Publication bias and its implications for evidence-based clinical decision making.

In this review, we define and discuss several aspects of publication bias: why it occurs; its importance to dental practitioners, dental educators, and dental students; its potential to affect treatment decisions; and how it can be detected. In addition, we briefly discuss attempts to reduce publication bias. Ideally, clinical decision making should be based on the totality of evidence and not on a sample biased by the selective publication of studies that show significant results. Dentistry increasingly depends on evidence-based decision making for treatment planning and therapy. As a result we, as a profession, need to fully appreciate the potential for publication bias to hinder advancements in oral health care by decreasing the availability of scientific evidence and threatening the validity of evidence-based practice.