Chapter 4. Clinical Operations

Policy and Procedure Manual

What are practice guidelines or clinical protocols?

Clinical policies and procedures are not meant to tell dental providers how to perform dental procedures; that is what their professional dental education does. However, practice guidelines may be adopted to encourage the use of the most scientifically acceptable materials and methods. The terms "clinical protocols" and "practice guidelines" are used somewhat interchangeably.

The Joint Commission defines practice guidelines as "descriptive tools or standardized specifications for care of the typical individual in the typical situation, developed through a formal process that incorporates the best scientific evidence of effectiveness with expert opinion."

Over the past decade, dentistry has begun to use more evidence-based practice guidelines. external linkEvidence-based means that sound scientific evidence rather than empirical observation is being used to make treatment decisions. The American Dental Association, the National Institute for Dental and Craniofacial Research, and some of the dental specialty societies periodically review the scientific literature covering selected dental topics and make recommendations (practice guidelines) for diagnosis and treatment. The practice guidelines are neither statutory nor regulatory documents. Format may vary, but the intent is to help providers choose the most effective mode of treatment that is best supported by scientific evidence.

Practice guidelines are not always readily accepted by practitioners because of concerns that their clinical judgment based on experience is removed from the equation. When used as a reference and "roadmap," however, practice guidelines can improve the diagnostic process and make outcomes predictably more successful. When used judiciously, they can help the clinic avoid charges of malpractice.


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