eb lecture_ 5th grade

8/11/2019 EB Lecture_ 5th Grade

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Dr. Hicham Nuaimi

BDS, Specialist Diploma in Operative and Esthetic DentistrySpecialist Diploma in Implantology Science

Master in Operative and Esthetic Dentistry (Holding )

EVIDENCE B SED

DENTISTRY


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Every day, consciouslyand unconsciouslywe

make the decisions of treatment plan regarding

our patients' care.


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How can I make a decision:

Clinical experiences

Discussion with colleagues, Supervisor, etc

Text books

Journal articles( literatures)

previous educational experiences.


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HISTORY

The evidence-based took hold in the medical field.

Formally introduced in the 1990s by DavidSackett and Gordon Guyatt of McMaster

University.


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SO THAT

Dentists are challenging to manage patient needs and

demands.

In addition keeping the advances in dentistry and

medical dental Science up to date, and relevant

literature that apply daily practice knowledge.


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DEFINITIONS

Evidence-based Dentistry requires the

integration of the best research evidence with

our clinical expertise and our patients unique

values and circumstances.PatientValues

ClinicalExpertise

Bestresearchevidence

EBD

SutherlandS.,JCanDentAssoc2001;67:204-6


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DEFINITION

EBD is an approach to oral health care that requires the

judicious integration of systematic assessments of

clinically relevant scientific evidence, relating to the

patient's oral and medical condition and history, with the

dentist's clinical expertise and patient's treatment needsand preferences

The American Dental Association (ADA)


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ADVANTAGES OF EBD?

Filters the information that emerges in the

literature

keeps up with the most updated research

Provides information on how similar cases

treated


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OUTLINE

Definition of EBD.

What is Evidence Based Practice.

Steps of Evidence Based Dentistry.

Levels of Evidence in EBD.

The Stages in Evidence Based Practice.

References.


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WHAT IS EVIDENCE BASED

PRACTICE?

is integrating the scientific basis for clinical care with

unbiased reviews and the best available scientific

evidence with clinical experience to allow thepractitioner critically assess research data, clinical

guidelines >>> to correctly identify the clinical

problem with high-quality intervention to outcome for

future improvement.


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EBD reducingprofessional autonomy.

SO THAT

Prof practitioners can positively use EBD tosupport their decision-making process and

encourage the publics trust in treatment


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What is the literature?


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1. PRIMARY LITERATURE

Researches published in a peer-reviewed

journal contain original research data or

preliminary reports.

The intended audience are researchersand

specialists, not the general public.


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2. SECONDARY LITERATURE

Researches that consists of organized works

and reference of the primary literature.

Ex, review articles (specifically meta-analysis and systematic reviews).

The intended audience are colleagues

within or without the respective discipline.


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3. TERTIARY LITERATURE

textbooks, encyclopedia articles, and

guidebooks or handbooks, that provide an

overview of key research and an

introduction to principles and practices.

an excellent resource for students.


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primary and secondary literature are the

core for EBD.


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OUTLINE

Definition of EBD.

What is Evidence Based Practice.

Steps of Evidence Based Dentistry.

Levels of Evidence in EBD.

The Stages in Evidence Based Practice.

References.


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EBD PROCESSINGSTEPS

1. Asking answerable questions

2. Finding the best evidence

3. Critically appraising the evidence

4. Applying a decision

5. Evaluation

Heneghan C, Badenoch D.Evidence-based medicine toolkit. 2d ed. Malden, MA:Blackwell, 2007


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STEP1

Asking answerable questions focused,

searchable, clinical , PICO

Patient, Problem, Population (subjects)

Intervention or therapy (study groups)

Comparison, Control, Context (studygroups)

Outcome (results)


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MESH SEARCH TERMS

In the sample clinical question, the key conceptsor

PICO parts must be identified with their MeSH terms:

Key Concept MeSH Term

P Children All Child 0-18 years (limit)

I School who based programs

Fluoride varnish

School health services

Topical fluoride

C Implied Implied

O Reduced incidence of dentalcaries

Dental caries


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PRACTICE CASE STUDY A

patient, a 50 years old man with moderateperiodontitis, who was recently diagnosed with type2 diabetes mellitus. His glycosylated hemoglobin is12%, which places him in the category of poorly

controlled diabetes. He is worried that his diabeteswill increase his chance of losing his teeth. Hewants to know the impact diabetes now has on hisoral health.

Evidence-Based Decision Making : A Translational

Guide for Dental Professionals, 2009


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CLINICAL QUESTION: CASE STUDY A

What impact will Type 2 diabetes mellitus haveon the oral health, specifically tooth loss, of a 50years old man with moderate periodontitis?

P= 50 years old man with moderateperiodontitis?

I= Type 2 diabetes mellitus

C= Implied

O= Tooth Loss


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CASE STUDY A: MESH SEARCH TERMS

In the practice case study, the key conceptsor PICO

parts must be identified with their MeSH terms:


P 50 years old man withmoderate periodontitis

Middle Aged: 45-64 years

(limit)

Periodontitis

I Type 2 Diabetes Mellitus Diabetes Mellitus, Type 2

C Implied Implied

O Tooth Loss Tooth Loss


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PRACTICE CASE STUDY B

A partnership between your community dental clinic

and the dental school is establishing an oral cancer

screening program as part of an outreach initiative.

To justify the new program, you must find researchthat supports the objective to increase patients

chance of early oral cancer detection.


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CLINICAL QUESTION: CASE STUDY B

Do community oral cancer screening programs increasea patients chance of early oral cancer detection?

P= AdultsI= Community oral cancer screenings

C= No screenings

O= Increase a patient

s chance of early oral cancerdetection


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CASE STUDY B: MESH SEARCH TERMS

In the practice case study, the key conceptsor PICO parts

must be identified with their MeSH terms:


P Adult Adult: 19-44 years(limit)

I Community

Cancer Screening

Community Health Services

Early Detection of Cancer

C Implied Implied

O Early DetectionOral Cancer

Already Stated

Mouth Neoplasms


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Can I just search using free-text and ignoreMeSH?


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NO,if we use just free-text

The search will be >>>>>> limited to just thephrases you have entered


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SO THAT Boolean operators

AND, OR, NOT


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The AND operator: Esthetic restoration ANDFunctional restoration


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The OR operator: Esthetic restoration ORFunctional restoration


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The NOT operator: Esthetic restorationNOTFunctional restoration


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dental caries

AND CHX will retrieve allarticles containing these two terms when theyappear together

AND will REDUCE the number of hits inyour search


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Esthetic post OR Metal post willretrieve all articles containing these two

terms regardless of whether they appear

together or notOR will INCREASE the number of hits in

your search


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Thank You.

eb lecture_ 5th grade

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