Evidence Based Dental Care Tools

Why aren’t there more evidence based dental software tools? An article by Merijohn et al. describes the need for evidence-based dental clinical tools. In particular, clinical benefits include better decision-making, opportunity to offer and explain more treatment choices, working at a higher standard and successfully treating complex patients. Increased staff pride, trust financial savings, and performance are also cited as benefits.

The authors define clinical decision support as follows:

“Clinical decision support (CDS) provides clinicians, staff, patients, or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times to enhance health and health care. It encompasses a variety of tools and interventions such as computerized alerts and reminders, clinical guidelines, order sets, patient data reports and dashboards, documentation templates, diagnostic support, and clinical workflow tools.”

In particular, this article (see below to click to download PDF) focuses on a three-part approach to clinical decision support as a workflow and treatment protocol. They focus on Assess (thorough patient history and preferences, risk factor assessment and evidence analysis), Advise (reviewing findings and potential care plans with patients) and Decide (patients making the choice). The authors also developed a series of “Dental Chairside Guides” that provide straightforward clinical guidance on diagnosing and treating various conditions (for instance, attached gingiva).

All of the main points of this article are still powerfully relevant to dental care. However, it was written in 2008. In the current US environment, all of these clinical decision support features should be available through the electronic health record. Rather than downloading diagnosis-specific PDFs, the EHR should integrate and present this information so that in a single interface, dentists can assess and advise patients, allowing for streamlined decision making and straightforward, electronic presentation of information. This would also reduce the burden on needing to update and maintain those care guides, as the integrated interface should provide the most recent clinical evidence.

Lessons Learned:

  • Evidence based dentistry is still a crucial need, and one that is still poorly met except by individual research.
  • EHRs offer the opportunity to reduce time spent assessing and advising patients about diagnoses and care plans.
  • Evidence-based information, visualizations and care plans should be evaluated while selecting dental EHRs.

Merijohn, George, Bader, James, Frantsve-Hawley, Julie & Aravamudhan, Krishna. (2008) Clinical Decision Support Chairside Tools for Evidence-Based Dental Practice. Journal of Evidence Based Dental Practice, 8:119-132 (Click to download PDF)