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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Caries in Children with Attention Deficit Hyperactivity Disorder

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This review of whether children and adolescents with attention deficit with hyperactivity disorder (ADHD) had more dental caries than children and adolescents without ADHD included 13 observational studies. The findings suggest a higher risk of caries in children with ADHD Odds ratio = 3.31(95%CI; 1.25 to 8.73) and a significantly higher DMFT index Mean difference = 0.75 (0.38 to 1.13). However because of heterogeneity in the included study designs and a lack of adjustments for confounding factors the findings should be interpreted cautiously.

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Oral piercing and oral complications

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This review examining the association between oral manifestations and the use of oral piercings included 54 studies. Damage to periodontal health and tooth structure were the most commonly reported complications however the quality of the evidence is of very low certainty.

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Power toothbrushes – Sonic or oscillating-rotating?

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This review of the efficacy of oscillating-rotating power toothbrush compared to high-frequency sonic power toothbrush includes 32 RCTs. The findings show moderate certainty evidence in favour of the oscillating-rotating however the clinical relevance may not be important.

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Full-mouth scaling or full-mouth disinfection (within 24 hours) for treatment of periodontitis

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This Cochrane review update comparing full-mouth scaling/disinfection (FMS/D) to conventional quadrant scaling for periodontitis for the treatment of periodontitis included 20 RCTs. However there is still no clear evidence that FMS/D approaches provide additional clinical benefit compared to conventional treatment.

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Sagittal split osteotomy – Do third molars increase the risk of complications?

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This review investigating whether the presence of third molars during sagittal split osteotomy of the mandible increases the risk of complications included 15 studies. The findings suggests no statistically significant relationship between the presence of 3Ms and complications. However a majority of the studies were retrospective with 13 studies being considered to be at high risk of bias so the certainty of the evidence is considered to be very low.

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Iron deficiency anaemia and early childhood caries

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This review assessing a potential association between early childhood caries (ECC) and iron deficiency anaemia (IDA) included 14 studies. While the findings showed an association between ECC and IDA the certainty of the evidence was very low so the findings should be interpreted very cautiously,

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Third molar surgery and antibiotics to prevent infection

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This review and infection of dry socket after third molar surgery identified 58 RCTs of whihc 34 contributed to a meta-analyses. The findings indicated that metronidazle and amoxicillin did reduce infection but the findings were of low certainty.

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Does surgical root coverage reduce dentine hypersensitivity?

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This review of the effect of surgical root coverage (RC) on dentine hypersensitivity (DH) associated with gingival recession included 13 RCTs. The findings suggest that RC techniques are associated with a reduction in DH a majority of the included studies were small and DH was only a secondary outcome.

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Pulpitis – How effective are diagnostic tests?

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This review of clinical tests for the diagnosis of the condition of the dental pulp included 28 studies from 29 publications. The quality of the included studies was low providing limited scientific evidence regarding the accuracy and reproducibility of diagnostic tests.

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Primary root canal treatment success rates

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Thiis review of the outcomes of primary root canal treatment (RoCT) in studies published since 2003 included 42 studies (15 RCTs, 14 prospective cohorts and 13 retrospective studies. While pooled success rates were high the quality of the included studies was limited and the studies were conducted in an academic or private practice environment.

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