Roger Federer does not have extraordinary natural reaction speed any better than members of the general public, which allows him to see a tennis ball quicker than anybody else. His ability to see a tennis ball which is travelling at 150mph from only a few yards in front of him is a practiced technique of pattern recognition - watching his opponent’s body, the angle of his arm, his shoulder and body position to estimate where the ball will land and finish. It takes years and years of hours and hours of practice to achieve this and it was only discovered by research on ATP tennis players carried out at Liverpool University. The researchers at Liverpool attached special iris cameras to tennis players to see where they were looking when they were receiving serves and were staggered to find out that they never looked at the ball or the head of the racket of their opponent. This is the counter intuitive truths which are revealed from proper measuring and reporting.
Recently many top sports franchises, and in particular, Premiership football teams have turned to statistical analysis to try to gain a professional and performance advantage. Some of the facts have been staggering. Regardless of Barcelona’s ‘the team who has the ball controls the game’ philosophy, percentage possession is relatively insignificant in the outcome of matches.
Counter intuitive?
In Margaret McCartney’s book ‘The Patient Paradox’ she references a study on patients entering A&E with head injuries. For many years patients were routinely given steroids when they entered after a significant head injury because the rationale was that steroids reduce swelling and reducing swelling in head injuries was a good thing so lets give them steroids. For twenty years this rationale persisted without proper measurement or observation and tragically, when the observation was done, it was estimated the up to 10,000 people had lost their lives as a result of steroid prescription in head injuries. This no longer happens, but only after correct observation and measurement.
So what’s the point? How does this affect me and my profession? What aspects of the treatment we are providing are in fact properly measured and proven to work with reproducible studies? The truth is sadly, very little.
This is perhaps relatively insignificant within dentistry and certainly within procedures in dentistry where there is little harm to patients, but in truth and particularly in implant dentistry, patients are paying for procedures, which simply are not proven to work because the dentist ‘thinks they work’ or ‘it works in their hands’.
Research needs to be reproducible and procedures need to be appropriate for the vast majority of practitioners in the 80% of competent zone. So for the implant dentists among you… where is the evidence that steroids are effective in reducing swelling post-operatively (we use them currently but why do we use them?). Where is the evidence that steroids do not lead to increased implant failure? Where is the evidence that PRGF works (in writing this blog I tried to search for decent and conclusive evidence that PRGF was effective and useful in implant dentistry. I could find nothing of significance. Perhaps someone could send me some?)
Where is the evidence that bone rings work? Where is the evidence that vertical grafting works? Where is the significant bank of evidence that shows that immediate anterior implants have long-term stable results?
These points are all open to discussion but it is a discussion we should have throughout our profession for the benefit of patients, not just for their health overall (of course that is the most important point) but also for their pockets and the things we sell which unfortunately are beginning to look a little bit hocus pocus.
Blog Post Number: 1227
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