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8
Evidence based practice
INTRODUCTION – WHAT IS EVIDENCE BASED PRACTICE?
The practice of dentistry is becoming more complex and challenging.
Developments in dental materials and techniques, changing socio-
demographic patterns, increasingly knowledgeable health care con-
sumers, and the information ‘explosion’ all place greater demands on
clinical decision making. As health care practitioners, it is important
to offer the best possible care for patients. However, few decisions
made in the health services are made as a result of good evidence.
Evidence based practice (EBP) aims to encourage the practitioner to
look for, and make sense of, the available research evidence in order 
to apply it to everyday clinical problems. This presents a challenge 
to the practitioner as within dentistry alone there are around 500 
journals publishing over 43 000 research articles a year. Given that a
large proportion of these papers are of limited relevance to everyday
practice and often of poor quality, how do you know which of these
articles you should read to inform your practice and which you can
disregard? You need to be able to identify articles that are both of a
high quality and relevant to your clinical practice.
EBP has been defined as ‘the conscientious, explicit and judicious
use of current best evidence in making decisions about the care of
individual patients’
1
. It aims to inform, not replace clinical judgement
and experience, by integrating the best evidence with clinical expert-
ise and patient preferences. EBP can be broken down into five key
stages, as illustrated in Fig. 8.1. The key stages require the develop-
ment of skills that encourage the process of life-long learning, allow-
ing the practitioner to identify and react appropriately to emerging
information. This chapter will explore, in brief, some of the skills
involved in the EBP process.
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