Derek Richards

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Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. He is a former editor of the Evidence-Based Dentistry Journal, the chief blogger for the Dental Elf website and a past president of the British Association for the Study of Community Dentistry. He has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Retired from the NHS he is currently a part-time senior lecturer at Dundee Dental School.

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Adult dental anxiety – management strategies

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This review of current management strategies for adult patients with dental anxiety in the dental clinic included 54 studies. Most of the psychotherapeutic behavioural strategies provided some benefits but there was limited supporting evidence for some approaches. Pharmocological approaches were not included.

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Deep caries management for immature permanent teeth

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This review of techniques and materials used for the management of deep caries in immature permanent teeth included 12 RCT papers. The findings suggest high success rates for pulpotomy, but only a small number of papers were available for other techniques.

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mHealth promotion for parents to improve children’s oral health

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This review of the effectiveness of the mHealth-delivered oral health education to parents parents regarding the improvement of parents’ knowledge, behaviours and children’s oral health status included 12 studies. The studies findings were variable with some demonstrating benefit and some no benefit with all 8 of the included RCTs being at high risk of bias.

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School dental screening for oral health

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This Cochrane review update assessing the effectiveness of school dental screening programmes on overall oral health status and use of dental services included 8 RCTs. There was not enough evidence to draw conclusions about whether traditional school dental screening can improve childrens dental attendance or lead to better oral health.

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Prevalence of different orthodontic malocclusions

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This review the prevalence of malocclusions and different orthodontic features in children and adolescents included 123 studies. However the broad range of approaches used in the studies to determine malocclusion and orthodontic features means that the findings need to be interpreted cautiously.

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Medication-related osteonecrosis of the jaw (MRONJ): Prevention and treatment

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This Cochrane review update of interventions for the prevention or treatment of medication-relatesd osteonecrosis of the jaw (MRONJ) included 13 RCTs. However the studies provided insufficient to either claim or refute a benefit of the interventions tested for prophylaxis or treatment of MRONJ.

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Single implant restorations – Immediate v non-immediate loading

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This review of clinical outcomes for immediate and non-immediate (early or conventional) loading in single-implant restorations included 10 RCTs. All the included studies had follow up periods of 2 years or more although the number of implant failures was very low overall (11 out of 522) in both goups.

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Nicotine replacement therapy – oral side effects

For inpatients with psychiatric symptoms of moderate severity, the study suggests those using nicotine inhalers were most successful overall in their quit attempts. There were no severe adverse reactions to the NRTs.

This review of the evidence on possible association between locally delivered nicotine replacement therapy(NRT) and oral side effects included 28 RCTs. Most of the RCTs were at high risk of bias mainly because of allocation concealment concerns. Reported oral side effects including oral soreness, gastric reflux or vomiting, and mouth or throat irritation.

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CAD-CAM removable complete dentures

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This review comparing the outcomes of , CAD-CAM removable complete dentures (CDs) with conventional CDs included 73 studies. A majority of the studies were in-vitro small, and involved multiple comparison. 39 studies contributed to meta-analyses of a broad range of parameters whiich suggest little technical difference between CAD-CAM and conventional CDs. However few studies reported on aesthetics or patient reported outcomes.

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Tooth extraction prior to head and neck radiotherapy and osteoradionecrosis risk

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28 mainly retrospective studies were included in this review which aimed to determine if tooth extraction prior to head and neck radiotherapy (RT )is associated with a reduced risk of developing osteoradionectosis (ORN). The findings showed a significant association of post-RT dental extractions with the risk of ORN development, odds ratio = 1.98 (95%CI: 1.17 to 3.35. However the certainty of the evidence was low to moderate.

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