Evidence‐based practice and the professionalization of dental hygiene

Abstract

The application of knowledge is fundamental to human problem solving. In health disciplines, knowledge utilization commonly manifests through evidence-based decision making in practice. The purpose of this paper is to explore the development of the evidence-based practice (EBP) movement in health professions in general, and dental hygiene in particular, and to examine its relationship to the professionalization agenda of dental hygiene in Canada. EBP means integrating practitioner expertise with the best available external evidence from research. Proponents of EBP believe that it holds promise for reducing a research-practice gap by encouraging clinicians to seek current research results. Both the Canadian and American Dental Hygienists Associations support practice based on current research evidence, yet recent studies show variation in practice. Professionalization refers to the developmental stages through which an organized occupation passes as it develops traits that characterize it as a profession. The status conferred by professionalization privileges a group to make and monitor its own decisions relative to practice. Dental hygiene's success in acquiring attributes of a profession suggests that transformation to a profession is occurring. This paper compares the assumptions and challenges of both movements, and argues the need for a principal focus on the development of a culture of evidence-based dental hygiene practice.

Obstacles to the implementation of evidence-based physiotherapy in practice: A focus group-based study in Belgium (Flanders)

“…We noticed that several physiotherapists used the focus group discussion as an opportunity to air their concerns about their inferior position at a political level and the medical establishment. The dominant position of the physician has also been a concern for nurses and dental hygienists who are supervised by medicals and dentists, respectively (Cobban, 2004;Kenny and Adamson, 1992). Recent findings of a focus group-based study indicate that nurses still have limited space for autonomous decisions under the supervision of doctors.…”

An argument for dental hygiene to develop as a discipline

“…As dental hygiene borrows heavily from other disciplines it may be argued that dental hygiene's perspective is not sufficiently distinct from others, because of the overlap with other areas, including dentistry, education and nursing. There are no concepts or theories that are widely acknowledged as the foundation of dental hygiene science (21), nor is there general agreement about which research methodologies are appropriate for the study of dental hygiene, and what criteria will be used to justify the acceptance of statements as true for dental hygiene (24). Further, much of the research conducted by dental hygienists has not been conducted within a conceptual or theoretical framework consistent with dental hygiene's unique perspective.…”

“…The nature of the knowledge used for dental hygiene practice is yet to be articulated in dental hygiene literature (21, 24). Carper (25) described four patterns or ways of knowing in nursing: science or empirics, art or aesthetics, ethics or moral knowing and personal knowing.…”

“…Dickoff and James (10) suggested that developing a capacity for referrals would be an important part of development as a profession. Woodall (39) and Cobban (24) have called for developing a culture of research‐based practice, and replacing procedures of limited value, such as polishing, with services that have demonstrated therapeutic or preventive merit which contributes to the good of society.…”

A proposed model for a collaborative approach to dental hygiene research

“…Evidence‐based practice addresses the health professional's desire to provide optimum care for clients to achieve the best outcomes, and health‐care administration's need for cost‐effectiveness. The intent of evidence‐based practice is to improve health outcomes (1). As dental hygiene responds to the increased need for quality oral health services, dental hygienists seek quality research findings on which to base their practice decisions.…”