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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Toothbrushing: fluoride toothpaste needed to reduce caries

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Three RCTs were included in this review of the association between personal oral hygiene and coronal dental caries. The findings suggest that in the absence of fluorides personal oral hygiene did not reduce the incidence of caries.

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Crown lengthening – Are outcomes stable?

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This review to assess if surgical crown lengthening produces stable clinical outcomes only identified 5 small trials all at high risk of bias

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Oral potentially malignant disorders – how common are they?

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This review of the prevalence of oral potentially malignant disorders included 22 observational studies providing a pooled estimate for prevalence of 4.47% (95% CI;2.43-7.08).

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Fixed orthodontic appliances- which type of archwire first?

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This Cochrane review of the effects of initial arch wires for the alignment of teeth with fixed orthodontic appliances includes 12 RCTs and updates a previous review. The review finds moderate quality evidence shows that archwires of coaxial superelastic nickel-titanium (NiTi) can produce greater tooth movement over 12 weeks than arch wires made of single-strand superelastic NiTi.

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Denture stomatitis: Is there a role for low-level laser therapy?

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This review of low-level laser therapy (LLLT) or photodynamic therapy (PDT) in the treatment of denture stomatitis only identified 4 small RCTs providing limited low quality evidence of clinical effectiveness.

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Dental anxiety in paediatric patients: Is cognitive behavioural therapy effective?

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This review of cognitive behavioural therapy(CBT) for dental anxiety and dental phobia in children identified 6 RCTs suggesting it therapy produces better anxiety reduction than diverse behavioural management techniques. However the available evidence is of low quality.

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Dentine hypersensitivity: Effectiveness of desensitising toothpastes

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This review evaluating the effectiveness of desensitising toothpastes included 53 RCTs. Most agents with the exception of those containing strontium or amorphous calcium phosphate were effective in relieving dentine hypersensitivity compared with negative controls.

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Local anaesthetics for preventing pain during dental treatment

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123 RCTs were included in this Cochrane review of local anaesthetic agents for preventing pain during dental treatment. 14 types of local anaesthetic were included evidence to support the use of one over another was limited so further research is needed to clarify the effectiveness and safety of one local anaesthetic over another.

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Periodontal health: no additional benefit from 6 monthly Scale and Polish

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This large multicentre, cluster randomised controlled compared the clinical effectiveness and cost-effectiveness of theory-based, personalised oral hygiene advice or scale and polish’ with routine care in improving periodontal health in dentate adults attending general dental practice.

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Orthognathic surgery: Are perioperative steroids beneficial?

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Bariatric surgery and marked weight loss is likely to improve knee complaints but there is a need for high quality studies

This review of perioperative systemic corticosteroids on clinically important outcomes in patients undergoing orthognathic surgery identified 8 small RCTs. A reduction in facial oedema was seen in those receiving systemic corticosteroids. However the quality of the studies is limited and there is lack of evidence on other outcomes or adverse effects.

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