State of the evidence base for medically necessary oral health care

Objective. The purpose of this article was to highlight the recent call for an evidence-based approach to public policy decision making with respect t o funding dental services and the need this creates for enhanced clinical r esearch activities. Study design. Systematic reviews on topics of importance to oral health car e practitioners are being conducted and published by various national and i nternational groups. Recent activities to assess evidence to support medica lly necessary dental services were reviewed. Results. An Institute of Medicine Committee on Medicare Coverage Extensions found little published scientific evidence that directly assessed the effe ctiveness of dental services in preventing or managing systemic health outc omes for patients with head and neck cancer, lymphoma, leukemia, organ tran splantation, 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 n eed for evidence to support or refute widely accepted dental treatment prot ocols for medically complex patients.