Evidence-Based Dentistry Overview

Evidence-Based Dentistry

• Focuses on combining the best research evidence, clinician expertise, and patient values for optimal patient care.
• Differs from traditional methods that heavily rely on clinician experience.
• Aims to improve the quality of information used in decision-making, avoiding information overload.
• EBM was first used in the early 1990s by David Sackett and colleagues at McMaster University.
• Evolves around a cyclical process of asking a question, acquiring evidence, appraising evidence, applying evidence, and assessing the results.
• Includes a crucial component of informed consent, involving a dialogue between the dentist and patient about treatment options, risks, benefits, and alternatives.
• Incorporating evidence-based models into the informed consent process can minimize legal issues in a litigious society.

Components of Clinical Decision Making

• Clinician's knowledge, skills, and attitude.
• Patient values, concerns, and expectations.
• Health system access rules (e.g., funding, Medicare).
• Concern about litigation.

Why Evidence-Based Dentistry (EBD) is Needed

• Large information gap between research and clinical practice.
• Clinicians sometimes lack tools to evaluate research quality.
• Researchers may not understand clinicians' information needs.
• Treatment decisions have historically relied on expert opinion, trial and error, or uncritical scientific literature, not always the best approach.

Cochrane Collaboration

• An important resource for evidence-based dentistry.

Evidence-Based Dentistry (EBD) Definition

• An approach to oral healthcare involving the judicious integration of systematic assessments of relevant scientific evidence, patient's oral and medical history, and clinician expertise, along with patient needs and preferences.

United States Commission on Dental Accreditation (CODA)

• CODA mandates oral health programs to teach and evaluate graduates on their competency to access, critically appraise, and apply scientific literature for providing evidence-based care.
• This is crucial for preparing oral healthcare providers to be critical thinkers, problem solvers, and lifelong learners.

EBD-Related Education Materials

• Includes skills in problem formulation, literature searching, critical appraisal, and research methodology.
• Offers courses, workshops, journal clubs, online learning, and other teaching projects.
• Features assessment strategies like questionnaires, examinations, validated assessments, interviews, rubrics, assessing attitudes, confidence, knowledge, skills, and clinical behaviors.

Steps of Evidence-Based Dentistry

• Ask the question.
• Acquire the evidence.
• Appraise the evidence.
• Apply the evidence.
• Assess the results.

Informed Consent

• An open dialogue with patients concerning their condition, treatment options (including no treatment), risks, benefits, and the clinician's competence.

EBD Implementation in a Litigious Society

• Helps avoid potential legal issues that can come from a lack of informed consent.
• Documentation of the informed consent process is essential.

Evidence-Based Dentistry Links

• Several resources exist for further exploration of evidence-based dentistry.