Evidence-based practice is a core component of all dental school curricula, and an emerging approach to care in dentistry. Evidence-based care is a structured approach to care that focuses on the use of systematically reviewed and critically appraised scientific evidence by health professionals instead of an individual health professional’s preferences and anecdotal knowledge. However, the evidence-based data is currently limited to a few dental measures.
Today, the majority of dental measures are process measures; there are few outcome measures except for those related to prevention, such as dental sealants and fluoride varnish. There is sure to be more focus on evidence-based dentistry in coming years. This will include examination of various dental interventions to see whether they lead to the results expected.
Regardless of the experience level of the clinical staff, there will be times when they need to access information to assist in clinical decision-making (e.g., clinical care guidelines, disease presentations, drug prescribing). Fortunately, there are many excellent free online resources that clinics can access.
Evidence-based clinical practice guidelines are considered to be the highest-quality scientific resource available to health professionals. Guidelines such as these include a systematic review of the literature that captures all individual studies conducted on the topic. The team developing the guideline then rates, based on a recognized and standardized protocol, each included study according to its quality (level of bias). Based on the quality and quantity of studies found, evidence summaries and recommendations are developed, which guide health professionals in their decision-making on how they should proceed with care. A review of the scientific literature of this intensity and magnitude would not be possible for individual health professionals to complete on their own. Thus, evidence-based clinical guidelines are helpful to health professionals, as the guidelines can quickly inform them about the best available science on the topic they’re interested in.
In some cases, no evidence-based clinical guideline has been developed that addresses the oral health professional’s topic of interest. In that case, systematic reviews and individual studies, which have been critically appraised by an independent evidence reviewer, can assist in addressing the health professional’s question. Critical appraisal is a structured technique for evaluating a study’s level of bias and treatment effect. Although not as robust as evidence-based clinical guidelines, critical appraisals do take expertise and time to complete; thus, resources such as studies that have been critically pre-appraised are also helpful to health professionals, as they quickly and objectively summarize and interpret study findings.
In light of the large number of new drugs entering the marketplace each year, clinics should consider maintaining a subscription to a mobile app and/or online drug reference resource. Electronic drug reference materials are preferred, as they allow for real-time content updates. The cost of the resources can vary, with higher-priced options containing lesion diagnosis support and information on the prevention and management of dental emergencies.
Safety Net Dental Clinic Manual
National Maternal and Child Oral Health Resource Center
Georgetown University