Odontologists--remember we need basic, foundational research in all areas of our discipline. Are our procedures scientifically valid and reliable?
Critically examine everything we've been taught. Question the scientific basis of every standard, guideline, best practice, or principle followed.
Keep in mind the quote often attributed to W. Edwards Deming: "Without data you are just another person with an opinion." I would add, if you use incorrect data, you may commit forensic malpractice, and, always remember: "First, do no harm."
We insist on evidence-based treatment in health care, why not in forensics?
Merely saying "we're following the science" without verifying that the "science" being followed is actually true is the same thing religions and cults do.
This is a transcription of a monologue I delivered to the AAFS Odontology Section at the Section's 2021 Annual Business Meeting on Wednesday, Feb 10, back when I used to be Somebody. I post it here by request:
I just want to take a few minutes to talk about something that has really been weighing on my mind. You know, at every one of our meetings for the last, well—many--years folks will invariably come up to me and say something like “hey, we need more research....more research…more research...”
And I’ve come to understand, at least as I think I understand it, that means “someone else needs to do some research.” And then no research gets done because we’re all waiting on someone else to do it.
Well, let me tell you—someone else doesn’t care about our research. Someone else isn’t going to do our research. We have to do our research. After all, we know more about forensic odontology than anyone else. And we care about it more than anyone else. So we’re going to have to do it. After some things that have happened, I think maybe everyone is somewhat afraid to do any research in odontology, especially in one particular area—but, if we want research, then we’re going to have to do research.
So, what am I trying to say? Ok, a little personal disclosure here—I’ve just retired after 16 ½ years working full time at a Medical Examiner’s office. It was a terrific job and I hated to leave. There’s various reasons why I retired—it was just time for several reasons—but one very important motive for me was that I wanted to go to graduate school and learn how to do proper research, and, fortunately, I was in a position to be able to get to do that--and luckily my wife is a very understanding and patient lady. So that’s what I’m doing in a PhD program in forensics now, and I’m loving it.
Why did I want to do this? People look at me and tell me I’m crazy, and I mean CRAZY—you know, at my advanced age and all that, but one reason is that—as I will certainly admit—I was rather critical of some odontology studies done in the not-so-distant past by some of our colleagues who are at this very meeting. But when I sat down and looked at myself in the mirror, I realized in my heart-of-hearts “who am I to criticize these studies? I don’t have any academic research credentials. What am I doing?” I think I owe them an apology. So, I sincerely apologize to Adam and Iain, and Mary and Peter--you all know who I mean.
And I think that, if we’re all being honest, we have to admit that as undergraduate dental students we simply are not taught research design and research methods and statistics, etc., etc. Dentists are pretty bright people, but one has to admit there are some things we simply weren't taught in dental school. It’s just not in the curriculum for folks who are going to be clinical, "wet fingered" practitioners. Oh, when folks go on to specialty programs, they get a little bit of that advanced training, but most of us dentists simply did not have that opportunity.
So my hope is—my challenge is—if “we” need more research—then go do it‼! Get the training! And quit telling me that someone else needs to do research.
Anybody here that’s graduated from dental school can get in a masters degree program in biology at their local college or university, I reckon. If you’re worried about taking the GRE—ask for a waiver based on your dental degree. Ask if they'll accept your ancient DAT scores--if you can find them! You may find some schools have very flexible entrance requirements right now due to the circumstances we find ourselves in. If you're near a dental school, you might even be able to talk your way into a degree program in oral biology--but the point is--go do it!
DO IT! Go learn proper research methods, research design, statistics. What was your undergraduate major?—Biology? Chemistry? Physics? Do a masters degree in that and a thesis on some basic science topic that can apply to forensic dentistry in some way. Just do it!!
And most of you know we have two active fellowship programs in the U.S.—Dr. Senn’s program in San Antonio and the newer fellowship program in Knoxville under Dr. Jim Lewis. The Fellows in those programs need research projects—volunteer to mentor them! Get with them and do some kind of formal study. Do it!
Because, in my view, all is not gloom and doom for the future of forensic odontology by any means. In the two Fellowship programs I just mentioned, for example, we are having many, many applicants interested--more than we can accomodate most years. For the ABFO board exam---after some, well, “tweaking” of the requirements--we’ve had a resurgence of folks applying to challenge the exam. There’s still a lot of interest out there in forensic odontology training.
Now, you might be wondering “wait a minute, why this call for research when we’re actually right in the middle of a meeting where research is being presented?” And that’s a good question. My concern is that in looking at the other Academy sections, such as Criminalistics or Path/Bio for example, they may have more than twice the number of abstracts submitted than the number they can accept. Frankly, most years the Odontology section can barely scrape together enough presentations to put on a program. We had a total of 22 submissions this year out of a grand total of 921 for the entire Academy--that's like, what...two and a-half per cent? We were the lowest of all sections—so, even though some research is being done, there’s not very much in comparison to the other disciplines here.
And I do understand that IRB requirements and HIPAA and ethical constraints sometimes grossly hamper the research we are able to do with living human subjects, but, nonetheless, if one is determined, it
can be done
So, do some research! Proper, well-thought-out, well-designed research. We need to get past all the personal and acrimonious disputes we’ve been having and instead we need to-–as is popular to say at this time—follow the science. Do the unbiased research and let the chips fall where they may. But we need to move forward.
It’s time….because none of us want innocent people sitting in jail.
But you know what?
Innocent people are sitting in jail.
Roger D Metcalf DDS, JD
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Fort Worth, TX 76136-1442
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