Evidence-based Dental Practice Research Articles

Knowledge and Attitude about Evidence-Based Dental Practice among Dentists in Al-Kharj, Saudi Arabia.

Quality of patient care will improve when dental professional practices are based on evidence. The present study was aimed at assessing the knowledge and attitude of private dental practitioners in Al-Kharj regarding evidence-based dentistry. The study sample consisted of 180 private dental practitioners in Al-Kharj, Saudi Arabia. A pretested questionnaire was used to collect information regarding knowledge and attitude toward evidence-based dental practice (EBDP). Data were collected by direct personal contact and information was collected on the same day. Awareness of EBDP among private dental practitioners was 67.8%. Also, 31.1% of subjects told that they practice EBD in decision-making about patient treatment. Only 16.7% of study subjects were aware of the Cochrane database, whereas 34.1% were aware of the evidence-based pyramid. Also, 91.7% thought that they needed to be trained regarding EBD. Awareness of EBDP is low among private dental practitioners but the majority of dentists think they need training regarding evidence-based dentistry.

Perspectives on the future of dissemination and implementation research in oral and craniofacial sciences.

Dissemination and implementation science is a field of research that promotes the adoption and maintenance of evidence-based interventions in healthcare delivery and community settings and seeks to understand the processes by which such adoption and maintenance occur. While dissemination and implementation science is an established field in health services research, it is relatively new and making inroads in dental, oral and craniofacial research. This article summarizes the proceedings from a scientific panel on 'Dissemination and Implementation Science for Oral and Craniofacial Health' that was held during the international Behavioral and Social Oral Health Sciences Summit. The panelists were four experts on dissemination and implementation science in dental and non-dental academic settings in the United States and Scotland, with affiliations ranging from schools of dentistry and public health to the National Institutes of Health and a healthcare system with integrated dental services. The panel discussion addressed how dissemination and implementation science can be used to further oral health research. The narrative report presented here aims to describe the panelists' reflections and insights on their current initiatives in dissemination and implementation research to inform future research endeavors within the oral and craniofacial sciences. Specifically, this article focuses on six discussion topics: (1) how organizational determinants can serve as facilitators or barriers to the implementation of evidence-based dental practice; (2) how dentistry can 'de-implement' practices that are not effective; (3) how implementation science can support the delivery of evidence-based dental practice using adaptation; (4) how to get started in implementation science; (5) how the broader environment can support large-scale implementation efforts; and (6) how oral and craniofacial science is well suited for advancing dissemination and implementation research.

Abstracts of randomized controlled trials in the field of dentofacial trauma: Reporting quality and spin.

Abstracts of randomized controlled trials (RCTs) provide a summary of the entire trial report. Their transparent, detailed, and accurate reporting is essential for clinical decision-making and evidence-based dental practice. The aim of this study was to assess the reporting quality and prevalence of spin in abstracts of RCTs in the field of dentofacial trauma. The PubMed database was searched to identify RCT reports published between 2017 and 2021 in the field of dentofacial trauma. The reporting quality of abstracts was assessed according to the 16-item CONSORT for Abstracts checklist and measured with an overall quality score (OQS, range: 0-16). Linear regression analyses were used to identify factors associated with reporting quality. Among the included RCTs, parallel-group RCTs with non-significant primary outcomes were selected for spin assessment using predefined spin strategies. One hundred and twelve eligible abstracts were identified and included. The mean OQS was 4.51 (SD, 1.35; 95% CI, 4.26-4.76). Abstracts with more than 250 words (p=.004) and a structured format (p=.032) had significantly better reporting quality. Of the 30 abstracts that were eligible for spin assessment, spin was identified in 23 (76.7%). Among these, spin was observed in the Conclusions sections of 22 abstracts (73.3%) and the Results sections of 9 abstracts (30.0%). Among RCT abstracts in the field of dentofacial trauma, the reporting quality was sub-optimal and the prevalence of spin was relatively high. Strict adherence to the CONSORT for Abstracts guidelines is needed to ensure complete and transparent reporting. Relevant stakeholders need to make concerted efforts to avoid spin.

Herbal Dentistry- A Narrative Review

The use of medicinal herbs in dentistry continues to expand rapidly across the globe. Herbal dentistry presents an attractive alternative to conventional synthetic materials. With a shift towards evidence-based dental practice, there is a need for dental clinicians to be fully aware of the alternatives and options currently available to them. This review article provides insight into the various herbal products currently available in dentistry. It provides a better understanding of the mechanism of action of the herbal products used to treat various dental problems. This narrative review identifies and summarises the most common medicinal herbs in various preventive and therapeutic spheres of dentistry. High anti-microbial, anti-inflammatory, antioxidant, and immunomodulatory activities along with wound healing ability and sedative-anxiolytic were identified to be the properties favouring use of these medicinal plants in dentistry. Although the natural alternatives discussed in the current narrative review have shown to be either superior or comparable to the synthetically available options, further long-term in-vivo clinical trials are required to substantiate this evidence and justify the replacement of later with herbal alternatives in dentistry.

DENTAL PATIENT-REPORTED OUTCOMES UPDATE 2022.

Much progress has been made this year in patient-reported outcomes related research. A number of important articles were published, shedding light on relevant methodological issues as well as future directions. In order to further promote the wide use of dental patient-reported outcomes (dPROs) and dental patient-reported outcome measures (dPROMs) in dental research and dental practice, and to provide novel insights into relevant measurement and analytical methods, the Journal of Evidence-Based Dental Practice has put together this special issue, the second of a series entitled Dental Patient-Reported Outcomes Update. To put Special Issue articles into a broader perspective, this review will provide a concise summary of key, relevant PRO and dPRO articles published during the year of 2022. A brief introduction of those manuscripts collected in this Special Issue follows. Six main domains are covered in this Special Issue: (i) the availability and applicability of dPROs and dPROMs, (ii) the current usage of dPROs and dPROMs in published research, (iii) methodological considerations in dPRO-related research, (iv) the landscape and trends of dPRO-related research, (v) the significance and relevance of dPRO usage, and (vi) dPROs and value-based oral health care.

A COMPREHENSIVE REVIEW ON ARTICAINE

Local anaesthetics (LAs) offer patients pain-free dental care while lowering patient apprehension and anxiety. Evidence-based dental clinical practice should be based on the most recent clinical studies and involve ongoing reevaluation of all available clinical data on the efficacy and safety of dental anaesthetics. When dealing with children, it is imperative to understand the overdosage of anesthetic agents resulting in toxic reactions and soft tissue trauma inflicted due to extended spans of anesthesia and variations of technique. The anaesthesia should have minimal side effects and optimal efficacy with the fewest injections possible. Hence, this review has been undertaken to assess the various parameters related to Articaine, the newer anesthetic.

Reframing perceptions in operative dentistry relating evidence-based dentistry and clinical decision making: a cross-sectional study among Jordanian dentists

BackgroundThe aim of the current study was to investigate current dental practice in operative dentistry in Jordan, and the relationship between evidence-based dentistry in caries research and decision making in clinical practice in operative dentistry.Materials and methodsThis cross-sectional study was conducted through a survey of dentists in Jordan. The survey aimed to explore the degree of knowledge and practice of evidence-based dentistry in caries research the dentists possess regarding clinical decision making in operative dentistry. The sample size was composed of (5811) dentists whom registered in Jordan Dental Association database. Descriptive statistics were generated and Chi-square test was used to examine associations between the different variables and the significance level was set at P < 0.05.Results4000 responses were collected from the web-survey, response rate (68.83%). Nearly half of the surveyed dentists focus on the chief complaint of their patients (n = 2032, 50.8%) rather than doing full mouth assessment. Nearly two-thirds of dentists (n = 2608, 65.2%) treat lesions confined to enamel with operative treatment. Half of dentists use operative treatment when asked about the routine management of radiographically detected proximal caries confined to enamel. When treating incipient lesions, the majority (n = 3220, 80.5%) use preventive treatment. Three-quarters of dentists (n = 2992, 74.8%) treat deep dentinal caries by removing just the soft infected carious dentin, and treated old failed restorations with replacement.ConclusionIn operative dentistry, the evidence-based research is not implemented clinically. To optimize relationship between evidence-based dentistry and clinical decision-making, dental curriculum has to be updated and modified constantly.

The Potential Role of Dental Patient-Reported Outcomes (dPROs) in Evidence-Based Prosthodontics and Clinical Care: A Narrative Review.

Oral health problems are associated with poor quality of life, with the potential to cause functional, aesthetic, nutritional, and psychological difficulties, in addition to pain and suffering. Traditionally, dental treatment outcomes are measured using purely clinical parameters; however, this may be ineffective as these parameters cannot adequately capture the full impact of poor oral health on the patient, or their respective coping strategies. From this perspective, there are significant benefits when the patient’s perception of their care is considered, and included in treatment planning and delivery. The impacts perceived by the patient on their treatment outcomes can be measured using patient-reported outcomes (PROS), or more specifically with dPROS, focused on dental patient-reported outcomes. Although there are some instruments available for measuring these outcomes in clinical trials, very little information is available for explaining the context in which these outcomes are considered, and also how to capture this information using appropriate instruments, specially in evidence-based dental practice. This article aims to review the literature, seeking to describe what has been considered about assessing patient’s outcomes, as well as how to measure them, and explore the potential benefits of using dPROS in evidence-based prosthodontics and clinical care of partially and fully edentulous patients.

WITHDRAWN: The consistent detection of oral bacteria in atherosclerotic plaque does not qualify for dental treatment to reduce cardiovascular risk.

The Publisher regrets that this article is an accidental duplication of an article that has already been published inThe Journal of Evidence-Based Dental Practice, 22/2, 101718, http://dx.doi.org/10.1016/j.jebdp.2022.101718. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Evidence-Based Prosthodontics.

The practice of evidence-based dentistry has assumed an integral part in today's world. It allows us to achieve self-motivated, problem-based learning, which eventually leads to acquiring clinically sound and relevant information that has a strong backing of evidence on a scientific basis. This would enhance the diagnosis but also the prognoses and treatment that are administered with the highest of ethical standards. Due to the advancement in material studies, dentistry, especially prosthodontics, is getting more intricate and complex due to the dynamic state in the development of new dental materials and equipment. The best evidence is sought through vast empirical literature consisting of controlled trials and reviews. Modern clinical practice should be concurrent with the latest scientific evidence that brings high standards to the treatment options and patient's values. This review highlights the evidence based dentistry on prosthodontics while also addressing the issues it poses in modern day dental practice.

DENTAL THERAPY AND DENTAL PATIENT-REPORTED OUTCOMES (dPROs).

Dental therapy was introduced into the dental team as an advanced practice provider with the intention to increase access to care while providing high quality care in a cost-effective manner. It is essential that the dental therapist is able to provide patient-centered care to minimize patients' suffering. In order to assess patients' suffering, it is critical to understand the impact of care and dental patient-reported outcomes (dPROs). The use of dPROs in evidence-based clinical practice can assess the impact that the advanced practice provider has in dentistry. The presence of dPROs in evidence-based clinical practice will show the equivalence and differences in impact of the dental therapist and dentist. Currently, there is limited research regarding the use of dPROs in dental therapy. A roadmap in this paper demonstrates possible ways to collect dPROs in dental therapy and advance evidence-based dental practice. Recommendations in ways to achieve the roadmap, possible research designs, and expansion in knowledge of dental therapy and dPROs are provided. It is important to explore the advanced practice provider and the possibilities in evidence-based dentistry with the usage of dPROs.

Dental Patient-Reported Outcomes Update 2021

Patients' needs and preferences have long been one of the three essential elements of evidence-based dentistry. However, in most areas of dental research, the voices of dental patients have been overlooked, resulting in findings with limited value for dental practice and a high level of avoidable research waste. Previous studies have shown that the appropriate use of dental patient-reported outcomes (dPROs) is essential for dental research to fully reflect the impact of oral diseases or oral health care on patients and to directly support dentist-patient communication. Therefore, the Journal of Evidence-Based Dental Practice decided to put together this Special Issue, to further promote the wide use of dPROs and to provide novel insights into the measurement and analytical methods for dPROs. This article briefly introduces the manuscripts contained in this issue, which cover a wide range of topics: standardization of dPRO-related methodology; current usage of dPROs in published research; significance and relevance of dPROs usage; identification of dPROs in the evidence; as well as dPROs and value-based oral health care.

Reframing Perceptions in Restorative Dentistry: Evidence-Based Dentistry and Clinical Decision-Making.

Objectives The worldwide interest of both dentists and patients in esthetic dentistry has affected decision-making in dental practice. The aim of this study was to investigate contemporary dental practice in restorative dentistry and the relationship between evidence-based dentistry in caries research and decision-making in clinical practice in restorative dentistry. Methods The study was conducted through a structured questionnaire distributed randomly at the Jordanian Dental Association registered dentists in Jordan. The questionnaire aimed to clarify the degree of knowledge and practice of evidence-based dentistry in caries research the dentists hold regarding clinical decision-making in restorative dentistry. Results The majority of the surveyed dentists (77%) treat teeth with irreversible pulpitis with root canal treatment rather than vital pulp therapy. 13.8% routinely insert a post and 23% routinely crown the tooth after root canal treatment regardless of the remaining tooth structure. Badly damaged teeth are treated with full crowns in 72% of the cases. Regarding Hollywood smile or smile makeover, the majority of dentists choose conservative approaches, and implants were the first choice to replace missing teeth for 93.8% of the surveyed dentists. Conclusion A higher degree of implementation of evidence-based dentistry in clinical decision-making was found in Prosthetic Dentistry than in Endodontics. Yet, the gap between evidence-based data and clinical practice needs bridging. More emphasis on communicating these data to educators to integrate them into the dental curriculum is a must.

Intraoral scanning reduces procedure time and improves patient comfort in fixed prosthodontics and implant dentistry: a systematic review.

ObjectivesThe primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes.Materials and methodsElectronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available.ResultsSeventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS.ConclusionsWithin the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes.Clinical relevanceReduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00784-021-04157-3.

RANDOMIZED CONTROLLED TRIALS IN DENTAL JOURNALS ON CHILDREN AND ADOLESCENTS: A BIBLIOMETRIC ANALYSIS

BackgroundRandomized controlled trials (RCTs) in dentistry provide essential evidence for dentists to practice evidence-based dentistry. This study aimed to analyze the scientific impacts of the RCTs conducted among children and adolescents published in dental journals and summarize the main contents of these studies. MethodsAn electronic literature search was conducted in the database Web of Science (WoS) Core Collection by two independent reviewers in June 2020, without an initial time limit. Articles reporting on RCTs conducted among children and adolescents in dental fields were identified. The most cited articles (the top 100 articles based on total citation counts and citation density) were selected. The bibliometric data were exported from the database WoS for further analysis. The citation counts were cross-checked in Google Scholar. In addition, the main content of the included RCTs was extracted and summarized. ResultsA total of 132 papers published in 28 journals reporting on RCTs in dentistry on children and adolescents were included in this study. The mean total citation count (within WoS) of the included RCTs was 60.0, ranging from 17 to 300, and the mean citation density value was 4.6, ranging from 1.3 to 15.0. The majority of the articles were in the thematic field of cariology (n = 79, 59.8%). Other thematic fields, orthodontology (20.5%), endodontology (5.3%), behavior science and quality of life (5.3%), oral and maxillofacial surgery (3.8%), oral hygiene (3.8%) and periodontology (1.5%) were involved as well. Around one-fifth of the articles (n = 23) were produced by the United States, and the included articles were most cited by the publications (n = 1937) from the United States as well. ConclusionsA wide range of dental topics were covered in the included RCTs conducted among children and adolescents. These top-cited RCTs mainly focus on the thematic field of cariology. The United States is an influential country with a large number of publication outputs and citations.

Teaching research methods to undergraduate dental students

The provision of undergraduate statistics teaching varies across UK dental schools, but some challenges are faced in all schools. These include the need to (i) demonstrate the relevance of statistics to dentistry, (ii) address the phenomenon of statistical anxiety likely to be experienced, and (iii) deliver the teaching with a limited number of statistically trained staff. Our objective was to design a research methods course that combined epidemiology and statistics teaching for undergraduates at Bristol Dental School (University of Bristol) that was clinically relevant, focused on concepts and interpretation rather than calculation, and was sustainable, using new technology to enhance learning. The research methods course was introduced in 2008, extensively developed over the next two years based on student and tutor feedback, and has run with only minor updates ever since. The aim of the course is to introduce year 2 dental students to the skills needed to practice evidence-based dentistry, i.e. understand and critically appraise published research. Basic epidemiological concepts, different types of study design, summarising and interpreting data, and choosing appropriate statistical analyses are covered. The course is introduced by a face-to-face lecture. This emphasises the relevance to future careers, and pre-empts the feelings of statistical anxiety by presenting evidence that exam results for this course are not associated with having achieved an A-level in mathematics. The rest of the course is delivered using the flipped classroom approach. Didactic teaching is in the form of nine e-lectures, each lasting 20-25 minutes. These are split into chapters to allow easy navigation, and include pop-up questions. Small group (up to 10 students) structured tutorials (one per e-lecture) are used to reinforce the material covered in the e-lectures, drawing on real clinical examples from research publications. They are interactive, and also include e-voting quizzes to allow the tutors and students to gauge the level of understanding that is being achieved. At the end of the course there is a revision session and written assessment, which must be passed before students can progress to year 3 of the dental degree. Approximately 70 students take the course each year, split into eight groups, and tutorials are based on pre-prepared materials. Tutoring on this course provides an attractive opportunity to gain teaching experience, with only a modest investment in time. Therefore, it has always been possible to recruit enough statisticians or epidemiologists in the Faculty of Health Sciences, University of Bristol to act as tutors. At least 89% of the students have passed the exam on first sitting each year, and all students have passed their re-sit exam. Marks ranged from 50-86% in 2019, and similar ranges were seen in previous years. Student feedback is consistently high, with virtually all students rating all components of the course at least satisfactory, and high percentages rating them good or excellent (e-lectures and tutorials were rated to be good or excellent by 72% and 95% of the students respectively in 2019). External examiners have been very complimentary, and only ever requested minor changes. Hence it has been possible to run a sustainable research methods course that engages students’ interest and produces excellent learning outcomes.

Making sense of the literature: an introduction to critical appraisal for the primary care practitioner.

With an abundance of published literature, it is essential that primary care practitioners have the basic skills to determine which studies should impact their clinical decisions and which ones should not. This ability comes from having the skills required to critically appraise the literature. Critical appraisal is a fundamental part of being able to practice evidence-based dentistry, which is a General Dental Council requirement. This article will aim to provide practitioners with the key concepts of critical appraisal and introduce simple methods which can be adopted to aid in the reading of a research paper from a critical viewpoint.

Evidence-Based Dentistry Among Iranian General Dentists and Specialists: A Knowledge, Attitude, and Practice Study

Background: The use of evidence-based dentistry (EBD) as the integration of investigations and clinical decisions has been a focus of attention in recent years. Objectives: The present study aimed to evaluate the knowledge, attitude, and practice of EBD among Iranian dentists in 2019. Methods: A total of 140 self-administered questionnaires with 57 items were distributed among dentists in the 2019 exhibition of Iranian dentists. Moreover, 60 self- administered questionnaires were sent to five different dentistry schools in Iran. The analyses were carried out using the Chi-square test, independent samples t-test, and Pearson correlation. Results: A total of 119 fully-responded self-administered questionnaires were analyzed in this study. The dentists attending EBD workshops obtained significantly higher scores of knowledge. The Cochrane Library, manufacturer’s brochures, and evidence-based guidelines were used the least for clinical decisions. Consultation with colleagues, use of textbooks, and personal judgment were mostly utilized for clinical decisions. In addition, 93.3% of the participants stated sensible uncertainties in their clinical decisions. The most important barriers to EBD were the need for long discussions with patients, lack of skills in the critical appraisal of articles, and lack of motivation in dentists with the incidence rates of 62.2%, 62.2%, and 39.5%, respectively. Conclusions: Due to the low levels of EBD knowledge among Iranian dentists, it is recommended to give further close attention to increasing the knowledge in this regard. However, their high enthusiasm for participation in EBD workshops and enhancement of EBD skills is promising.

Evidence-based dental practice and clinical diagnosis

Evidence-based dentistry and its application in making diagnosis result in a significant reduction of errors. The frequency of errors depends not only on accuracy of a diagnostic pathological test but also on the prior chance of disease being present. For deciding the usefulness of diagnostic test, an added component to take into account is the relative value of the probable health states resulting from diagnosis and therapy. These can be determined by information obtained from the patient and the numerical values of the probable dental health status with the help of a visual analogue scale (VAS) technique. Clinical decision analysis can then be accomplished to calculate the applicable diagnostic approach for the patient. Clinical decision analysis is commencing to imprint the development of guidelines for the diagnostic convenience of radiographs although its further use in dentistry needs refinement and development.

Dentists' Knowledge, Attitude, and Practice Regarding Evidence-Based Dentistry Practice in Riyadh, Saudi Arabia.

Objective:The aim of this study was to assess the existing level knowledge and the use of evidence-based dentistry among dental clinicians.Methods and Materials:A cross-sectional questionnaire-based survey was conducted among 400 male and female dental practitioner’s working in academic, governmental, and private sectors in Riyadh, Saudi Arabia.Results:In this study, a total of 400 subjects were recruited of whom 253 (63.3%) were male dental practitioners and 147 (36.8%) were female dental practitioners: 229 (57.3%) subjects belonged to 25–34 age group, 145 (36.3%) to 35–44 age group, 18 (4.5%) to 45–54 age group, and 8 (2%) to >55 age group. Among them, 202 (50.5%) were mixed practice, 91 (22.8%) were working in academics, 76 (19%) belonged to private practice, and 31 (7.8%) belonged to government practice. In addition, 225 (56.3%) were general practitioners and postgraduates, 86 (21.5%) were specialists, 47 (11.8%) were consultants, and 42 (10.5%) had other qualifications. In total, 221 (55.3%) subjects completed their qualification within before 1–5 years, 153 (38.3%) completed their qualification within before 6–10 years, 19 (4.8%) completed their qualification within before 11–15 years, and 7 (1.8%) completed their qualification within 16–20 years.Conclusion:This survey mirrors the necessity to conduct continuing dental education programs on evidence-based practice (EBP), so as to give the dentists of Riyadh better knowledge regarding EBP so that they can administer it in their daily clinical practice and deliver better quality care to their patients.