Journal of Research in Dental

The Evidence Based Dentistry (EBD) is very slightly known in Iran and has been defined as an approach to the oral healthcare that requires the judicious integration of systemic assessments of clinically relevant scientific evidences, relating to the patient’s oral, medical conditions and histories among with dentist’s clinical expertise and the patient’s treatment needs and preferences. ^[1-5] EBD is a popular medical field activity in the whole world, involving the utilization of the results of clinical dental research that improves decision-making procedures to render the best treatment available to patients, determining the highest-quality treatment methods. ^{[6, 7]}
 
EBD is considered invaluable and useful in many ways as it is discussed blow.
 
First of all, it has been revealed that dental practitioners who make decisions using this method rather than their own personal judgments, are successful in improving their clinical skills, expertise and dexterities. They are able to improve treatment qualities and outcomes with the assistance of EBD. In addition, they can make judgments about the merits and demerits of the potential treatment methods subsequent to assessing the validity of the evidences gathered. Moreover, the awareness that the treatment rendered conforms to the best evidence available which might boost the patient’s confidences while receiving dental services. As a result, EBD is believed to be an absolute requirement in the dental practice routines and has become very popular. ^[8-11]
 
Secondly, teaching EBD to dental students is an important step to promote rendering evidence-based treatments. This type of education paves the way for dentist’s understandings of the basic and applied sciences and increases their awareness of treatment methods for difficult cases. It will also enables dental students to increase and revise their knowledge after graduating from the university. This newly acquired knowledge will have a great impact on the clinical treatment methods they choose. These days, EBD is openly moving to new directions in dental researches and is gradually closing the gap that exists between the dental researchers and clinicians. ^[12-14]
Finally, EBD has also enlightened a massive range of new dental research fields and yet further evaluations are necessary in this regard. Researchers should work hard to achieve the aims of EBD. ^[15]
Navabi et al. evaluated this knowledge and used it among Iranian dentists. The results revealed that Iranian dentists were not familiar with EBD concepts and the majority of them preferred consultation with colleagues or seeking electronic databases for this matter. 56.1% of the dentists had, little knowledge about EBD and 20.7% did not have a clue at all. The main barrier to the use of EBD was lack of time according to 44.1% of the respondents, while 42.8% of the dentists used the internet less than one hour per week. ^[16]
 
Considering the importance of Randomized Clinical Trials (RCTs) in the evidence-based approach, RCTs are somehow considered the “gold standard” between clinical researches. They provide the highest level of evidence for the clinician in relation to treatment options. ^[17] The quality of the design and the way an RCT is carried out, have a significant effect on the validity of its results, therefore clinical epidemiologists have devised a process known as “critical appraisal” to assess RCTs. ^[18] upto now, checklists and criteria have been prepared worldwide to assist readers in evaluating the quality of RCT reports, along with the facts which ensembles the most valid tools. ^[19]
 
Large numbers of RCTs are carried out each year in academic centers in Iran. In many cases selective reporting of studies with positive outcomes, caused bias conclusions over their judgments about the evidence available. ^[20-22]
Application of ensemble in one study showed the quality of reporting RCTs amongst Iranian dental journals which, does not conform the recommended standards generally and needs to be improved.
 
In the results section of the study mentioned above, acceptable methods for randomization and blinding were found in 8% and 11.5% of the papers respectively, out of 113 reviewed published articles. Reasons for withdrawal were also given in just 20.4% of them all. The quality of reporting clinical trials were insufficient to allow readers to assess the validity of the trials. Greater attention to quality aspects of the design and coverage of RCTs in Iranian dental Journals are compulsory and the dental research community should view these outcomes with concern. ^[23]
 
RCTs is considered a basic element of EBD and as mentioned before, the statement of both RCTs in dentistry and EBD in Iran is inappropriate. Despite rapid developments in recent years, many practitioners are still reluctant to adopt evidence-based principles in their routine practice and educating dental practitioners is a major component in adopting evidence-based approach to oral health care. Training in EBD may be facilitated if dental schools and faculties have access to main databases to tackle some of the possible barriers. All the dental practitioners should be instructed in design of RCTs during their education. These provide support for dentist’s clinical decisions, minimizing misdiagnosis by ensuring the best decision making in relation to procedures and treatments. Practicing dentists should be familiar with the results of updated RCTs not only to assist them in the diagnosis and treatment, but to help them evaluate product studies from dental manufacturers or to provide evidence for insurance companies for coverage of procedures. It is a significant contribution to produce a new generation of dental practitioners equipped with these skills as well as the faculty members who can appreciate the importance of EBD for the future of dental fields.