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Inevitably, a question will stup you -- no matter how organized you are

Inevitably, a question will stup you -- no matter how organized you are. Here are some shortcuts on researching for the answers that make you look like you're still n the cutting edge of your profession.

by Cathy Hester Seckman, RDH

Fresh out of college, hygienists are all alike, full of good intentions to maintain that cutting edge – in more ways than one. Our instruments may remain sharp, and our technical expertise strong, but our theoretical expertise may get bogged down under the weight of too much information and too little time.

Have you ever fumbled for the right answer when a patient asks a technical question? I have. Just the other day, a woman wanted to know if I could help her choose a power toothbrush.

"There are so many," she said. "Which one is right for me, with my implants?"

Personally, I happen to hate power toothbrushes – they make my head vibrate. But that doesn't mean I shouldn't keep up with the research and recommend the right ones to patients.

"Hmmm," I said, hoping to sound knowledgeable. "Let me think about this for a minute." I flossed the next quadrant and started thinking.

A Clinical Research Associates study several years ago compared power and manual toothbrushes. But whatever happened to that newsletter? I couldn't even remember what it said. Then it dawned on me that, a few days ago, a company rep had given me a flyer on their latest power brush, which featured a special head for implants.

"Aha!" I said with a flourish of the floss. "I know just the brush for you."

Cutting edge? Well, no. Good intentions aside, we shouldn't make recommendations to patients based on the latest glossy flyer from a company rep. We should base them on research, clinical findings, and hard technological data.

The only question is, how?

Thinking about that later, it was clear I didn't know much about finding answers for patients. The question of research would take – research. Here's what I discovered.

Dental magazines and journals are great. They arrive in the mail, they appear in the lunchroom, they pile up beside the bed. But there's no easy way to catalogue the information they contain. My husband, the mechanic, likes to rip trade magazines apart and file important articles by subject and date in ringed binders. He has a binder for carburetors, one for manufacturer's recalls, one for brakes, etc.

All that relentless organization makes me cringe, but it's actually a good idea. If I'd had a binder for power brushes, for instance, I could have put every article I've ever seen on power brushes into it. Maybe the mechanic could have built a shelf in my operatory to store all those binders, and I could have answered the patient's question very professionally with just a flip through the binder.

What if you need more in-depth information? What if a patient asks a question that you can't answer just by browsing through dental magazine articles, however well filed?

Articles on research and clinical studies from broader fields are a really good source of information, but they don't drop into our mailboxes as conveniently as RDH and Access magazines. The average hygienist has to work to find them.

A few years ago, I needed information on temporomandibular disorders for another article. If you wanted to look up the latest findings on TMD for a patient in need, or for your own education, where would you start?

I started at the local library. The average small-town Carnegie library doesn't carry books on TMD, of course. That would be too easy. But they can find them. The college kid who sits at the reference desk discovered a 1997 title, "Disorders of the Temporomandibular Joint," which he got for me on interlibrary loan within two weeks.

Subscription databases were next. I'd never heard of those, but the kid explained. There are companies – LEXIS-NEXIS is one, the Online Computer Library Center Inc. is another – that collect and collate information on any number of topics. You wouldn't need to subscribe to such a service yourself. Even the tiniest hometown library probably subscribes to one or two, and all it takes is a library card to access that information.

Searching a health periodicals database, the kid found TMD articles for me over a three-year spread from Health magazine, Clinical Reference Systems Yearbook, American Family Physician magazine, and the Journal of the American Dental Association.

Don't forget college libraries in your quest for more research. I discovered that my alma mater was happy to give me a library card, even though I graduated – ahem – a really long time ago. Because of the dental hygiene program, their library is more attuned to dental research materials. The dental section of the stacks is well-filled, and so is the dental magazine archive.

I also can search subscription databases through the college library's Web site, order the articles I want, and have them delivered by e-mail within a week or two.

Free databases on the Internet pop up and disappear on a regular basis, but using them can be more frustrating than it's worth. I've had better luck through libraries.

Professional organizations and associations are a good source of information, and you can find those at the library, too. Ask to see the Encyclopedia of Associations, the Research Centers Directory, or the Yearbook of International Organizations.

It might be more productive, though, to look for those organizations on the Internet, because you'll get more than just basic data. You also may get useful information you didn't even know was available. During my TMD hunt I typed "temporomandibular disorder" into an Internet search box. That netted addresses for the American Dental Association (which I expected) and also for the American Academy of Head, Neck and Facial Pain, of which I'd never heard. Both sites contained pages of helpful background information. Another good address discovered in the search was for the National Fibromyalgia Partnership Web site. Until I started looking, I hadn't realized TMD is a big problem for fibromyalgia sufferers.

If you want a broader search, or just want to know what's out there, type "dental organizations" into a search box. You'll not only find organizations like Clinical Research Associates (www.cranews.com), you'll find groups devoted to every specialty you've ever heard of, plus more.

The Web sites of dental product manufacturers are worth searching for information. They often provide links to research findings. The findings will support the dental products being sold, of course, but you already realize that. The sites are still worth searching. If you wanted information, for instance, on Sjogren's Syndrome, a company that markets artificial saliva products could help.

That Internet search, besides giving me the Web addresses of professional organizations dealing with TMD, also listed dozens of other addresses. When you're doing serious research, it's best to question the credentials of the Web sites you find. Anyone can put up a Web site and link it to search engines, but their information may not be reliable.

Here are some things to consider about Web sites before you trust what they say:

  • Who is responsible for the site, and what are their credentials? Is it a professional organization, or is it Joe "I have TMD" Smith, a guy with too much time on his hands and an ax to grind?
  • Who wrote the information, and what are their qualifications? If it's health-oriented information, it should be written by a health professional.
  • Look for references and citations so you can judge the quality of the information.
  • Is the material dated? Even if a respected professional provided the information, it might be dangerously outdated.
  • Does the site request personal information? If you're asked to fill out a questionnaire, there should be a privacy policy to read, as well as an explanation of why they want the information.
  • Even if you trust the source of the information, don't make it your only source. Try to confirm what you've learned elsewhere.

Whether it takes digging in piles of magazines, browsing dusty library shelves, or burrowing through Internet search engines, finding the right answers for your patients can give you the satisfying feeling that you're staying right where you should be – on the cutting edge.


Where to search the Internet

The Internet changes faster than the speed of sound, and sites you've used for years can disappear overnight, but here are some generic search engines I've found useful in the past when searching for dental and health information.

  • http://www.mamma.com
  • http://www.go2net.com
  • http://www.metafind.com
  • http://www.profusion.com
  • http://www.internets.com
  • http://www.completeplanet.com
  • http://www.thebighub.com

Cathy Hester Seckman, RDH, is a frequent contributor who is based in Calcutta, Ohio.

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