Interview

An interview with Emanuel Dias

» Associate Professor of Oral and Maxillofacial Surgery and

Traumatology – University of Pernambuco. » Chief of the Maxillofacial Surgery and Traumatology Sector –

Oswaldo Cruz University Hospital. » Former Dean of University of Pernambuco (1999-2006). » Former President of the Brazilian College of Oral and

Maxillofacial Surgery and Traumatology (2001-2003). » Former Vice-President of the Federal Dental Council (CFO) (2008-2012). » Former President of the Teaching Committee of the Federal

Dental Council (CFO) (2003-2013). » Professor of Master, PhD and Postdoctoral Programs at the

University of Pernambuco (UPE).

How to cite: Dias E, Porto GG. Interview with Emanuel Dias. J Braz Coll Oral Maxillofac Surg. 2019 Sept-Dec;5(3):14-6. DOI: https://doi.org/10.14436/2358-2782.5.3.014-016.oar

Prof. Emanuel Dias, maxillofacial surgeon for 38 years, has held very important positions for the specialty, when he fought and contributed to its consolidation in Brazil. His wise and true standpoint about the specialty, particularly with regard to education and continued strengthening of the OMF surgery, is reported briefly in the following interview.

The Oral and Maxillofacial Surgery and Traumatology has been developing, particularly in the last 40 years, an extremely important scientific and healthcare advance. It managed to combine, by the large dental schools, the undergraduate and graduate education to its development in major hospitals. It began to understand that the specialty would develop naturally as all medical surgical specialties within large hospital environments, which naturally led the professionals of the specialty, especially professors, to understand that multiprofessionality and multidisciplinarity of OMF surgery are unquestionable aspects. It is impossible to discuss and advance the OMFST without thinking about these aspects.

The OMF surgery and multidisciplinarity

This environment involving other professions provided and provides, by large teaching hospitals, training in the long term. Large residencies of

OMFST are currently held in 3 years of full

time activity, leading residents to stay connected to other residencies and move in environments with different specialties, particularly medical. There is also the relationship with general examination of the patient, such as hospitalization, ICU, wards, nursing resources, complementary tests, the admission of other patients with underlying diseases or serious diseases, infectious or oral cancer, which requires a much greater preparation. There is also the relationship of OMF surgery with other dental specialties that are absolutely relevant, even though most are clinical, i.e. they are offered in clinics and offices.

It is important to understand that we are in Brazil and we have proper illnesses or very classic of the country. We have many patients with important metabolic changes, some of which are characteristics of our tropical diseases. Notwithstanding, we have people who, as mentioned by Darcy Ribeiro, formed "a kind of new Rome", a mixture of races that determines a highly personalized facial esthetic standard. It is necessary to learn not to copy external models in an unrestricted manner; it is necessary to bring the knowledge to internal applicability, so that we can offer results within a functional esthetic perception of the type of people with whom we live.

An important factor in the specialty that should be better addressed in residencies is tumors, large resections, tissue replacements, possibility of working with transplant patients or patients with incurable diseases such as AIDS. There are many patients who work with cancer protocol with chemotherapy or radiation, which we need to understand more so that we may actively participate.

Specialty strengthening

We still must discuss that we are in a country where more than 50,000 people die per year due to accidents. We are in a country where most major public hospitals have one OMF surgeon in the ER team, which was an extraordinary achievement. We need to be involved in national movements that work in the prevention of trauma, its etiology and the mechanisms of trauma.

It is a great specialty that has a different team from other dental specialties, because they necessarily need an anesthesiologist, all supporting elements of hospitalization, collaboration of doctors in ICU, Cardiology, Hematology, Infectious Diseases, hospitals working with 24-hour laboratory, blood banks. This dimension cannot be ignored or put behind, because some wish to do procedures that can transform OMFST in a subarea, with limited importance.

I believe that surgery is only one: it begins in studies of the types of patients, types of diseases, surgical techniques, from anesthesiology to large studies of techniques of major craniofacial disorders, and we must be involved in all this.

Technology and good clinical practice

The speed of knowledge construction has been so rapid that some professionals seeking this knowledge, which can also be achieved so quickly by the available technologies, somehow neglect the clinical experience. Naturally, technological application, knowledge and the speed at which this knowledge is acquired will only be associated with good clinical practice if there is clinical experience. This means that it takes time, we need to operate, assist

patients, be in places that provide an important movement of patients, so that the modern technology may be associated with the experience of each of us. One thing depends on the other. It is necessary to be updated and have time to use this action. Time really defines the quality of who is doing and applying this technology. Always operating, always treating and being in major centers that enable the examination of several patients with filled activities will provide a huge practice.

Opinion of those who understand the subject

I advocate that OMFST develops not only under the aspects of modern methodology and modern pedagogy for teaching and learning, but also that new models should be applied in undergraduate and graduate. To discuss accords and internationalization sounds like an absolutely irreversible practice.

I further advocate that the large training centers particularly occupy these large multidisciplinary spaces. I do not believe in specialist training in short time. At least 3 years are necessary within large hospital settings with good teams, which allows a solid learning, which surely form the basis of any surgeon for the future. This is my expectation; this is not a momentary vision, but the opinion of someone who is practicing the specialty for over 38 years and has been in all possible spaces in relation to education and assistance.

Profa. Dra. Gabriela Granja Porto

- Editor-in-Chief of JBCOMS - Journal of the Brazilian College of Oral and Maxillofacial Surgery.