Avoiding junk science
October 15, 2018
Every dentist comes across unique patient cases that send him or her in search of the most current clinical information to guide their decision-making.
Lately, Dr. Partha Mukherji said he has been seeking more information to gain a better understanding of sleep apnea and comorbidities associated with obstructed sleep apnea.
“It is extremely important to utilize properly appraised evidence-based literature when treating a patient,” said Dr. Mukerji, adjunct assistant professor at Texas A&M University College of Dentistry. “While achieving optimal health for our patient is the ultimate goal, we must remain vigilant in how we interpret the evidence.”
To help ADA members with evidence-based decision-making, the Association offers dentists several resources to dentists that provide reliable, cutting-edge clinical information.
These resources include:
• Evidence-based policies and guidelines on topics including oral cancer and the new caries guideline on nonrestorative caries treatments, including silver diamine fluoride recommendations.
• DynaMed Plus, an evidence-based point-of-care database that includes drug information, topical summaries, clinical calculators and images.
• All-new videos on how to integrate the latest in evidence-based dentistry into your practice to optimize patient care and address misleading information patients encounter.
• One-on-one help with research from the ADA Library & Archives.
Dr. Mukherji said his go-to resources include the ADA Center for Evidence-Based Dentistry website, ebd.ada.org; PubMed/MEDLINE, the National Library of Medicine’s searchable database of almost 20 million citations from more than 5,400 medical, dental, health and scientific journals that is available to ADA members through the ADA Library & Archives; and the Journal of the American Dental Association.
“I am a fan of those who make discoveries and educate patients on the oral-systemic link,” said Dr. Mukherji. “However, I am just as much of a fan of those skeptics who take time to read between the lines deciphering exactly what the oral-systemic links are. The latter is more crucial now than ever where it seems that what could be perceived as evidence-based is oftentimes manipulated to be used as a tool to increase patient treatment acceptance.”
In addition, the ADA offers clinical practice guidelines that aid to dental professionals in clinical decision-making and help them incorporate evidence gained through scientific investigation into patient care. Guidelines include recommendation statements intended to optimize patient care that are informed by a systemic review of evidence and assessment of the benefits and harms of alternative care options.
A clinical practice guideline “Nonrestorative Treatments for Carious Lesions Clinical Practice Guideline,” published in the October issue of JADA lays out the evidence that certain nonrestorative interventions for carious lesions are effective. Over two years, an expert panel convened by the ADA Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated the guideline’s recommendations, which are available to view online at ADA.org/caries. In conjunction with this guideline, an instructional video on how to apply SDF will be released soon.
The guideline released in October is the first of four in a series on caries management that the ADA will be releasing in the coming years. Topics such as caries prevention, restorative caries treatments and caries detection and diagnosis will be covered in the series’ upcoming guidelines.
“The ADA has made significant strides in establishing clinical guidelines, maintaining a doctor- and patient-friendly EBD website and hosting workshops at the ADA Headquarters and in dental schools,” he said. “I applaud and am inspired by those at the ADA and elsewhere who work tirelessly sifting through the plethora of literature, creating guidelines (not doctrines) and developing tools to help practitioners adapt as we see fit for our patients.”