Position Statement: Use of Evidence-Based Dentistry to Improve Patient Outcomes

Use of Evidence-Based Dentistry to Improve Patient Outcomes

Position Statement of the American College of Prosthodontists
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The evidence based-practice method for evaluating and implementing scientific knowledge has grown in popularity over the past two decades. This method relies on a methodological, systematic approach to extract and assimilate evidence from a large body of literature and then use it to effect clinical practice. This evidence-based approach is defined as the "conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research".¹

In dentistry, evidence-based practice, better known as evidence-based dentistry (EBD) is defined 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”.² Thus, EBD is not only a rigid methodological process of scientific evidence evaluation. It is also an approach to health care that relies heavily on clinical professional judgment and patient preference.

The American College of Prosthodontists (ACP) has a long history of embracing EBD. More than two decades ago, the ACP recognized that prosthodontics is a unique dental specialty that would benefit greatly from EBD.³ The ACP remains a strong advocate of EBD, or evidence-based prosthodontics, and maintains a strong leadership role in its implementation.

In light of advancing dental technology, the ever-expanding body of knowledge and the increasing variability in the quality of available dental literature, identifying sound evidence to incorporate in evidence-based prosthodontic practice is becoming more and more challenging. As a steward of EBD, the ACP is committed to developing strategies that help in the advancement and the implementation of EBD into clinical practice. These strategies include collaboration with other organizations involved in advancing EBD and making EBD resources readily available for prosthodontists and patients. The ACP is actively engaged with the ADA Center for EBD and the Cochrane Oral Health Group to collate, synthesize and generate evidence-based principles to apply to prosthodontics care.⁴

Pursuing and implementing EBD is also an integral part of the ACP Strategic Plan and its scientific arms: the Education and Research Division and the Journal of Prosthodontics Implant, Esthetic, and Reconstructive Dentistry. By educating prosthodontists and future prosthodontists on methods to seek and identify evidence and by fostering pertinent strategies to evaluate experimental methods, risk of bias and quality of evidence; providers will be able to successfully apply acquired evidence into practice and they will be better equipped to manage patients. The ACP believes that the benefits derived from an evidence-based approach will positively influence treatment outcomes and significantly improve oral healthcare.

References

1. Sackett DL, Rosenberg WM, Gray JA, et al: Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71-72.

2. ADA Center for Evidence-Based Dentistry: About EBD. http://ebd.ada.org/about.aspx. Accessed September 18, 2014.

3. ACP Messenger: Prosthodontic research symposium slated. Chicago, American College of Prosthodontists, 1994;24:6.

4. Carr AB: Evidence and the practice of prosthodontics: 20 years after EBD introduction. J Prosthodont 2014 Oct 14. doi: 10.1111jopr.12232 [Epub ahead of print].