In the last Oral Health Survey, striking data were presented in terms of the prevalence of oral pathology and attendance at the dentist’s office in Spain. The population continues going mainly to the dentist when they have a problem or when it hurts. 2% recognize that He has never been to the dentist and 15% have not gone once in the last 5 years. 92-94% of the adult population has cavities, and a third of children 5-6 also. Of the total caries only 12% receives treatment. In spite of the incredible increase of dentists in Spain, if what the WHO recommends is a dentist for every 3500 inhabitants, here we have zones of 1 for every 500; In spite of the drop in prices (a current impasse is around 60 euros, when the last time we spoke in pesetas was around 10,000, more than a decade ago), the levels of pathology are still extraordinarily high, especially if we compare with neighboring countries.
We keep crying on the shoulder of the institutions asking for a numerous clauses, we keep litigating with intruders, we keep complaining about the arrival of dentists from other countries (by the way, many times infinitely better trained than here), we continue to implore that they do not open new faculties of Dentistry, we regret because lots of recently graduated dentists go to work abroad (oh, my God, with the money it costs to form a dentist in Spain!!!!). We look at each other’s navels, we look at each other a lot, we take care of it and we take off all the fluff we have left. We look at it, we touch it and we scratch it … and from there we do not leave.
With the amount of disease out there, with the number of patients that have not been treated, with the amount of ignorance about prevention … In addition, patients have increasingly lower purchasing power and as a result of the economic crisis have come and go every more time to the mutilating dentistry of the SS. Rather it seems that we should focus on getting how many people who never go to the dentist do so as soon as possible to prevent the disease appears, and if it appears, it is treatable at the lowest possible cost. The patients who already come to our consultations are an increasingly smaller cake and it is distributed every year among more and more dentists. And we’re not going to pretend that we do not know what the word “overtreatment” means, consequence of the disastrous work situation and the null scruples of both dentists and employers who take advantage of them. It is paradoxical that there is overtreatment in patients who go to the dentist while every time there is actually more and more untreated pathology.
In recent years, in spite of all the above, the implant ology courses have multiplied exponentially (lately, in addition, with special emphasis on the resolution of peri-implantitis, which is the failure of implant therapy), suggesting that many dentists interested in the last resort of patient rehabilitation. Because Implant ology is an optimal and great solution, indisputably, but it symbolizes the failure of all Dentistry: preventive dentistry, conservative dentistry, endodontic, periodontics. The implantologist arrives when everything else has failed.
The fact is that more and more dentists are proposing to rehabilitate fewer and fewer patients. And few seem to realize that in the meantime those same patients appear new caries, new or old unresolved periodontal problems. It is very curious to see the follow-up of the clinical cases that appear in the specialized journals: how the implants are kept but in the remaining teeth in the initial photo there was a simple caries, then an occlusal filling (a simple filling), when placing the implant rehabilitation … in the photo at five years there is endodontic-pin-crown …. What happened? Who has been concerned to maintain the health of what was right? Who cared that what was slightly sick did not get worse? No one? It’s possible?
From my point of view, from dentist-to-foot, as responsible is the dentist as the patient. It is true that there are patients who refuse to use hygiene measures, who are not skilled with flossing, who do not pay attention to how they brush their mouths … but I find that there are many patients, too, with tremendous rehabilitations already done, they come to my clinic and it is not that they do not know how to pass the thread, IT IS THAT THEY DO NOT KNOW WHAT IS THE THREAD OR THE INTERDENTAL BRUSHES. They have had enough money to do a series of rehabilitations, which involve a lot of appointments in consultation, and nobody has told them how it is maintained, nobody has explained some hygiene measures, nobody has told them that this work should be reviewed periodically.
I think we make a lot of mistakes by omission, that we continue working as when the whole mountain was oregano, as when the waiting lists were weeks and not days. And we keep those errors and we do not realize that ESA is the real crisis in our sector. The patient finishes the treatment and when he has finished, he does not know where the three endodontic are, if he has a “pin” or an “implant” (which for many patients both are screws inside the body and a point inside a tooth). ), how your diabetes affects your periodontal health, why your 9-month-old son has to bring it to the YA consultation (and not wait for the first definitive tooth to come out, as many pediatricians continue to recommend). And this is HEALTH EDUCATION.
An educated patient is a healthy patient or at least aware of the disease and how complications can be prevented as a result of it. And those responsible for health education, at oral level, we are dentists and hygienists. It cannot be that in Spain there are many more dentists than registered hygienists a year. It cannot be that we continue to occupy more of the disease than of health, of implants than of brushes and thread.
As long as this continues, we will continue to plummet. We will continue doing treatments that attract more pathology (it is not by chance that in the CAOD index score a sealed tooth equal to a decayed one, but we act as if a sealed tooth scored the same as a healthy one).
Let’s fight for the health of our patients through Preventive Dentistry, which is the only branch of Dentistry that provides the necessary weapons to have oral health. The others solve problems, often creating others. Prevention serves so that these problems do not appear. Why have we forgotten this?