el hogar, y mejorar así su salud oral.
La determinación de riesgo de caries a nivel individual es bastante sencilla y se basa en una correcta realización de historia clínica: anamnesis, exploración y pruebas complementarias, como por ejemplo la realización de radiografías de aleta de mordida. Tras la identificación de riesgo de caries del paciente, y la clasificación del mismo, se implantará de forma individual un protocolo preventivo para cada paciente según el riesgo.
Este proyecto surge de la necesidad constatada de mejora en la atención clínica de la asignatura de Odontología Preventiva y Comunitaria, que es cursada por alumnos del último curso del Grado de Odontología. Tradicionalmente y a pesar de ser una asignatura centrada en la prevención, por motivos logísticos, se hacían intervenciones puntuales sobre el paciente, sin poderlo controlar en el tiempo para mantener su salud oral.
Se proponen nuevas metodologías e innovación en enseñanza presencial junto con nuevas iniciativas y herramientas para la evaluación de la satisfacción de los estudiantes, implicándolos en los procesos de evaluación de la calidad en la materia de Odontología Preventiva y Comunitaria.
La mejora de la calidad de la atención odontológica pasa por tener en cuenta los sistemas de organización y planificación del tratamiento y mantenimiento en salud del paciente. Sería de gran interés poder aplicar estos sistemas para minimizar los errores cognitivos por parte de los alumnos en la clínica.
Igualmente, hemos constatado que el profesorado debe implicarse y conocer profundamente los sistemas de control de calidad en la clínica. La implantación de protocolos preventivos, en función del riesgo, tanto en clínica como en el hogar, es un pilar básico para una odontología de calidad.
Este proyecto se desarrolla en la Facultad de Odontología de la UCM en la asignatura Odontología Preventiva y Comunitaria. Para el diagnóstico de riesgo de patología oral, se utilizan fichas clínicas desarrolladas por profesores de la asignatura, a las que se añaden en el caso de la ficha de riesgo de caries, una modificación del protocolo CAMBRA (Caries Management by Risk Assessment), que es un método que intenta evaluar el riesgo de caries dental y el manejo de la misma según el riesgo individual de cada paciente, basándose en los factores de riesgo, en los factores protectores y en los indicadores de enfermedad. CAMBRA sigue el modelo de caries como un balance o desbalance continuo entre factores patológicos y factores protectores.
Entre los propósitos del proyecto está el capacitar al alumno, mediante modelos de evaluación, para analizar el riesgo de patología oral, individualizar protocolos preventivos en función del mismo, optimizando el control y seguimiento periódico del paciente, para que finamente redunde en una mayor seguridad durante los procedimientos diagnósticos y operatorios llevados a cabo por los alumnos.
The diagnosis of risk of caries, periodontal disease, and pathology of the oral mucosa, represents a very important advance for the diagnosis, being a fundamental element in modern dentistry, so it is intended to design a tool that facilitates learning in this scope for undergraduate students in Dentistry. It is important to point out that we handle two of the most prevalent diseases in the world in our day-to-day life, with caries occupying the first position and periodontal disease the sixth. For their prevention, it is important to know the risk of these pathologies in each patient and to implement, according to their risk, an action protocol both in the clinic and at home, and thus improve their oral health. Determining caries risk at the individual level is quite simple and is based on a correct medical history: anamnesis, examination and complementary tests, such as bitewing X-rays. After identifying the patient's caries risk and classifying it, a preventive protocol will be implemented individually for each patient according to risk. This project arises from the confirmed need for improvement in clinical care in the subject of Preventive and Community Dentistry, which is taken by students in the last year of the Degree in Dentistry. Traditionally and despite being a subject focused on prevention, for logistical reasons, specific interventions were made on the patient, without being able to control it over time to maintain their oral health. New methodologies and innovation in face-to-face teaching are proposed along with new initiatives and tools for evaluating student satisfaction, involving them in quality assessment processes in the field of Preventive and Community Dentistry. Improving the quality of dental care involves taking into account the organization and planning systems for treatment and maintenance of the patient's health. It would be of great interest to be able to apply these systems to minimize cognitive errors on the part of students in the clinic. Likewise, we have found that the teaching staff must be involved and have a deep understanding of the quality control systems in the clinic. The implementation of preventive protocols, depending on risk, both in the clinic and at home, is a basic pillar for quality dentistry. This project is developed in the Faculty of Dentistry of the UCM in the subject Preventive and Community Dentistry. To diagnose the risk of oral pathology, clinical files developed by teachers of the subject are used, to which, in the case of the caries risk file, a modification of the CAMBRA protocol (Caries Management by Risk Assessment) is added, which is a method that attempts to assess the risk of dental caries and its management according to the individual risk of each patient, based on risk factors, protective factors and disease indicators. CAMBRA follows the caries model as a continuous balance or imbalance between pathological factors and protective factors. Among the purposes of the project is to train the student, through evaluation models, to analyze the risk of oral pathology, individualize preventive protocols based on it, optimizing the control and periodic monitoring of the patient, so that it ultimately results in greater safety during diagnostic and operative procedures carried out by students.
The diagnosis of risk of caries, periodontal disease, and pathology of the oral mucosa, represents a very important advance for the diagnosis, being a fundamental element in modern dentistry, so it is intended to design a tool that facilitates learning in this scope for undergraduate students in Dentistry. It is important to point out that we handle two of the most prevalent diseases in the world in our day-to-day life, with caries occupying the first position and periodontal disease the sixth. For their prevention, it is important to know the risk of these pathologies in each patient and to implement, according to their risk, an action protocol both in the clinic and at home, and thus improve their oral health. Determining caries risk at the individual level is quite simple and is based on a correct medical history: anamnesis, examination and complementary tests, such as bitewing X-rays. After identifying the patient's caries risk and classifying it, a preventive protocol will be implemented individually for each patient according to risk. This project arises from the confirmed need for improvement in clinical care in the subject of Preventive and Community Dentistry, which is taken by students in the last year of the Degree in Dentistry. Traditionally and despite being a subject focused on prevention, for logistical reasons, specific interventions were made on the patient, without being able to control it over time to maintain their oral health. New methodologies and innovation in face-to-face teaching are proposed along with new initiatives and tools for evaluating student satisfaction, involving them in quality assessment processes in the field of Preventive and Community Dentistry. Improving the quality of dental care involves taking into account the organization and planning systems for treatment and maintenance of the patient's health. It would be of great interest to be able to apply these systems to minimize cognitive errors on the part of students in the clinic. Likewise, we have found that the teaching staff must be involved and have a deep understanding of the quality control systems in the clinic. The implementation of preventive protocols, depending on risk, both in the clinic and at home, is a basic pillar for quality dentistry. This project is developed in the Faculty of Dentistry of the UCM in the subject Preventive and Community Dentistry. To diagnose the risk of oral pathology, clinical files developed by teachers of the subject are used, to which, in the case of the caries risk file, a modification of the CAMBRA protocol (Caries Management by Risk Assessment) is added, which is a method that attempts to assess the risk of dental caries and its management according to the individual risk of each patient, based on risk factors, protective factors and disease indicators. CAMBRA follows the caries model as a continuous balance or imbalance between pathological factors and protective factors. Among the purposes of the project is to train the student, through evaluation models, to analyze the risk of oral pathology, individualize preventive protocols based on it, optimizing the control and periodic monitoring of the patient, so that it ultimately results in greater safety during diagnostic and operative procedures carried out by students.