Understanding science and evidence-based decision making in orthodontics

Abstract

The early part of the 1990s ushered in evidencebased decision making for health care. Presently, there is a resurgence in evidence-based decision making with evidence-based dentistry (EBD) the buzzword in dental periodicals. The call for dentists to understand science and research is not new. The Geis Report of the early 1920s petitioned medical and dental schools to become more scientific in their teaching and practice. William Geis’s cry for dentists to be educated and practice in a climate of science was evident in the last part of the 20th century. In orthodontics, several icons in the profession have stressed the importance of science in clinical practice. William Proffit wrote, “The orthodontic practitioner is akin to the scientist who must continually evaluate new research findings.” Furthermore, Peter Vig stated, “orthodontists have lain greater emphasis on mastering their art than mastering their science. . . . There are many orthodontic controversies, past and present, that center on whose art is superior.” Lysle Johnston claimed, “Those who advocate new therapies seem disinclined to provide evidence of efficacy (it may be bad for business); the profession as a whole, perhaps being convinced in dental school of the irrelevance of ‘science,’ seems equally disinclined to demand it.” And it is conceivable that the apparent disregard for the principles of scientific inquiry prompted Alton Moore to write, “Clearly, the promulgation of simple rules and pat formulas and the immediate and uncritical adoption of them prior to testing . . . have inhibited true progress.” It seems, however, that dentistry and orthodontics have lagged behind medicine in the quest to incorporate science into clinical practice. Perhaps the art in the practice of dentistry has overshadowed the need for