Evidence-based dentistry in clinical practice
Section snippets
IDENTIFYING BEST EVIDENCE
The emphasis on assessing the strength of the evidence for any given question increased substantially in the 1990s, as it grew increasingly obvious that single studies were insufficient to answer such questions. Replication is the basis for scientific discovery. In medicine, expert opinions and even information based on case studies are not considered to be sufficiently strong or credible evidence in the decision-making process. Rather, the collective knowledge gleaned from reviewing all
MODELS FOR CLINICAL DECISION MAKING
Dentists have been trained to rely on knowledge gained from experience (both successes and failures) and to learn from colleagues when providing oral health care to patients. Most dental students are trained under the auspices of the so-called master teacher or clinician. Unfortunately, dental academicians have yet to develop a formula for training so-called master clinicians. As a result, dental students are taught by several inconsistent and sometimes contradictory teachers, and are trained
EVIDENCE-BASED CLINICAL PRACTICE
Using three examples below, we illustrate how dentists can use model 3 when making clinical decisions.
IMPLICATIONS OF EBD
Scientific evidence, when collected and analyzed systematically, can provide useful and current information to dental practitioners. However, scientific evidence by itself is insufficient for dentists to provide appropriate dental care. By necessity, dentists also should consider patients’ circumstances and preferences regarding outcomes when recommending treatments.
The ADA definition of EBD, included within the Association’s EBD policy statement,1 is explicitly addresses the need to
CONCLUSION
In the evidence-based approach to clinical decision making, dentists incorporate the best scientific evidence—evidence that is critically appraised in systematic reviews—with clinical experience and their patients’ preferences for treatment outcomes. The dental profession should define clinically relevant questions, commission systematic reviews to answer those questions and, when evidence is not available, advocate for good-quality clinical research to be conducted to provide the answers.
References (17)
- et al.
Dentists’ perception of their treatment practices versus documented evidence
Int Dent J
(2002) - et al.
Occlusal treatments in temporomandibular disorders: a qualitative systematic review of randomized controlled trials
Pain
(1999) ADA policy statement on evidence-based dentistry
And now, a few words for the other side
N Y State Dent J
(2000)Evidence-based versus experience-based decision making in clinical dentistry
J Am Coll Dent
(2000)- et al.
The genome projects: implications for dental practice and education
J Dent Educ
(2002) - et al.
Variation in dentists’ clinical decisions
J Public Health Dent
(1995) The future of dentistry: the evidence revolution
Br Dent J
(1998)
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Practical Science is prepared by the ADA Council on Scientific Affairs and Division of Science, in cooperation with The Journal of the American Dental Association. The mission of Practical Science is to spotlight what is known, scientifically, about the issues and challenges facing today’s practicing dentists.
Although Practical Science is developed in cooperation with the ADA Council on Scientific Affairs and the Division of Science, the opinions expressed in this article are those of the authors and do not necessarily reflect the views and positions of the Council, the Division or the Association.