Evidence-Based Caries, Risk Assessment, and Treatment (original) (raw)
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Evidence-based dentistry: A new dimension in oral health
Journal of Advanced Clinical and Research Insights, 2014
The success of evidence-based medicine depends on the integration of the best research evidence. It is a blend of our patient's unique values and circumstances with our clinical expertise. Evidence-based dentistry is a new paradigm in medicine, meaning that a therapy should be based on evidence gathered from scientifi c studies, preferentially based on randomized clinical trials involving a substantial number of patients. There are three main interrelated aspects to the practice of oral medicine. They are clinical care, research, learning, and teaching. Most of the oral diseases are complex, chronic problems that do not have defi nitive etiology. Many diagnostic tests are costly and need to be critically evaluated for their sensitivity, specifi city and cost benefi ts analysis. Most treatment protocols are opinion based, and prognosis of many oral diseases is diffi cult to predict. Hence, practice of evidence-based health care in oral medicine will defi nitely be helpful when clinical decisions are made.
The challenge of evidence in clinical medicine
Journal of Evaluation in Clinical Practice, 2010
The primary goal of evidence-based medicine (EBM) has been to change the way clinicians make decisions. But EBM has inappropriately privileged the results of clinical research for medical decision making and has undermined the importance of other kinds of medical knowledge, pathophysiologic understanding and clinical experience, to clinical practice. Here, the specific advantages and limitations of each kind of medical knowledge are examined. No particular kind of medical knowledge is necessarily more compelling than the others when it comes to making specific patient care decisions. Several cases where medical knowledge is conflicting are examined to demonstrate the weighting and negotiation necessary for sound clinical judgement. Expert clinicians must utilize a variety of reasons and methods of reasoning in arriving at the best clinical decision or recommendation for an individual patient. The process can be formalized and made explicit, but it cannot be narrowed, simplified and focused only on the results of clinical research.
Evidence-based practice in dentistry
2000
SUMMARY The importance of evidence in teaching and in support of clinical decisions is well established in health care, including dentistry. Defence of clinical decisions increasingly requires reliable data or evidence to support the stance taken. Assistance in finding the best evidence comes from a variety of sources, including computerised databases, journals, continuing education meetings, and study clubs. The randomised
2005
The literature does not provide a clear definition of Evidence based Healthcare (EBHC) and there is some uncertainty between authors as to whether the concepts ofEBHC and Evidence-based medicine (EBM) and Evidence-based dentistry (EBD) arecomparable and the terminology is interchangeable. However the most frequently useddefinition of EBHC is: Evidence-based medicine (EBM)“the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” 1.
A Descriptive Analysis of Clinical Articles Published in the Last 50 Years in the Dental Literature
The Journal of Contemporary Dental Practice
Aims: This article describes the methodologies used in the dental literature and described how these approaches have changed over time. Materials and methods: Thirty-three ISI peer-reviewed journals were included in the analyses. Data were extracted independently by 11 investigators and in duplicate. Any differences in the results were resolved via discussion or by a third reviewer when necessary. Data were collected regarding the methodology used in the article, and dental specialty related to different study designs. In the case in which more than one study design or specialty was reported, reviewers were trained to identify the main methodology/specialty. Results: The majority (36.96%) used a case report (CR) as the primary methodology, followed by a clinical trial (CT) (18.21%) or randomized CT (15.11%). The least used methodologies included a cohort (COH) study (6.07%) or a systematic review (SA)/meta-analysis (MA) (6.73%). Periodontology published the highest number of case controls (CCs) (46.8%), randomized CTs (RCTs) (29.9%), cross-sectional (CS) studies (26.0%), SRs/MAs (19.8%), and CTs (17.1%). Oral and maxillofacial surgery published the highest number of CRs/case series (54.5%) and COH studies (30.5%), whereas operative dentistry published the lowest number of CRs/case series (0.7%), CCs (2.9%), and SRs/MAs (2.3%). CRs/case series retain the highest number of publications across all time points in the dental literature overall. Conclusion: Our results indicate an improvement in the types of research and the pyramid of evidence, which will help in applying evidencebased dentistry (EBD) in clinical decision-making. Clinical significance: Types of studies used in the dental field are not yet investigated. Thus, little is known about the common study design types in dental literature. This can affect the decision made regarding technique, risk factors, prevention, or treatment.