Evidence-based Practice in Dentistry: Benefit or Hindrance

Abstract

evidence-based dentistry. Of course we must. The future of dentistry depends on our consistent and concerted marriage, as it were, of the "best available" research evidence with the diagnostic modalities and the treatment interventions our patients need.The concerns over variability of practice is not a question of style or individuality. It is a question of quality and standards. Patients expect and deserve the best care available for them based on the evidence, personal preferences, and the skills and knowledge of the provider. The pressure on the dental care industry to have evidence for even its most basic of treatments and products is wellfounded. Take for example the recent NIH Consensus Conference (http://www.nidcr.nih.gov/news/consensus.asp), which discusses dental caries. Among many other conclusions, the panelists agreed that more rigorous studies are needed not only to support current methods but also to improve them.The American Dental Association Commission on Accreditation requires that dental students acquire a wide variety of skills in managing scientific information with critical thinking. However, most dentists were not taught the skills and tools of evidence-based dentistry in dental school. Therefore, they have little confidence in or respect for the scientific method, and place little or no demands for higher standards of research evidence. Certain dental manufacturers may be content to publish their research in the form of abstracts, and to support their products with statements such as "University studies show...". It is time that dentists take control of the products they utilize: The liability is theirs. Therefore, dentists must take it upon themselves to evaluate the validity of the research evidence for or against any given products they use. It is also time for the socio-political environment that surrounds dentistry (e.g., the insurance companies for the coverage of dental treatment, Congress for the funding of dental research) to have access to the "best available" evidence to make the better-informed and cost-effective decision.The well-being of our patients depends upon the successful integration of the "best available" evidence into novel and improved treatment modalities. The question is not "why" but "how". How can we actualize this union? How can we identify the "best available" research evidence? How can we most effectively integrate it into the common day-to-day exercise of dental practice? These are fundamental and timely questions for dentistry in the 21st Century.There are many approaches to evidence-based dentistry, but it may suffice to paint a very broad picture at the onset and

“The Art of Knowing”: Social and Tacit Dimensions of Knowledge and the Limits of the Community of Practice

“…It has developed from 'a desire to rise from origins based frequently in craft traditions and strictly experiential knowledge' (27) and become one of the foundations of health care and health care education. An extensive literature has developed advocating the application of EBP principles in clinical dentistry (28,29). Evidence is only evidence if shared, which usually takes place through spoken and written words.…”

Real-World Implementation of Evidence-Based Dental Practice

“…14-18 As Chiappelli et al 19 have stated, evidence-based dentistry is not to be confused with dentistry based on evidence. The focus here will be on the third component, patient values.…”

Librarians' Roles in Evidence-Based Dentistry Education: A Review of Literature and a Survey in North America

“…Various obstacles to the adoption of EBD by dentists have been discussed in the dental profession, [15][16][17]31 among which are the lack of high-quality evidence from high-quality dental clinical trials 35 and the lack of secondary tools for practicing dentists to evaluate the literature. 36 One of the participants touched specifically on these two issues in the open-ended question, suggesting that dental librarians are well-versed in recognizing the needs and concerns in the dental profession.…”

“…16,17 Meanwhile, it was pointed out in a guest editorial in Journal of Dental Research that ''most dentists were not taught the skills and tools of evidence-based dentistry in dental school.'' 15 Although the barriers for dentists in implementing EBD may not be addressed by EBD education alone, 31,32 the importance of teaching dental students the key skills required to practice EBD was emphasized in an editorial of Evidence-based Dentistry. 18 With the continuous evolution of EBD, EBD education has been included in formal educational programs and has made significant progress in predoctoral education.…”