Time and again, whether at round table discussions or other dental venues, the question is asked of me,“How do you choose the materials that you use?” The question and the topic have been discussed a number of times among dental educators and leaders in our profession. To my knowledge, it hasn’t been done in print, at least not in an introspective and candid manner.
There are numerous products in any one category competing for the attention and investment of dental professionals. Similarly, it seems just as many information sources about products and techniques also are competing for that attention: lectures, seminars, DVDs, tradeshow floors, promotional product marketing pieces, and printed publications. Choosing which to believe and trust is as important as the selection of products that will ultimately be used in clinical practice and the treatment of patients. Where is the bias and where is the reliability?
Put products and information under the microscope. Part of the problem that clinicians face when choosing among dental products is determining which is really better, newer, safer, and proven. Research—properly conducted, thoroughly reported and referenced, and relevantly applied—is the key. As practitioners, we need to be critical of the “evidence” we’re given and determine if it is weak or sufficient to support our decision to use a product and technique as described. When the information is available, I encourage you to scrutinize it. Are the research methods sound? What was the study design (eg, randomized clinical trial or in vitro testing; is there a control group)? Can the tests be duplicated? Is there anything influencing the content? Is the source of the information among those you trust and consider credible? As I’ve mentioned previously, potential bias on the part of speakers, authors, and researchers may or may not be fully disclosed.
Wait and see. We need to learn from the mistakes made over the years and exercise patience until the research results are there. Too many new products have been introduced into the marketplace and incorporated or prescribed in practice with little, if any, supporting clinical data, only to fail and then quickly disappear. The dental practice is not the place where new product research should occur. However, when we choose to use products without sufficient supporting documentation, that’s in a sense what we’re doing.
Buyer beware. It’s my belief that you don’t have to have anything to be successful in dentistry other than good skills and the ability to perform quality dentistry. When someone pushes products on you—telling you that Product A is something that you must have, I’d be suspicious. If “influence leaders” provide you with their opinion, you would like to believe that it’s based on verifiable evidence, so challenge them. Ask the questions. Why is this composite or bonding agent the best? What makes this a better impression material than the others? What does the clinical research say? How was the research conducted and who conducted it? Were other products in the category also evaluated and how do they all compare? Remember: If it sounds too good to be true, then it is too good to be true. There are a lot of good products out there—many good composites, many good bonding agents, many good cements. If you’re happy with what you’re currently using, keep using it. If you’re not happy with what you’re using, you might want to consider something else. But no matter whose opinion you listen to, make sure they’ve actually used the product that they’re talking about, not just promoting it, and that they can support their opinion with data.
Living up to our reputation. For being willing to address the role that media messages—including those contained in dental trade publications—play in influencing clinicians’ decisions about products, I give credit to the publishers and editorial staff of Inside Dentistry. We would not truly be fulfilling our mission of providing objective coverage of the issues that face the profession if we only chose to address those that don’t affect us or to which we are not a party. Truth be told, our quality publication is among the many sources of information that is supported by advertising, and our content—which is always peer-reviewed by multiple members of our board—does include manufacturer and product-specific technique articles, both of which are clearly identified. We maintain the highest standards when evaluating the clinical relevancy of all of our material, but ours is still among the vast array of information that clinicians must determine is credible. If we cannot look at our own practices objectively and consistently hold ourselves accountable to our readers, then we cannot make the claims we do about our product—a peer-reviewed dental journal.
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