Prácticas Tuteladas

Show a favorable attitude and ability to work in a team.
Promote the importance of comprehensive dental care for the patient.
Develop ethical behaviors in dental practice.
Establish a relationship of respect and help with the patient.
Being able to diagnose and propose an ideal treatment plan and its alternatives.
Develop a clinical philosophy based on the prevention of oral diseases.
Know the current techniques of dental treatment according to the best scientific evidence.
Adapt the individualized integrated treatment for each patient.
Reason the proposed therapeutic procedures based on scientific criteria, stating the reasons why one treatment is optimal compared to others.
Acquire and develop clinical manual skills.
Critically determine the quality of the treatment performed.
Establish the appropriate protocol for maintaining the patient's oral health.

The subject of Supervised Practices (Prácticas Tuteladas) is core and compulsory, it falls within the 5th year of the Dentistry Degree. Three subcategories are distinguished within this subject, depending on the type of patients treated: Supervised Practices in Adult Patients (represents 50% of the total credits of Supervised Practices), Supervised Practices in Patients with Systemic Pathology and/or Disability (represents 25% of the total credits), and Supervised Practices in Pediatric Patients (represents 25% of the total credits).

The contents of the subject are eminently practical and will integrate all the skills that the student has been acquiring throughout the previous years of study. Both adult and child patients and patients with systemic pathologies and/or disabilities will be received and will undergo diagnosis, planning, and treatment of their oral disease. There will be multidisciplinary treatments that, due to their complexity, will have to be referred to specific treatment units.

On the other hand, the subject will promote the updating of knowledge in the seminars, which may be in the form of problem-case resolution, presentation of clinical cases, or search for the best evidence of a clinical topic.

In the Supervised Practices subject, the student puts into practice all the knowledge acquired during the degree, in an integrated, sequential, and orderly way, to establish a diagnosis and carry out a treatment plan for the patient. The student will be able to carry out a diagnostic judgment of the oral pathology presented by the adult patient, the child patient, and the patient with systemic pathology and different degrees of disability. To do this, they must know the basic sequence of an oral examination, take a detailed clinical history, and correctly interpret the radiological, analytical, and model analysis tests. She will be able to propose an ideal treatment plan, as well as compromise alternatives when the case requires it. In addition, she must be able to carry out each phase of the treatment plan in a logical order (urgent treatment, motivation, medical-surgical treatment, conservative treatment, prosthodontic treatment, and maintenance).

The bibliography includes all those sources of information related to the different parts that make up Supervised Practices.

• ADULTS
Non-electronic books:
• Echeverría García J, Pumarola Suñé J. El Manual de Odontología. Ed. Elsevier Masson, Amsterdam, 2008.
• Bain CA. Treatment Planning in General Dental Practice. A Problem-based Approach. Ed. Churchill Livingstone, Edinburg, 2003.
• Del Río Highsmith. Odontología Integrada para Adultos. Ed PUES, Madrid, 1999 y 2003.
• Calvo Guirado JL. Prácticum en Clínica Odontológica Integrada de Adultos, 2011.
• Kay E, Shearer AC, Humphris G. Integrated Dental Treatment Planning. A case-based approach. Ed. Amazon, Oxford, 2005.
• Cohen M. Interdisciplinary Treatment Planning. Ed. Quintessence Publ, Chicago, 2008-2012.
• Mallat Callís E. Reconstrucción de dientes endodonciados: una pauta de actuación clínica. Ed. Ediciones Especializadas Europea, 2007.

• Stephen J Stefanac. Diagnosis and Treatment Planning in Dentistry. Ed. Elsevier, 2023.

Free access electronic books from BUSC or free access PDFs from Google:
• Cydulka RK et al. Emergencias orales y dentales. En: Manual de Medicina de Emergencias, 5º edición 2018. Ed. Mc Graw-Hill/Interamericana.
• Ahmad N et al. Infecciones dentales y periodontales. En: Microbiología Médica, 6º edición 2017. Ed. Mc Graw-Hill/Interamericana.
• Adams and Victor. Dolor facial de origen dental o sinusal. En: Principios de Neurología, 2017. Ed. Mc Graw-Hill/Interamericana.
• Consejo de Dentistas de España. Plan estratégico de acción para el periodo posterior a la crisis creada por el COVID-19. 2020.
• Ministerio de Sanidad. Directrices de Buenas Prácticas en las Clínicas Dentales. 2020.
• Gutmann, James L. Solución de problemas en endodoncia: prevención, identificación y tratamiento. 2012. Ed. Elsevier.
• Fradeani M, Barducci G. Tratamiento protésico: aproximación sistemática a la integración estética, biológica y funcional. 2006. Ed. Quintessence.

Related websites:
• American Dental Association. https://www.ada.org/en
• European Centre for Disease Prevention and Control. Infection prevention and control in dentistry. https://www.ecdc.europa.eu/
• Council of European Dentists. The voice of dentists and oral health in Europe. https://cedentists.eu/
• American Association of Endodontics. https://www.aae.org/specialty/ Coronavirus Disease 19 (COVID-19): Implications for Clinical Dental Care; Root Canal Safety; Guide to Clinical Endodontics; Treatment Planning; Cone Beam Computed Tomography; Regenerative Endodontics

• PEDIATRIC DENTISTRY
The basic bibliography allows the student to consolidate the essential knowledge of this part of the subject. The so-called complementary bibliography includes texts for those who wish to study Paediatric dentistry in greater depth.

Basic Bibliography

- USC Paediatric Dentistry practice book (see Teaching Methodology - Seminars).

Books:

- Odontología pediátrica y del adolescente. 10th Ed. Mc Donald RE. & Avery DR., 2018
- Pediatric Dentistry. Cárdenas Jaramillo D., 2017. (accessible online)
- Diagnosis and treatment in Orthodontics. Ustrell JM., 2016
- Paediatric dentistry. Monty D., Cameron A., and Toumba J., 2014. (accessible online)
- Paediatric dentistry: the evolution from child to young adult. Boj JR., 2012
- Handbook of paediatric dentistry. Cameron AC. 2010.
- Atlas of paediatric dentistry. Waes, Hubertus JM., 2002.

Websites:

https://www.odontologiapediatrica.com/
https://www.eapd.eu/index.php/policies-and-guidelines
https://www.aapd.org/research/oral-health-policies--recommendations/
https://www.cochranelibrary.com


Complementary Bibliography

Books:

- Paediatric dentistry: child and adolescent oral health in today's world. Noemí Bordoni, 2010
- Atlas of paediatric dentistry for paediatricians and dentists. Elena Barbería Leache, 2005
- Paediatric dentistry. Elena Barbería Leache, 2002
- Paediatric dentistry. J.R. Pinkham, 2001

• SPECIAL CARE PATIENTS
Books:
• Litle J, Falace D, Mille C, Rhodus N. Tratamiento odontológico del paciente bajo tratamiento médico. 5ª Edición. Harcourt y Mosby, 1998.
• Machuca Portillo G, Bullon Fernández P. Tratamiento Odontológico en Pacientes Especiales. 3ª edición. Laboratorios Normon, Madrid, 2013.
• Dias de Andrade E, Ranali J, Pierro Neisser M, Korytnicki D. Emergencias médicas en Odontología. Sao Paulo. Artes Médicas Latinoamericana, 2004.
• Urraco Rodríguez A, Díaz Alonso MT. Complicaciones médicas en la consulta dental. SmithKline Beecham, Madrid, 1995.
• Durán C, Feijoo JF, Limeres J et al. Guía de Prescripción farmacológica en odontología. (Editor Pedro Diz. ISBN. 987-84-695-5471-5. (se podrá solicitar a los profesores de la materia).
• Scully, Diz-Dios, Kumar. Special Care in Dentistry Handbook of Oral Healthcare.
E-Book, 1st Edition. Churchill Livingstone, 2006.

Specialized journals (with contents on Patients with Special Care):
• Bristish Dental Journal
• Gerodontology
• Journal of Disability and Oral Health
• Journal of the American Dental Association (JADA)
• Medicina Oral, Patología Oral y Cirugía Bucal
• Special Care in Dentistry

Links of interest:
• International Association for Disability and Oral Health (http://www.iadh.org/)
• Sociedad Española de Odontoestomatología para Pacientes con Necesidades Especiales

Knowledge
Diagnose, plan and carry out, in general, a multidisciplinary, sequential and integrated treatment of limited complexity in patients of all ages and conditions and in patients with special needs (diabetics, hypertension, oncology, transplants, immunosuppressed, anticoagulated, among others) or disabled. Specifically, the dentist must be competent in establishing a diagnosis, prognosis and developing adequate therapeutic planning, and particularly in orofacial pain, temporomandibular disorders, bruxism and other parafunctional habits; dental and periapical pathology; oral-dental trauma; periodontal and peri-implant tissue pathology; bone pathology of the jaws, oral soft tissues and adjacent glands; states of partial or total edentation and in the planning of their rehabilitative treatment through dentition and mucosa-supported prosthesis, or through dental implants, dental malpositions and/or malocclusions and other anatomical or functional alterations of the face or the stomatognathic system and their possible corrections orthodontic, orthopedic or surgical. Must be competent in professional values, in healthcare communication, in clinical reasoning, clinical management and critical judgment.

Competencies
Comp01.- Capacity for analysis and synthesis.
Comp02. - Ability to organize and plan.
Comp03.- Oral and written communication in one's own language.
Comp05.- Basic computer handling skills.
Comp06.- Information management skills (ability to search and analyze information from diverse sources).
Comp07.- Problem resolution.
Comp08.- Decision making.
Comp10.- Teamwork.
Comp11.- Interpersonal skills.
Comp12.- Ability to work in an interdisciplinary team.
Comp13.- Ability to communicate with experts from other areas.
Comp14.- Appreciation of diversity and multiculturalism.
Comp16.- Ethical commitment.
Comp17.- Ability to apply knowledge in practice.
Comp19.- Capacity for autonomous learning
Comp20.- Ability to adapt to new situations.
Comp21.- Ability to generate new ideas (creativity).
Comp22.- Leadership.
Comp24.- Ability to work autonomously.
Comp26.- Initiative and entrepreneurial spirit.
Comp27.- Concern for quality.
Comp28.- Achievement motivation.

Skills or abilities
H/D01.- Know the essential elements of the dental profession, including ethical principles and legal responsibilities
H/D02.- Understand the importance of such principles for the benefit of the patient, society and the profession, with special attention to professional secrecy.
H/D03.- Know how to identify the patient's concerns and expectations, as well as communicate effectively and clearly, both orally and in writing, with patients, family members, the media and other professionals.
H/D04.- Understand and recognize the social and psychological aspects relevant to the treatment of patients.
H/D05.- Know how to apply the principles of anxiety and stress control on oneself, on patients and on other members of the dental team.
H / D06.- Understand the importance of developing a professional practice with respect to the patient's autonomy, beliefs and culture.
H/D07.- Promote autonomous learning of new knowledge and techniques, as well as motivation for quality.
H/D08.- Know how to share information with other health professionals and work as a team.
H/D09.- Understand the importance of maintaining and using records with patient information for subsequent analysis, preserving the confidentiality of the data.
H/D20.- Obtain and prepare a medical history that contains all relevant information.
H/D21.- Know how to perform a complete oral examination, including the appropriate radiographic and complementary examination tests, as well as obtaining appropriate clinical references.
H/D22.- Have the ability to make an initial diagnostic judgment and establish a reasoned diagnostic strategy, being competent in recognizing situations that require urgent dental care.
H/D23.- Establish the diagnosis, prognosis and adequate therapeutic planning in all clinical areas of Dentistry, being competent in the diagnosis, prognosis and preparation of the dental treatment plan of the patient who requires special care, including medically compromised patients. (such as diabetics, hypertensives, immunosuppressed, anticoagulated, among others) and patients with disabilities.
H/D24.- Recognize life-threatening situations and know how to perform basic life support maneuvers.
H/D25.- Know and apply the basic treatment of the most common oral-dental pathology in patients of all ages. Therapeutic procedures should be based on the concept of minimal invasion and a global and integrated approach to oral treatment.
H/D26.- Know how to plan and carry out multidisciplinary, sequential and integrated dental treatments of limited complexity in patients of all ages and conditions and patients who require special care.
H/D27.- Pose and propose preventive measures appropriate to each clinical situation.
H/D28.- Acquire clinical experience under appropriate supervision.

The students of the Supervised Practices will acquire and develop the clinical skills that meet the needs of their professional practice, meeting the global expectations of the dental patient from an integrated approach.

The teaching methodology is as follows:

CLINICAL PRACTICES.
It is a supervised clinical practice activity, where the student will acquire the skills that allow them to integrate the knowledge, skills, and abilities acquired in the previous modules, to apply them to an adult, pediatric or systemic pathology and/or disability patient.

The teacher will act as a tutor, guiding and helping the student in their clinical decisions and in the application of the treatment.
In stage 1, the practices will take place in person in the boxes on the second floor of the faculty. These practices in the pits can be combined with discussions of the clinical cases, which are received by the faculty, through the TEAMS platform.

SEMINARS.
Fundamentally, the skills of research evaluation, continuous updating, and group and cooperative work will be acquired. The estimated time for the seminars is 20 hours, of which 10 hours belong to Supervised Practices for Adults, 5 hours to Supervised Practices in Patients with Systemic Pathology and Disabilities, and 5 hours to Supervised Practices in Pediatric Patients. The seminars given in Special Patients have an average duration of 1 hour (range, 45-75 minutes) and they are structured from a hierarchical perspective, in which the teacher interacts with the students, since the topics that are addressed are largely unknown to them and are not included among the contents of the subjects previously taught. The seminars have a differential characteristic that is their overlap with clinical activity.

In scenario 1, they will take place in person in Classroom Suárez Núñez.

TUTORIALS.
They will serve to contrast the advances in the acquisition of competencies, continuous follow-up, clarify doubts about clinical practice, provide information, and guide research activities.
Tutorials will preferably be face-to-face, although, by mutual teacher-student agreement, they could be done virtually. The tutorial will be requested through the USC email and the appointment will be assigned in the schedule that each professor has assigned for the tutorials. The preferred platform for tutoring will be Microsoft TEAMS, but other communication tools such as email itself or even telephone contact may be used. The student will transfer his doubts and the need for tutoring to the teachers.
It is important that the student frequently check the USC email and the Virtual Classroom as they will be used for notifications.

To evaluate the subject of Tutored Practices, three parts are distinguished:

1) Tutored Internships (adults)
2) Tutored Internships (children)
3) Tutored Practices (special patients)

The final grade of the students will be made through a weighted sum of the marks of these three parts of the subject as follows: 50% Tutored Practices (adults); 25% Tutored Practices (child patients) and 25% Tutored Practices (special patients). It is necessary to pass each of the three parts of the subject in order to make the average.
In cases of fraudulent completion of exercises or tests, the provisions set out in the Regulations for evaluating the academic performance of students and reviewing qualifications will apply.

1) Evaluation of the part corresponding to Tutored Practices (adults)
Both in the first call (first and second opportunities) and in the following calls, the qualification of the students will be carried out through continuous evaluation and completion of a final exam:

a) The continuous evaluation will have a weighted value of 80% of the final grade. The person who has directly supervised the clinical teaching will assess the aptitudes, attitudes, skills, competencies and skills developed by each student as the subject is taught according to the attached rubric.

GUESTED PRACTICES FOR ADULTS. 24/25 PRACTICE EVALUATION RUBRIC
Date:
BOX NO:
Activity scheduled for practice:
Student operator:
Student assistant:
Circulating student:
Teachers:


1. General operating rules:
Puntuality
Correct clinical clothing (appropriate, clean, PPE if applicable)
Basic exploration material prepared
Clinical history reviewed and discussed with the teacher/tutor
GOOD
(4)
REGULAR
(2-4)
EVIL
(1)


2. Documentation:
Signed LOPD document
Signed treatment plan
Covered and updated medical history
Odontogram is and updated
The visits are well collected
Correctly managed payments
GOOD
(5-6)
REGULAR
(4-3)
EVIL
(1-2)


3. General diagnosis (first visit and review):
Identify present and absent teeth
Scanning with probe and mirror following correct
Taking justified x-rays and knowing the technique
Justifies other complementary tests: models, periodontogram, etc. (if necessary)
Identify/rule out risk factors (dental, occlusal, etc.)
Recommends a diet diary if necessary
Identify dental pathology and establish a treatment sequence.
Motivates the patient for the next visits
GOOD
(6-8)
REGULAR
(3-5)
EVIL
(1-2)


4. Treatment plan:
The plan integrates all the data obtained in the examination and includes all pathologies that require treatment
The proposed procedures are correct
The sequence to develop the plan is correct
Includes individualized preventive measures
They are able to justify all aspects of the plan
Clearly explain the plan to the patient and their family/companions
GOOD
(5-6)
REGULAR
(3-4)
EVIL
(1-2)


5. Local anesthesia:
Complete instruments, prepared
Know the technique to be used (truncular, infiltrative, intraligamentous) and the anatomical structures involved
Review with the assistant the steps to take
Know needles, active ingredients and maximum doses
Execution: patient position, use of topical anesthesia, s, aspirates before infiltrating, does not remove the needle at the patient's first reaction, slow infiltration, checks effectiveness, etc.
GOOD
(4-5)
REGULAR
(3-4)
EVIL
(1-2)


6. Isolation:
All necessary instruments prepared and easily accessible
Assess tooth anatomy
Selecting the appropriate clamp
Clamp with safety silk thread
Correct placement of the clamp and obtains good insulation
Shows the patient the dam in place and explains its advantages
GOOD
(5-6)
REGULAR
(3-4)
EVIL
(1-2)


7. Preventive Dentistry:
Necessary instruments prepared and easily accessible
The operator directs the office as a responsible healthcare professional and the rest work as a team. Everyone involved in the treatment session
Knows materials/instruments to use depending on the characteristics of the patient (age, risk factors, etc.)
Answer correctly the questions proposed by the tutor (properties of the material, alternative materials, other use techniques, etc.)
Correctly execute the treatment
GOOD
(5)
REGULAR
(4-3)
EVIL
(1-2)


8. Conservative Dentistry:
Necessary instruments prepared and easily accessible
The operator directs the office as a responsible healthcare professional and the rest work as a team. Everyone involved in the treatment session
Know the material/instruments that should be used
Answer correctly the questions proposed by the tutor (properties of the material, alternative materials, other use techniques, etc.)
Correctly execute the treatment
GOOD
(5)
REGULAR
(4-3)
EVIL
(1-2)


9. Oral Surgery:
Necessary instruments prepared and easily accessible
The operator directs the office as a responsible healthcare professional and the rest work as a team. Everyone involved in the treatment session
Know the material/instruments that should be used in each case
Answer correctly the questions proposed by the tutor (properties of the material, alternative materials, other use techniques, etc.)
Correctly execute the treatment
GOOD
(5)
REGULAR
(4-3)
EVIL
(1-2)


10. Prescription of medications (if applicable):
Decides based on the rational use of medications
Know the possibility of allergies, intolerances or interactions
Know the appropriate dosage for each case and its alternatives.
Prepares the prescription correctly and presents it finished for the signature of the professor/clinical tutor
GOOD
(4)
REGULAR
(3)
EVIL
(1-2)

Specific comments about the quote:
Total score achieved=
Maximum possible =



b) Final exam: It will be in person and will have a weighted value of 20% of the final grade. It will consist of a written exam on one or more clinical assumptions. The person who has directly supervised the teaching will develop one or more clinical scenarios for each group of students that he or she has supervised. The final exam will be in person on the day and place established in the Center's exam calendar. If the student does not take the final exam, the grade will be Not Presented.


2. Evaluation of the part corresponding to Tutored Practices (children)
Diagnosis seminars, treatment plan and oral presentation of cases of patients with malocclusions will be evaluated. It will be assessed individually and in groups by clinical practice boxes.


3. Evaluation of the part corresponding to Tutored Practices (special patients)
In the seminars, the students' ability to analyze, approach the different diagnostic tests and make treatment decisions in the different clinical cases presented will be evaluated. The ability to bring together as a group and the clarity of the presentations that the students have to make will be valued.

The student's individual work in this subject is 120 hours.

It is convenient for the student to review the subjects of the first cycle and those that are the priority of the subject. In addition, it is recommended to use the recommended bibliography and an article provided by the teacher.

The treatments that, due to their characteristics, cannot be interrupted until the following academic year, must be completed by the responsible students who started that treatment, and the professor who tutored them, even beyond the end of teaching date.