Key Points
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Evidence-based dentistry needs to have information relevant to the dental primary care setting to help general dental practitioners improve their patients' oral health outcomes.
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No summary of clinical research exclusively conducted in the dental primary care setting has previously been available.
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This review identifies forty three clinical trials conducted in dental primary care from the Cochrane Controlled Trials Register.
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A description of the studies is followed with a discussion of the merits and shortcomings of the research designs used.
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The review found no evaluations of strategies to improve general dental practitioners' participation in primary care-based clinical research.
Abstract
Objective To identify controlled clinical trials done exclusively in dental primary care and to classify the research according to design. Details of any procedures used to recruit general dental practitioners and any special organisational arrangements were also collected.
Design A scoping literature review.
Setting Dental primary care defined as general dental practice, community and school dental settings.
Participants Published randomised controlled trials using randomised or quasi randomised approaches and controlled clinical trials were considered for inclusion in the review. Reports were excluded if they did not describe either a randomised controlled trial or a controlled trial. Studies were excluded if the setting was not primary dental care or the intervention was for non-dental conditions. Conference abstracts without a full report and trials published in a language other than English were also excluded.
Main outcomes Experimental and quasi-experimental designs, clinical areas and different kinds of strategies used to recruit dentists, any organisational arrangements made to support research in dental primary care.
Results The search of the Cochrane Oral Health Group Controlled Trials Register found 174 articles. Forty-three randomised controlled trials met the inclusion criteria. Trials to evaluate the effects of interventions for types of anaesthesia, periodontal diseases, smoking cessation techniques, dental materials, organisational aspects of dental care, patient anxiety, post extraction healing rates, antibiotics were identified. All were done in general dental practice. Trials in school and community settings were also included.
Conclusions Practice-based research needs to be encouraged to provide dental primary care with relevant evidence upon which effective treatment can be based. This review shows there are few trials done in dental primary care to inform clinical practice, most of which have been reported since 1997. The range of trial designs shows that this method of evaluation can be used to evaluate dental primary care interventions and this is promising for those with an interest in improving dental patient outcomes. More research on how to recruit dentists into clinical trial research must be done.
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Acknowledgements
The author thanks Ms Silvia Bickley of the Cochrane Oral Health Group for conducting the literature search, Ms Hazel Braid for her assistance with the preparation of the manuscript and Dr Gail Topping for checking the abstracts of the identified reports to ensure that the inclusion/exclusion criteria were correctly applied.
Fay Crawford is funded by the Chief Scientist Office, Scottish Executive.
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Crawford, F. Clinical trials in dental primary care: what research methods have been used to produce reliable evidence?. Br Dent J 199, 155–160 (2005). https://doi.org/10.1038/sj.bdj.4812576
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DOI: https://doi.org/10.1038/sj.bdj.4812576
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