[The criterion mode of evaluating functioning of stomatologic polyclinic].

To improve quality and efficiency of primary health care and to strengthen its preventive directivity is possible through health care modernization including implementation of management technologies, development of database for evaluation and control. The purpose of the study is to develop method of evaluating activity of stomatologic clinic. The methodology was based on concepts of "functional systems" and "decision making". The listing of informative criteria was based on data analysis of functioning of stomatologic service of the Chechen Republic in 2002-2016 and results of sociological survey of stomatologists (n=181), health care administrators in stomatology (n=45), paramedics (n=220) and patients (n=359). The experts (n=13) developed required number of criteria and their gradation. The algorithm of evaluating activity of stomatologic clinic was developed using systematic approach. The listing of 52 criteria and their 10 blocks were established. The experts established coefficients of significance of criteria (0.0084-0.0781; ≥0.0224 - more significant, <0.0224 - less significant). Three levels were determined for each criterion (according principle of minimization) that became a basis for calculation of integrated indicator of efficiency of functioning of stomatologic polyclinic. The expanded methodological approaches ensure comparartivity of estimates of stomatologic polyclinic in various time periods. The health care authorities have opportunity to objectify analysis of functioning of a number of polyclinics in different periods.

Predicting professional school performance with a unique lens: are there other cognitive predictors?

BACKGROUND: We investigated the associations between admissions criteria and performance in four cohorts of pre-dental MS in Oral Health Sciences (OHS) program at Boston University Schools of Medicine and Dental Medicine. Previously we have reported that OHS serves as a successful pre-dental pipeline program for students from underrepresented groups. METHODS: We evaluated academic variables that further affect overall graduate GPA and grades in the first year dental school courses taken by OHS students at Boston University between 2012 and 2016 as part of the MS curriculum. Demographic data, region of residency, undergraduate grade point average, number of science and math credits, major of study, dental admissions test scores and undergraduate institution were collected. The competitiveness of the undergraduate institution was scored based on Barron's Profiles of American Colleges. OHS-GPA was assessed and individual grades in two first year dental school courses taken as part of the OHS curriculum were collected. Analysis of variance, the Chi-square test and Fisher's Exact test were utilized to assess associations between academic performance parameters, successful program completion and matriculation to dental school. RESULTS: Results indicate that undergraduate major, age and number of science course credits taken had no impact on MS performance in the Boston University MS in Oral Health Sciences program; however, students who took an undergraduate course in Physiology performed better than those who did not (p = 0.034). This was not the case with courses in Cell Biology and Biochemistry. Students with DAT scores over 20 academic average (p = 0.001), 18 total science average (p = 0.001) and 22 reading comprehension (p = 0.004) performed better in dental school courses taken in OHS. CONCLUSION: We report that strong test scores, attending a mid or highly rigorous undergraduate institution and completion of an undergraduate Physiology course are positive predictors. We hope these findings will guide admission's decisions and improve recruitment to, and future success of, graduate student's pursuit of professional school. Understanding alternative predictors of success may help to reduce the intrinsic bias among applicants from underrepresented groups and continue to look beyond the DATs (or MCATs) to decrease the gap between professionals from underrepresented groups and those they serve.

Oral Medicine for undergraduate dental students in the United Kingdom and Ireland-A curriculum.

INTRODUCTION: Oral Medicine focuses on care for patients with chronic, recurrent and medically related disorders of the orofacial region that are distinct from diseases of the periodontal and tooth tissues, with an emphasis on non-surgical management. At present, there are no shared outcomes for Oral Medicine to define the standards to be achieved before new graduates become registered dentists engaged with ongoing professional development. CURRICULUM: We present a consensus undergraduate curriculum in Oral Medicine agreed by representatives from 18 Dental Schools in the United Kingdom and Republic of Ireland. The scope of Oral Medicine practice includes conditions involving the oral mucosa, salivary glands, neurological system or musculoskeletal tissues that are not directly attributable to dental (tooth and periodontium) pathology. Account is taken of the priorities for practice and learning opportunities needed to support development of relevance to independent clinical practice. The outcomes triangulate with the requirements set out by the respective regulatory bodies in the UK and Republic of Ireland prior to first registration and are consistent with the framework for European undergraduate dental education and greater harmonisation of dental education. CONCLUSIONS: This curriculum will act as a foundation for an increasingly shared approach between centres with respect to the outcomes to be achieved in Oral Medicine. The curriculum may also be of interest to others, such as those responsible for the training of dental hygienists and dental therapists. It provides a platform for future collective developments with the overarching goal of raising the quality of patient care.

[The academic discipline 'forensic medicine' as an important component of the training of dental practitioners]. / Distsiplina 'Sudebnaia meditsina' - vazhnyi étap podgotovki vracha-stomatologa obshchei praktiki.

The authors discuss the conceptual issues of the academic program designed to teach forensic medicine to the students of the stomatological faculties of educational medical institutions. The program has been elaborated in conformity with the federal state educational standard of higher professional education in the speciality stomatology'. It defines the goals and objectives of this discipline, the scope of its competences, the subject matter and the content, the requirements to the studies and educational work, control over the level of its success, academic progress, and other aspects of the training activities, with special emphasis being placed on the formation of the general professional competence of the students to enable them to work independently after they graduated from the institute. The program takes into consideration the latest achievements in forensic medical science and their practical applications. Much attention is given to the organizational and processual aspects of forensic medicine, thanatology, general and special traumatology, mechanical asphyxia, effects of the environmental factors, intoxication, forensic medical expertise of living subjects and material evidence.

Evaluation of oral mucosal diseases: inter- and intra-observer analyses.

BACKGROUND: Essential to the diagnosis and management of oral mucosal diseases are visual evaluation and monitoring of the oral cavity. Digital photography has recently become an important clinical tool. The aims of this study were to (i) evaluate inter- and intra-observer differences between oral medicine and other dental specialists when assessing changes in oral mucosal pathology and (ii) assess the influence of calibration labels incorporated into the clinical images on the reliability and consistency of evaluation. METHODS: Ten oral medicine specialists (OM) and 10 other dental specialists (DS) participated in the study. Pairs of images captured with an intraoral camera at two time points from 17 cases of mucosal diseases were presented to the participants. Each pair of photographs was presented with a calibration label (showing length and white to black hues) and again without one. The participants were asked to respond to a questionnaire evaluating changes in size, color, location, and severity for each image pair. RESULTS: Oral medicine specialists had better absolute agreement and consistency than DS when evaluating the changes in the images; however, these parameters did not exceed 52% in either group. The incorporation of a calibration label in the images increased agreement and consistency of evaluations in both groups. CONCLUSIONS: Follow-up evaluations of oral mucosal lesions are performed better by oral medicine practitioners compared to other dental specialists. The incorporation of a calibration label in the clinical images seems to enhance evaluation.

[Stomatologic complications of eating disorders]. / A pszichoszomatikus evészavarok sztomatológiai szövodményei.

Since the 1990s numerous international experts have reported about the somatic complications of eating disorders including those having a dental and stomatological nature. Several reports emphasised that deformations in the oral cavity resulting from this grave nutritional disease typical of the young generation could already appear in the early stage and, therefore, dentists are among the first to diagnose them. Dentists are still often unaware of the importance of their role in multidisciplinary treatment. Even if they knew what the disease was about and recognised it on the basis of deformations in the oral cavity in time, their advice that their patients should brush their teeth more often would fail to eliminate the root cause of the problem. Not only the earliest possible treatment of the complications of the bingeing-purging mechanism and the maintenance of oral hygiene are important, but controlling and curing pathological habits with active participation of psychiatrists are also required to ensure full recovery. Due to the multidisciplinary nature of the disease, manifold communication is required. For this reason, publishing the dental ramifications of organic and systemic diseases at dental conferences and in technical journals, as well as providing information about oral complications of eating disorders for general practitioners and specialists are particularly important.

[Contemplations on responsibility for oral healthcare]. / Bespiegelingen over verantwoordelijkheid in de mondzorg.

The academic dental education in The Netherlands has been extended to 6 years, among other reasons in order to make it possible for responsibility for oral healthcare to be borne in a wide medical context. It is the job of the 3 national dental schools to make this happen. The new dentist should know and recognize all (peri-)oral disorders and oral symptoms of systemic diseases, and he should be able to deliver oral healthcare to medically compromised patients. Accepting this responsibility is required for dentistry to be transformed into medical oral healthcare and for dentists to be upgraded to oral physicians.

[Detection of temporomandibular joint diseases in elderly and senile age in ambulatory medicoprophylactic institutions].

The research analyzes diagnostic TMJ's disease's identification work of stomalogists owned to different types of day care properties (municipal, departmental, private). This research based on examination of primary medical records of 1906 patients aged 61 to 89 years, including 2978 prescribing lists made by stomatologists - orthopedists to dental outpatient's card. This research shows that in case of outpatient conditions in the primary examination of patients of elderly and senile age stomatologists pay attention to joint pathology in the presence of acute patients' complaints, caused by TMJ's displacement, arthritis, painful TMJ's dysfunction or pronounced sound phenomena of TMJ. Stomatologists examine TMJ's pathology more particularly. The TMJ's pathology complicates the tooth replacement made to patients contrary to absence of indications of disease presence in primary medical records. The prepared conclusion and recommendations allow improving the outpatient diagnosis of TMJ's pathology.

Scandinavian Fellowship for Oral Pathology and Oral Medicine: statement on oral pathology and oral medicine in the European Dental Curriculum.

BACKGROUND: For many years, dentists have migrated between the Scandinavian countries without an intentionally harmonized dental education. The free movement of the workforce in the European Union has clarified that a certain degree of standardization or harmonization of the European higher education acts, including the dental education, is required. As a result of the Bologna process, the Association for Dental Education in Europe and the thematic network DentEd have generated guidelines in the document 'Profile and Competences for the European Dentist' (PCD). This document is meant to act as the leading source in revisions of dental curricula throughout Europe converging towards a European Dental Curriculum. In order to render the best conditions for future curriculum revisions providing the best quality dentist we feel obliged to analyse and comment the outlines of oral pathology and oral medicine in the PCD. METHODS: The representatives agreed upon definitions of oral pathology and oral medicine, and competences in oral pathology and oral medicine that a contemporary European dentist should master. The competences directly related to oral pathology and oral medicine were identified, within the PCD. RESULTS: The subject representatives suggested eighteen additions and two rewordings of the PCD, which all were substantiated by thorough argumentation. PERSPECTIVES: Hopefully, this contribution will find support in future revisions of the PCD in order to secure the best quality dental education.

[Prevention and control of novel coronavirus infection in department of stomatology].

During a short period of time, the COVID-19, a respiratory disease caused by a novel coronavirus and first reported by the end of the year 2019 in China, has spread rapidly to many countries and regions outside China. The number of confirmed cases and deaths continued to rise. World Health Organization announced that the outbreaks of the novel coronavirus infection have constituted a Public Health Emergency of International Concern. Efficient infection control can prevent the virus from further spreading, which may make the pandemic situation under control. Due to the specialty of oral healthcare settings, the risk of cross infection is severe among patients and oral healthcare workers. It's urgent to implement more strict and efficient infection control protocols. This article, based on existing guidelines and published researches pertinent to dental infection-control principles and practices, mainly discusses epidemiological characteristics of COVID-19 and the features of nosocomial infection in oral healthcare settings, and furthermore provides recommendations on patient's evaluation, and infection control protocols in departments of stomatology under current circumstance.

[Evidence based medicine as background for development of stomatological patient report conducting].

Urgent need in methodology of information estimation for true clinical decision taking gave powerful impulse for evidence based medicine concept development that appeared at the end of 80th years. Proved efficacy and safety, optimal correlation of the indices were the stages of the methods and means selection for rationing. In our country such approach found its reflection in developing clinical protocol conducting (standards for doctors), in vitaly important medicines listing and lists of medicines that could be refunded in the system of additional medicine provision.

How Evidence-Based Dentistry Has Shaped the Practice of Oral Medicine.

Oral medicine is "the discipline of dentistry concerned with the oral health care of medically complex patients, including the diagnosis and primarily nonsurgical treatment and/or management of medically related conditions affecting the oral and maxillofacial region." In each of these areas, evidence-based medicine has shaped theoretic understanding and clinical practice. The available evidence allows for improved patient management. Further evidence, as it becomes available, should be reviewed on a regular basis to guide our clinical practice.

[Management in stomatology: the theory and practice].

The article is devoted to a scientific-theoretical substantiation of management as the theory and practice of management of stomatologic activity.

[Mouth diseases and the position of oral medicine]. / Mondziekten en de plaats van oral medicine.

The field of oral and maxillofacial surgery has greatly evolved during the last five decades. In The Netherlands, oral medicine is covered by the specialist in oral and maxillofacial surgery. Related to the increase in the ageing of the population, it is expected that both the dentist and the family dentist will more and more faced by patients with less usual oral disorders, either as a sign of a local disease or as a sign of a general (systemic) disease. Regarding research, there is a trend of a shift from therapeutic towards innovative research. Therapeutic research is mainly aimed at treating symptoms, whereas innovative research tries to increase insight in development of a disorder or to prevent the development of that disorder or to reduce its progression.

[Guidelines for the use of sialendoscopy in salivary gland diseases].

Salivary gland disease is a common disease in oral clinical care. Sialendoscopy technique has been widely used in salivary gland disease in recent years. Compared with traditional treatment, it is a safe, minimally-invasive and cost-effective technique, thus presenting significant benefits both for the patient and the health-care system. As for providing a comprehensive and updated source of current information on sialendoscopy, it's important to standardize the operating processes for salivary gland sialendoscopy. Experts from Chinese Stomatological Association have made a guideline about diagnosis and treatment of salivary gland disease by sialendoscopy, based on domesticpractical experience and international reports.

The use of tools to support oral lesion description in oral medicine referrals.

Poor description of oral lesions jeopardize the prioritization of appointments in Oral Medicine. The present study investigated whether the use of support tools changes the quality of descriptions focusing on health care prioritization. Two oral lesions (A and B) were described by 64 dental students and 48 dentists using three methods: (a) without support tools (free); (b) using the oral examination form from the Specialties Manual in Oral Health/Brazilian Ministry of Health (SMOH form); and (c) using the OralDESC guideline. The descriptions were compared with a gold standard and percentage of agreement was analyzed by the Kruskal-Wallis and Dunn's tests (p<0.05). Descriptions with the OralDESC presented higher information quality. Considering items essential for prioritization, the OralDESC demonstrated better performance for lesion A; for lesion B, free descriptions and descriptions using the OralDESC were of higher quality than those using SMOH form. Therefore, the OralDESC offered greater support for the description of oral lesions for health care prioritization in Oral Medicine.

Comportamiento del Servicio de Urgencia Estomatológica en tiempos de covid-19. Jagüey Grande, Matanzas, 2020 / Behavior of the Dentistry Emergency Service in the times of COVID-19. Jagüey Grande, Matanzas, 2020

RESUMEN Introducción: en marzo de 2020, la Organización Mundial de la Salud determinó que la covid-19 podía caracterizarse como una pandemia. Desde entonces, Cuba implementó medidas de control sanitario y evita el colapso de los servicios de salud. Por su parte, la atención estomatológica básica quedó sustituida por la de urgencias y es brindada por personal calificado con equipos de protección. Objetivos: describir el comportamiento de la atención a urgencias estomatológicas. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal (de marzo a agosto de 2020), a un universo constituido por 3 722 pacientes atendidos en dicho período, 32 estomatólogos y 29 licenciados. Se estudiaron las variables edad, sexo y patología de urgencias. Resultados: entre los estomatólogos que atendieron urgencias, predominaron los de 22 a 35 años (68,75 %), el sexo femenino (77,27 %) y licenciadas del grupo de 36 a 50 años (68,96 %). Los pacientes atendidos en Urgencias fueron mayormente de 19 a 59 años (76,03 %) y de sexo masculino (52,76 %). Los motivos más representativos de asistencia allí, fueron la odontalgia (53,68 %), el absceso alveolar agudo (17,35 %), la hiperestesia dentinaria (6,15 %) y la estomatitis aftosa (5,02 %). Conclusiones: la atención estomatológica de urgencia fue brindada fundamentalmente por personal joven, no comprendido dentro del grupo vulnerable, de sexo femenino. Las principales urgencias estomatológicas fueron la odontalgia por estados inflamatorios pulpares, el absceso alveolar agudo, la hiperestesia dentinaria y la estomatitis aftosa, prevaleciendo pacientes adultos del sexo masculino (AU).

ABSTRACT Introduction: in March 2020, the World Health Organization decided that COVID-19 could be characterized as a pandemic. Since then on, Cuba has implemented health control measures and prevents the collapse of the health services. For its part, basic dentist care was replaced by emergency care and is provided by qualified personnel with protective equipment. Objective: to describe the behavior of care to dentistry emergencies. Materials and methods: a cross-sectional, descriptive, observational study was carried out to a universe formed by 3 722 patients, 32 dentists and 29 bachelors. The variables age, gender and emergency pathology were studied. Results: among the dentists who attended the emergency, those aged 22-35 years (68.75 %), who were female (77.27 %), and bachelors from the 36-50 age group (68.96 %) predominated. The patients treated in the Emergencies were mostly 19 to 59 years old (76.03 %) and male (52.76 %). The most representative reasons for care there were toothache (53.68 %), acute alveolar abscess (17.35 %), dental hyperesthesia (6.15 %) and aphthous stomatitis (5.02 %). Conclusions: emergency dentistry care was provided mainly by young female persons, not included within the vulnerable group. The main dentistry emergencies were toothaches by pulpal inflammatory states, acute alveolar abscess, dental hyperesthesia and aphthous stomatitis, prevailing adult male patients (AU).

El enfrentamiento a la covid-19 en servicios estomatológicos cubanos / Facing COVID-19 in Cuban Dentistry Services

RESUMEN El escenario estomatológico, si no se aplican adecuadamente los protocolos de protección, constituye una importante fuente de infección cruzada entre pacientes y profesionales de la Estomatología. Muchos son los microorganismos involucrados, y a esto se ha incorporado recientemente el SARS-CoV-2. Al tener en cuenta la letalidad mundial de esta enfermedad, es imprescindible reconsiderar si las medidas de bioseguridad establecidas son estrictas y eficaces para evitar su propagación. Fue realizada esta investigación con el objetivo de actualizar información relacionada con la presente pandemia y los modos de actuación que propicien una consulta estomatológica segura en tiempos de COVID-19 (AU).

ABSTRACT The dentistry setting is an important crossed infection source among patients and Dentistry professionals if the protection protocols are not adequately applied. There are many microorganisms involved, and recently SARS-CoV-2 has added to them. When taking into account the worldwide lethality of this disease, it is bare essential reconsidering if the stablished biosafety measures are strict and efficacious to avoid spread. A thematic update was carried out with the aim of updating the information related to current pandemic and the ways of acting propitiating a safe Dentistry consultation in times of COVID-19 (AU).