International Journal of Evidence-Based Practice for the Dental Hygienist 1/2017 Every day you make clinical decisions that affect your patients' health and well-being. But are those decisions supported by current scientific evidence? This new quarterly journal will not only help you answer this question but also: • Provide the information you need, when you need it • Prepare you to answer your patients' questions with authority • Boost your confidence in your clinical decision-making ability • Teach you the skills you need to conduct your own scientific inquiry This rss-feed covers the latest table of contents including the abstracts. en Quintessence Publ. Comp. Inc. 2017-03-03 International Journal of Evidence-Based Practice for the Dental Hygienist 1/2017 Editorial: Can a Google Search Trump Your Expertise? Frantsve-Hawley, Julie<br>Page 5 - 6 Interprofessional Education and Collaboration as an Approach to Overcoming Perceived Barriers in Improving Oral Health Coan, Lorinda / Reddington, Amanda R.<br>Page 7 - 17<br>The primary objective of this article was to systematically review the literature in order to document the oral-systemic links in health issues and the resulting importance of oral health to overall health, as well as to demonstrate the need for oral health education in all health professions due to the significance of these identified systemic links. The history of interprofessional education (IPE) and successful examples of collaboration between medical/ allied medical and dental/allied dental programs is presented; specifically, instances in which emerging professionals learn together about the significance of oral-systemic links and about oral health as an important consideration in achieving overall national and global health objectives. Of special interest were examples of interprofessional experiences designed, where possible, to include direct patient contact. Searches were performed using electronic databases of the National Library of Medicine and Medline/PubMed using keywords and MeSH terms with a variety of related terms associated with oral-systemic links ("diabetes," "cardiovascular disease preterm low birth rate," and "ventilator-associated pneumonia"). The terms "interprofessional education," "IPE," "interprofessional collaboration," "IPCP," and "medical dental collaborations" were also searched. Furthermore, general websites and internet resources were explored for disseminated posters or presentations that shared individual program accomplishments implementing IPE initiatives. Results were limited to English language, but year of publication was not limited in order to provide a more robust background on the topic of interest. Bibliographies of relevant manuscripts and review articles with similar objectives that were published from 2000 to 2016 were also used. Evidence related to oral-systemic links and results that would contribute to the understanding of interprofessional collaboration occurring in educational settings, as well as practice between emerging and working professionals dedicated to meeting global and national health care initiatives associated with oral health, were actively retrieved. The search yielded 97 usable sources. Quality Resources for Clinical Decision Making: Part 4. Understanding the Flossing Controversy Gurenlian, JoAnn R. / Forrest, Jane L.<br>Page 18 - 21<br>This is the fourth article in a four-part series designed to help readers build skills in finding scientific evidence and in understanding how to use the evidence to make clinical decisions. This article builds on the previous illustration of how to use the Trip database and PubMed. The recent flossing controversy is provided as a context to demonstrate the need to use an evidence-based approach in your clinical decision making in order to provide the most relevant and appropriate care for your patients. Critical Thinking in Action: Consideration of Alternative Hypotheses Brunette, Donald M.<br>Page 22 - 24<br>This is one of a series of articles that will use excerpts from the dental literature to illustrate some of the concepts of critical thinking and apply them to aspects of dental hygiene and dentistry. In this article, consideration of alternative hypotheses is discussed. Guideline on Recall and Maintenance for Patients with Restorations Based Mostly on Expert Opinion Saltmarsh, Hope / Healy, Shavonne R.<br>Page 25 - 30<br>Background: Evidence-based clinical practice guidelines (CPGs) should be considered when implementing patient care protocols into practice. Current recommendations and protocols for the management of tooth- and implant-borne restorations are lacking and poorly defined. Due to the anatomical challenges associated with these types of prostheses, plaque control can be difficult, and so professional and at-home maintenance regimens may be unique when compared to a natural dentition. This article critically appraises a 2016 CPG for recall and maintenance of patients with tooth- and implant-borne restorations. <br>Clinical question: This CPG was created because of concerns regarding risk of failure for tooth- and implant-borne restorations. <br>Summary of methods: A scientific panel of experts was convened by the American College of Prosthodontists (ACP) to critically evaluate and debate a previously published two-part systematic review and to create this CPG. The authors, appointed by the ACP, the American Dental Association (ADA), the Academy of General Dentistry (AGD), and the American Dental Hygienists' Association (ADHA), added recommendations based on expert opinion and consensus. <br>Critical appraisal: The authors did not follow many of the best practices for development of evidence-based CPGs. The recommendations of the CPG are supported by the lowest level of clinical evidence, expert opinion. <br>Practical implications: The use of this guideline may improve care protocols for healthy adult patients with toothand implant-borne removable and fixed restorations. This guideline may supplement but not replace the ADHA's Standards for Clinical Practice of Dental Hygiene. Critical Appraisal of a Systematic Review on the Accuracy of Caries Risk Assessment Methods Maragliano-Muniz, Pamela<br>Page 31 - 34<br>Background: Dental caries remain a significant oral health problem for all age groups. A number of methods for testing caries susceptibility are currently used and included in risk assessment tools. The ability to determine a patient's caries risk level permits care to be individually tailored to the patient for effective caries management. <br>Clinical question: What is the diagnostic accuracy of different methods used for identifying individuals with increased risk of coronal dental caries? <br>Summary of methods: A search was conducted in PubMed, the Cochrane Library, the Web of Science, and the reference lists of included studies for English-language articles up to January 2015. Two authors independently screened the retrieved titles and abstracts, and full articles were retrieved if at least one author found it matched the defined problem. The two authors then independently reviewed the full texts. Risk of bias, heterogeneity, and the overall quality of the evidence were assessed. <br>Critical appraisal: Strengths of the review included adherence to guidance in the PRISMA statement, assessment of publication bias using QUADAS-2, grading of the evidence, and performance metrics evaluated using AMSTAR. However, the search included only English-language articles, and only three studies included enamel caries. As stated by the authors, the high level of heterogeneity precluded a meta-analysis. <br>Practical implications: Identifying at-risk patients is necessary for effective caries management. Greater clinical relevance would be achieved with a systematic review on susceptibility to enamel caries. There is a need for high-quality studies on caries susceptibility assessment methods that would subsequently enable meta-analyses of all variables. Critical Appraisal of a Cross-Sectional Study on the Association Between Vitamin D and Dental Caries in Canadian Children Wong, Grace / Chen, Rebecca<br>Page 35 - 38<br>Background: Research has been conducted to evaluate the effect of vitamin D on the prevention of dental caries in children; however, there are still uncertainties surrounding the association, requiring further investigation. <br>Clinical question: In children between the ages of 6 and 11 years who participated in the Canadian Health Measures Survey (CHMS), is vitamin D status associated with dental caries experience? <br>Summary of methods: The authors conducted a cross-sectional study using data from the CHMS of children between the ages of 6 and 11 years. Vitamin D status was determined by analyzing 25-hydroxyvitamin D (25[OH]D) in serum samples at both ≥ 50 nmol/L and ≥ 75 nmol/L. Dental caries experience was recorded using dmft/DMFT. The statistical modeling categorized the caries experience dichotomously to plot the association between vitamin D serum levels and dental caries. <br>Critical appraisal: Although the authors concluded 47% decreased odds of dental caries experience with 25(OH)D levels at ≥ 50 nmol/L and 39% decreased odds at ≥ 75 nmol/L, the strength of the findings was considered low to moderate given the statistical models chosen, the research design, and the scope of the study. The possible causal dose-response relationship was not explored in this study. <br>Practical implications: As oral health practitioners, it is important to understand the potential benefits of vitamin D in relation to dental caries. Patients need to be informed that an adequate level of vitamin D should not replace other evidence-based caries prevention regimens. Other health care professionals should be consulted for further advice in relation to other health benefits of vitamin D. Critical Appraisal of a Systematic Review on the Effect of Cessation of Community Water Fluoridation on Tooth Decay Rothen, Marilynn<br>Page 39 - 42<br>Background: Community water fluoridation (CWF) is a population-level intervention for the prevention of tooth decay through the controlled addition of fluoride to public drinking water. It appears that cessation of CWF is occurring with increasing frequency, and understanding the effect of CWF cessation on dental caries would be useful for communities faced with making a decision about CWF. <br>Clinical question: What does a systematic review of published research show is the impact of CWF cessation on dental caries? <br>Summary of methods: A total of 13 databases were searched, yielding a total of 29 publications accounting for 15 occurrences of CWF cessation that took place in 13 countries between 1956 and 2003. Study results from 12 of the occurrences were included in the qualitative synthesis, and 3 study group combinations were included in the quantitative synthesis. <br>Critical appraisal: This is the first systematic review on cessation of CWF and its impact on dental caries. The AMSTAR checklist was used to evaluate the review, and 9 of 11 criteria were met, indicating high methodologic quality. Additionally, the review identifies gaps in knowledge for future research, such as the equity of dental caries distribution in the community after CWF cessation. <br>Practical implications: This systematic review demonstrates a trend toward an increase in dental caries in children with cessation of CWF. For communities debating the topic of CWF cessation, it is useful to know that outcomes from research studies on dental caries post-CWF cessation have been compiled and analyzed to improve understanding of this public health measure. No Superiority of Laser Therapy When Compared with Conventional Modalities for Management of Peri-implant Diseases Alqutaibi, Ahmed Yaseen / Aboalrejal, Afaf<br>Page 43 - 45<br>Background: This article critically appraises a systematic review that was conducted in 2014 to evaluate the efficacy of laser therapy for the management of peri-implantitis. <br>Clinical question: What is the efficacy of laser therapy when compared with conventional modalities for the treatment of patients with peri-implantitis? <br>Summary of methods and results: A search was carried out in three electronic databases for relevant articles published in English, and a manual search in related journals was also conducted. Two reviewers independently selected studies and extracted data. The inclusion criteria were prospective, controlled clinical studies in humans including 10 or more patients that evaluated the use of laser therapy compared with conventional modalities for the management of peri-implantitis. Gain in clinical attachment level (CAL) and reduction in pocket depth (PD) were considered primary outcomes. Due to substantial heterogeneity, a meta-analysis was performed only for the efficacy of the Er:YAG laser, and the pooled data did not reveal statistically significant treatment effects in comparison to conventional methods. <br>Critical appraisal: This systematic review included only six studies (five randomized controlled trials). Three studies were considered at high risk of bias, one at moderate risk of bias, and two at low risk of bias. <br>Practical implications: There is limited evidence to evaluate the efficacy of laser therapy over that of conventional therapy for treatment of peri-implantitis. Before a surgical approach is considered, the Er:YAG laser may be used as a phase I therapy to treat peri-implantitis. Oral Health Critically Appraised Topics (CATs) Page 46 - 52<br>The University of Texas Health Science Center at San Antonio (UTHSCSA) Oral Health CATs Library was established in 2011, with the aid of an NIH grant, as a component of the Dental School's Evidence-Based Practice Program. Each CAT provides a concise answer to a focused clinical question based on the most recent and highest level of evidence. This online searchable library contains over 950 CATs written by student/faculty teams, and about 150 new CATs are added annually. The CATs are indexed by the British Trip Database, which allows users to search over a large number of evidence-based sites. The journal is grateful to UTHSCSA for sharing these CATs with our readers. Comparison of Dental Hygiene Research Topics in Korean and International Literature Lee, Ga-Yeong / Bae, Soo-Myoung / Kim, Chang-Hee / Lee, Sun-Mi / Kim, Nam-Hee<br>Page 53 - 60<br>Background: For the globalization of dental hygiene, it is important to identify research categories of dental hygiene studies worldwide. In this article, the current status of dental hygiene research in South Korea was compared with that in the rest of the world. <br>Methods: A total of 1,955 articles (1,539 from Korean journals and 416 from international journals) published from journal inception (January 2001 for Korean journals and January 2003 for international journals) to December 2014 were compared and analyzed. Each article was classified by its title according to three criteria: (1) research topic; (2) US National Dental Hygiene Research Agenda (NDHRA); and (3) Korean academic classification of dental hygiene discipline. <br>Results: Korean studies were mostly focused on identifying oral health status (28.6%) according to characteristics of the subject(s) (17.1%), while international studies were mostly interested in identifying oral health status (42.4%) by using oral health care products (26.1%). Health promotion/disease prevention as classified by the NDHRA was the topic most studied in both the Korean (37.2%) and international (51.9%) dental hygiene research. Distribution according to academic classification of dental hygiene disciplines showed the results to be concentrated on social dental hygiene (35.5%) in Korea and on clinical dental hygiene (40.6%) in the international community. <br>Conclusion: Korean and international dental hygiene researchers most commonly focus on health promotion and disease prevention. By academic classification, Korean literature focuses on social dental hygiene and international literature on clinical dental hygiene. To enhance the dental hygiene profession, a research agenda for dental hygienists is needed on an international level. 2016 REVIEWERS Page 61 - 61