How to Make Confident, Evidence-Based Care Decisions in Dentistry

Are you making the most informed choices for your patients? Whether you're recommending a product, selecting a restorative material, or adapting a treatment plan, you're already engaging in evidence-based dentistry – but how confident are you in separating clinical science from marketing hype?

What is Evidence-Based Dentistry?

Evidence-based decision-making in dentistry combines your clinical expertise, the best available research, and patient preferences. Every time you rely on current studies, professional experience, or insights from trusted colleagues, you’re putting this model into action.

But with new dental technologies, materials, and techniques emerging constantly, staying informed is key. Are you fully leveraging your education, critical thinking, and up-to-date research to guide your dental treatment recommendations?

Why Research Matters in Clinical Decision-Making

When you graduate from an accredited dental or hygiene program, you're equipped with foundational scientific knowledge. Some programs also train you to critically evaluate dental research – a vital skill in an era of rapid innovation.

Making confident, evidence-based decisions means more than trusting instincts or tradition. It involves continually reviewing new clinical data, staying current with dentistry best practices, and applying research to support the care you deliver every day.

Why Rely on Evidence-Based Decisions, Including Off-Label Uses?

You may find yourself considering an evidence-based approach for several reasons:

• New research may support applications beyond current FDA clearance.
• The FDA approval process is lengthy and expensive.
• Clinical needs evolve faster than product labeling does.
• Peer-reviewed studies or professional guidelines may support an alternative use.

Evidence-based decisions reflect your professional judgment, informed by the best available data. They allow you to responsibly incorporate new technologies, materials, and treatment protocols into your practice, while still maintaining a safe standard of care.

Often, you're navigating constraints of time and cost. It can take years for enough peer-reviewed research to satisfy regulatory bodies like the FDA. By the time a product receives formal approval for a new use, it may no longer be clinically relevant—or even available.

Meanwhile, conducting rigorous studies is costly, and not all companies can afford the time or funding required for full FDA clearance. That’s where your ability to interpret research becomes so important.

How You Can Make an Evidence-Based Decision

When you’re considering the use of a new product, technique, or material – especially if it’s off-label – you need to rely on credible, high-quality evidence. That often means prioritizing randomized controlled trials (RCTs), systematic reviews, and professional guidelines.

Here’s a process you can follow:

1. Define your clinical question.
   Ask yourself: Why do I want to use this new approach? What outcome am I hoping to achieve?
2. Gather high-quality, unbiased research.
   Focus on recent studies (published within the last five years), especially systematic reviews and RCTs.
3. Evaluate risks and rewards.
   Will this product or material improve your patient’s outcome? Are there any documented side effects or limitations?
4. Consult professional resources.
   Talk to colleagues, review CE materials, and lean on expert consensus where needed.
5. Inform your patient and document your rationale.
   Especially with off-label use, it’s essential to explain your reasoning to the patient and record it in their chart.

Making evidence-based decisions isn't about abandoning your training – it’s about enhancing it. You already have the knowledge and clinical experience to evaluate new ideas. Now you’re adding a structured, science-backed approach to assess whether those ideas belong in your practice.

Examples of Evidence-Based Decisions in Dentistry

You’ve likely already made evidence-based decisions without realizing it. Consider the following examples:

• Fluoride varnishes were originally cleared for reducing sensitivity, but evidence now strongly supports their use for caries prevention and remineralization.
• Silver diamine fluoride (SDF) is FDA-cleared for hypersensitivity, yet many clinicians use it off-label for arresting carious lesions, supported by numerous studies.
• Silver nanoparticles are not only antimicrobial but have shown promise in enhancing remineralization—making them useful in various restorative and preventive treatments.

Even though these products were not initially labeled for decay prevention, research supports their expanded use. Dental professionals have adopted these methods based on strong evidence, well before regulators caught up.

Moving Forward: Stay Current, Stay Critical

If you’re considering trying something new in your practice, whether it’s a technique, a material, or a product, you’re already on the path of evidence-based thinking. You have the foundation, the clinical intuition, and the resources. The next step is doing the research, asking the hard questions, and ensuring the benefits outweigh the risks for your patients.

Evidence-based dentistry isn’t about waiting for permission. It’s about staying informed, being thoughtful, and using your expertise to offer care that’s innovative, ethical, and effective.

By staying current, consulting with colleagues, and learning from continuing education, you’ll position yourself at the forefront of clinical excellence. The decisions you make shape not just individual outcomes, but the future of dentistry as a whole.

References:

Pieren JA, Gadbury-Amyot C. Darby & Walsh Dental Hygiene: Theory and Practice. 6th ed. St. Louis: Elsevier; 2025: Chapter 3 and pg 281-283.

Walraven T. Off-Label and totally legal: What the FDA won’t say about fluoride varnish and SDF. Dentalbuzz. 05/29/25. Available at: https://www.dentalbuzz.com/2025/05/29/off-label-and-totally-legal-what-the-fda-wont-say-about-fluoride-varnish-sdf/?fbclid=IwQ0xDSwKoQ0BleHRuA2FlbQIxMQABHt78NMhmTQMYp2y_PkMaIQZm_vVIN6xQJ9qguA8G-TnHAOMQzpcJ9kuQa_5O_aem_ZecQh_gZp7pPGF0GK0cRsw