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Clinical Practice Guidelines

Clinical practice guidelines include recommendation statements intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. These are the strongest resources to aid dental professionals in clinical decision making and help incorporate evidence gained through scientific investigation into patient care.

The process for developing clinical practice guidelines is described in the ADA Clinical Guidelines Handbook.


Nonsurgical Treatment of Chronic Periodontitis

A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents an evidence-based clinical practice guideline and systematic review on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts. For patients with chronic periodontitis, SRP showed a moderate benefit, and the benefits were judged to outweigh potential adverse effects. The authors voted in favor of SRP as the initial nonsurgical treatment for chronic periodontitis. Although systemic subantimicrobial-dose doxycycline and systemic antimicrobials showed similar magnitudes of benefits as adjunctive therapies to SRP, they were recommended at different strengths (in favor for systemic subantimicrobial-dose doxycycline and weak for systemic antimicrobials) because of the higher potential for adverse effects with higher doses of antimicrobials. The strengths of 2 other recommendations are weak: chlorhexidine chips and photodynamic therapy with a diode laser.

Recommendations for the other local antimicrobials (doxycycline hyclate gel and minocycline microspheres) were expert opinion for. Recommendations for the nonsurgical use of other lasers as SRP adjuncts were limited to expert opinion against because there was uncertainty regarding their clinical benefits and benefit-to-adverse effects balance.

Note that expert opinion for does not imply endorsement but instead signifies that evidence is lacking and the level of certainty in the evidence is low. As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner’s professional judgment and the patient’s needs and preferences.

View Guideline Now

View Prosthetic Joint Guideline Now

In 2014, the ADA's Council on Scientific Affairs assembled an expert panel to update and clarify the clinical recommendations found in the 2012 evidence-based guideline Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures.

View Topical Fluoride Guideline Now

The panel assessed the efficacy of various topical fluoride caries-preventive agents, including mouthrinses, varnishes, gels, foams and pastes.

View Fluoride Supplements Guideline Now

The panel concluded that dietary fluoride supplements should be prescribed only for children who are at risk of developing caries and whose primary source of drinking water is deficient in fluoride.

View Fluoride Toothpaste for Young Children Guideline Now

The American Dental Association (ADA) Council on Scientific Affairs met with stakeholders to discuss differing public messaging on the use of fluoride toothpaste for young children. The participants agreed that a unified recommendation on the use of fluoride toothpaste for young children would be preferable and less confusing to the public.

View Non-Fluoride Caries Preventive Agents Guideline Now

The panel addressed several questions regarding the efficacy of non-fluoride agents in reducing the incidence of caries and arresting or reversing the progression of caries.

View Reconstituting Infant Formula Guideline Now

The panel recommended that dentists can suggest the use of powdered or liquid concentrate infant formulas reconstituted with optimally fluoridated drinking water while being aware of the potential risks of enamel fluorosis due to exposure to fluoride from multiple sources.

View Pit-and-Fissure Sealants Guideline Now

The panel concluded that sealants are effective in caries prevention and that sealants can prevent the progression of early noncavitated carious lesions.

View Screening for Oral Cancer Guideline Now

The panel suggested that clinicians remain alert for signs of potentially malignant lesions or early-stage cancers while performing routine visual and tactile examinations in all patients, but particularly in those who use tobacco or consume alcohol heavily.

View Infective Endocarditis Guideline Now

The guidelines update the 1997 recommendations by the American Heart Association for the prevention of IE. The committee concluded that IE prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcomes from IE.

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