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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Oral anticoagulant therapy: Preventing bleeding in patients having dental extractions

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This Cochrane review of antifibrinolytic agents for preventing bleeding in people on oral anticoagulants undergoing dental extractions or minor oral surgery included 4 RCTs. Topical tranexamic acid was effective in reducing post-operative bleeding following dental procedures.

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Vital pulp treatments in mature molars

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4 different vital pulp treatments for deep caries management of mature permanent molars were tested in this stud .The findings suggest that these techniques could be used but other approaches are available.

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Overdenture attachments systems: splinted or unsplinted?

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9 studies were included in this review of the effect of splinted or unsplinted overdenture attachment system on clinical outcomes. The findings suggest no difference however, the quality of the evidence is limited.

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Metformin as an adjunct to periodontal treatment

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This review of metformin as an adjunct to scaling and root planing for chronic periodontitis included 5 RCTs that were of limited quality and mainly from one research group. The findings suggest benefit.

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Caries risk assessment: Limited evidence for current models

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This review of the effectiveness of Caries Risk Assessment (CRA) models included 32 studies providing limited evidence that CRA is effective for caries assessment and prediction.

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Orthodontic patients: Reminders improved oral hygiene and compliance

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Recent research has shown how behavioural activation can be delivered via smartphones.

14 RCTs were included in this review of the effect of different reminders on oral hygiene and compliance in orthodontic patients. For most outcomes measured beneficial effects were seen in the patients receiving reminders.

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Root Caries: Incidence and increment

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This review of the incidence and increment of root caries included 20 longitudinal studies that provided an overall estimate of incidence of 18.25% 1(95%CI; 13.22%-23–28%) and increment of 0.45 (95%CI; 0.37–0.53).

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Oro-antral communications: evidence for treatment approaches insufficient

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Only one small study comparing compared pedicled buccal fat pad and buccal flap for the management of oro-antral communications and fistulae was found for this Cochrane review update of this clinical question.

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Oral lichen planus: Rate of malignant transformation

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This review of the malignant transformation rate (TR) of oral lichen planus included 21 observational studies the majority of which were retrospective. The overall estimate of TR was 1.4%.

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Silver diamine fluoride for caries prevention in primary teeth

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Four RCTs were included in this review of silver diamine fluoride (SDF) for the prevention of caries in primary teeth. Meta-analysis involving 2 of the studies suggest a preventive fraction = 77.5% (95%CI; 67.8– 87.2%)

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