Competency model for dentists in China: Results of a Delphi study.

OBJECTIVE: With the increasing awareness of the importance of oral health, patients have an increasing need for integrated care from dentists. In China, the dentistry examination consists of two parts: a practical skills examination and a comprehensive medical examination; to date, no assessment methods that are based on specialized dentistry competencies, unlike the United States, Canada, and other countries, have been established. Therefore, the purpose of this study was to construct a competency model for dentists in China in order to guide the development, admission, training and assessment of dentists. METHODS: Using a literature review, focus group interviews and in-depth personal interviews, a dentist competency index was developed with an expert consultation questionnaire. A panel of 20 specialist experts was chosen from ten national medical universities to carry out two rounds of Delphi expert analysis, using the boundary value method to filter the indicators and the Analytic Hierarchy Process to calculate the weights of the primary indicators. RESULTS: Two rounds of Delphi results showed that the expert authority, enthusiasm, and coordination coefficients were high. Constructs of the competency model that included seven primary indicators and 62 secondary indicators determined the weight of each index. The seven primary indicators included the following: clinical skills and medical services, disease prevention and health promotion, interpersonal communication skills, core values and professionalism, medical knowledge and lifelong learning ability, teamwork ability and scientific research ability. CONCLUSION: In conclusion, the use of the Delphi method to construct an initial model of Chinese physician competency is scientific and feasible. The initial competency model conforms to the characteristics and quality requirements of dentists in China and has a strong scientific basis. The dentist competency model should be used in the National Dental Licensing Examination in China.

Procedimento de bichectomia: uma discussão sobre os aspectos éticos e legais em odontologia / Bichectomy procedure: a discussion on the ethical and legal aspects in odontology

Introdução: O procedimento denominado de bichectomia consiste na remoção parcial de uma estrutura adiposa na região das bochechas e ganhou recente popularidade entre a classe odontológica, que passou a executá-lo amplamente, com demandas predominantemente estéticas e, com isso, dúvidas e incertezas surgiram a respeito dos seus aspectos éticos e legais. Objetivo: O objetivo deste trabalho foi buscar legislações nacionais, bem como normativas e resoluções emitidas por conselhos profissionais, visando abordar tais controvérsias, alumiando os profissionais quanto à legitimidade do procedimento. Resultados: Verificou-se que desde 1978, os Conselhos Federais de Medicina e de Odontologia vêm emitindo resoluções para determinar limiares de atuação profissional, em especial, com enfoque na especialidade Cirurgia e Traumatologia Bucomaxilofacial, visto que é a especialidade odontológica clínica que mais se aproxima de campos de atuação médica. Com o tempo, estes Conselhos foram atualizando estas Resoluções, tendo em vista os avanços técnicos e científicos da área, porém todas as resoluções analisadas são unânimes em afirmar que a realização de bichectomia com finalidade estritamente estética é atribuição médica. Conclusão: Desta forma, com base nos documentos atualmente vigentes, verifica-se que o cirurgião-dentista que estiver disposto a realizar a cirurgia de bichectomia com finalidade exclusivamente estética estará incorrendo em transgressões administrativas e, consequentemente, tais interpretações podem ser vislumbradas em outras esferas (cíveis e criminais).

Introduction: Bichectomy consists of removing part of a fat structure in the region of the cheeks, and it recently gained popularity in the field of odontology, which began to widely perform the procedure, with predominantly aesthetic demands and, with that, doubts and uncertainties arose with respect to its ethical and legal aspects. Objective: The objective of this work was to seek national laws, as well as normative and resolutions issued by professional councils, aiming to address such controversies, enlightening professionals to the legitimacy of the procedure. Results: Since 1978, the Federal Councils of Medicine and Dentistry have issued resolutions to determine thresholds for professional performance, which particularly focused on Oral and Maxillofacial Surgery and Traumatology because it is the closest clinical dental specialty of medical practice. Over time, these Councils have been updating these resolutions, considering the technical and scientific advances of the area, but all the resolutions analyzed were unanimous in affirming that the accomplishment of bichectomy with a strictly aesthetic purpose is a medical attribution. Conclusion: Subsequently, based on the documents currently in force, it is verified that the dental surgeon who is willing to perform bichectomy surgery for aesthetic purposes will be incur administrative infractions and, consequently, such interpretations can be seen in other legal areas (civil and criminal).

Responsabilidade civil do cirurgião-dentista: a doutrina em processos e o contraponto odontológico / Dentist’s civil responsibility: doctrine cited in lawsuits and the dental counterpoint

A partir do levantamento de julgados envolvendo responsabilidade civil e contratos de prestação de serviços do Cirurgião-Dentista presentes no Tribunal de Justiça do Rio Grande do Sul, verificou-se a prevalência de citação do autor Guimarães Menegale (1939), uma vez que este autor da área do direito tem sido referência no tema, e até hoje é citado e/ou suas teses são compiladas por outros autores do direito. O estudo observacional das jurisprudências avaliou o inteiro teor das decisões (tanto acórdãos como sentenças), disponíveis na internet, utilizando-se por busca eletrônica no site do Tribunal Gaúcho do ano de 2007 até o ano de 2010, identificando a citação de algum doutrinador de responsabilidade civil, com destaque para o autor Guimarães Menegale (1939). Dos 67 julgados levantados, quatro em estância de recurso reportaram diretamente Guimarães Menegale (1939). O contraponto clínico/científico permite concluir que algumas das teses deste autor não encontram respaldo no conhecimento odontológico contemporâneo, o que pode estar perpetuando interpretações equivocadas acerca da responsabilidade profissional dos Cirurgiões-Dentistas.

The author Guimarães Menegale (1939) prevailed in lawsuits judged by Rio Grande do Sul’s Court of Justice involving dentists’ civil responsibility and contracts for services rendered because this author of law books, cited to this day, has been a reference in the subject and/or his theses are compiled by other such authors. This observational study of jurisprudence used the electronic search engine provided by the site of the said Court of Justice to search and assess the entire content of the decisions (both judgments and sentences) issued from 2007 to 2010 available in the Internet, identifying the citation of some civil responsibility indoctrinator, especially the author Guimarães Menegale (1939). Of the 67 judged lawsuits, 4 in the board of appeals directly reported Guimarães Menegale (1939). The clinical/scientific counterpoint allows one to conclude that some of this author’s theses are not supported by today’s dental knowledge, which may be perpetuating incorrect interpretations regarding dentists’ professional responsibility.

Responsabilidad profesional en odontología / Professional liability in dentistry

Pese a que es difícil disponer de datos concretos sobre casuísticas de reclamaciones legales contra los dentistas, ya que los datos están muy fragmentados y son poco accesibles, disponemos de series como los datos del Colegio de Odontólogos y Estomatólogos de la I Región, que recoge todas las reclamaciones de los pacientes motivadas por una atención odontológica presentadas ante la Comisión Deontológica del Colegio. También disponemos de series de datos sobre sentencias judiciales debidas a reclamaciones sanitarias analizadas anteriormente en estudios de la Escuela de Medicina Legal de Madrid. Según los datos derivados de estas series, es evidente que la presión legal de los pacientes está incrementando. Así es y así será en el futuro, incluso de forma más acusada. Debemos por tanto, asumirlo e intentar adoptar las medidas que minimicen este riesgo, o limiten sus consecuencias en caso de producirse. ste es el objetivo principal del presente estudio (AU)

It is difficult to provide specific data on of legal claims against dentists on a case-by-case basis due to the data being highly fragmented and not usually accessible. However, we do have available data series, such as the one from the College of Dentistry and Stomatology of Region I, which includes all patient claims motivated by a dental care submitted to the College's Ethics Committee. We also have data series relating to court judgments due to health care claims that had been previously discussed on studies carried out by the School of Legal Medicine of Madrid.Based on data derived therefrom, it is clear that the legal pressure of patients is increasing. This is how it is and how it will be in the future, perhaps even more sharply. We must therefore accept it and try to adopt measures that minimize this risk or limit its consequences, should they occur (AU)