COHG Prioritisation Exercises 2011-14 Cochrane Oral Health Group has undertaken an extensive prioritisation exercise to identify a core portfolio of the most clinically important titles to maintain. COHG defined 8 areas of dentistry, fit 234 existing titles within the scope of those areas, and subsequently contacted all authors of Cochrane titles relevant to these areas for their opinion of which they felt to be most important. After analysis of the authors’ rankings, lists of the titles our authors thought to be most important were ratified and discussed by panels of experts in August 2014 for each of 6 remaining areas of dentistry (periodontology, dental public health, oral medicine, oral and maxillofacial surgery, cleft lip/palate, and operative and prosthodontic dentistry), with orthodontics (January 2011) and paediatrics (February 2013) having been undertaken in previous years using the same methodology. For some topic areas, in addition to prioritising existing titles, expert panels also identified new titles of clinical importance considered to be currently missing on The Cochrane Library. The resulting list of priority titles will be subject to revision periodically (as the evidence-base in oral health grows over subsequent years), to ensure that COHG’s editorial resource continues to be invested in the most clinically important reviews. Each dental area’s panel was comprised of members considered to be internationally-renowned experts within their field, and who are currently active in clinical practice and/or research. For the August 2014 cluster of dental areas, each panel also included membership from IADR’s Global Oral Health Inequalities network to assist in ensuring that global burden of oral health conditions/disease was considered fully when discussing how each area’s research ought to be prioritised. The IADR GOHIRA representatives were: Periodontology: Mary Cullinan Dental public health: Olalekan Ayo-Yusuf Oral medicine: David Williams Oral and maxillofacial surgery: Bruce Donoff Cleft lip/palate: Peter Mossey Restorative Dentistry: Maria Fidela de Lima Navarro Furthermore, Christopher Fox, Executive Director of IADR, personally participated and contributed to the prioritisation of the following areas of dentistry: periodontology, oral medicine, cleft lip & palate, dental public health, and operative and prosthodontic dentistry. To supplement COHG’s decision-making processes, an online public consultation survey (link) was conducted over an 18-day period (22 July-8 August 2014), and was promoted (and repeatedly shared) via social media channels (Twitter, Facebook, Pinterest), The Cochrane Collaboration’s Consumer Network (CCNet), The University of Manchester’s globally-distributed alumni, and The University of Dundee’s weekly bulletin. The public were asked 2 specific questions: the first on their concerns, and the second to identify which questions what they wanted to know the answers to. 1. Tell us what your biggest oral health concerns are. These can be concerns that you have for yourself, or for any dependent people (children/elderly/disabled) that you care for. Answered: 81 respondents 2. Tell us what the top 3 oral health questions are that you would like to know the answer to? Answered: 81 respondents, totalling 223 queries 1 Respondents provided free text responses which in many cases covered multiple concerns. At the close of the initial 18-day period, a total of 81participants had elected to respond to the open survey invitation, from across 5 continents (Africa, n=2; Americas, n=15; Asia, n=4; Europe, n=58; Oceania, n=2). 79% (64/81) of respondents were female, and there was a broad distribution of responses across age groups from 16-75 years old. To further enhance the prioritisation exercise outcomes, COHG has indicated the reviews which are included in the 30 highest accessed titles (full-text downloads) on The Cochrane Library, as provided to the Group by The Cochrane Collaboration’s 2013 impact report for oral health titles. Periodontology The issue of aging/disease/disability was a dominant concern (27%; 22/81) for the public, closely followed by issues in maintaining gum health (25%; 20/81). Recurrent concerns included bleeding or receding gums, techniques and product use (particularly flossing), harms of whitening teeth, and sensitivity. The decision was taken to pool the highest priority periodontological titles in to smaller clusters, as follows: . Primary prevention Rank Title ID Title Amendments/Explanatory notes Recall intervals for oral health in primary care * 0100 doesn’t solely concern perio, but is of use to 0100 patients* other dental areas also. Last published: December 2013 (Review) - The expert panel suggested that 0100 and 0110 1 Routine scale and polish for periodontal health would be better consolidated into a single review. COHG acknowledges that this suggestion would only 0110 in adults Last published: November 2013 (Review) be rational for particular countries where both interventions are performed concurrently e.g. USA. Powered versus manual toothbrushing for oral health 2 0013 Last published: June 2014 (Review) - Full-text downloads (2013): 0013 ranked 5th of 145 (2,512) . Maintenance Rank Title ID Title Amendments/Explanatory notes Interventions for the maintenance of the Title to be altered at next update to ‘Professional dentition in patients treated for periodontal 1 0235 interventions for the maintenance of the dentition in disease patients treated for periodontal disease’ Last published: October 2011 (Protocol) Psychological interventions to improve adherence to oral hygiene instruction in adults with periodontal 2 0123 diseases Last published: April 2007 (Review) NEW TITLE Interdental cleaning for the prevention and control of periodontal disease and dental caries 0245 and 0257 to be consolidated into a single Flossing for the management of periodontal review, with the scope expanded to allow for the diseases and dental caries in adults inclusion of children. 0245 Last published: December 2011 (Review) This will enhance the strength and utility of the 3 - Full-text downloads (2013): 0245 ranked 11th review for clinicians and patients. of 145 (1,508) Upon publication of the new title, 0245 and 0257 will Interdental brushing for the prevention and be withdrawn from The Cochrane Library. control of periodontal diseases and dental 0257 caries in adults Last published: December 2013 (Review) 2 . Other priority titles Rank Title ID Title Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia 1 0142 Last published: August 2013 (Review) - Full-text downloads (2013): 0142 ranked 2nd of 145 (3,542) Treatment of periodontal disease for glycaemic control in people with diabetes 2 0091 Last published: May 2010 (Review) - Full-text downloads (2013): 0091 ranked 23rd of 145 (1,030) Periodontal therapy for the management of cardiovascular disease in patients with chronic 3 0252 periodontitis Last published: August 2014 (Review) . Periodontitis treatment – not priority titles for maintenance on The Cochrane Library Title ID Title Amendments/Explanatory notes Systemic antibiotics as adjunctive treatment for 0125 chronic periodontitis Last published: January 2005 (Protocol) Guided tissue regeneration for periodontal infra-bony 0006 defects Last published: April 2006 (Review) The expert panel suggested that it was a duplication of Full-mouth disinfection for the treatment of adult effort for Cochrane Oral Health Group to focus 0084 chronic periodontitis resources on the update of periodontitis treatment Last published: January 2008 (Review) systematic reviews, as these reviews are already Enamel matrix derivative (Emdogain) for periodontal undertaken, and updated, by other international 0076 tissue regeneration in intrabony defects periodontal organisations (e.g. AAP; EFP). Last published: October 2009 (Review) Interventions for replacing missing teeth: treatment of peri-implantitis 0023o Last published: January 2012 (Review) - Full-text downloads (2013): 0023o ranked 21st of 145 (1,119) Oral Medicine There were multiple mentions of Sjogren’s syndrome, oral cancer (detection and treatment), mouth ulcers and dry mouth as being issues of concern to the public; however, given that it is estimated that around half of all oral medicine conditions are unseen by (or unknown to) the general public, the expert panel was wary of skewing the outcomes of the survey in relation to determining which priority oral medicine titles were to be maintained. The decision was taken to pool the highest priority oral medicine titles in to smaller clusters, as follows: . Oral cancer diagnosis/screening Rank Title ID Title Screening programmes for the early detection and prevention of oral cancer Last published: November 2013 (Review) 1 0083 Prioritised by dental public health expert panel also. - Full-text downloads (2013): 0083 ranked 25th of 145 (1,019) Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with 2 0263 clinically evident lesions Last published: December 2012 (Protocol) Clinical assessment to screen for the detection of oral cavity cancer and potentially malignant 3 0264 disorders in apparently healthy adults Last published: November 2013 (Review) 3 . Management of oral conditions Rank Title ID Title Amendments/Explanatory notes Interventions for myogenous Title to be altered at next update to ‘Interventions for temporomandibular disorder (TMD) patients temporomandibular disorder (TMD) patients’. Last published: