Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
Department of Oral Biology, Faculty of Odontology, Malmö University, Malmö, Sweden.
Int Endod J. 2022 Apr;55(4):282-289. doi: 10.1111/iej.13679. Epub 2022 Jan 20.
In many clinical cases a dentist may feel certain when for example diagnosing, deciding on treatment, or assessing the prognosis-in other cases many dentists may feel a degree of doubt or uncertainty. This paper aims to explore the philosophical concept of uncertainty and its different dimensions, using the condition "persistent apical periodontitis associated with a previously root filled tooth" as an example. Acknowledging that uncertainty exists in any clinical situation can be perceived as uncomfortable, as some might regard it as a weakness. Whilst some types of uncertainty met in dental practice can be addressed and reduced, there are other types which are inevitable and must be accepted. To make sound decisions, it is pertinent that the dentist reflects on and values the consequences of uncertainty. In this paper, a conceptual model is presented by which the dentist can identify the type of uncertainty in a clinical case, making it possible to decide on a strategy on how to manage the uncertainty and its possible consequences, with the aim to support the dentist's care for their patients. The understanding that uncertainty exists and the ability to acknowledge and be comfortable with it when making decisions should be addressed throughout our professional career, and thus ought to be developed during undergraduate education. Some suggestions on how teachers could target this are given in the paper.
在许多临床情况下,牙医在诊断、决定治疗方案或评估预后时可能会感到确定,但在其他情况下,许多牙医可能会感到一定程度的怀疑或不确定。本文旨在探讨不确定性的哲学概念及其不同维度,以“与先前根管治疗的牙齿相关的持续性根尖周炎”为例。承认任何临床情况下都存在不确定性可能会让人感到不舒服,因为有些人可能认为这是一种弱点。虽然在牙科实践中遇到的某些类型的不确定性可以得到解决和减少,但还有其他类型的不确定性是不可避免的,必须接受。为了做出明智的决策,牙医应该反思并重视不确定性的后果。本文提出了一个概念模型,通过该模型,牙医可以识别临床病例中的不确定性类型,从而可以决定如何管理不确定性及其可能的后果的策略,以支持牙医为患者提供的护理。理解不确定性的存在以及在做出决策时承认和接受不确定性的能力应该在我们的整个职业生涯中得到解决,因此应该在本科教育中得到发展。本文还提出了一些关于教师如何针对这一问题的建议。