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Using Evidence-Based Practice to Be a Wise Consumer of Science
Julie Frantsve-Hawley, editor-in-chief, is the executive director of the American Association of Public Health Dentistry and an adjunct clinical assistant professor in the Department of Restorative Dentistry at the University of Illinois College of Dentistry. She formerly served as director of the American Dental Association (ADA) Center for Evidence-Based Dentistry (EBD), where she developed and launched the ADA EBD website and an evidence-based practice guidelines program. She is a registered dental hygienist and received her PhD from Harvard University’s Biological and Biomedical Sciences Program, after which she conducted a postdoctoral fellowship at the University of California, San Francisco. She is editor of the textbook Evidence-Based Dentistry for the Dental Hygienist.
International Journal of Evidence-Based Practice for the Dental Hygienist
The cover story of the March 2015 issue of National Geographic was dedicated to an article on the War on Science.1 The cover shows an image of astronauts on the moon and lists a number of topics for which there is doubt in the court of public opinion yet overwhelming scientific support and consensus among scien- tists: climate change, evolution, the moon landing, vaccinations, and genetically modified foods. The article itself starts with an excerpt from Stanley Kubrick’s 1964 movie Dr. Strangelove, with a dialogue between two characters on com- munity water fluoridation. One of the characters asks the other, “Do you realize that fluoridation is the most monstrously conceived and dangerous communist plot we have ever had to face?” The article then points out that, surprisingly, “half a century later, fluoridation continues to incite fear and paranoia,” going on to discuss the overwhelming body of evidence supporting the safety and effec- tiveness of community water fluoridation. So why, in spite of overwhelming and consistent evidence, do we still see science being rejected? What can we do to ensure that we are using science appropriately?
We are all consumers of science, whether we realize it or not. What is a science consumer? It is an individual, organization, or group that uses science in making decisions. We do this every day, and so much so that it typically goes without notice. When we go to the grocery store to purchase food, we likely think of the new dietary guides released by the US Department of Health and Human Services and the US Department of Agriculture.2 These are based on the Scien- tific Report of the 2015 Dietary Guidelines Advisory Committee.3 We consider calories, nutritional content, and a balanced diet; all are based on science. When purchasing a car, we may consider if a hybrid car is more fuel efficient and better for the environment. Science forms the basis for developing the car and hybrid technology as well as the basis for our concern about the environment.
Of course, when we help our patients make individualized treatment deci- sions about their own health care, we want to help them understand science and use it soundly and appropriately in their decision-making process. We clearly consider the science behind the effectiveness of the considered treatments or preventive interventions. But there is also science behind how we communi- cate with our patients, especially when we use techniques such as motivational interviewing. In fact, there is an entire journal dedicated to the science of com- municating science.4 Both the American Association for the Advancement of Science5 and the Alan Alda Center for Communicating Science6 have workshops focusing on communicating with our audiences and patients. There is also a realm of science called dissemination and implementation science that is fo- cused on how you, as a health care worker, learn about and use science in your everyday practice. The National Institutes of Health has grants dedicated to this area of research,7 and there is a journal dedicated to this, too.8
When you start to see things through this lens, you will realize that science is everywhere and that we use it routinely to make decisions. And we do this without much notice or awareness. This is much like driving to work every day, where we get from point A to point B without noticing how we got there. We have become so comfortable in our routine driving patterns that we are almost

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