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The academic course is closed. giving its last gasps and we already have here summer. A not insignificant number of new dentists are preparing to make contact with the world of work or to start new learning projects around masters and postgraduate degrees that complement their training. Both things are intimately related. Dentists often want to be trained especially in those subjects that have a practical impact on daily life and can allow them to access the best paid jobs possible. That is why specialties such as implantology, periodontics, endodontics, etc. they have great postgraduate training programs in high demand, many of them at considerable prices.

On the other hand, the bulk of the profession recognizes that the greatest benefits in terms of health for the population come from preventive activities related to oral health. Activities that are not precisely among the most productive. It is not often that Specialists in Prevention or Public Health are trained.

It is obvious that there is a dissociation between what is desirable and what is real in terms of prevention. Many professionals consider that prevention is not economically profitable for their clinics. The insurance entities themselves, the mutuals, do not pay, on occasions, for the concepts of visit, review, hygiene, subordinating prevention to repair.

Conceptually, the role of restorative dentists: endodontists, surgeons, implantologists, estheticians, conservators, etc. is to return the patient to health, function and aesthetics. Once this has been achieved, the maintenance of these three variables over time would enter the field of prevention. All activities derived from it in any field of knowledge: surgery, conservative, prosthodontics, etc. they are the responsibility, in my opinion, of the “preventive department”. A sufficiently trained preventive department (not only in caries prevention), but also in endodontics to carry out follow-up, in prosthodontics to carry out control, disassembly and replacement of prosthetic structures if necessary, in radiology. a to evaluate the evolution of the images that were considered controlled, in conservative with the idea of ??monitoring the deterioration and the aesthetics of the restorations. I call for multidisciplinary training for those in charge of maintaining stable patient oral health. A broader training than the classic idea that only relates prevention to fluoride and dental hygiene and that seems more thought of in relation to the skills of the dental hygienist than to the capabilities of a dentist.

A holistic vision of prevention, with a body of billable and concrete clinical acts, beyond The classic relationship with caries and its relapses would give real value and an economic impact to the cabinet's income statement, to the specialty. On the other hand, I would relate prevention to the recapture and loyalty of the patient through the elaboration of assistance protocols and maintenance circuits of dental contact –ndash; user/patient. Of course, this requires the collective work of all the members of the dental team: hygienists, receptionists, dentists, computer technicians and medical management, based on trust in the good work of each one and in the safety that each one has the necessary skills and experience to follow the protocols that are implanted, in a consensual manner, by the medical management itself. It is very possible that the real verification that prevention has an impact on the clinic's income statement and not only on the patient's health, would make it possible to convert the activities linked to the maintenance of oral health into something truly attractive for consultation.

The loyalty and care of the patient portfolio is the best way to ensure a flow of visits and at the same time maintain good oral health

This is, therefore, a good time to design projects that consider prevention at the same level as other specialties. It is a good time for the new additions of dentists to transmit this vision of prevention and for the established clinics to incorporate procedures, protocols and circuits that promote it. Loyalty and care for your own portfolio of patients is probably the best way to ensure a flow of visits and at the same time maintain good oral health. On the other hand, it is never too late to trust that insurance companies begin to assess the risk in terms of health for patients more than in terms of risk for their short-term income statement, valuing the overhaul and maintenance of health over restoration. Prioritizing all this would mean cost savings for patients and insurance entities in the long run and, of course, an improvement in their oral health.

Dr. Manuel Ribera Uribe

Professor of Gerodontology and special patients.

International University of Catalonia

**Translated with Google Translate