Word Of Mouth – A Dental Blog

As I’ve said before, as dentists we wear many different hats; we’re clinicians, biologists, artists and scientists.  As scientists and clinicians we should be basing our treatment decisions and recommendations on scientific facts and evidence, not hearsay.  That’s the basis of evidence based science.
Two articles in this past Sunday’s newspaper caught my attention.
The first article, on the front page of the href=”http://www.nytimes.com/”>New York Times, addressed the relatively new technique of robotic surgery.  The pros and cons of robotic assisted surgery vs. the old fashioned way of using human hands were evaluated.  The author, Gina Kolata, discussed the lack of scientific studies proving that robotic assisted prostate surgery resulted in better results for patients.  Only one long term study has been done that included robotic surgery, but that study didn’t really differentiate between robotic results vs. non-robotic results. 

In the absence of definitive conclusions, the author goes on to discuss the role of marketing in the patient decision making process; newer being interpreted in many instances as being better.  She also discusses how popular robotic surgery is becoming even in the absence of studies citing its clinical superiority!  And finally, she points out the pressure placed on medical institutions to provide these services because of the huge initial investment in the robotic technology.  All with no evidence that robotic surgery gives better results.

The 2nd article, also in the New York Times (Style section),  dealt with stress and tooth grinding.  Michael Winerip, the author, relates several discussions he had with various dentists and dental professionals in an effort to support his premise that these stressful economic times are causing more tooth grinding; a plausible hypothesis indeed.  But once again, show me the evidence!  Where is the science behind the conclusion that increased stress in causing increased grinding?  Indeed, Mr. Winerip states in his article that “there are no studies about grinding and its relation to the recession.”

 There is no reason to dispute that one dentist in the article made 65% more night guards in 2009 than the year before.  But just because we are living in extremely challenging economic times may not be the only reason the number of night guards made increased.  Nor is polling 3 or 4 dentists a sufficient scientific pool on which to conclude that increased stress is causing more grinding.  The entire subject of tooth wear is extremely complicated; indeed the vast majority of teeth wear occurring not during the night, but during the day.
Our goal as health care providers should be to evaluate our patients concerns, evaluate conditions that exist, and come up with treatment solutions that can address the problems based on scientific evidence, not just the solution “du jour”.  That’s what scientists do.
Just my thoughts, thanks as always, for listening.

RMS