Editorial

Quantity and quality in dental care

Roberto Gómez G*

* Medical comptroller. Seguros Centauro Salud Especializada.

Correspondence

For a long time ago, the relationship that exists between the amount and the quality in any event, process or phenomenon has been known; a correlation that is totally applied to the dental care as is analyzed in the following paragraphs:

IN CASE OF INCREASE OF QUANTITY AND QUALITY

The general paradigm explains that increases in quantity produce increases in quality until it reaches the highest point as it is shown in the figure 1.

This correlation it is observed during the acquisition of the clinical skills of the curricula, because the student must do 10, 20, 30 times each clinical procedure besides having a good theoretical foundation to achieve total security and perfect skills.

No one can think that a student can perform a clinical procedure that he has only practiced in a few occasions.

So, it must be recognized that the quality in the dental care that the student provides for the patient in his first clinical interventions, lacks the necessary requirements.

A student that graduates from the dental school having done - for example - 5 to 10 dental extractions, will perform them utilizing more time with a higher risk for the patient that in turn will result in post-surgical problems, in comparison to the student with the same theoretical bases but more clinical practice.

The Medical and Dental specialties are based precisely in the correlation between quantity and quality. They are looking for an increase in the amount of knowledge and practice that are translated in the increase of quality in the care.

Even without being specialists, is common that because of their personal preferences or profile (cultural, economical, or epidemiological) the dental surgeons tend to perform certain treatments; for this reason they increases the quality of their services in that particular area, and this reflects positively in the attention to their patients.

Similarly, years of experience equate improvement of the quality of dental care: more accurate diagnostics, more confident and better treatments.

This correlation can be seen on a regular basis among dentists that work on the health public services as IMSS, ISSSTE, Secretaría de Salud, who perform an important amount of treatments giving them an extraordinary clinical skill.

ON THE OTHER HAND, THE EXCESS IN QUANTITY AND DECREASE IN QUALITY

Once reached this level between the relation of quantity and quality (where other factors contribute as continuous education, professional update and thoughtful and reasoned performance of the profession), the professional reaches a plateau phase that maintains his services in a certain quality level (Figure 2).

In the second stage the increases in quantity will translate in decreases of quality; that can be proven watching the number of patients that each dentist of a health institution has to attend, the clinicians can only concentrate in diagnose and treatment because of the lack of time; then the patients report no satisfaction because they would like to have a longer chair time.

In the private practice this phenomenon also occurs when the dentist has more patients per hour in order to earn more money, then the patient is aware of the lack of time devoted to him and deplores it.

In everyday life we can find many examples of how the excess diminishes the quality, for example attempting to learn all the content of a course a few hours before the examination, trying to do many activities simultaneously, pretending to make many clinical procedures in a short time, etc.

As a conclusion, it is important to identify this correlations between quantity and quality to stay in the right interval, with the exact number of patients that would allow us to offer the quality they deserve; because a dentist with few patients becomes a risk for his lack of skill and a professional with too many engagements is also a risk because of his inability to treat them all properly.

Address correspondence:
Roberto Gómez G, MD.
E-mail: roberto.gomez@centauro.com.mx

Note

This article can be read in its full version in the following page: http://www.medigraphic.com/facultadodontologiaunam