How Do We Know What We Know?

by Fay Goldstep, DDS, FIADFE, FASDA

We go through life on many roads picking up information and details as we grow, mature and age. The journey of life is a journey of knowledge. How do we gain knowledge? How do we know what we know?

The ancient Greeks created a branch of philosophy dedicated to this question called epistemology. A quick online search for the term yields: “Epistemology is the theory of knowledge. It is concerned with the mind’s relation to reality. It requires different psychological routes to knowledge including different processes of reasoning – logical and scientific – introspection, perception, memory, testimony and intuition.”

That is certainly a mouthful! A theory of knowledge includes mind and reality, logic and science, perception, testimony, intuition. We do not just “know” a fact. Many processes come into play and there can be much confusion when these processes no longer follow a predictable path.

To know a fact there must be evidence and the evidence must come from a trusted source. This can be challenging as many sources may supply contradictory facts that are often coloured with opposing agendas. This is certainly evident in our day-to-day world. Polarizing political views, over-riding identity focus, and fear, fuel misinformation through the bombardment of ever-present social media.

In the practice of dentistry things are clearer because there is a verifying mechanism inherent in our search for knowledge for clinical success. Scientific research is tested by clinical investigation and confirmation. Clinical dentistry verifies the research and becomes its conscience. It is interesting to note that the term “conscience” is a combination of “con” or “with” and the Latin word “scientia”, meaning “to know” or “knowledge”. What an ideal team – investigative science and the dental chair, working together to progress and confirm.

Dental science provides the materials, ideas and techniques that have been evaluated under academic conditions. The true test lab becomes the dental chair. Of course, we must vet our scientific sources. Who are the investigators? Who has funded the research? What is the evidence? How significant is it? Will this new technique/material/process benefit my patient? Will it be easier or faster than my present system? How difficult will it be to integrate into practice? Is it going to affect my bottom line? True testing begins at the chair where many questions are answered, and new ones appear.

Science opens our door to knowledge with continuing education through articles and lectures about unknown possibilities. Clinical practice is the laboratory where we hone our techniques to excellence. This is where we finally know what we know!

We are lucky to be in a field where we can escape from the insanity of the outside world, where it is has become impossible to “know”, and to work in the dental world, where “con-science” is our guide. In this world, the dental patient and the dental team are the ultimate beneficiaries.

About the Author

Dr. Fay Goldstep sits on the Oral Health Editorial Board (Healing/Preventive Dentistry), has served on the teaching faculties of the Post-graduate Programs in Esthetic Dentistry at SUNY Buffalo, the Universities of Florida (Gainesville), Minnesota (Minneapolis), and has been an ADA Seminar Series speaker. She has lectured nationally and internationally on Soft-Tissue Lasers, Electronic Caries Detection, Healing Dentistry and Innovations in Hygiene and has published numerous textbook chapters and articles on these topics. Dr. Goldstep is a consultant to a number of dental companies, and maintains a private practice in Markham, Canada. She can be reached at Fay Goldstep, has lectured nationally and internationally on Proactive/Minimal Intervention Dentistry, Soft-Tissue Lasers, Electronic Caries Detection, Healing Dentistry and Innovations in Hygiene. She has been a contributing author to four textbooks and has published more than 100 articles. She sits on the editorial board of Oral Health. Dentistry Today has listed her as one of the leaders in continuing education since 2002. Dr. Goldstep is a consultant to a number of dental companies, and maintains a private practice in Richmond Hill, Ontario. She can be reached at

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