A practical approach to evidence-based dentistry

Scientific evidence is a crucial underpinning of clinical practice. Nevertheless, the first series of articles aimed at providing clinicians with guidelines for critically appraising the evidence that informs clinical practices did not appear until 1981.1 Ten years later, the term “evidence-based medicine”2 first appeared in the medical literature. Subsequently, between 1993 and 2000, a group of evidence-based medicine enthusiasts3 published a series of 25 articles that aimed at assisting clinicians in understanding and applying the medical literature to their clinical decision making in a clinical setting.4 The concept of evidence-based medicine soon expanded to other clinical areas. The first article to use the term “evidence-based dentistry” (EBD) was published in 1995 by Richards and Lawrence,5 and since then other articles have been published on the topic.6-11 There is, however, still no guide easily accessible for practicing dentists in the United States that addresses the critical appraisal and use of evidence specifically aimed at clinicians in oral health care fields. A series of articles (Box) will be published in The Journal of the American Dental Association, aimed at providing an overview of the basic concepts of EBD to assist oral health care professionals in making use of evidence to inform their clinical decisions. The series will consist of, in addition to this introductory commentary, six core articles that will address the main topics in EBD. In this introductory commentary, we will define EBD, delineate its principles and outline the main steps in the process of EBD. The first core article will describe how to state questions in a format that facilitates searching for the evidence, and where and how to search for such evidence. In the remaining articles, we will explain how to use literature about therapy and prevention, etiology and prognosis, and diagnosis as well as systematic reviews and clinical practice guidelines.