Evidence-Based Dentistry

Presenters Name

What does EBD mean?

Three Components of EBD

Is an approach
to oral health
care
Is a method to
acquire,
understand and
apply the most
current science

Evidence

Clinical
Expertise

Patients
needs &
preferences

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The Clinicians Role

r
o
f
In

s
m

Information
Data
Statistics
Knowledge

Judgment
Values
Decisions
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Acknowledging the Difference

Evidence-Based
Practice
Uses best evidence
Systematic appraisal of
quality of evidence
Objective, transparent,
less biased
Acceptance of levels of
uncertainty

Traditional Practice
Unknown basis of
evidence
Limited/incomplete
appraisal of quality of
evidence
Subjective, opaque,
potentially biased
Black and white
conclusions
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The Value of Evidence-Based Practice

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Barriers to change
Time
Access
Complexity of
information

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What is evidence?

What is pre-appraised evidence?

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Tiered approach to finding evidence-based information

1. Clinical
Practice
Guidelines

2. Critical
summaries of
systematic
reviews

Systematic
reviews

3. Independent
appraisal of
systematic
reviews (and/or
other trials)

Implementation
into clinical
practice

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How do I find the best evidence-based information

to guide my practice?

ADA clinical practice guidelines

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13

What are the levels of primary evidence?

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How does EBD work?

The EBD Process

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Step 1: Framing the Answerable Question

Population or Problem

Intervention

Comparison (Optional)

Outcome

 Framing the question

Increase chances of finding the answer
Know when youve found the answer
Help to find it quickly
Identify search terms

In patients with periodontal

disease, will short-term systemic
antibiotics, when compared to
surgery, reduce pocket depth?

Population

In patients with periodontal

disease, will short-term systemic
antibiotics, when compared to
surgery, reduce pocket depth?

Population

In patients with periodontal

disease, will short-term systemic
antibiotics, when compared to
surgery, reduce pocket depth?

Intervention

In patients with periodontal

disease, will short-term systemic
antibiotics, when compared to
surgery, reduce pocket depth?

Intervention

In patients with periodontal

disease, will short-term systemic
antibiotics, when compared to
surgery, reduce pocket depth?

Comparison

In patients with periodontal

disease, will short-term systemic
antibiotics, when compared to
surgery, reduce pocket depth?

Comparison

In patients with periodontal

disease, will short-term systemic
antibiotics, when compared to
surgery, reduce pocket depth?

Outcome

In patients with periodontal

disease, will short-term systemic
antibiotics, when compared to
surgery, reduce pocket depth?

Outcome

SEARCH STRATEGY

EBD website ebd.ada.org

YES

STOP

EBD website and PubMed

YES

STOP

YES

STOP

PubMed
(Clinical Studies)

Other levels of evidence

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31

Quality

1.Are the results valid?

Are the studies well

designed and executed?
What types of studies
are there?
Quantity
How many studies are
there?
What are the population
sizes?
Consistency
How consistent are their
results?

1.Are the results valid?

2.What are the results?

Certainty of the
effect
Magnitude of
the effect

1.Are the results valid?

2.What are the results?
3.Can the results be
applied to my patient?

Is the population
similar?
Is the provider
similar?
Is the setting
similar?

EBD Champions 2.0

Implementing Science in Practice

Advanced
Evidence-Based
Dentistry
Workshop:
Assessing the
Quality of
Evidence

"Perhaps the best course of my dental

career.

"Highly recommend the program . . . a

great means of extending the practice of
EBD."

The better the research, the more

confident the decision. Victor Montori, Mayo
Clinic

Evidence alone is never sufficient to

make a clinical decision. Victor Montori, Mayo
Clinic

External clinical evidence can inform,

but can never replace, individual
clinical expertise. David Sackett

THANK YOU!

ADA Contact: ebd@ada.org