pico

Examples of cases and the corresponding PICO 1. April just recently had stitches removed from the site where a cancerous lesion was removed by an oral surgeon. She is relieved that the lesion was detected before cancer progressed to the bone. However, she is concerned that she may get another lesion that is more aggressive and fears that she may have to have some of her jaw removed in the future. She asks you to find out the likelihood of this happening. PICO: In an otherwise healthy female, will a history of one oral cancerous lesion increase the probability of future oral lesions that may be more aggressive? PICO classification: Harm, etiology, causation

2. Angelica is 37-year-old woman who loves to swim and dive. Her favorite food is garlic bread; however, she is bothered by her bad breath after eating it. She is curious about what methods are available to help her breath smell better. She wants to know if brushing her tongue will help or if she can use an antibacterial mouthrinse to fix the problem. PICO: In persons will halitosis or bad breath, will using a toothbrush to brush the tongue as compared to using an antibacterial mouthrinse be more effective in freshening the breath? PICO classification: Therapy/prevention

3. Arnold is a 65 year old male who had a heart attack at age 60. He comes to you distressed because of an article he read on the Internet about the dangers of mercury in amalgam filling. He is now convinced that his eight amalgam fillings are poisoning him and is very concerned about his health. He doesn’t want to replace the fillings if it isn’t necessary but needs proof that he is going to be healthy. You inform him that you will investigate the latest information and get back to him with your findings. Since in this case Arnold prefers not to replace the fillings: PICO: In an aged male with known cardiovascular disease, does the presence of multiple amalgam restorations containing mercury pose a health risk? PICO classification: Prognosis

4. 7 year old George lives in a rural area and drinks well water. George’s mom tells you she recently had the water tested in their well and she was told by town officials that the water doesn’t have enough fluoride to prevent tooth decay. George hates to brush his teeth, and so now his mom is really worried about George getting decay. His pediatrician recommended a daily vitamin containing fluoride but she is wondering if one topical application of fluoride will be enough to prevent cavities.

PICO: In children who do not have access to fluoridated water, will one topical application of fluoride as compared to daily vitamins with fluoride be more effective in preventing tooth decay? PICO classification: Therapy/prevention