Evidence-Based Dentistry

Sources of information for evidence-based decision making in dentistry:

Evidence-based dentistry consists of the conscientious, explicit and judicious use of current best evidence in making decisions about the care of patients. The practice of evidence-based healthcare means integrating individual clinical expertise with the best external clinical evidence from systematic research. (Adapted from Sackett et al., Evidence Based Medicine, 2000.) In other words it is the integration of the patient's clinical presentation, the patient's desires and expectations, the clinician's judgment and experience and the best available scientific evidence to make treatment decisions about individual patient needs.

How does the clinician in private practice get access to "the best available scientific evidence" in order to make the best treatment decisions? What is the best scientific evidence? Scientific evidence can be ranked (from strongest to weakest) as follows:

• Systematic Reviews (meta-analysis) of clinical studies
• Randomized controlled clinical studies
• Cohort Studies
• Case Reports
• Narrative reviews, expert opinions, editorials
• Animal and in vitro (laboratory) studies

Hence, probably the best source of scientific information are the systematic reviews, which are comprehensive and critical reviews of the literature by experts. Here are some excellent sources of systematic reviews to help you in your clinical decision making:

• The Cochrane Collaboration
• Database of Abstracts and Reviews of Effects
• National Institute of Clinical Excellence (U.K.)
• Agency for Healthcare Research and Quality (U.S.)