Patient safety in dentistry : dental care risk management plan

Objectives: Although the safety of patients has been one of the inherent concerns of dental practice, but because the proposals made in the field of dentistry are few and improperly structured, this paper constitutes an attempt to present a proposal titled "Plan for Dental Health Care Risk Management," promoted by the General Council of Dentists of Spain, including a description of the proposed work methodology. Design: The "risk management plan" proposed in this paper is based on applying the basic concepts dealt with in patient safety to the field of dentistry, due to the fact that the available bibliography contains no specific "health care risk management plan" for dentistry specifically. Results and conclusions: In order to implement health care risk management in the field of dental care provided at any level throughout Spain, a seven-step plan which covers the main objectives in Patient Safety is provided. © Medicina Oral S. L

The clinical safety of disabled patients: proposal for a methodology for analysis of health care risks and specific measures for improvement

The clinical risks associated with health care have been a known factor since ancient times, and their prevention has constituted one of the foundations of health care. However, concern for the risks involved in health care treatments has risen very significantly in recent years, becoming a modern current of concern for clinical health care risks which is referred to by the name of "patient safety" in the scientific literature. Unfortunately, there are no studies on patient safety in dental practice or case studies of adverse events in this practice. In addition to the lack of studies on adverse events in regular dental practice, there are even fewer references to treatment for disabled patients. In this article, we provide a "proposal for analysis" of the clinical risks associated with treating disabled patients, which will make it possible to evaluate the health care risks associated with the treatment of patients who have a specific disability, at one determined moment and in one specific environment

Analysis of 415 adverse events in dental practice in Spain from 2000 to 2010

Introduction: The effort to increase patient safety has become one of the main focal points of all health care profes - sions, despite the fact that, in the field of dentistry, initiatives have come late and been less ambitious. The main objective of patient safety is to avoid preventable adverse events to the greatest extent possible and to limit the negative consequences of those which are unpreventable. Therefore, it is essential to ascertain what adverse events occur in each dental care activity in order to study them in-depth and propose measures for prevention. Objectives: To ascertain the characteristics of the adverse events which originate from dental care, to classify them in accordance with type and origin, to determine their causes and consequences, and to detect the factors which facilitated their occurrence. Material and Methods: This study includes the general data from the series of adverse dental vents of the Spanish Observatory for Dental Patient Safety (OESPO) after the study and analysis of 4,149 legal claims (both in and out of court) based on dental malpractice from the years of 2000 to 2010 in Spain. Results: Implant treatments, endodontics and oral surgery display the highest frequencies of adverse events in this series (25.5%, 20.7% and 20.4% respectively). Likewise, according to the results, up to 44.3% of the adverse events which took place were due to predictable and preventable errors and complications. Conclusions: A very significant percentage were due to foreseeable and preventable errors and complications that should not have occurred

Knowledge of oral cancer and preventive attitudes of Spanish dentists. Primary effects of a pilot educational intervention

Objective: To assess the knowledge and preventive attitudes that Spanish dentists have towards oral cancer, before and after an educational intervention. Methods: A quasi-experimental study based on a nationwide intervention. All Spanish dentists were offered an on-site course on oral cancer. An individual questionnaire was administered before and after attending the course. The main outcome measures were systematic examination of the oral cavity, promotion of healthy habits and knowledge of clinical aspects. Results: 440 GDPs entered the study. Age: 40.7±10.7, range 21-74. Professional experience: 13.9±8.9 years, range 0-45. Of those who participated in the study, 53.1% had never attended a course on oral cancer, 72.4% stated that they perform a systematic examination of the oral mucosa, 88.2% provided systematic counselling on tobacco cessation, and 54.7% reported that they did the same for alcohol. In addition, 32.3% advised patients to eat fruits and vegetables high in antioxidants. Professional experience was significantly associated with oral mucosa systematic examination (t= 2.9; p=0.003), advice on alcohol consumption (t=5.0; p=0.000), and on fruit and vegetable intake (t=5.1; p<0.001). None of these practices were specifically associated with knowledge on oral cancer. All areas of knowledge examined showed statistically significant improvement after the educational intervention. Conclusions: The intervention appears to have improved the GDP´s knowledge, confirming the importance of this national campaign

Extrusion apical de detritus durante el tratamiento endodóntico

The authors made a literature review about the causes of the apical extrusion of debris, during endodontic treatment. In the root canal instrumentation there is always, besides the strict control of the working lenght, the possibility that dentin chips and residual pulp tissue can be forced apically through the apical foramen. Those, contaminated or not contaminated, materials can lead to an inflammatory and pos-operative reaction, known as flare-up. To avoid the apical extrusion and minimize flare-ups, some methods are proposed, as the selection of instrumentation techniques that extrude less amounts of debris apically and the respect for the aseptic chain during intracanal procedures. The authors conclude that although all the instrumentation techniques cause some degree of extrusion, crow-down techniques and those which involve rotary movements, significantly reduce the amount of debris extruded.info:eu-repo/semantics/publishedVersio

Patron de masticación en las clases III de Angle.

The sample consistent of 12 patients (four females and eight males) with a mean age of 176 years and a diagnosis of Angle class III malocclusion posterior crossbite was selected resultants chowed that 75% of patients shift their mandible towards the working side. 66% on the sample, with presented left-side masticatory pattern, and 75% of patients 75% of those with a right-side masticatory patten, and condylar displacement towards the noon worlking side. No rclationship was found between condole displacement and no relation relationship was found between condylar displacement on the location of the posterior crosbite, nor its severityPatrón de aritmética en las clases III de Angle. CES Odont 1996; 9:38-40. Se seleccionó una muestra de 12 pacientes (cuatro hombres y ocho mujeres) con edad promedio de 17.6 años, los cuales tenían diagnóstico de clase III de Angle y mordida cruzada posterior.- Los resultados mostraron que el 75% de los pacientes desplazaban la mandíbula hacia el lado de trabajo. El 66% de la muestra en masticación izquierda y el 75% en masticación derecha tenían desplazamiento condilar hacia el lado de no trabajo. No se encontró relación entre el desplazamiento del cóndilo con la situación de la mordida cruzada ni con la severidad de la misma

Planning cancer control in Latin America and the Caribbean

Non-communicable diseases, including cancer, are overtaking infectious disease as the leading health-care threat in middle-income and low-income countries. Latin American and Caribbean countries are struggling to respond to increasing morbidity and death from advanced disease. Health ministries and health-care systems in these countries face many challenges caring for patients with advanced cancer: inadequate funding; inequitable distribution of resources and services; inadequate numbers, training, and distribution of health-care personnel and equipment; lack of adequate care for many populations based on socioeconomic, geographic, ethnic, and other factors; and current systems geared toward the needs of wealthy, urban minorities at a cost to the entire population. This burgeoning cancer problem threatens to cause widespread suffering and economic peril to the countries of Latin America. Prompt and deliberate actions must be taken to avoid this scenario. Increasing efforts towards prevention of cancer and avoidance of advanced, stage IV disease will reduce suffering and mortality and will make overall cancer care more affordable. We hope the findings of our Commission and our recommendations will inspire Latin American stakeholders to redouble their efforts to address this increasing cancer burden and to prevent it from worsening and threatening their societies.SCOPUS: re.jinfo:eu-repo/semantics/publishe