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. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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Dexamethasone reduced pain and swelling following third molar surgery

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This review included 8 RCTs involving a total of 476 patients and found that submucosal dexamethasone reduced postoperative pain and swelling. Although only one of the studies was at low risk of bias and there was a possibility of publication bias, the findings should be considered with caution.

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Medication related osteonecrosis of the jaw

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Thirteen studies were included in this review of medication related osteonecrosis of the jaw. The majority were case series ( 9) with the risk of osteonecrosis after tooth extraction being higher in those taking IV bisphosphonates ( 3.2% (95% CI: 1.7–4.7%) than those on oral bisphosphonates 0.15% (95% CI: 0.0–0.36%).

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Caries risk assessment – limited evidence to support current methods

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Only 18 studies were identified for this review of caries risk assessment models. Previous caries experience and salivary mutans streptococci levels were the only two methods with more than 3 studies and the quality of evidence for these two approaches was low.

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Dentine hypersensitivity – calcium sodium phosphosilicate pastes effective suggests review

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This review of the use of Calcium Sodium Phosphosilicate (CSPS) for the treatment of dentine hypersensitivity included 11 trials involving a total of 1190 patients suggesting that a 5% CSPS-containing toothpaste is effective for use as an at-home treatment.

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Breastfeeding and caries risk

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63 studies were included in the review of the association between breastfeeding and caries. The majority (73%) were cross-sectional. The findings suggest that breastfeeding up to 12 months of age is not associated with an increased risk of dental caries and in fact may offer some protection compared with formula.

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Low quality evidence that periodontal treatment improves glycaemic control in diabetics

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This update of a 2010 Cochrane review found low quality evidence that periodontal treatment involving scaling and root planing does improve glycaemic control in people with diabetes, with a mean percentage reduction in HbA1c of 0.29% at 3-4 months, but there is insufficient evidence to demonstrate that this is maintained after 4 months.

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No high quality evidence of treatments for keratocyst

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While there are a number of reviews of treatment options for the keratocystic odontogenic tumour (KCOT), this update of a Cochrane review could identify no relevant RCTs of treatment options. So there is a clear need for well designed and conducted randomised controlled trials to evaluate treatments for KCOTs.

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Micro-invasive treatments can slow caries progression

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8 trials involving a total of 365 patients were included in this Cochrane review of micro-invasive treatments for proximal caries. Micro-invasive treatment significantly reduced the odds of lesion progression compared with non-invasive treatment (e.g fluoride varnish) or oral hygiene advice (e.g to floss) OR=0.24, (95% CI; 0.14 to 0.41).

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Shortened dental arch and oral health related quality of life

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The concept of the shortened dental arch was first raised as a concept 30 years ago, with the WHO endorsing a functional dentition of 20 functional teeth without resorting to a prosthesis. This large cross-sectional study from Brazil suggests that having a shortened dental arch does not have any significant impact on oral health related quality of life.

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Orthodontic bonding: trial suggests primer not needed

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This trial of the effects of primer on the bracket failure rate in orthodontic patients involved 49 patients, using a cross-mouth design; and found fewer bonding failures in the non-primer group 5.5%, compared with 3.1% in primer setting and adjusted odd ratio of 1.89 (95% CI 0.97–3.68).

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