Assessment of key elements to determine causation and risk factors in dentistry

The best research method for assessing therapeutic modalities is the RCT. The prospective nature and the randomization of the subjects in an RCT provide the greatest opportunity to control bias and offer the most valid answer to the clinical question. Observational studies generate hypotheses about causation and should be viewed as a first step in the continuum of health care delivery. The preponderance of evidence will mount as the hypotheses are tested by additional prospective, longitudinal, observational trials. The clinician's involvement is to design and implement therapeutic strategies to alter the causal exposure, intervene in the dose-response gradient, and block the pathophysiologic mechanisms. Dentistry is an art and a science. Moving through the continuum from causation hypothesis to therapeutic intervention is the science of dentistry. It is the science of dentistry that will change the scope of the profession in this millennium.