I'd like to offer some suggestions and ideas and how to disseminate and
implement evidence-based dentistry in practice. I'd like to start with
challenges with dissemination and implementing evidence-based dentistry
these include challenges amongst colleagues in academia and of course
with patient education. Some examples of statements overheard in some continuing
education courses are things like "we treat patients not statistics" "that EBD
stuff is for those in academia" and mention in previous conference "why do we
need guidelines?" "Is EBD being used as a buzzword?" Now there are also challenges
teaching EBD to students probably one of the most important challenges is how to
educate and ultimately provide evidence-based care to patients this is
especially important when they ask questions and in their minds when they
provide their version of evidence with regards to for example oil pulling or
frequency are taking radiographs or root canals causing cancer and more recently
flossing. Now if we take a step back to the challenges faced among colleagues
patients and in academia we cannot overlook that there is still a broader
issue that broader issue being the need for more evidence-based reviews more
evidence-based literature systematic reviews and ways to sift through the
myriad of literature that is so ubiquitous these topics are covered by
my friends and colleagues in the EBD series online let me provide a blueprint
of some ideas to help overcome these challenges and therefore provide
possibly better evidence-based oral health care for your patient. We'll
discuss team training communicating patient care sifting through some of the
junk science and having readily available guidelines already published
we'll discuss some strategies on how to implement in practice because remember
making an informed and educated decision with your patient is ultimately key in
practice and then we'll touch upon discussing the science among colleagues.
So let's dive into team training here's a tip on how to implement EBD with your
staff in your practice have your team trained and on board with your treatment
philosophy with regards to EBD educate staff on EBD principles.
Train staff on how to use ADA's EBD website such as the systematic reviews
and searching clinical guidelines. Communicate evidence and research to
patients have access to clinical guidelines chairside and also have
printouts of clinical reviews that are common to your patient.
Now your team can also pick one topic a month to bring maybe to a monthly meeting such as
flossing, sealants, oil pulling, dental implants or even relearn some of the EBD
clinical guidelines or plain language summaries that may already be published
you can also pose a topic to your staff to research now place this topic for
staff to read once a week or you can discuss it during a brief morning
meeting and then remember to catalogue these articles and catalogue any of the
feedback that you get not only from your team there may be also from your
patients as a private practitioner these are some challenges you may face amongst
colleagues and with patients similar to the food industries from farm-to-table
concept I often seek from laboratory to mouth so what exactly does the appraised
research say what are some of the best ways to treat patients what does the
science say about antibiotic prophylaxis routine use of antibiotics what does the
science say about opioids as used for post endodontic procedures or post surgery
what does the science say about adjunctive laser therapy for initial stage pareo
therapy what about the use for sealants use of SDF or silver diamond fluoride
what does the science say about pulp capping with regards to pulpotomy or
stainless steel crowns. Now when I hear from patients there's the usual, "well I
read this on the internet" or "do I really have to have sealants?" "I don't have to
take x-rays" "my teeth don't hurt" so to answer these questions I would suggest
keeping some articles handy chair side with you articles pertaining to those
topics that were just mentioned you could bookmark some pages you may find
relevant from Cochrane, PubMed, the ADA EBD website. Again keep some of these handy
for the plain language summaries that your patient may want to take with them
if they choose so these could be found on the ADA's EBD website so remember
when speaking to colleagues here's some suggestions to disseminate an appraised
scientific guideline or article you could speak at your local district
Dental Society you can speak at a hygiene Society you could form a study
club or with proper permission you can even write a newsletter article as
social media continues to be a major source of where we get our information
using various platforms can aid not only your colleagues but also your patients
for example if they like your Facebook page or if they follow you on Twitter or
Instagram the use of hashtags can be beneficial as well for example hashtag
EBD champs you can also form a study club with your friends include your
specialist friends you can also pick up the phone and start discussions you can
also join or form a Facebook group, a LinkedIn group.
now as you champion evidence-based care with your colleagues team and most
importantly your patients keep these things in mind you want to educate and
inform your team and patients when making treatment decisions disseminate
knowledge amongst practice team and also allow for professional discussion and
debate I hope these suggestions and strategies mentioned will offer you a
starting point in disseminating and implementing EBD in practice.
Remember that evidence-based dentistry improves patient care by integrating
three important aspects of clinical practice a dentists expertise a
patient's needs and preferences and the best available scientific evidence for
more EBD resources visit EBD.ADA.org