Is there a Scientific Basis for the Recommendation of New Therapy?

An issue with which the investigator must wrestle is the clinical application of the experiment and whether to recommend the experimental therapy or product. A new therapy or product should not be recommended by a health professional until investigations demonstrate a statistically significant superiority to the current therapy or product. A belief by an investigator or clinician that a new therapy is better, based on his or her observations, is not enough evidence to support a change in practice.

Conversely, statistical significance does not mean necessarily the findings of an investigation are clinically important, or the new therapy or product has enough value that the profession should adopt it. Hypothetically, an investigation comparing the gain of attachment levels following periodontal surgical therapy versus periodontal debridement showed a superiority of surgical therapy that was statistically significant; however, the actual clinical difference was so small it did not make sense for the investigator to recommend one form of therapy over the other. Furthermore, the cost/benefit ratio must be considered when weighing the value of research findings. Since, in this example, surgical therapy was much more expensive and uncomfortable for patients, it was not logical or scientifically sound to recommend surgery over periodontal debridement.

When it comes to making decisions about a new therapy, take an attitude of "prove it to me." Do not be the first to use a new therapy in your practice on the premise that newer is better. We all know oral health professionals who follow this course of action. In regard to new dental products, it is important to know the history and practices of the companies that manufacture these products. If they have a history of poorly conducted research, of making unsupported claims, or of withholding information, the practitioner should probably pursue the products of a more reputable company. The most rational approach for treatment decision-making is to wait until there is a volume of scientific reports that supports a particular therapy or product before deciding to incorporate it into patient care.