Research in Dental Hygiene 14

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Objectives After studying this chapter, the dental hygiene student should be able to:  Describe the purpose of dental hygiene research.  Describe the use of evidenced-based practice in dental hygiene.  Describe the role of government and private entities in research.  Describe the connection between research and private practice.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Competencies After studying this chapter and participating in accompanying course activities, the dental hygiene student should be competent to do the following:  Use evidence-based decision making to evaluate and incorporate emerging treatment modalities.  Assume responsibilities for dental hygiene actions and care based on accepted scientific theories and research as well as the accepted standard of care.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Research in Dental Hygiene  To accurately interpret research, the dental hygienist must understand basic research principles.  Dental hygiene is based upon research and the results it yields.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Research and Dental Public Health  Scientific method: a body of techniques that uses observation, reason, and experimentation to gather evidence that is empirical and measurable  The study of disease in populations is accomplished by conducting research using the scientific method.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Evidence-Based Practice  The concept of evidence-based dental hygiene means that students learn the practice of dental hygiene based on independent research done by other practitioners and scientists as reported in peer-reviewed medical and dental hygiene journals.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved FIGURE 14-1 Evidence-Based Practice

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Examples of Non-evidence-based Dental Hygiene  “Trial and error” treatment practices  Anecdotal reports of successful periodontal treatment  Selection of oral care products because of advertising

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved An Example of Evidence-based Dentistry  It used to be believed that all plaque had to be removed from the surface of the tooth prior to the application of fluoride.  After studies were conducted, it was found that the presence of plaque does not interfere with the penetration of fluoride into the tooth structure.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Did you know? For dental hygiene to evolve into its own scientific discipline, a research base must be established that is solely generated by the profession.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved The Components of a Research Study  Research question or hypothesis  Research proposal  Sampling techniques  Data analysis and interpretation  Research conclusions and publication

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Research Question or Hypothesis  Research always begins with a question.  The next step is the development of a hypothesis.  A hypothesis is the result of asking a question that can be researched.  Questions arise from a researchers observations, observed occurrences, and previous research.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Research Question or Hypothesis (cont'd)  Hypothesis: a question to be answered by a study; it is the result of asking a question that can be researched.  Null hypothesis  Alternative hypothesis

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Research Proposal  A detailed plan for the study, or a protocol  Used to validate the significance of the research and secure funding  Created after a valid hypothesis is stated

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Components of a Research Proposal  The research question  The review of the literature  The research study design

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Sampling Techniques  A sample that is a representative subset of the population must be used.  Subjects have the right to participate or not; this can result in a loss of subjects.  A large sample is the most accurate representation of the population.  Important in descriptive studies because large samples produce more valid results  Demonstrates statistical significance of differences when large sample sizes are used in experimental studies

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Types of Samples  Random (ensures adequate representation)  Stratified  Systematic

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Types of Samples (cont'd)  Judgmental (results in selection bias)  Convenience (results in selection bias)  Cluster

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Types of Samples (cont'd)  Research should represent a cross section of the population with regard to gender, age, race, and ethnicity.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Data Analysis and Interpretation  The analysis method is decided upon prior to the inception of the study.  Not all data collected is useful for analysis.  Many times a statistician is used to help with the mathematics.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Research Conclusions and Publication  Most research concludes saying that more research is warranted in the subject matter.  Each bit of information gathered from a study contributes to the overall body of knowledge.  Recent studies can suggest future study questions to be examined.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Research Conclusions and Publication (cont'd)  Studies must be published in order for evidence- based dentistry to practiced.  Publication is recommended in peer-reviewed journals.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Bioethics  Bioethics has an inherent role in health care.  It distinguishes between morally acceptable and unacceptable behavior.  Large institutions have their own code of ethics; this includes the FDA.  Institutions that conduct medical research are monitored by the institutional review board (IRB).

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Institutional Review Board  This organization is in charge of reviewing the ethical implications of a research study.  It assures that the rights and safety of the research subjects are respected and protected.  The IRB protects the institution and the researchers against lawsuits and helps to assure that the results of the research will not be flawed should the research be ethically unsound.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Ethical Considerations for Institutions  Research misconduct  Includes plagiarism, copyright or patent infringement, falsifying or fabricating data, misrepresenting data, and conflict of interest  Human study subjects must always be voluntary.  Participants must be free to participate or not and to withdraw at any time for any reason.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Informed Consent  Informed consent requires that a subject in a research study be educated about the study’s purpose, duration, experimental procedures, alternatives, risks, and benefits.  It is a process not just a form.  Information is presented to the potential subjects.  The information must be written in a language that the participants understand.  It should also be revised when necessary.

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Informed Consent (cont'd)  There is one exception to obtaining informed consent, and that is when using surveys or questionnaires.  If the participant is non-English speaking, a minor, or not competent to give consent, informed consent becomes an extremely important ethical component of the research.  Research subjects must not be identified.  Exception: if consent is obtained to use photographs in an article

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved

Dental Public Health & Research: Contemporary Practice for the Dental Hygienist, 3/e Christine Nielsen Nathe Copyright ©2011 by Pearson Education, Inc. All rights reserved Summary Every dental hygienist, whether directly involved in research or not, should be familiar with basic research design, including hypothesis, various types and merits of study designs, and the uses and limits of statistics. Understanding and using these tools will help dental professionals incorporate evidence- based dentistry into their daily practice.