Evidence-based dentistry (EBD) uses current scientific evidence to guide decision-making in dentistry. It is an approach to oral health that requires the application and examination of relevant scientific data related to the patient's oral and medical health. Along with the dentist's professional skill and expertise, EBD allows dentists to stay up to date on the latest procedures and patients to receive improved treatment. A new paradigm for medical education designed to incorporate current research into education and practice was developed to help practitioners provide the best care for their patients.[Ref 1] It was first introduced by Gordon Guyatt and the Evidence-Based Medicine Working Group at McMaster University in Ontario, Canada in the 1990s.
The new model set by EBM utilizes 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.[Ref 2]
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.— ADA[Ref 3]
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.[Ref 4]
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.
Evidence-based dental journals have been developed as resources for busy clinicians to aid in the integration of current research into practice. These journals publish concise summaries of original studies as well as review articles. These critical summaries, consist of an appraisal of original research, with discussion of the relevant, practical information of the research study.
Systematic reviews are also helpful for the busy practitioner because they combine the results of multiple studies that have investigated the same specific phenomenon or question.
- Evidence-Based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA 1992. 268: 2420–25.
- Sackett D, Straus S, Richardson W. Evidence-Based Medicine: How to Practice & Teach EBM. 2nd ed. London, England: Churchill Livingston. 2000.
- ADA Policy Statement on Evidence-based Dentistry. http://www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/policy-on-evidence-based-dentistry Accessed 17 Aug 2010
- Competencies for the New General Dentist. http://waverleyoaksdental.com/files/ADEACompetenciesNewDentist.pdf Accessed 17 Aug 2010