This domain describes the basic knowledge necessary for domains II to V. A varying depth of knowledge and understanding of each aspect will be required in order to achieve the appropriate levels of competence. |
Main Competency 1.1
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Upon graduation, a dentistry student, should be capable of applying the knowledge and understanding of basic, biological, health, social, and applied sciences in clinical and collective practice, in order to recognize the process of dental caries and other alterations of hard dental tissues for decision making in health promotion, prevention and management of the disease in individuals and populations. |
Specific Competencies
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With regard to the development, growth and structure of relevant oral tissues, a dental student upon graduation should: |
Have knowledge of:
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1.1.1 The normal development, growth and structure of dental and oral tissues (e.g. dental hard tissues, pulp and salivary glands) at the macroscopic, microscopic and molecular levels. |
1.1.2 Developmental disorders of dental and oral tissues at the macroscopic, microscopic and molecular levels. |
With regard to the etiology, pathogenesis, and modifying factors of dental caries and other dental hard tissue disorders, a dental student upon graduation should: |
Be capable of:
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Have knowledge of:
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Be familiar with:
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1.1.3 Describing and discussing the mechanisms and dynamic processes involved in the maintenance of health, as well as the response to dental caries and dental hard tissue alterations, at the macroscopic, microscopic and molecular levels. |
1.1.6 Biochemical events in dental biofilm, saliva and dental hard tissues. |
1.1.10 Individual risk assessment of other dental hard tissue disorders. |
1.1.4 Describing and discussing the role of dental biofilm, saliva, fluorides, diet and nutrition related to dental caries and other dental hard tissue disorders. |
1.1.7 Microbiological events, including acid and base production and other biofilm metabolic processes associated with dental caries. |
1.1.5 Describing and discussing the role of individual risk factors and social determinants related to dental caries and other dental hard tissue disorders. |
1.1.8 The role of environmental factors, medications, and systemic diseases related to caries and other dental hard tissue disorders. |
1.1.9 The different instruments for clinical assessment of individual caries risk. |
With regard to the identification/detection, assessment and synthesis/diagnosis in relation to caries risk and caries lesions, as well as other dental hard tissue alterations, a dental student upon graduation should: |
Have knowledge of:
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Be familiar with:
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1.1.11 The physical, biochemical and biological basis of hard tissue changes related to the detection and assessment of dental caries and other dental hard tissue disorders. |
1.1.15 The mode of action and limitations of emerging methods of detection, assessment and diagnosis of caries and other dental hard tissue disorders. |
1.1.12 The physical, biochemical and biological basis of methods of detecting and assessing dental caries and other dental hard tissue changes for diagnosis. |
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1.1.13 The rationale for the operational characteristics to assess the validity and performance (sensitivity, specificity and predictive values) of detection, assessment and diagnostic methods for dental caries and other dental hard tissue disorders. |
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1.1.14 The principles for assessing individual risk factors and social determinants related to risk for dental caries and other dental hard tissue disorders. |
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With regard to behavioral sciences, a dental student upon graduation should: |
Have knowledge of:
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1.1.16 The psychological, sociological, and socioeconomic factors, which delineate interpersonal skills, communication, and behavior modification at the individual and group levels in relation to the management of dental caries and other dental hard tissue disorders. |
1.1.17 The principles of ethics, bioethics and professionalism in relation to the management of dental caries and other dental hard tissue disorders. |
With regard to prevention and management, a dental student upon graduation should: |
Have knowledge of:
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1.1.18 The mode of action, composition, properties, limitations and side effects (local and/or systemic), of dental biomaterials, products and, limitations and side effects of techniques, for the management of caries risk and the non-operative and operative management of caries and other dental hard tissue disorders, at the individual and collective level. |
With regard to epidemiology and research methodology, a dental student upon graduation should: |
Have knowledge of:
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1.1.20 Basic concepts of epidemiology. |
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1.1.21 Research methodology, including study designs, sampling, bias control, and statistics, and their limitations. |
Domain II: Assessment and Risk Synthesis and caries lesions (and other dental hard tissue disorders)
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This domain refers to the assessment and diagnostic synthesis of caries risk and lesions and other dental hard tissue disorders. It represents a bridge between basic knowledge and decision making, preventive management (risk and non-operative) and operative management. It requires synthesis and evidence-informed and appropriate decision-making skills for clinical and public health practice. It also applies to other dental hard tissue disorders. |
Main Competency 2.1
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On graduation, the dentist must be capable of identifying individual risk factors and social determinants for caries (development/progression of caries lesions). The graduate should also have the ability to apply these skills to dental hard tissue disorders. An appropriate level of knowledge and understanding is required to reliably collect and record valid and clinically relevant data. |
Specific Competencies
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With regard to risk assessment, a dental student upon graduation should: |
Be capable of:
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2.1.1 Assess and record, individually and collectively, the presence of caries protective and risk factors (social, systemic, intraoral and behavioral), based on clinical history/anamnesis, interview and clinical examination, considering periodic reevaluation. It also applies to other dental hard tissue alterations. |
Main Competency 2.2 - Detection and assessment of caries lesions and other dental hard tissue disorders.
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Upon graduation, the dentist must be capable of collecting, based on visual/tactile and radiographic methods, data on the signs and symptoms of dental caries, detecting the experience (past occurrence) of dental caries, as well as the presence of caries lesions on tooth surfaces, assessing and categorizing their state of severity and their state of activity. Similar competence is required for the detection and assessment of other dental hard tissue disorders. |
With regard to screening and assessment, a dental student upon graduation should: |
Be capable of:
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Have knowledge of:
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2.2.1 Recognizing abnormal dental tissue in primary and permanent dentition, differentiating between carious and non-carious lesions, as well as between primary and secondary coronal and root caries lesions. |
2.2.5 The operational characteristics and limitations of other diagnostic methods (e.g. fluorescence based) for caries and other dental hard tissue disorders. |
2.2.2 Collecting and recording data on the presence of the caries process (detection) and assess its different stages of severity and its activity (related signs and symptoms). |
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2.2.3 Collecting and recording data on signs and symptoms of other dental hard tissue disorders, with emphasis on erosive tooth wear and developmental enamel defects such as dental fluorosis and hypomineralization of molar-incisor molars (HMI) or primary second molars (HSMP). |
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2.2.4 Appropriately use visual-tactile (with rounded tip probe support) and radiographic (coronal radiographs) diagnostic aids for dental caries, recognizing their operational characteristics and limitations. Visual diagnostic aids also apply to other dental hard tissue disorders. |
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Main Competency 2.3 - Synthesis and diagnosis of caries risk and lesions (and other dental hard tissue disorders)
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Upon graduation, the dentist must be capable of synthesizing all relevant information contained in the clinical history by combining and interpreting individual/collective risk factors and caries findings, taking into account the patient’s needs, preferences and interests, to decide the risk classification, severity and activity of caries lesions, establish a diagnosis and together with the patient, design a personalized management plan, including both follow-up and re-evaluation. The graduate should also be competent in applying these skills with respect to other dental hard tissue disorders. These aspects are linked to the clinical decision making reviewed in domains III and IV. |
Be capable of:
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2.3.1 Comprehensively analyze caries risk data, obtained from individual/group assessment and existing monitoring, review or reassessment, to classify the risk, deciding together with the patient or guardian/group, considering their needs, preferences and interests, a health promotion plan, preventive management and reassessment intervals accordingly. It also applies to other dental hard tissue disorders. |
2.3.2 Comprehensively analyze data on caries lesions, obtained from current assessment and existing monitoring, review or reassessment, to classify their severity and activity, deciding together with the patient/guardian, considering their needs, preferences and interests, an appropriate management plan, including control, non-operative management and operative management with preservation of tooth structure, as well as monitoring. It also applies to other dental hard tissue disorders. |
2.3.3 Communicate to the patient/guardian or group the results of the caries risk assessment and the presence, severity and activity of caries lesions and other dental hard tissue disorders and provide recommendations that give them tools to control the pathology(ies) and improve their oral health. |
2.3.4 Provide interdisciplinary consultation and management, or refer for specialist or medical diagnosis and management, in case of systemic conditions related to caries or unknown dental hard tissue disorders. |
Domain III. Decision making and implementation of risk management and nonoperative caries lesions management
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This domain is concerned with the individual/group management of risk and caries lesions and other dental hard tissue disorders (primarily erosive tooth wear and developmental enamel defects), with emphasis on planning, re-evaluation and long-term maintenance of risk management and non-operative management of caries lesions. This domain also includes communication with the patient (individual/group) as an essential part of the decision-making process. |
Main Competency 3.1 - Patient, Family and Community Communication in Different Health Care Settings
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Upon graduation, the dentist must be capable of communicating to patients of all ages, families and caregivers (or collectively), aspects of risk management and non-operative management of caries lesions, and other dental hard tissue disorders, in an effective, reflective and interactive manner. Communication should consider the age, socio-economic and cultural circumstances of the patient/families/caregivers/collective and the environment in which it takes place, strengthening autonomy and participation. |
Specific Competencies
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With regard to communication with the patient, family/caregivers and the collective, in different health care settings, a dental student upon graduation, should: |
Be capable of:
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Have knowledge of:
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3.1.1 Establishing an empathetic and mutually trusting relationship with the patient/family/caregivers/ collective. |
3.1.7 Behavioral factors that facilitate the delivery of preventive management dental care. |
3.1.2 Identifying and understanding and discussing the expectations, wishes, attitudes, needs and demands of the patient/family/caregivers/collective as inputs for promotional and preventive management planning. |
3.1.8 Patient/family/caregiver/collective factors that influence communication and affect preventive management recommendations (e.g., expectations, time adherence, and manual dexterity). |
3.1.3 Identifying and understanding the psychological, physical, socioeconomic and cultural factors that may influence patient/family/caregiver/collective adherence to the measures implemented for promotional and preventive management and their outcome. |
3.1.9 Nonverbal communication skills; e.g., intonation, body language, sitting position, and eye contact. |
3.1.4 Helping the patient/family/caregivers/group understand the importance of their role in the preventive management of dental caries, involving them to promote their understanding of the disease, to increase their adherence to individual/group preventive measures, and thus contribute to their future oral health. It also applies to other dental hard tissue disorders. |
3.1.10 Behavioral interventions; e.g., motivational interviewing, self-determination theory, and short behavior change tool. |
3.1.5 Providing appropriate and timely consultation/inter-consultation by exchanging patient/family/caregiver/collective information with other dental specialties and/or relevant health care professionals. |
3.1.11 The importance of patient/family/caregiver/collective recognition of the association between oral diseases and systemic diseases. |
3.1.6 Assessing patient/family/caregiver/collective readiness to change and potential compliance with the proposed preventive management plan. |
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With regard to decision making and risk management and non-operative management of caries lesions, a dental student upon graduation, should: |
Be capable of:
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3.2.1 Making decisions based on synthesis (Domain II). |
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3.2.2 Developing health education actions directed to patients/families/caregivers/collective, relative to the etiology of dental hard tissue diseases and empower them to take responsibility for their oral health. |
3.2.3 Developing actions to promote healthy eating aimed at patients/families/caregivers/collective. |
3.2.4 Developing actions to teach appropriate oral hygiene measures to patients/families/caregivers/collective. |
3.2.5 Conducting professional prophylaxis. |
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3.2.6 Recognizing the mechanisms of action, limitations and adverse effects of self-applied and professionally applied individual/collective preventive management agents (e.g. fluorides, antimicrobials, calcium/arginine-based strategies, sealants), as well as their methods of administration/application. |
3.2.7 Administrating, prescribing or applying, preventive and/or therapeutic agents, when indicated, for risk management and non-operative management of caries lesions. |
3.2.8 Monitoring the effects of mechanical and chemical control of dental biofilm, as well as the clinical status of sealants (assessing whether they need to be reapplied or repaired). |
3.2.9 Polishing, adapt and/or repair dental biofilm retentive restorations that do not require replacement. |
3.2.10 Considering the needs of people in vulnerable conditions, such as frailty, cognitive dependence or impairment, disabling conditions, systemic or psychiatric illnesses. |
3.2.11 The role of diet and its association with the risk of developing caries and other dental hard tissue disorders. |
Domain IV. Decision making and implementation of the operative management of caries lesions
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This domain deals with the operative management of caries lesions and other alterations of dental hard tissues, with emphasis on their planning, maintenance and re-evaluation, accompanied by continuous preventive (risk and non-operative) management (Domain III). It involves applying the principles of tooth structure preservation. In addition, it is aligned with other fundamentals of dentistry: pediatric dentistry, restorative dentistry, endodontics, orthodontics, periodontics and prosthodontics, in terms of the execution of the restorative phase or an operative management plan for caries lesions. It is recognized that operative intervention should only be considered when non-operative (preventive) management options alone are no longer likely to be successful. |
Main Competency 4.1 - Clinical decision making leading to operative management of caries lesions
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Upon graduation, the dentist must be capable of collecting, interpreting and synthesizing all relevant information contained in the clinical history necessary to formulate appropriate operative management options that can be presented and agreed upon with the patient or guardian to decide on an individualized plan. This requires the ability to decide when it is appropriate to intervene operatively (in cavitational/cavitated caries lesions or those beyond the outer third of the dentin) and to know how to do so, understanding the consequences and prognosis of the decisions made. This applies to other dental hard tissue lesions. |
Specific Competencies
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With regard to clinical decision making leading to the operative management of caries lesions, a dental student upon graduation, should: |
Be capable of:
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Have knowledge of:
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4.1.1 Selecting the appropriate treatment option for each situation, based on the best available evidence from the full range of non-operative and operative management options available, and on the individual case. |
4.1.4 The reactions of the dentin-pulp complex to the caries process and other dental hard tissue alterations and restorative procedures. |
4.1.2 Recognize, understand and manage the outcomes and consequences of operative intervention. |
4.1.5 The success and failure rates of the different types of restorations. |
4.1.3 Conduct ongoing reflection on the decision-making process and management plan for operative interventions. |
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Main Competency 4.2 - Operative management of caries lesions
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Upon graduation, the dentist must be capable of using the operative management of caries lesions and other dental hard tissue alterations in an appropriate manner, with maximum preservation of dental structure, considering the restoration of dental tissue loss in form, function and esthetics, and simultaneously, promoting oral health. Additionally, the graduate should be able to systematically evaluate (at re-evaluation intervals and during management) all outcomes of operative management, and to adequately make decisions for maintenance, repair or replacement of a restoration, giving appropriate instructions to the patient or guardian, for its maintenance, as well as for the prevention of damage to their restorations and caries lesions associated with them. |
Specific Competencies
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With regard to the operative management of caries lesions and their re-evaluation and follow-up, a dental student upon graduation, should: |
Be capable of:
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Have knowledge of:
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4.2.1 Deciding, prior to performing a restoration, taking into account the restorability of the tooth, when, how and how far to extend the removal of decayed tooth tissue (or other dental hard tissue alteration), seeking to achieve maximum preservation of tooth structure, maintain pulp and periodontal viability and generate functionality, to prolong tooth survival and increase the longevity of the restoration, consistent with the patient’s comprehensive treatment plan. |
4.2.7 Emerging techniques for the removal of carious tissue (e.g. step-by-step excavation) and for the management of other dental hard tissue disorders. |
4.2.2 Selecting and handling of the appropriate restorative biomaterials, considering their physical-mechanical and chemical properties, biocompatibility and longevity. |
4.2.3 Selecting and performing appropriate operative techniques, both for the biomaterial and the case. |
4.2.4 Identifying the response of operative procedures performed on the mucosa, pulpal organ-dentin, periodontal tissues, occlusion and function. |
4.2.5 Evaluating and monitoring the outcomes (results) of operative management of caries lesions over time. |
4.2.6 Establishing a maintenance schedule for the restoration, to prolong its longevity, and repair or replace when appropriate. |
Domain V. Evidence-based cariology in clinical practice and public health |
This domain addresses the core skills of evidence-based dental practice within the undergraduate curriculum, which includes the two phases of cariology, clinical (particularly related to individuals) and public health (particularly related to the collective). It should be noted that public health cariology requires additional competencies to those listed in domains II-IV. This domain relates to caries and other dental hard tissue disorders. The core competencies in evidence-based dentistry, which are generic to the undergraduate curriculum as a whole and not just cariology, are integrated with critical thinking and lifelong learning skills within dental practice. The clinical cariology competencies in caries assessment and management for the individual patient fall within domains II-IV, and for Public Health cariology, the competencies are presented within this domain, in close relation to the principles of evidence-based dentistry. |
It is important for these topics to be recognized in the clinical and public health practice setting. |
Main Competency 5.1 - Oral Public Health in Relation to Cariology
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Upon graduation, the dentist must be capable of preventing and controlling dental caries and other dental hard tissue disorders, at a collective level. This requires an understanding of epidemiology, social determinants, health promotion and preventive strategies, the right to health, public policies, care systems and current regulations in oral health. It also requires an understanding of the interaction of these oral pathologies with other disorders, general health status and nutrition. |
Specific Competencies
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With regard to oral public health as it relates to cariology, a dental student upon graduation, should: |
Be capable of:
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Have knowledge of:
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Be familiar with:
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5.1.1 Recording and interpreting dental caries and other dental hard tissue disorders at an epidemiological level. |
5.1.5 The rights, duties and interests of individuals and health-related professionals, and the management of situations related to these. |
5.1.11 Understanding health systems, their evolution at the global and national levels, and current regulations in relation to oral health. |
5.1.2 Assessing oral health conditions, dental caries and dental hard tissue disorders in a community and their needs for care and attention. |
5.1.6 The concept of quality of life related to general and oral health, with emphasis on dental caries and other alterations of dental hard tissues. |
5.1.12 Trends in oral health patterns and treatment needs. |
5.1.3 Planning, implementing and evaluating jointly, with the corresponding entities and with patients or guardians, strategies for health promotion and prevention of dental caries and other dental hard tissue disorders and their relationship with other pathologies, at the individual and collective levels. |
5.1.7 The interactions between dental caries and other health problems. Also applies to other dental hard tissue disorders. |
5.1.13 International approaches to oral health care systems. |
5.1.4 Analyzing population risk, considering social determinants and their relationship with the oral health situation and the burden of disease due to dental caries and other dental hard tissue disorders during the course of life, including identification of lifestyles, previous knowledge and social practices related to oral health, participating in the development of proposals to transform the situations found. |
5.1.8 Health promotion and prevention of oral disease in populations, with emphasis on caries and other dental hard tissue disorders. |
5.1.14 General health - economics aspects of the management of dental caries and other dental hard tissue disorders. |
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5.1.9 The organization of oral health care and public health in their country, in accordance with the national health system and current regulations. |
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5.1.10 The descriptive epidemiology of caries and other dental hard tissue disorders, in relation to different variables such as age, general health and social determinants. |
Main Competency 5.2 - Evidence-based cariology
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Upon graduation, the dentist must be capable of developing an evidence-based practice to apply to the fields of dental caries, malformation injuries, traumatic injuries and other dental hard tissue disorders. This requires the ability to search for evidence of best clinical practices, make a critical appraisal, to select and apply in an informed manner the best available evidence. |
Specific Competencies
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With regard to dental caries and other evidence-based alterations of dental hard tissues, a dental student upon graduation. should: |
Be capable of:
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Have knowledge of:
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5.2.1 Identifying gaps in knowledge; formulate a structured clinical question that has a possible answer and search for evidence, using appropriate scientific resources (including biomedical research databases such as Pubmed, Cochrane, Scielo, etc.). |
5.2.4 The principles of evidence-based dentistry and the hierarchy of evidence. |
5.2.2 Seek out and use the most appropriate current clinical management guidelines, recognizing their limitations. |
5.2.5 The transfer of evidence-based dentistry to clinical practice and public health, as well as to the individual and collective level. |
5.2.3 Critically analyzing the evidence on diagnostic methods and therapies to decide on their implementation, recognizing the existing methodological limitations. |
5.2.6 The principles of research methodology, including study design, bias control, representativeness, biostatistics, and extrapolation. |