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Evidence Based Dentistry for Effective Practice

Jan Clarkson, Jayne E Harrison, Amid I Ismail, Ian Needleman, Helen Worthington (Eds) Martin Dunitz, London, 2002 228 pp., Softback £30.00 ISBN 1–84184–199–4

In an era when the aspiration to deliver scientifically validated healthcare is de rigueur, the publication of this book is most welcome and I enjoyed reading it. In case of doubt as to why members of the dental team should be familiar with Evidence Based Dentistry then consider the following. In dentistry alone there are around 500 journals publishing over 43,000 research articles a year. However, the dental community does not have a strong scientific base to justify many of the current methods used in the diagnosis and treatment of many oral conditions and on the basis of systematic reviews already conducted, there is limited evidence for the effectiveness of common interventions.

With 21 contributors and five editors, there is no shortage of expertise to inform the contents of this book. The early chapters describe the principles of evidence based practice, the process of turning clinical problems into answerable questions, and the value of different types of evidence and where to find them. The section on how to conduct a literature search would be useful to those carrying out such a search for the first time and the chapter on the how and why of critical appraisal is particularly good.

The following chapters describe the process of conducting a systematic review and outline the principles of the statistical pooling of data from different studies in such reviews. As the authors point out, the depth of coverage is insufficient to enable a novice to conduct a systematic review, but rather will be of value to practitioners wishing to further their understanding of the general principles of the process of systematic reviewing. There then follows a detailed description of the ethos of the Cochrane collaboration and of the work of the Cochrane Oral Health Group in particular.

Having discussed the theory and process, the later chapters in the book discuss the practical consequences of evidence-based dentistry, and the short and longer-term implications for clinical practice, under and postgraduate dental education, and for research. The last chapter, on the challenges to evidence-based practice is particularly good, and takes a realistic approach to the many challenges ahead if the organisation and delivery of oral health care is to be truly efficient and effective.

In general the book is well written and easy to read. If I were to make any criticisms then, perhaps inevitably, with so many contributors there is an element of repetition between some of the chapters, but this is a minor irritation. The book concludes with an appendix outlining case studies and I found this the least useful part of the book—excepting the fact that they illustrate the low quality of evidence we have for many clinical interventions.

The intended readership of the book is not stated explicitly. Whilst it is probably at a level beyond all, but the keenest undergraduate, it contains information of value to all those involved in dentistry, be it primarily in the delivery of clinical care, education, or research. If you worry that the evidence-based bandwagon is in danger of passing you by, then I thoroughly recommend that you read this book for an up to date review of the state of play in this important topic.

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