A new CDA Journal collection is tackling a persistent challenge in dentistry: the long delay between emerging evidence and its widespread adoption in clinical care. The collection, “All the Care Your Patients May Not Be Receiving: Clinical Practice Guidelines for Dentists,” highlights 11 areas where current evidence may not yet be fully reflected in routine dental care.
The Journal took the challenge one step further by inviting experts in those areas to develop plain-language summaries of 11 CPGs that dentists can easily understand and apply to their practice.
Journal Editor-in-Chief Kerry K. Carney, DDS, CDE, recently talked about the inspiration behind the collection and why it’s important for dentists to stay up to date on emerging evidence in clinical care.
How was the idea for this collection conceived?
Last year, I was carpooling with another longtime leader in organized dentistry when the subject of prophylactic antibiotic coverage for joint replacement patients came up. I was surprised to learn from the conversation that my colleague was unaware that a clinical practice guideline had been published more than a decade before, which contradicted the lifelong prophylactic antibiotic coverage we learned to follow in dental school many years ago.
Is this a persistent problem in dentistry or just an isolated case?
I’d say it’s a persistent problem. That carpool conversation made me think that many more in our dental profession may still be following old guidelines. It really highlighted how outdated practices can persist long after evidence evolves.
It came to light again a few months later when I participated in a panel discussion of dental editors at the American Association of Dental Editors and Journalists annual conference. In that discussion, some editors (who are also dentists) expressed concerns that many science-based and evidenced-based CPGs languish for years without clinicians incorporating them into their patient care. Right then, I knew the Journal needed to address this problem.
Is the delay between new guidance and patient care a problem found only in dentistry? What causes the lag?
No, it’s not exclusive to dentistry. Evidence has shown that it takes 17 years for new information in medicine to become routine care in medical practice. Dentistry likely faces a similar lag time. The reasons for the delays are complex, but one critical step toward narrowing the gap between evidence and practice is improving access to clear, actionable guidance.
Is that why you chose to develop plain-language summaries of the CPGs rather than reprinting the full CPGs that are already published online?
Yes, we wanted dentists to easily access and understand the recommendations so they could be easily applied to their practice. By improving accessibility in this way, we hope the collection will help shorten the time it takes for evidence-based CPGs to reach chairside.
How were the 11 CPGs chosen?
Early on, our senior editor Dr. Lindsey Robinson and I invited Dr. Elliot Abt and Dr. Christopher Smiley to be guest editors of the collection. They were part of the AADEJ editors panel, and both have experience developing guidelines, so we knew they would be perfect for this project. They identified 11 areas they thought needed the most support and then invited experts in those areas to write brief, plain-language summaries of the CPGs.
What are some of the areas addressed in the 11 CPGs?
Harkening back to my carpool conversation – prophylactic antibiotic coverage for joint replacement. The summaries also cover CPGs for acute dental pain management, antibiotic use with pulpal/periapical pain and infective endocarditis, TMD treatments, early detection of oral cancer, and caries management, to name a few.
Why is it important for dentists to stay up to date on the latest evidence-based clinical practice guidelines?
We have a shared responsibility within the dental profession to ensure our patients receive care based on the best available evidence – not just on the practices we learned years ago. And our patients deserve the most current evidence-based care.
Read the 11 CPG executive summaries in the CDA Journal collection. Reinforce your knowledge by taking a quiz over each summary and earn .05 C.E. units per quiz – free for CDA members; $25 per quiz for nonmembers.
More in the CDA Journal:
Dry socket after lower wisdom tooth removal: A 10-year review