Decision making in periodontics: a review of outcome measures

Clinical decisions regarding selection of appropriate periodontal therapy is a multifactorial process involving the assimilation of information from clinical experiences, relevant research, and patient preferences for anticipated outcomes. In order to select the treatment which is most beneficial to patients, a rational, systematic approach to decision making is needed. Clinical experience is a key factor in decision making, but one not easily controlled for. Research to date has focused on clinical or proximate outcomes as a measurement of treatment efficacy, but few of these studies provide the highest level of evidence. While Quality of Life issues play an important role in treatment selection, patient-based outcomes have not been well researched in dentistry. This paper outlines a method clinicians can use to evaluate treatment efficacy studies. In addition, the evidence from longitudinal periodontal treatment efficacy studies is reviewed and the use of patient-based outcome measures is examined.