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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Treating obstructive sleep apnoea syndrome with oral appliances results in more short term TMD pain than using CPAP

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Obstructive sleep apnoea syndrome (OSAS) affects about 4% of the male and 2% of the female population of North America. Standard treatment is with continuous positive airway pressure (CPAP) however this has poor adherence in some groups and oral appliance therapy is an alternative therapy. The aim of this trial was to assess variations in [read the full story…]

Restoring the shortened dental arch with partial removable dental prosthesis

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The shortened dental arch (SDA) has been defined as having an intact anterior region but a reduced number of occluding pairs of posterior teeth. The World Health Organization has stated that the retention, throughout life, of a functional, aesthetic, natural dentition of not less than 20 teeth and not requiring recourse to prostheses should be [read the full story…]

Mineral Trioxide Aggregate and Super Ethoxy–Benzoic Acid have similar success rates as root- end fillers following endodontic surgery

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A range of materials have been used for root-end filling after endodontic surgery with a systematic review by Tang and Yin in 2010 finding that; ‘mineral trioxide aggregate (MTA) as root-end filling is better than amalgam and purely gutta-percha but similar to intermediate restorative material(IRM).’ However, only a 5 trials could be included in that [read the full story…]

1-step bonding technique for orthodontic appliances provides modest time saving compared with 2-stage techniques

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The application of dental bonding to orthodontics had had a significant impact on with  bonded appliances replacing multi-banded systems.  With the development of bonding systems there is increasing interest in 1-step systems.  These self-etch systems (SEPs) are used by about 30% of American practitioners and are thought to reduce chair-side time.   The aim of this [read the full story…]

Tailored approaches to oral health education for non surgical periodontal treatment are cost effective

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This cost effectiveness study is based on a data from a randomised controlled trial published by Jönsson et al (2010), that trial compared an individually tailored oral health educational programme (ITOHEP) on periodontal health with a standard oral health educational programme. and found, ITOHEP intervention in combination with scaling is preferable to the standard programme [read the full story…]

Some limited evidence to support the use of chlorhexidine to prevent dry socket

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Dry socket (alveolar osteitis) socket is a painful complication of  tooth extraction that occurs in about  5%  of  extractions of permanent tooth. It is more common following the extraction of wisdom teeth. That aim of this review was to assess whether chlorhexidine, when compared to placebo and/or other interventions, reduced the incidence of alveolar osteitis [read the full story…]

Are zirconia-based restorations clinically successful?

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A new critical summary of a 2010 systematic review  by Al-Amleh et al  on zirconium use in dentistry is now available from the ADA Centre for evidence based dentistry. The summariser notes that three types of zirconium ceramics are currently used in dentistry. The original review’s aim was evaluate these restorations in relation to framework [read the full story…]

Sealants, fluoride varnish and silver diamine fluoride compared

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Dental caries is unfortunately still a common problem among children worldwide.  Cochrane reviews have shown the effectiveness of pit and fissure sealants (Hiiri et al  2009)  and fluoride varnishes (Marinho et al 2002) . While other reviews have found silver diamine fluoride (SDF) to be effective (Rosenblatt et al 2009).  The aim of this trial [read the full story…]

No differences in the surgical outcomes between open and closed exposure for palatally displaced maxillary canines

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The upper permanent canine normally erupts between 11-12 years of age. However, for between 1-3% of children this does not occur and in 50% of the cases it is due to the tooth being displaced palatally. Two surgical approaches are used to allow orthodontic alignment. An open procedure  where  a palatal flap is raised ,overlying [read the full story…]

Available evidence suggests little difference in outcomes between primary or secondary closure techniques after surgical removal of third molars

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Classic wound closure following removal of impacted this molars involved the surgeon covering  and hermitically closes the socket with a flap, allowing primary wound healing. Proponents of  this approach suggest that it decreases the risk of post operative infection.  the alternative approach is to allow healing by secondary intention. Those who prefer this approach suggest [read the full story…]