Introduction

This course provides information to assist clinicians in understanding the goals of periodontal health, which are to arrest disease progression, to improve clinical attachment levels and to give the patient a comfortable, esthetic and functional dentition that can be maintained by both the patient and the therapist. It is essential to understand the role of the periodontal structures and why we need to maintain their health and function. The recognition and control of periodontal disease may help prevent future tooth loss and possibly may impact systemic health as well.

It is important for the clinician to focus on oral health goals and to make therapeutic choices that are supported by the best available scientific evidence. Evidence-based practice decision-making relies on a process of identifying and evaluating relevant information on diagnostics, treatments and prognoses.¹ Reliance on clinical experience and intuition, or poorly designed studies alone can be misleading. Inductive reasoning and uncontrolled observations often lead to false conclusions due to factors such as bias, the placebo effect (an improvement in health not attributable to treatment) and the nocebo effect (an ill effect resulting from the suggestion or belief that something is harmful). The findings of randomized, controlled clinical trials provide the gold standard for the highest level of evidence. In order for the study to be valid it must be reproducible, answer an appropriate question and measure the pre-determined variable among other criteria. Success criteria for clinical significance should be defined prior to the start of the study. Consecutive controlled case studies may be considered to demonstrate clinical success, but not clinical predictability. Case reports can show the potential for a technique to have a desired outcome. Variables that may confound study outcomes include bias, chance events not addressed by statistics, including systemic influences, diet, materials and patient expectations and their attributes. For comprehensive courses on understanding and evaluating a research report, please review the following:

• Using Research for Clinical Decision-Making: Evaluating a Research Report

• Using Research for Clinical Decision-Making: The Elements of a Research Report

This course will start by defining periodontal oral health and wellness goals for the periodontal patient. It will also review the concepts of periodontal health, physiology and disease manifestations. Finally the course will evaluate the evidence supporting each therapeutic option and how it meets these goals