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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How clean is your toothbrush?

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This review of the level of toothbrush contamination and the factors affecting contamination in the general population included 15 studies. The findings show that toothbrush contamination occurs after first use and rises with continuing use. However, there is little evidence of significant adverse events from current practices.

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Oil pulling for oral health

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This review of oil pulling compared to chlorhexidine and other mouthwashes in improving the plaque, gingival and bacteria count parameters included 25 RCTs. However, the studies are modest in size of short duration and all except one study were considered to be at high risk of bias. Consequently the available evidence is of very low certainty and should be interpreted cautiously.

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Oral submucous fibrosis and malignant transformation

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This umbrella review of the proportion of oral cancer development in oral submucous fibrosis patients included 4 systematic reviews published between 2019 and 2022. Mean values for malignant transformation across the reviews range from 4.2% to 6%.

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Dental water jet and oral health maintenance in orthodontic patients

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This review assessing the effect of incorporating the dental water jet (DWJ) into the oral hygiene routines of orthodontic patients included 6 RCTs. While the findings suggest a benefit from the use of the DWJ the limited number of small studies none of which were at low risk of bias means the findings should be interpreted cautiously.

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Oral piercings and periodontal health

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This review of the influence of oral piercings on the periodontal health status in adult patients included 8 small observational studies. In line with other reviews the findings indicate adverse effects on periodontal health from oral piercings. However the quality of the evidence is low.

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Oral leukoplakia – global prevalence

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Leukoplakia

This review of the prevalence of oral leukoplakia reported from 1996 to 2022,by continent, definition, age, and living habits included 69 studies. The findings provided a global pooled estimate for prevalence of 3.41% (95%CI: 2.65 to 4.26%).

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Caries experience in patients with diabetes mellitus

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This review of caries experience in adult patients with diabetes mellitus (DM) compared diabetics to individuals without DM included 13 mainly cross-sectional studies. The findings suggest higher DMF scores in patietns with DM.

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Third molar surgery and antibiotic use

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This review of antibiotic prophylactic treatments in relation to the risk of developing dry socket (DS) and site-specific infection (SSI) after lower third molar extraction included 16 RCTs. Antibiotic did reduce the risk of DS and SSI in health patients but the number needed to treat (NNT) was high so the use should be considered only after a careful assessment of an individual patient’s risk.

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Oral cavity and oropharyngeal cancers – surgical treatments

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This update of a Cochrane review of the relative benefits and harms of different surgical treatment modalities for oral cavity and oropharyngeal cancers includes 15 RCTs. Moderate-certainty evidence from 5 RCTs showed trials that elective neck dissection of clinically negative neck nodes at the time of removal of the primary oral cavity tumour is superior to therapeutic neck dissection, with increased survival and disease-free survival, and reduced locoregional recurrence.

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Bruxism in Down Syndrome patients

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This review to assess the prevalence in bruxism in patients with Down Syndrome included 8 small studies. The studies were hetrogeneous with a pooled prevalence of 33% (95% CI: 22 to 45%).

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