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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Evidence-based dentistry | 1/2 | https://en.wikipedia.org/wiki/Evidence-based_dentistry | reference | science, encyclopedia | 2026-05-05T07:00:33.408006+00:00 | kb-cron |
Evidence-based dentistry (EBD) is the dental part of the more general movement toward evidence-based medicine and other evidence-based practices. The pervasive access to information on the internet includes different aspects of dentistry for both the dentists and patients. This has created a need to ensure that evidence referenced to are valid, reliable and of good quality. Evidence-based dentistry has become more prevalent than ever, as information, derived from high-quality, evidence-based research is made available to clinicians and patients in clinical guidelines. By formulating evidence-based best-practice clinical guidelines that practitioners can refer to with simple chairside and patient-friendly versions, this need can be addressed. Evidence-based dentistry has been defined by the American Dental Association (ADA) as "an approach to oral healthcare that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences." Three main pillars or principles exist in evidence-based dentistry. The three pillars are defined as:
Relevant scientific evidence
Patient needs and preferences
Clinician's expertise
The use of high-quality research to establish the guidelines for best practices defines evidence-based practice. In essence, evidence-based dentistry requires clinicians to remain constantly updated on current techniques and procedures so that patients can continuously receive the best treatment possible.
== History == Evidence-based dentistry (EBD) was first introduced by Gordon Guyatt and the Evidence-Based Medicine Working Group at McMaster University in Ontario, Canada, in the 1990s as part of the larger movement toward evidence-based medicine and other evidence-based practices.
== Clinical decision making == Much praise has gone to the dentistry approach of clinical decision making. In an EB case report written by Miller SA, is focused on the "use of evidence-based decision-making in private practice for emergency treatment of dental trauma". The case concludes with high praise for this method, going as far to say that "[the] evidence-based method was efficient, and very helpful in optimizing the management of the emergency dental treatment". However, it is important to ensure that the collection of data in the evidence during evidence-based clinical decision making isn't corrupted. Crawford JM writes about publication bias, as well as the possible effects it can have on evidence-based clinical making. He writes that it is important to watch out for publication bias, as it can "hinder advancements in oral health care by decreasing the availability of scientific evidence and threatening the validity of evidence-based practice". There are many tools that have been developed for dental-based clinical decision making. Authors Rios Santos JV, Castello Castaneda C, and Bullon P all documented the "development of a computer application to help the decision making process in teaching dentistry." It offers the ability to review information, to help reinforce information that is learned by students. Teaching staff can also "design any theme they wish, increasing the efficiency and support capabilities of the program".
== Principles == In summary, there are three main pillars exist in evidence-based dentistry which serves as its main principles. The three pillars are defined as:
Dentists' clinical expertise Patient needs and preferences Relevant scientific evidence
=== Dentists' clinical expertise === Much less attention is paid to both the other two spheres of EBD, clinical expertise and patient values. Clinical expertise plays a part in the successful outcomes of treatment with diagnostic skills preventing over and under-treatments, technical dental skills maximizing the longevity of surgical and restorative procedures and communication skills being core to patient management and perceived success.
=== Patients needs and preferences === Not all patients have the same priorities for their care. Understanding a patient's individual needs, wants and circumstances gives the clinician a place from which to discuss treatment options available with the patient. This might be competing priorities between dentists, therapists, and hygienists who generally aim for longevity and aesthetics and patients who may be more interested in keeping costs down, aesthetics or would prefer less invasive treatments.
=== Relevant scientific evidence === Given that "Patient needs and preferences" and "Dentist's clinical expertise" are variable and will differ among numerous clinicians and population, "Relevant scientific evidence" is of critical importance. Therefore, it is imperative that information referenced to are derived from high-quality, evidence-based research, which can be used to establish the guidelines for providing the best practices. In essence, Evidence-based dentistry can allow clinicians to remain constantly updated on the newest techniques and procedures so that patients can continuously receive the best treatment possible.
== Evidence based process ==
=== Best scientific evidence === The new model set by EBM uses a systematic process to incorporate current research into practice. The evidence-based process requires the practitioner to develop five key skills:
Formulate information needs/questions into four part questions to identify the patient/problem (P), intervention (I), comparison (C), and outcomes (O), known mnemonically as the PICO questions. Conduct an efficient computerized search of the literature for the appropriate type and level of evidence. Critically appraise the evidence for validity with an understanding of research methods. Apply the results of the evidence to patient care or practice in consideration for the patient's preferences, values and circumstances. Evaluate the process and your performance through self-evaluation. The American Dental Association defined evidence-based dentistry like so:
Evidence-based dentistry (EBD) is an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences. The American Dental Education Association (ADEA) has incorporated the definition of evidence-based dentistry into core competencies required by dental education programs. These competencies focus on graduates to become lifelong learners and consumers of current research findings and require students to develop skills that are reflective of evidence-based dentistry. A dentist's learning curve for using the evidence-based process can be steep, but there are continuing education courses, workbooks and tools available to simplify the integration of current research into practice.
=== Assessing the quality of evidence ===