title: State of the evidence base for medically necessary oral health care.
abstract: OBJECTIVE
  The purpose of this article was to highlight the recent call for an evidence-based approach to public policy decision making with respect to funding dental services and the need this creates for enhanced clinical research activities.
  
  
  METHODS
  Systematic reviews on topics of importance to oral health care practitioners are being conducted and published by various national and international groups. Recent activities to assess evidence to support medically necessary dental services were reviewed.
  
  
  RESULTS
  An Institute of Medicine Committee on Medicare Coverage Extensions found little published scientific evidence that directly assessed the effectiveness of dental services in preventing or managing systemic health outcomes for patients with head and neck cancer, lymphoma, leukemia, organ transplantation, and heart valve repair or replacement.
  
  
  CONCLUSIONS
  The scientific community must strive to meet the challenge of conducting well-designed randomized, controlled trials that test the impact of dental treatment interventions on systemic health to meet the growing need for evidence to support or refute widely accepted dental treatment protocols for medically complex patients.
authors.affiliation: Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill 27599-7450, USA. Lauren_Patton@dentistry.unc.edu
authors.forename: L L
authors.initials: LL
authors.lastname: Patton
authors.forename: B A
authors.initials: BA
authors.lastname: White
authors.forename: M J
authors.initials: MJ
authors.lastname: Field
mesh_terms: D002985:Clinical Protocols; D003657:Decision Making; D017742:Dental Care for Chronically Ill / Q000191:economics; D018865:Dental Research; D019317:Evidence-Based Medicine; D005378:Financial Support; D006291:Health Policy; D006801:Humans; D015201:Meta-Analysis as Topic; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D017063:Outcome Assessment, Health Care; D011643:Publishing; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D014481:United States