Derek Richards

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Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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Articaine: Safety and efficacy compared to lidocaine

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This review assessing the safety and efficacy of articaine for routine dental treatment compared to lidocaine included 12 RCTs involving a total of 919 patients. The findings indicate that articaine is is a safe and efficacious local anaesthetic for all routine dental procedures.

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Occlusal reduction and post-endodontic pain

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This review analysing the influence of occlusal reduction on postoperative pain levels after endodontic treatment includes 12 RCTs. The findings suggests no difference was seen in post-treatment pain levels after occlusal reduction.

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Composite resin or amalgam fillings for permanent posterior teeth

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This updated Cochrane review of the efficacy and safety of direct composite fillings versus amalgam fillings included 8 RCTs. Low‐certainty evidence suggests that composite resin restorations may have almost double the failure rate of amalgam restorations.

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Topical anaesthesia: Does it reduce pain perception of local anaesthetic injections?

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This review of the effectiveness of topical anaesthesia in in reducing pain during local anaesthetic injections for dental procedures included 22 RCTs. Statistically significant differences were seen during needle puncture with topical anaesthetic use in the maxilla and palate but not the mandible.

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Intraoral stents to reduce oral toxicity of radiotherapy

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This review assessing the effectiveness of intraoral stents in reducing toxicities in oral cavity induced by radiotherapy in head and neck region included 7 small studies. While the analysis suggests a beneficial effect from the use of intraoral stents the included studies only provide verylow certainty evidence so further high-quality RCTs are needed.

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Denture stomatitis: Are natural products effective?

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This review comparing topical natural substances with conventional antifungals in the treatment of denture stomatitis included 17 studies 14 of which were RCTs. A wider range of natural products were tested and showed similar efficacy to antifungals however, almost all the studies were at high risk of bias so the certainty of the evidence is very low.

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Fibre or metal posts for restoring endodontically treated teeth?

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This review evaluating the difference between fibre and metal posts for endodontically treated teeth included 10 studies 6 of which were RCTs. The findings suggest no differences in outcomes between the two main types of post assessed. However, the evidence is of low certainty.

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Orthodontic ligation methods and biofilm formation

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This review comparing elastomeric ligation with self-ligation and steel wire ligation for orthodontic appliances and their effect on clinical outcomes included 11 RCTs. The findings suggest no significant differences although the trials were small with a majority at high risk of bias.

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Third molar extraction– effect of preoperative oral corticosteroids on pain, swelling and trismus

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Four RCTs involving a total of 212 patients were included in this review of a single pre-operative dose of oral corticosteroids in reducing pain,swelling & trismus after surgical removal of lower third molars. While the findings suggested there was little benefit to the patients none of the studies were small and none of them were at low risk of bias.

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Titanium or biodegradable osteosyntheses in orthognathic surgery?

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This review assessing the efficacy and morbidity of biodegradable vs. titanium osteosyntheses in orthognathic surgery included 33 studies 11 of which were RCTs. The findings suggest that biodegradable osteosyntheses is a valid alternative to titanium osteosyntheses for orthognathic surgery, but the quality of evidence is low.

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