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Dental Practice Parameters

Dental Practice Parameters

The dental practice parameters describe the clinical considerations in the diagnosis and treatment of 30 oral health conditions and 4 types of evaluations. Each year the parameters are reviewed by a committee of dentists and are updated, as necessary. They are intended to be used voluntarily by dentists to aid in their clinical decision making.

In the health care fields, many different terms are applied to documents that are aimed at providing clinical guidance to practitioners, such as “parameters” “guidelines,” “standards,” “clinical recommendations,” “clinical options,” and so forth. Although these terms are commonly used interchangeably, the developers of the guidance documents often choose a particular label they think connotes the intended use and force of the recommendations presented in the documents. Thus, the ADA defined parameters as distinct from “guidelines” and “standards” and defined the terms as follows (Trans.1993: 47):

Parameters describe the range of appropriate treatment for a given condition. In comparison to standards or guidelines, parameters broaden the range of professional judgment for the practitioner. They strengthen the ability of the provider to evaluate options and arrive at appropriate treatment.

Guidelines are intended to be more flexible than standards. Guidelines should be followed in most cases, but they recognize that treatment can and should be tailored to fit individual needs, depending on the patient, setting and other factors. Deviations from guidelines would be fairly common and could be justified by differences in individual circumstances.

Standards are intended to be applied rigidly and carry the expectation that they be applied in all cases and any deviation from them would be difficult to justify. A standard of care indicates that measurable criteria are present and these criteria shall be used in order to arrive at a given level of outcome. Standards say what must be done.

The preamble that precedes each set of dental practice parameters more fully explains why the dental practice parameters were developed and how they are intended to be used.

Another distinction among standards, guidelines and parameters, postulated in the 1990s, was the degree to which each was based on scientific evidence versus professional consensus. Today as evidence-based practice has come to the fore, guidelines, parameters, standards, recommendations, etc. are equally likely to be developed on the basis of scientific evidence. This is clearly apparent in perusing the National Guidelines Clearinghouse, www.guidelines.gov, which is a database of guidelines, parameters, standards, recommendations, protocols, etc. that are evidence-based, albeit to varying degrees. The dental practice parameters were developed through a professional consensus process.

The American Dental Association continues to maintain the dental practice parameters; but, in addition, it is developing evidence-based information and recommendations. The dentist may thus refer to both sources of information.

Visit other resources for guidelines and parameters developed by other organizations.