DOI: https://doi.org/10.62204/2336-498X-2025-2-12

MEDICINE AND PHYSIOLOGY

PRACTICING MANUAL SKILLS IS A KEY LINK IN THE TRAINING OF A DENTIST

Inna Gorb-Gavrylchenko,
Doctor of Philosophy, Associate Professor,
Associate Professor at the Department of Therapeutic Dentistry,
Dnipro State Medical University, Dnipro, Ukraine,
innagorbgavrilchenko@gmail.com; ORCID: 0009-0009-4438-4660

Annotation. The main link in the development of practical skills is industrial practice. Particular attention is paid to the treatment of patients with periodontal profile. During industrial practice, theoretical and practical knowledge is consolidated and expanded, manual skills in periodontology, treatment of caries and its complications are acquired.

Keywords: Manual skills, therapeutic dentistry.

Introduction. One of the most important links in the training of students of the medical university of the dental faculty is industrial practice. It is a link between theoretical training and subsequent practical activity of the student [1].

Against the background of increasing attention to the training of a modern specialist, modernization of higher professional education based on a competency-based approach, a universal set of specific methods and pedagogical technologies of training applicable at these levels is not proposed. In this case, the competence-based approach, which assumes a focus on the result in the form of not only knowledge, skills, and skills, but also mandatory practical experience, requires a rethinking of the methods of selection and construction of training methods in the process of professional training of a specialist.

Training at the dental faculty involves the student receiving not only theoretical knowledge, but also the ability to work with their hands, communicate with the patient, and think clinically. During classes, students receive an algorithm of the actions to be performed, the teacher monitors and, if necessary, corrects shortcomings in the work [2]. Today, during practical classes, the trainee’s patients are his relatives and friends who give their consent to this. Therefore, the number of patients accepted by students is quite limited, especially for students from other regions and areas. Practice and control of practical skills occur during practical classes and when working on phantoms. However, the use of phantoms in training, although effective, cannot completely replace the entire variety of situations encountered in the clinic. Many authors note the underdevelopment of even propaedeutic skills in students, and there is no need to even talk about such complex manipulations as working with the periodontium [3].

Conducting industrial practice ensures the acquisition and consolidation of necessary skills, the formation of professional competencies, readiness for independent and individual work, and making responsible decisions. Working with patients develops in students the ability to scientifically analyze medical and socially significant problems, readiness for logical analysis of various types of reasoning, mastery of communication skills, argumentation, polemics and discussion [4].

Independent work of students makes up approximately 1/3 of the total workload of practical training in the discipline and includes: keeping a practical diary, working with literature, preparing talks, lectures, reports, presentations on issues of treatment and prevention of dental diseases, preparing materials on dental education (memos, health bulletins, questionnaires, presentations, etc.). This form of work promotes the development of students’ cognitive activity, creative thinking, instills the skills of independent information search, and also forms the ability and readiness for self- improvement, self-realization and creative adaptation [5].

Various types of independent work, including independent work of the student, contribute to the acquisition of a culture of thinking, the ability to logically correctly formulate its results in written and oral speech; readiness to form a systematic approach to the analysis of medical information, the perception of innovations [6].

Modern medicine has a huge arsenal of new laboratory and technical means for examining a patient, but the doctor’s task is to be able to analyze the entire complex of data obtained and, based on the results of these studies, substantiate, make a diagnosis and designate a treatment algorithm, that is, to be professionally competent. In this regard, the competence of students is one of the most important indicators of the quality of education and the pedagogical process at a university. The competence-based approach in higher education allows for the formation of basic and professional competencies, that is, the readiness of students to use the acquired fundamental knowledge, skills and abilities, as well as methods of activity to solve practical and theoretical problems that arise in the process of professional activity.

In connection with the intensive development of dentistry, the constant emergence of the latest filling materials, the modernization of equipment, the introduction of modern drugs, there is a need to use theoretical knowledge in practice. Students have this opportunity when undergoing industrial practice at bases where the equipment meets the modern requirements of the dental market.

While studying at the Medical University, 4th-year students of the Faculty of Dentistry undergo industrial practice in therapeutic dentistry as an assistant to a dentist- therapist.

Main part. The purpose of conducting industrial practice in therapeutic dentistry is to check and consolidate the knowledge and practical skills acquired by students within the boundaries of the goals defined in the educational and professional training program. Under the guidance of teachers, they examine the patient using basic and additional examination methods, formulate a clinical diagnosis, make a treatment plan, fill out an appointment diary. During the industrial practice, students consolidate the stages of treatment of complicated and uncomplicated caries, non-carious lesions. Students in the clinic also focus on the sanitary and epidemiological regime for the prevention of AIDS, viral hepatitis, tuberculosis, apply the basic principles of asepsis and antisepsis.

Special attention during the internship of 4th-year students is given to the treatment of periodontal diseases. During the 7th-8th semesters, they study the section

«Periodontology» and at the end of the year they consolidate the acquired knowledge in practice. If we talk about the complex treatment of periodontal diseases and, first of all, periodontitis, then, as is known, it should include a certain sequence of preventive and therapeutic measures. Providing assistance in full is possible in two ways. The first way is to involve the maximum number of specialists in providing dental care: a hygienist, a dental therapist, a dental surgeon, an orthopedic dentist. If we use the first principle, then the responsibility of a specific doctor for the final result of treatment is completely «blurred». The second way is to carry out the main stages of complex treatment by a doctor directly involved in providing assistance with this pathology – a periodontist. During their internship, students have the opportunity to become familiar with the equipment and organization of work in a periodontal office, and to master and consolidate basic practical skills.

One of the important tasks in working with students on the basis of a generally accepted plan of clinical examination is the task of teaching special methods of examination of patients with periodontal disease. But the emphasis only on the main methods cannot give the completeness of the clinical picture, and therefore many mistakes in diagnosis and treatment can occur. Additional methods are extremely important. Modern medicine provides a huge arsenal of new laboratory and technical means of examining the patient, and the doctor’s task is to be able to interpret the entire set of received data and, based on the results of these studies, to justify, make a diagnosis and draw up a treatment algorithm, that is, to be professional and competent.

In the periodontology office, students examine patients with periodontal diseases using basic clinical (questioning, clarifying complaints, life history, disease history, external examination, examination of the vestibule of the oral cavity, the oral cavity itself, dental arches, gums, gingival attachment, determining the presence, depth and contents of periodontal pockets, tooth mobility, furcation, recession, etc.) and special examination methods (evaluating the hygienic condition of the oral cavity using the Fedorov-Volodkina and Green-Vermillion indices, conducting the Schiller-Pisarev test, determining the PMA index, the Russell periodontal index, the SPITN index). Additional examination methods include: assessing the condition of the alveolar bone tissue using orthopantomograms and computed tomography.

Independent clinical examination of a patient by a student allows to identify the student’s abilities, to comprehensively assess the patient’s condition taking into account his age, concomitant diseases, social and psychological structure of the personality. This form of work teaches the student to see and highlight the cause and its consequences of the development of pathological processes in all relationships in the human body. During the patient’s appointment, the student examines the clinical signs of the disease, collects anamnesis, subjective and objective data, and conducts differential diagnostics. After the patient’s appointment, all students must fill out an outpatient medical record of a dental patient, record in the record the plan and results of the examination, and an individual treatment plan for a periodontal patient.

In the process of treating periodontal patients, students have the opportunity to remove dental plaque using modern dental instruments: hand scalers, universal curettes, Gracey curettes, ultrasonic devices, periodontal burs, brushes and rubber caps with polishing pastes, air-abrasive systems (Air Flow Prophy Unit, Air Powered Prophy-Jet) are used to polish the surfaces of the roots, after which remineralization of hard tissues is carried out. After removing dental plaque, hardening and non-hardening periodontal materials are applied. At this stage of treating patients, students widely use the developments of the Department of Therapeutic Dentistry. During their internship, student interns take part in operations to perform closed curettage of periodontal pockets. During the treatment of patients with periodontal diseases, students have the opportunity to carry out such types of physiotherapy treatment as electrophoresis, diadynamic therapy, and quantum therapy.

The treatment of a patient with a certain disease not only allows for a deeper study of this issue according to modern literary sources, but also promotes the development of communication skills with patients taking into account the ethical and deontological features of the patient’s pathology, the formation of clinical thinking, medicinal behavior, accuracy and discipline.

Having finished receiving patients in the periodontology office, the students began to receive patients with odontopathology.

During dental treatment during the industrial practice, students consolidate their skills in preparing carious cavities with high-speed and low-speed tips using diamond and carbide burs, master modern filling materials and restoration technologies. For the treatment of deep caries, calcium-containing materials (Calcimol, Life, Dycal) are used as therapeutic pads, glass ionomer cements were used as insulating pads, and light- curing composites are used for filling teeth.

For endodontic treatment of complicated caries, endodontic tips, apex locators, and modern endodontic instruments are used.

In destructive forms of periodontitis, calcium-containing materials were used for temporary obturation of canals. The canal is filled using a single pin, cone gutta-percha, lateral condensation and vertical condensation. Every year, the number of canals filled using fiberglass pins increases.

During their internship, students conduct health education work among the population, participate in medical conferences, and conduct educational and research work.

At the end of their industrial practice, students passed the final modular control. According to the terms of the credit-modular system, the final modular control of practice in the 4th year involves solving two situational problems and, special attention at the Department of Therapeutic Dentistry is paid to practical skills that students demonstrated on phantoms.

Conclusions. Thus, industrial practice in therapeutic dentistry is an important stage in the training of dentists and is of great importance in acquiring practical skills. Our observations at the Department of Therapeutic Dentistry show that students after completing industrial practice take a more serious approach to studying theoretical material. It is during industrial practice that the theoretical and practical knowledge of 4th-year students is consolidated and expanded, deeper practical skills in periodontology, treatment of caries and its complications, provision of emergency and urgent medical care are acquired. This, first of all, is associated not only with the student’s ability to independently carry out any manipulation. It is important for the future dentist to understand the importance of the actions he or she performs, the need for correct decision-making, as well as subordination, the ability to work and communicate with patients, mentors, and surrounding medical personnel.

Observing the process of receiving patients, the experience of self-diagnosis and treatment of patients contributes to the implementation of basic communication skills in professional activities. At this stage of training, dental students acquire in-depth professional communication skills. By means of the components of in-depth professional communication skills, the elementary level of dental culture is carried out.

The creation of adequate conditions for students to undergo industrial practice is the key to the successful development of special competence in general and organizational and communicative competence in particular during industrial practice, which will subsequently help future doctors to carry out professional activities, applying their knowledge, skills and experience.

References:

1. T.O. Petrushanko, A.K. Nikolishin, N.M. Ilenko, E.V. Nikolishina, & O.P. Stupak (2012). Organization and methodical provision of professional practice in therapeutic dentistry in the context of a credit-modular system. Ukrainian Dental Almanac, (6).
2. B. Tsevukh, & Yu. O. Kurunova (2015). Peculiarities of students’ learning at medical university in current minds. Innovations in Dentistry, (4 (10)), 61-64.
3. N. M. Ilenko, & O. M. Boychenko (2018). Methods for developing professional motivation of senior students at the Department of Therapeutic Dentistry. Ukrainian Dental Almanac, (1), 91-92.
4. A. V. Samoilenko, V. Yu. Orishchenko, I. V. Gorb-Gavrilchenko (2014) Current approaches to the formation of a level of knowledge and the memory of students from the section “Periodontal diseases” in the minds of the credit-modular system. Modern dentistry. (1), 134-142.
5. Gorb-Gavrilchenko, I. V. (2022). SELF-INDEPENDENT WORK OF THE STUDENT AS AN ELEMENT OF THE INITIAL PROCESS. Health of clinical and experimental medicine, (2), 28–31.

6. Pavlenko S. A., Pavlenkova O. V., & Amosova L. I. (2007). Viral practice is an initial cognitive process of preparation and specialization of a future fakhist. Current problems of medical medicine: Bulletin of the Ukrainian Medical Dental Academy, 7 (4 (20), 315-317.