Guest Editorial
September-October, 2009 edition

Research

By Carol A. Jahn, RDH, MS

In June, more than 150 dental hygiene professionals from around the world convened in Bethesda, Md., for the North American Dental Hygiene Research Conference. The attendees came from 33 states in the U.S. and five Canadian provinces plus Great Britain, Italy and Sweden. Their backgrounds included academia, public health, government, industry and clinical dental hygiene. In all, the conference featured 40 speakers as well as 38 poster presentations of original research, all by dental hygiene investigators. Presentation summaries and poster abstracts will be published in the fall 2009 edition of the Journal of Dental Hygiene.

Dental hygiene research may not seem sexy or glamorous, but it is a critical factor in the forward progression and vitality of our profession. I have great respect for research; it stimulates my inquisitive nature and excites my forward thinking. Over the last 10 years, new research has increased our knowledge base and brought new products to market. It has uncovered the oral-systemic link, established the concept of plaque as a biofilm, and introduced us to local delivery drugs, tools for oral cancer screening and xylitol.

At the same time, research can be overwhelming, intimidating and confusing. Hundreds of articles are published each month in dental journals alone. Not only is it difficult to keep up with everything, but many studies lack a clinical focus. It’s also safe to guess that almost all of us have read or heard about a groundbreaking health care discovery only to hear something a few months later that completely contradicts the earlier finding.

This conundrum leaves many clinicians unsure of what to do. Early adoption may make you feel like a trendsetter...until you learn that the new product/treatment really isn’t any better than what you were doing and worse, it is costing you and your patients more money. On the other hand, being the last holdout because the way you do it is the way you learned in school is not an attractive place to be either.
What can clinicians do to bridge the gap between research findings and clinical application?

One way is to embrace evidence-based dentistry (EBD). I have long been a proponent of EBD. From my viewpoint, it is bringing a fresh awareness of scientific literature to our profession. Whether it is a continuing education course or a journal article, it seems the newfound expectation is there must be qualified references to back it all up. Some would feel this is a very simplistic view of EBD, but I think this is a great place for clinicians to start. As an author and speaker myself, I think those of us who embrace these roles need to carry the mantle of EBD. I consider it my obligation to do due diligence on the subjects I teach so I can discuss with my audience the best evidence available. In this way, speakers have an opportunity to help clinicians feel more connected to quality research and confident about its implementation.

Another way is a little more esoteric. Be curious. When we allow ourselves to be curious, we open up to both the possibilities and the limitations. The truth is that, more than anything, research simply tells us what is possible. Only on rare occasions does it give us absolutes. The link between periodontitis and cardiovascular disease is a good example. It is well established that these two conditions are related by something more than chance occurrence. Yet a definitive causal relationship remains elusive. This elusiveness in turn stimulates our curiosity, which fuels the desire to learn more. This is the foundation of research: asking questions and seeking answers.

As clinicians, we use our natural curiosity every day when we ask our patients about their oral health and overall well-being. We seek answers in the medical history, our clinical exams, and our exchange of dialogue. We make observations and look for correlations. Clinicians help drive research. Long before the literature identified smoking as a significant risk factor for periodontal disease, clinicians had figured it out. Similarly, it has been said that for many years prior to the emergence of study findings, ICU nurses had observed that their cardiac patients often had poor oral health.

Unleashing your natural curiosity can help you take the first step to feeling more confident as well as becoming more competent in the arena of research and EBD. The more you ask, the more you learn. As you learn, you become more competent. With competency comes confidence. Competent, confident clinicians who understand research and can apply it to clinical practice strengthen our profession as whole.

Carol A. Jahn, RDH, MS is a lifelong member of ADHA and has had many roles and elected positions including ADHA Treasurer. Currently, she is the ADHA representative to the International Federation of Dental Hygiene and she serves on the Governance Committee. She is employed by Water Pik, Inc as the Manager of Professional Education and Communications. She can be reached at cjahn@waterpik.com.