Tools and Methods for Evidence-Based Research in Dental Practice: Preparing the Future

provides. This is critical, because, based upon the best The vast amount of information and research available in dentistry engenders an immense challenge for dentists to manage patients. The future of dental practice rests on the ability of professionals to learn essential strategies for reliably accessing and evaluating the most current and valid research development for the benefit of each individual patient. Evidencebased research in dentistry emerged as a systematic process of critically assessing the published evidence to determine the best treatment for any given patient. The process consists of 5 steps: 1) defining the research question; 2) searching for the pertinent published literature; 3) evaluating the research reports systematically; 4) forming a consensus statement of the best available evidence; and 5) evaluating its clinical relevance. Evidence-based dentistry relies on standard methodology and instruments for searching the available evidence, for analyzing the quality of research reports (ie, internal and external validity), and for evaluating the implications of the best available evidence for the dental community of professionals, patients, insurance carriers, and funding agencies. This article describes the principal tools and methods now available for evidence-based research in dentistry. We also propose avenues of future evolution for this emerging field of research in dental practice. EVIDENCE-BASED RESEARCH IN DENTAL PRACTICE Research is fundamental to the advancement of dentistry as a science. Research provides the process for breaching new frontiers, for entering and conquering new domains of knowledge, and for securing the development and testing of novel and improved modes of intervention for our patients. Research uses the scientific process to state hypotheses and to verify and test theories rigorously. Research is the quality control gate for our past and current understanding of psycho-biological phenomena and the stepping stone to our vision of future models of health and disease. Research is the most fundamental tool available to dentists to insure the validity of the biological principles that lay as foundations to the profession. The outcomes of research produce new evidence that either confirms or challenges pre-existing models and principles. Research evidence is the mortar dentists and scientists need, require, and use to further the knowledge base of the clinical practice. Dentistry in the 21st Century flourishes on research evidence, lest it remain stagnant in perspective and models that are passés. Dental practice must increasingly rely upon the new frontiers in knowledge and understanding that research Journal of Evidence-Based Dental Practice Volume 4, Number 1 available evidence at any given time, the most appropriate dental treatment is devised and administered to the patient. Evidence-based research in dental practice is that approach of clinical dental practice that relies upon the best available evidence in the formulation of modes of intervention specific to the needs of each patient. If dentists are to rely confidently on evidence-based dental practice, then the various elements that determine its actualization must be well characterized and well understood, lest the process of evidence-based dentistry be undermined. The need for evidence-based research in dental practice arises from the astonishing rate of growth of the research literature in dentistry. The average dentist has a limited amount of time that can be dedicated to the pursuit of updating knowledge by reading published research. Therefore, it is not surprising that an ever-growing schism separates those responsible for developing and testing novel and improved treatment interventions in dental practice from those who could use them on the patients. Clinicians often lack the sophistication in research methodology, design, and data analysis to assess critically the validity and the reliability of published research. In an effort to correct these situations, the movement of evidence-based research in dental practice has emerged, following a similar successful effort in medicine. Specialized groups (eg, Cochrane Group) have begun to generate superb critical and systematic evaluations of the research literature in certain domains of dental practice. These reports go beyond the traditional literature reviews and emphasize the critical analysis of the articles’ methodology, design, and data analysis. They often, but not always and depending upon the data, incorporate meta-analytical techniques to subsume the statistical significance of the single reports under evaluation into one overarching statement of research outcome. These reports consistently pursue the translation of statistically significant results into clinically relevant findings. Indeed, the sole and principal aim of evidencebased research is to generate a statement of consensus among all the examined research articles with respect to the best available evidence. The value of Cochrane-type systematic reviews cannot be underestimated: these works generate invaluable, high-quality, and most reliable updated statements of the evidence in dental practice. However, whereas Cochrane reports should produce the necessary bridge between dental research and dental practice, they are de facto impractical to the dentist and pragmatically of little help. Their major drawback is unquestionably their