The modern practice of clinical dentistry has come an incredibly long way from the days of the village “surgeon-barber.” This was the person typically called upon for tooth-extraction — virtually the only oral health remedy for the vast majority of people in recorded history.
In this early part of the 21st century, clinical dentistry and other forms of health care are undergoing a dramatic evolution, some might call it a revolution, which is referred to as evidence based care. Evidence based practices are currently in the process of changing much of how dentistry, as well as other professions, are practiced. This new model is a positive development for both dentists and patients.
The Emergence of Today’s Hot Topic in Medicine, Evidence Based Practices, and The Debt it Owes to Germ Theory
While the term and idea behind “evidence-based care” is currently enjoying its much-deserved turn in the spotlight, the basic concept that it contains — using valuable scientifically-derived evidence to make the practice of medicine better in every way — was first formulated in the 19th century. Many advances were made in the field of medicine in the later-half of the 1800s, including the hugely significant emergence of germ theory. This revolutionary theory described the role of microorganisms in disease and sowed the seeds that led to today’s evidence based care movement.
Germ theory proposed a dramatically different view of disease than the prevailing wisdom held, and was tragically ignored by doctors of the day. However, the work of men such as Robert Koch and Louis Pasteur and other pioneering scientists and doctors, and their application of the scientific method in medicine, eventually convinced the last of the traditionalists. By the beginning the of 20th century, the practice of medicine based on reliable, scientifically-derived evidence was well on its way to being cemented in the medical minds and institutions of the West.
This triumph of the scientific method was more or less contained to doctors and other professionals, though. Today, things are markedly different. Billions of people across the world are more empowered, mainly thanks to an increase in education and technology that puts the world’s combined knowledge usually no more than a few keystrokes away. Health care consumers are now encouraged under the new model to take a larger, more informed role with their doctor in making the health care treatment and wellness decisions that make sense for them.Evidence based practices will impact many spheres, not just dentistry and medicine in general, in ways both small and large.
In This New Model, Asking The Right Question is Key
Aided by the above changes, consumer watchdog groups, citizen activists and journalists have started to bring some added pressure to bear upon professions as varied as doctors, academics and politicians. In the movement towards more and more evidence as opposed to traditional belief and personal opinion, an increasing amount of people have an expectation that these professional men and women will formulate the crucial questions that must, but haven’t yet, been asked. With this key in hand, it is up to academics and researchers to provide the answers, which then form the basis of effective policies and practices. Professionals in many fields, dentistry included, that welcome evidence based practices know that asking the right question is sometimes just as important as getting an answer. It is within the above context that evidence based care has become a buzzword.
The New Model Revolves Research, Meta Analysis and Skilled and Willing Doctors to Put New Ideas Into Practice
Scientifically sound studies are the basis of evidence based care and work to answer crucial questions. Regarded as one of the best methods, scientifically sound randomized control trials (RCTs) are by far the most potentially useful and enlightening method of studying the issues that demand answers. Such answers that result from RCTs usually provide the most significant impact, and can bear heavily on issues such as disease prevention, diagnosis, prognosis and treatment.
Though RCTs are considered one of the best methods for answering vital questions, other study methods serve important roles as well and fill crucial gaps in medical knowledge. Academics and student researchers are primarily the unsung heroes who conduct studies and publish results in peer-reviewed journals.
Meta analysis — the practice of comparing, contrasting and analyzing an entire group of individual studies that attempt to find answers to the same question — forms the bed-rock of evidence based practices. Meta analysis is the biggest single source of valuable indicators and conclusions, making them invaluable in informing you and your dentist’s decisions and advice regarding your oral health in particular.
Barriers to Widespread Adoption of Evidence Based Practices Exist, But Can be Overcome
There are some noteworthy challenges to universal acceptance and adoption of evidence based care, even as it is widely regarded as the single best method of delivering optimal and cost-effective health care. Two issues in particular may slow down the pace of adoption of this new model. First, society in general should be encouraged to value the evidence that academics, researchers and scientists uncover. A problem emerges in this regard when bias and conflicting interests of researchers and academics become such a concern that people lose respect for any and all conclusions reached by researchers. Second, many health care practitioners, particularly a small but significant number of dentists, feel their authority encroached upon by evidence based dentistry.
Society’s Big Role to Play in Fostering Scientific Inquiry
Research projects are on the whole completely ethical and without a shred of impropriety, but it is true that uncertainties in this regard can muddy the waters a bit. Extremely fraught is the issue of research funding and bias. Studies require funding, and usually quite a lot of it, especially in the case of RCTs. Who provides that money and the potential for conflicts of interest or bias, including the problem of unconscious bias, are the biggest factors that can lessen the significance of any compelling and urgent new research. Society’s regard, or lack thereof, can even prove in the long run to be an existential threat to this kind of crucially important realm of inquiry. Simply put, there is no iron-clad way to prevent these problems in every single case. Despite this note of caution, academics, researchers and scholars do extremely important and laudable work every day and collectively make progress possible in a confusing and messy world.
A minority of dentists are hesitant to embrace the new, evidence based model. There are several factors that are limiting wide and fast adoption of evidence based practices, particularly in dentists’ offices across the country. While firm statistics are lacking, it is believed that, in general, dentists are adopting evidence based care at a slower rate than in other medical settings.
A few factors could be responsible for this. Some medical professionals may think that evidence based health care practices are basically a recipe approach. They see this new care delivery model as an approach that circumscribes their authority by assigning care plans and treatment options to patients on their behalf.
Another objection raised by a minority of dentists actually has to do with the name of the new model. Some dentists get hung-up on two words, “based” and “evidence”.”Based” evokes in some dentists’ minds a monumental change, an eschewing of everything they’ve learned and observed in their career. And the term “evidence” has simply been traditionally rare in medical settings, and also has negative connotations — for instance, “evidence” is presented at a trial, usually by a prosecution trying to get a guilty verdict from a jury.
These objections, though, are without merit. Evidence based dentistry essentially involves bridging the gap between the valuable and meaningful insights that academic researchers uncover, and the effective practical use of these insights in the examination room or on the dentists’ chair. Evidence based care furthermore serves to empower to a greater extent both the patient and their dentist through a culture of a well-informed and trusting relationship between doctor and patient.
As more and more doctors adopt evidence based practices, as well as electronic health records and other innovations, many more people will have access to high-quality, cost-effective health care.
One likely outcome of the evidence based care movement is that a broader shift in the culture will occur, as people see up close and personal the huge benefits of evidence based practices, and thus the merit of increasing public and private funding for critical research. This will contribute to a much larger number and diversity of research projects. Undoubtedly, new and more effective options for patients will be the result of such increased awareness and resources.
As when germ theory was gaining a foothold in some forward-thinking doctors’ minds in the 1800s, there are many dentists, including this practice, who welcome the benefits of evidence based health care practices and the principles of continual improvements via scientific discovery that it is based upon. Evidence- and merit-based practices are already here and steadily getting more prevalent. Dentistry and various other spheres of life stand to benefit greatly as a result.