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There is increasing importance placed on conducting clinical trials in dentistry to provide a robust evidence base for the treatment provided, and models of care delivered. However, providing the evidence upon which to base such decisions is not straightforward, as the conduct of these trials is complex. Currently, only limited information is available about the strategies to deliver successful clinical trials in primary care settings, and even less available on dental clinical trials. Considerable knowledge and experience is lost once a trial is completed as details about effective management of a trial are generally not reported or disseminated to trial managers and researchers. This leads to loss of vital knowledge that could assist with the effective delivery of new trials. The aim of this study is to examine the conduct and delivery of five dental clinical trials across both Australia and the UK and identify the various factors that impacted upon their implementation. Findings suggest that early stakeholder engagement, and well-designed and managed trials, lead to improved outcomes for researchers, clinic staff and patients, and increases the potential for future dissemination and translation of information into practice. more...

This paper explores when and how to conduct qualitative research with children in dentistry, using research interviews as a method of data collection. Methodological guidance is also provided, based on research and a recent dental public health study in which 74 children from Years 2 (6-7-year-olds) and 6 (10-11-year-olds) were interviewed about their understanding of and attitudes to food. more...

This paper explores the most common methods of data collection used in qualitative research: interviews and focus groups. The paper examines each method in detail, focusing on how they work in practice, when their use is appropriate and what they can offer dentistry. Examples of empirical studies that have used interviews or focus groups are also provided. more...

This paper is the first in a series of four that provides an overview of the key elements of qualitative research. In particular, it discusses issues such as what qualitative research is, when its use is appropriate, what it can offer dentistry and approaches to data collection and analysis. Where appropriate, examples of dental studies that have used qualitative methods are also provided for practical purposes. more...

Evidence-based healthcare has become the mainstream of current healthcare practices, yet there seem to be many misunderstandings concerning this concept. This paper reviews several aspects of the concept of evidence-based healthcare in a simple question-and-answer format. The areas considered include: the significance of the evidence-based concept in clinical practice, the method of conducting a detailed electronic search of the literature, and the interpretation and application of research evidence to patients and immediate clinical applications. more...

Aims: To investigate experiences and expectations of parents/siblings of adults with Down Syndrome (DS) regarding oral healthcare, and explore factors impacting on access and experience of dental care for this group., Design: A two phase qualitative and quantitative study using in-depth interviews with a convenience sample of six parents/siblings, and a postal questionnaire of 200 parents/siblings of adults with DS who are members of the Down Syndrome Association., Results: The main themes elicited from the qualitative interviews related to concern, experiences, parents'/siblings' attitudes, preferences and information. The response rate from the postal questionnaire was 63.5%. Adults with DS attended the dentist regularly but received little restorative treatment. Experience of oral healthcare was influenced by the attitudes and skills of dental health professionals; stigma; and relatives' expectations of dentists, their oral health beliefs, information and support received, knowledge and priorities. Parents/siblings wanted dentists to be proactive in providing more information on oral health issues in collaboration with other health and social care professionals., Conclusions: Whilst most adults with DS visited the dentist regularly, relatively little treatment had been provided. Parents highlighted a need for appropriate and timely oral health information early in their child's life, and access to dentists who were sympathetic, good communicators and well-informed about DS. more...

Writing up your research for publication is an important part of the research process, since it is through publication in all its forms that the wider community becomes aware of your contribution to knowledge. How the research is written up will depend to a large degree on your target audience; in this final paper we discuss writing up your research for members of your practice, funders of your research, and for publication in academic journals. more...

The analysis of data from a research project seeks to answer the research question which the investigators set at the outset of the study. This article provides information on data analysis for both quantitative and qualitative data, always referring the reader back to their initial research question. Advice is also given on software which can be used for the analysis of data. A guide is provided to the choice of appropriate statistics for studies involving quantitative data. more...

In previous articles, we have considered how to formulate a research question and choose an appropriate methodological approach to answer that question, including the use of evidence-based research instruments or measurement scales. In this article, we put this information together in the form of a research proposal and consider how to obtain funding for the research project, as well as fulfil ethical requirements. more...

An important part of the design process for any study is deciding how to assess and measure the phenomena you are aiming to research. In this article we will use the term outcome measure to indicate the tool or index that can be used to quantify, in an accurate and predictable way, the phenomenon under investigation. This might, for example, be a patient's opinion, the effect of a treatment, the outcome of an intervention, or the prevalence of an oral disease. The paper presents an overview of outcome measures which can be used in research. We will discuss the properties to look for in a measure, suggest suitable evidence-based measures and briefly introduce how to go about developing new measures, in particular, questionnaires. more...

The first step in planning and conducting any research is identifying the research question, that is a testable statement of the question which the research aims to answer. In this article three distinct types of research question are identified: Descriptive questions (for example Who? What? Where? When?); Questions of relationships (How are two or more things related?); Questions of comparison (often these questions will ask about cause and effect). Examples are given of each type of research question. The process of devising a research question is described, in particular searching for relevant information, and evaluating the quality of the information obtained. A list of useful resources is provided. more...

The principles which underlie a well-designed clinical trial were introduced in a previous paper. The trial should be controlled (to ensure that the appropriate comparisons are made), randomised (to avoid allocation bias) and, preferably, blinded (to obviate assessment bias). However, taken in isolation, these concepts will not necessarily ensure that meaningful conclusions can be drawn from the study. It is essential that the sample size is large enough to enable the effects of interest to be estimated precisely, and to detect any real treatment differences. more...

To facilitate statistical discussion, it is essential to have an understanding of factors, effects, interactions, confounding, bias, estimation and hypothesis testing, to name but a few terms commonly used in statistical investigations in dentistry. These terms were explained in the previous paper in this series. This second paper is concerned with describing and differentiating between the various research designs that may be adopted. more...

Assessment of the acidogenic and cariogenic erosive potential of foods requires the use of reproducible and standardised methods. The methodology laid down at the San Antonio conference in 1985 remain today the basis for research on and the testing of foods. The 1999 workshop has updated the appropriate methodology and introduced guidelines on the testing of erosive potential of foods. It is to be hoped that researchers wishing to evaluate foods and their effect on the teeth will continue to use these methods. more...

Aim: To investigate the caries status of, and the delivery of care to, a group of regularly attending adolescent dental patients. To conduct research in primary dental care. A subsidiary aim was to compare the caries status of this sample to population samples., Setting: General dental practices across Scotland., Design: A 3-year cohort study., Subjects: 41 volunteer general dental practitioners and 616 adolescent patients (mean age = 12.1 years at baseline) defined by the practitioners as 'regular' attenders., Results: All practices remained in the study. 403 subjects were seen at both baseline and final examination and 329 were examined at all 4 annual examinations. The mean D3MFT (dentine caries threshold) was 1.8 at baseline and 3.9 at the final examination, three years later. Of the 541 subjects seen at baseline 62% had experienced either restored or unrestored dentinal caries. Thirty-four percent of all those examined at baseline had all the unrestored dentinal caries. The majority of the disease was to be found in the molar teeth, particularly the first permanent molars. The provision of sealants was relatively high with 85% of subjects having at least one sealed tooth by the final examination. Although disease levels were related to socio-economic status, the Care Index was not., Conclusions: The 'regularly attending' subjects had a better normative level of dental health than their peers in the Scottish population. However, wide variation was found. The project also demonstrated the feasibility of undertaking research in partnership with general dental practitioners. more...

The concept, planning and initiation of a research project into the treatment of temporomandibular dysfunction carried out by a group of GDPs in their own practices is described. Reports of the experimental studies will be presented as a further series of papers. more...

General dental practitioners comprise the target market for manufacturers wishing to sell new therapies for the treatment of periodontal disease. However, because of the often limited information supplied by manufactures, GDPs may be unable to make informed decisions about whether a new product can benefit their patients and practice. This article explains the stages of clinical research undertaken before products can be marketed and discusses a potential role for GDPs in clinical research. more...

Electronic infrared thermography is an imaging modality for the accurate quantification of surface temperature. It has been used in medicine since the 1960s but its use in dentistry has been limited. Its use in dentistry could, however, be very useful, for example in objectively quantifying post-surgical inflammation and studying the effects of treatment with agents such as analgesics and anti-inflammatory drugs. more...