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Dental Hygiene Library Resources: Evidence Based Dentistry

A short library resource guide for students enrolled in the dental hygiene program.

What is Evidence Based Dentistry?

The American Dental Association (ADA) defines the term evidence-based dentistry as 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."

Scientific evidence, or best research evidence, means validated and relevant research, this can include literature review, clinical research (like controlled trials), and other types of research studies. 

Clinical expertise is the ability for a practitioner to use their clinical skills, experience, and knowledge to correctly assess and diagnose a patient's health condition and the risks or benefits of different interventions. 

Patient values include an individuals unique preferences, concerns, expectations, and should be considered and integrated into a treatment plan. 

Steps of EBD

The process of Evidence Based Dentistry consists of the following steps:

  1. Formulating well-structured searchable clinical questions
  2. Determining the level of evidence that best answers the question
  3. searching for the best available evidence
  4. critically appraising the evidence for its validity and usefulness 
  5. applying information of the patient
  6. evaluating the efficacy of EBD application on patient

Citation: Durr-e-Sadaf. (2019). "How to apply evidence-based principles in clinical dentistry." Journal of Multidisciplinary Healthcare, vol. 12: 131-136. 

You can also think about the Steps of EBD as the 5A's:

  1. Ask the question
  2. Acquire the evidence
  3. Appraise the evidence
  4. Apply the evidence 
  5. Assess the results

Clinical Question - PICO

A well-structured clinical question should be able to define the following: 

P - Patient/Population

How would you describe a group of patients similar to your own?

What is the condition or disease you are interested in?

I - Intervention

What do you want to do to this patient?

Treat, diagnose, or observe?

C - Comparison/Reference Standard

What is the main alternative (gold standard) to compare with the intervention? (does not always need a direct comparison)

O - Outcome

What can you hope to improve, accomplish, measure, or affect?

What are the relevant outcomes? (comfort, quality of life, etc.)

The outcome should be patient-oriented

 

Image: Durr-e-Sadaf. (2019). Table 1: Formulating a PICO question [table]. In, "How to apply evidence-based principles in clinical dentistry," Journal of Multidisciplinary Healthcare, vol. 12: 133. 

PICO helps determine question domain. This domain is the category that your question falls into. Determining the domain helps focus your search by determining the types of information (study types) needed. 

Question Domains 

Therapy - how to best treat the problem

Etiology/Harm - what causes the problem?

Prognosis - what will the problem look like over time?

Diagnosis - identify the problem

Economic - How much will this problem cost? What is the cost/benefit of treating this problem with this intervention?