Science Based on Seriousness

This is how research is done

We have to collect information from studies conducted by researchers, by universities all over the world and draw conclusions based on true evidence, not on simple opinions or just on each person’s individual experience. We must be true and report what we do well and what we do badly, without fear of comparing our results with those of our peers, with those who do the same as us, who occupy their time with the same scientific, medical, academic or surgical occupation.

What sort of professional do we want to be?

When we carry out a professional activity, we have to know what level we want to reach: the one where the professionals who carry out techniques well studied and proven by reason and experience are. Or the one with those who perform fantastic, well-known techniques, but which are executed perfectly only by a small group of scientists. Those who study and try to improve the techniques in their daily lives. Those who investigate and create new techniques, based on existing knowledge, and add something new backed up by scientific support.

Scientific Evidence vs Commercial Evidence

The scientific evidence is not always the same and is in line with commercial evidence. Commercial evidence is the one that works better when presented to patients, and is not always the best option and the most obvious from a scientific point of view. We are currently crossing a desert, where there is a decrease in available resources and, with this, the struggle for survival legitimizes all kinds of actions. We’re in the “anything goes” era:

– An education system that annually adds 750 graduates to an already saturated and exhausted market.

– Confusion reigns, where all the dentists seem to know and studied the same thing. Where some, through a crash course, manage to learn and understand what others needed years of dedication, study and experience.

– Large groups that approach everything and everyone as Excel sheets.

– Clinics announcing miracles and almost unique techniques. But they often do not fully master the medical and surgical processes.

And where are the patients in this mess, how can they protect themselves?

Just as when we, doctors and researchers, do when we collect scientific information, we have to know how to apply a process of validation of content and sources. In other words, we have to understand whether what is said in a scientific article is true, useful, reproducible and has reliable sources.

And we have search engines, we have appropriate places to do the “screening” in order to make sure that the new techniques or concepts that are being announced and introduced in the scientific or medical environment are serious and reproducible in an “in vivo” context with our patients; and not just in an “in vitro” environment, limited to the laboratory in an environment with exceptionally controlled external conditions and variables.

My aim is to warn that the treatment process, based on a serious, professional and honest relationship between doctor and patient, like any other kind of relationship, scientific or social, depends on the two observers, on two actors: doctor and patient.

The relationship depends on the two parties involved

It should be a serious process with mutual and bilateral accountability.

On the part of the doctor, he should:

– Respect the patient and maintain a cordial and comfortable environment with the patient during treatment.
– Have the necessary qualifications to do what he says he is capable of
– Ensure the seriousness and quality of his sources, his bases, the places where he learned and collected his knowledge.
– Protect the patient by choosing the best quality products and the most predictable and studied techniques.
– Do not experiment with patients, except in properly prepared studies, in research centers and after the respective ethics committees have given their positive opinion and “green light” to these experiments.
– Inform the patient as much as possible about the proposed treatment, explaining the advantages, disadvantages, dangers, possible complications, duration and longevity and their guarantees.

On the patient’s part, he should be responsible for:

– Respect the doctor and maintain a cordial and comfortable environment with the doctor during treatment.
– Collect information about the chosen doctor and understand and investigate his qualifications and curriculum. We can’t take the risk of comparing professionals. Sometimes it can even be offensive to compare different professionals and fees when doctors are totally different in experience, curriculum, materials and facilities used during treatment.
– Ask the doctor to show similar clinical cases, with images, photos and X-rays of situations that can be used during the patient’s treatment.
– If possible, collect information from patients already treated with similar techniques, protecting their personal data.
– The patient will be able to find out about his or her treatment options in order to take a more active and informed role with the doctor. There should be a sharing of responsibility at the time the treatment plan is chosen.

No illusions

We must not be under any illusions, nor must we be deceitful, claiming that things always go as smoothly as possible in all interventions, and that we are able to guarantee 100% compliance with the patients’ expectations.

Expectations and their management should also be bilateral

Expectations on the part of the doctor:

The doctor has to manage his expectations in a clinical and scientific context, ensuring that his techniques and knowledge will be sufficient in all clinical cases to treat the patient. But that doesn’t always happen. So, the professional is obliged to:

– Search for new materials properly studied and proven
– Consider referring a patient to a colleague who is better prepared and qualified to do the treatment
– Understand if it is time to improve his curriculum and seek new knowledge, study and train with more experienced doctors and surgeons.
– If he does not wish to study further, he must identify his limits, without ever exceeding them. If he does so, he runs the risk of not being able to comply with the treatment plan, with the necessary strictness and quality, something that seriously harms the patient.

Expectations on the part of the patient:

– He must realize that the impossible is the enemy of balance and common sense. He should reflect and measure his expectations regarding the treatment so as not to be disappointed.
– He should ask the doctor for a detailed, complete and clarifying explanation, confronting the expectations he has regarding the treatment and the possible final results.
– He should understand all possible complications during treatment.

Maintaining a good relationship

All relationships, whether professional, medical or personal, depend on a very specific balance and dynamics, and on the effort of both parties.
With education, common sense and seriousness, science can be at the disposal of the doctor and the patient, in this fantastic process that allows the recovery and the improvement of health, function and aesthetics.

The seriousness of the whole process is based on the science of the doctor-patient relationship.

Finally, thank you for your time and attention to my text.
See you soon and don’t forget to be happy. After all, smiling doesn’t hurt.
If smiling causes you pain, nausea or imbalance, consult your dentist.

See you next time!

Dr. Luis Pinheiro

Master in Science (MSc) in Oral and Maxillofacial Surgery at Eastman Dental Institute – University College of London
Associated Member of the British Association Of Oral Surgery (n.º 2277)
Associated member of the Portuguese Society of Oral Surgery
Private Practice in Oral Surgery and Implantology in Lisbon
Implantology and Advanced Surgery in Corpse – University of Barcelona
Rehabilitation of Atrophic Jaws with Accreditation in Zygomatic Implants – INEPO – São Paulo
Permanent member of the S.I.N. – Implant System – as a speaker for Portugal and Europe, with more than 1000 hours of training given, Oral Surgery and Implantology

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Case of the Month – Nuno Inácio

Dr. Luis Pinheiro June 1, 2020

Nuno Inácio Age- 40 Country – Portugal Description of the Clinical Case The patient arrived at the clinic with his