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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Topical fluorides were most consistent in slowing progression of early carious lesions

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Dental caries is a chronic disease that usually progresses slowly. The demineralisation of the tooth seen in the early stages of dental decay are reversible so progression to cavitation can be prevented.  The aim of this review was to appraise the evidence for the efficacy of  nonsurgical caries preventive methods to arrest or reverse the [read the full story…]

Similar performance from glass fibre–reinforced epoxy resin posts and titanium posts in endodontically treated teeth at 7 years

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Yesterday (Dental Elf 14th Jan 2012) we looked at a review that compared cast and fibre posts in-vitro. Here we are looking at a trail that compares the use of more flexible, dentine-like (low Young modulus) glass fibre–reinforced epoxy resin posts (GFREPs) with rather rigid, stiff (higher Young modulus) titanium posts (TPs) in order to [read the full story…]

Review of in-vitro studies shows greater fracture resistance for cast posts

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Endodontically treated teeth (ETT) are considered to be more brittle and subject to fracture. Posts are frequently used to restore ETT and use of the appropriate post material is considered important to a successful restoration.  The aim of this review of in-vitro studies was to compare the fracture load of ETT restored with cast of [read the full story…]

Review shows that tranexamic acid reduced blood loss in orthognathic surgery

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Significant blood loss can occur during orthognathic surgery and there are risks associated with blood transfusion so minimizing blood loss during surgery is important.  A large number of trials and reviews have shown that the antifibrinolytic agent tranexamic acid ( a synthetic amino acid lysine analog )  can effectively reduce bleeding in a number of [read the full story…]

Study shows that berberine had a positive effect on recurrent aphthous ulceration

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Recurrent aphthous stomatitis (RAS) is usually episodic and self-limiting but can produce severe ulcers that interfere with eating speaking and swallowing.  Minor RAS  (MiRAS) is the most common form.  The aim of this trial was to investigate the efficacy and safety of berberine (an isoquinoline alkaloid originally isolated from medicinal herbs) in the treatment of [read the full story…]

Flossing, scaling and bugs in the blood

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Some of the evidence used to in the formulation of the NICE guidance on antibiotic prophylaxis for invasive dental procedures that we discussed yesterday was the recognition that everyday oral activities cause bacteraemia (Dental Elf  10th May 2011). This new cross-sectional study by Zhang et al looked the bacteraemia caused by flossing compared with scaling [read the full story…]

Costs of routine antibiotic prophylaxis prescribing to dental patients in the USA

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In March 2008 the National Institute for Health and Clinical Excellence (NICE) produced new guidance recommending the cessation of antibiotic prophylaxis for all patients at risk of infective endocarditis undergoing dental and a wide range of other invasive procedures. At the time this was controversial and although there were similar changes to recommendations in American [read the full story…]

Critical summaries from the American Dental Association-Center for Evidence-based Dentistry-Jan 2013

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A number of new critical summaries have been made available on the ADE-EBD website of the past few weeks. The first is an appraisal of a 2010 review by Martínez-Maestre et al. that looked at the association between dental bone loss and systemic osteoporosis.  The reviewer highlighted that this was a weak review of observational [read the full story…]

Seasons Greetings

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  Christmas and the New Year is a busy period for us Elves, so we will be taking a short break from blogging over the festive period and coming back to a computer near you on the 7th January 2013. Many thanks to all our readers and followers Nadolig Llawen a Blwyddyn Newydd Dda.   [read the full story…]

Small study shows improvements in obstructive sleep apnoea/hypopnoea syndrome with two designs of oral appliance

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Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is though to affect around 4% of the male and 2% of the female population of North America. Continuous positive airway pressure (CPAP) particularly for moderate to severe cases.   The aim of this cross-over trial was to compare the two types of mandibular advancement appliances (MAAs) with different structures, retention [read the full story…]