Dentistry has always been a mixture of arts and sciences, of opinion mixed with facts. The ongoing "Perspectives" section of JADA and, specifically, Dr. Gordon Christensen’s January JADA column, "When Is a Full-Crown Restoration Indicated?" (JADA 2007;138[1]:101–3), raise a number of troubling issues.
In order to provide the profession (and third-party observers, insurance payers, policymakers, etc.) with the best evidence, it is critical that clinical recommendations be based on the best unbiased evidence available. Where expert opinion is the best evidence available, a broad number of observations or a consensus are certainly preferred.
As a profession, we are past simple opinion from the podium (where we were 150 years ago). The literature has a number of well-performed clinical trials and systematic reviews addressing the issue of full-coverage dental restorations, which were not used as a basis of support or to balance Dr. Christensen’s views.1–3 Furthermore, I find it ironic that Dr. Glick, the JADA editor, outlines the critical need to be balanced in citing substantial support for tenured arguments in the editorial section of the same edition in "You Are What You Cite: The Role of References in Scientific Publishing" (JADA 2007;138 [1]:12–4).
If dentistry is to be retained as an independent, science-based profession, and for the safety of our patients, we must begin to hold "opinion leaders" to a higher "evidence leader" standard and insist on evidence-based diagnostic and treatment guidelines. JADA should lead in this effort and reject pure self-reinforcing, opinion-based diatribe such as printed in this column.
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