Webpalestra COVID-19 (Coronavírus): prática baseada em evidência na odontologia durante a pandemia do COVID-19

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Historical perspectives on advertising and the meme that personal oral hygiene prevents dental caries.

The consensus of a leading scientific panel in 1930 was that oral hygiene products could not prevent dental caries. Their view was that dental caries prevention required the proper mineralisation of teeth and that vitamin D could achieve this goal. Over a hundred subsequent controlled trials, conducted over seven decades, largely confirmed that this scientific panel had made the right decisions. They had, in 1930, when it comes to dental caries, correctly endorsed vitamin D products as dental caries prophylactics and oral hygiene products as cosmetics. And yet, despite this consistent scientific evidence for close to a century, an opposing conventional wisdom emerged which thrives to this day: oral hygiene habits (without fluoride) protect the teeth from dental caries, and vitamin D plays no role in dental caries prevention. This historical analysis explores whether persistent advertising can deeply engrain memes on dental caries prevention which conflict with controlled trial results. The question is raised whether professional organisations, with a dependence on advertising revenues, can become complicit in amplifying advertised health claims which are inconsistent with the principles of evidence-based medicine.

History of the Dental Trauma Guide.

The history of the Dental Trauma Guide dates back to 1965, where guidelines were developed for trauma records and treatment of various trauma entities at the Department of Oral and Maxillofacial Surgery at the University Hospital in Copenhagen. In 1972, a unique possibility came up at the Serum Institute in Copenhagen to test various dental trauma procedures in monkeys, which served as kidney donors in the polio vaccine production. Over the years, 40 000 dental trauma patients were treated at the Trauma Centre according to established guidelines, and 4000 of these have been enrolled in long-term follow-up of various trauma entities. This has resulted in 79 clinical studies, and 64 studies in monkeys have examined the effect of various treatment procedures and the aetiology of most healing complications.

Sumter S. Arnim, D.D.S., Ph.D.: Texas leader in evidence-based dentistry.

Many lessons can be learned from the career of Dr. Sumter Arnim, chief among them that we have a professional obligation to apply scientific knowledge to the practice of dentistry and to involve our patients in their dental care, and to share this translational knowledge with one's colleagues. Arnim's work was an honor not only for the University of Texas Dental Branch (now, The University of Texas School of Dentistry at Houston), but for every school and student with whom he interacted. Our profession is better for having had Sumter Arnim as one of its members, and he can be credited with having played a leadership role in what is now known as evidence-based dentistry in Texas, the United States, and beyond. One of the authors of this paper (JVJ) had the opportunity to be a student at the University of Texas Dental Branch during the time that Dr. Sumter Arnim was faculty member. Dr. Arnim was deservedly respected by his students and faculty colleagues alike, due in no small part to his dedication to dentistry. This dedication to the profession was well known, as Dr. Arnim had been accepted to Yale University Medical School, but soon after enrollment there, he elected to pursue a Ph.D. degree in Pathology, rather than M.D. Dr. Arnim constantly stressed the bacteriologic nature of dental disease and the value of prevention to his Dental Branch students, serving as Director of the Postgraduate School with great distinction. His steadfast belief in the biological basis of dentistry was manifest in his frequent admonition to the student body: "You can either be doctors or hardware merchants." Finally, it is ironic that in 2011, the American Dental Association has reiterated some of Arnim's career themes in its current publication on barriers to oral health in the United States, with primary messages that include, "Prevention is essential. A public health model based on the surgical intervention in disease that could have been prevented after that disease has occurred, is a poor model," and, "Treating the disease without educating the patient is a wasted opportunity."

The maturation of science within dentistry: the impact of critical milestones and visionary leaders on contemporary achievements.

In the last 150 years dentistry has faced myriad challenges as it has developed as a technical profession; but even greater struggles to develop a true scientific basis, one that permeates both the academic and practice sectors. In the latter part of the 19th century, technical advances abounded and clinical practice was empirically driven. The first few decades of the 20th century were a tumultuous time in the scientific evolution of dentistry, and many political barriers existed. The formation of scientific journals, research institutes, and a focus on dental education all contributed to a slow and sometimes agonizing evolution of the scientific development of dentistry. Today, while research endeavors are vast, the dental educational system and its embracing of new science within its curricula may not have kept pace with the vision of William J. Gies to revitalize the dental profession over 75 years ago. We are on the brink of a remarkable transformation for both dental education and the practice of dentistry, one that will require enhanced leadership, a revitalized vision and a passion for excellence to allow its continued progress and ultimate success.