Students Learn How Data Can be Used to Help Patients

clinical-studies

What kind of teeth-whitener works best? Which type of toothbrush should I use? Which restorative and surgical procedures have the best outcomes?

Patients ask these questions all the time and dentists often respond with expert advice.

But evidenced-based dentistry – in which practitioners use the latest research to inform day-to-day treatment decisions – is becoming more widespread, says Dr. Kenneth Markowitz, an Associate Professor of Oral Biology and Restorative Dentistry.

Earlier this month in Markowitz’s class, Applying Evidence to Clinical Dentistry, second-year students learned how to evaluate clinical research and presented their findings.

They pored over various types of studies to determine which information was the most credible and well-documented – and, most importantly, the most useful to patients.

Some explored electric toothbrushes versus manual (the evidence supports electric), while others investigated whether higher amounts of carbamide, the active ingredient in tooth whiteners, worked better at greater concentrations.

Project partners Kendra Thomas and Eli Jankelovits examined randomized clinical trial studies as part of their presentation. They determined that solutions with 16 percent carbamide worked slightly better than those with 10 percent strength. But at higher levels, carbamide caused greater tooth sensitivity -- enough of a trade-off that Markowtiz said he’d recommend the lower strength to patients. “Some results can be statistically significant but mean nothing to your patient. Others are clinically significant,’’ he told the class.

According to Markowitz, evidence-based dentistry is easily applied to some clinical situations, while others are more challenging. Studies involving products, such as tooth brushes or dental floss, are considered more reliable because researchers don’t have to control for the varying skills of a practitioner.

But as evidenced-based dentistry has evolved, its being applied to more complex clinical situations.

Students David F. Paladines Gabior and J.J. Caruso found data that suggested dental implants could be successfully inserted immediately after an extraction, despite the once-standard practice of waiting six months for the area to heal.

Studies like these are increasingly being used to change methods of treatment, said Markowitz.

“Before, it was considered impossible to do the implant right after the extraction of a tooth, but now, its more acceptable because of the results of this type of research,’’ he said.