The Forsyth Center for Evidence-Based Dentistry, the first evidence-based dentistry center in the U.S., was established in 2003. Its goal is to promote increased use of high-quality research findings in clinical decision making.
The Center identifies and evaluates the best clinical evidence available worldwide and develops methods for integrating that evidence into clinical practice. Clinical and economic findings are used to support advocacy for changes in community, state and national health care policies and systems.
Center activities include:
Funding from the International Association for Dental Research and the Fulbright Foundation provides seed capital for the Center, specifically to develop the website for the Pan American Evidence Based Dentistry Center. The site offers identical versions in English, Spanish and Portuguese, and an e-Newsletter. This project is being developed in collaboration with the Pan American Health Organization; the University of Pernambuco, Recife, Brazil; and Valparaiso University, Valparaiso, Chile.
The Center has developed EviDents.org, an evidence-based dentistry search engine for identifying high-quality clinical evidence on any oral health topic in less than five seconds on MEDLINE. The Center's team is currently developing the capability to simultaneously search BIREME, the Virtual Health Library of Latin America; Database of Abstracts of Reviews and Effects (DARE); and the National Guideline Clearinghouse.
The Center proposes to work on all elements of the evidence pipeline, thus facilitating improvements in health care and reducing the lag time between scientific discovery and widespread implementation in clinical practice. The Center will accomplish this goal by establishing four core activities:
Active dissemination of effective techniques and procedures stimulates sustainable change. Therefore, the Center has identified, and is actively working with, groups in Massachusetts and Maine to effect systematic change in clinical practice.
The Center's mentoring and leadership model was developed and pioneered by the Institute for Healthcare Improvement. Representatives of the stakeholder groups convene to introduce the concepts of evidence-based dentistry and quality improvement; agree on what questions are to be asked and answered; and develop a draft charter. Monthly electronic forums and quarterly meetings review processes and outcome measures.
The Center conducts an average of three intensive training workshops and seven lectures in evidence-based dentistry each year. The Center expects to continue these activities and to add a conference every other year. With the simultaneous 10-year anniversaries of the Oxford Centre for Evidence-Based Dentistry and the Cochrane Collaboration's Oral Health Group, and the 5th anniversary of the Forsyth Center for Evidence-Based Dentistry, Dr. Niederman and his team are planning the first of these events, an international evidence-based dentistry conference and workshop to be held in Boston in 2008.
As the value of video conferencing increases, the Center is developing distance-learning modules linked to the Internet site about evidence-based dentistry. The distance-learning program will be modeled after the current in-person intensive training workshops, with specific modules based on the five-step process of evidence-based dentistry.
The Center currently publishes original research, systematic reviews and editorials on clinical topics. The Center's Director is the founding Associate Editor for both Evidence-Based Dentistry and Education for Evidence-Based Practice.
Demonstration programs are models for delivering evidence-based care that improve access to care, improve health and are financially sustainable. The Center currently has two ongoing programs: one in caries prevention, and a second in periodontal care.
In addition to proving preventative dental care to elementary school children, the ForsythKids Demonstration Program is helping to develop a large longitudinal database, which contains data for more than 20,000 children collected over more than five years. This consolidated database offers the unique opportunity to determine the costs, outcomes and effectiveness of preventive care, delivered to different populations, by different clinicians, over multiple years.
The Periodontal Disease Demonstration Program compares the cost and effectiveness of preventive non-surgical periodontal care, delivered in general practitioners' offices by dental hygienists, with surgical care provided in periodontal specialty practices by periodontists. This program is being launched at a particularly appropriate time, because growing evidence links periodontal infections with systemic disease. This connection underscores the importance of accessible, cost-effective periodontal care. With 150,000 hygienists and only 5,000 periodontists currently practicing in the U.S., preventive care is both more available and less expensive than surgical care.
