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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Inferior alveolar nerve block: can NSAIDs improve anaesthetic success?

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This review of the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) as premedication on the success of inferior alveolar nerve block includes 13 RCTs suggesting NSAIDs have a positive impact on success.

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Corticosteroids for post-endodontic pain

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This review of the efficacy of corticosteroids on postoperative endodontic pain. found that patients receiving corticosteroids reported significantly lower pain scores at 6, 12 and 24hrs postoperatively.

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Bicycle helmets and facial injuries

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This review of the effect of bicycle helmet use on facial injuries included 9 observational studies involving 23,461 patients. Those wearing helmets were less likely to sustain a facial injury (OR = 0.69, 95%CI; 0.63– 0.75)

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Dental pulp testing methods: which is best?

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This review of dental pulp test accuracy included 28 studies. While the findings suggest that laser doppler flowmetry and pulse oximitery are the most accurate the quality of the available studies is low.

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Canine tooth transplantation

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This review of canine autotransplantation included 6 low quality studies are suggests good survival although both resorption and ankylosis increase after 5 years

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Pulp treatments in primary teeth

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This Cochrane review of pulp treatments for primary teeth included 87 trials. Pulp treatments were generally successful with many trials having no clinical or radiological failure in either arm.
Mineral trioxide aggregate (MTA) may be the best medicament to apply after pulpotomy. For pulpectomy there was no conclusive evidence that one medicament or technique is superior to another.

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Orthodontic treatment with fixed appliance had no impact on clinical attachment level

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This review of the impact of fixed appliance orthodontic treatment on clinical attachment levels included 9 small prospective studies finding no no clinically relevant detrimental effect. However the overall level of evidence is low to very low.

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Interdental cleaning aids

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This network meta-analysis of the comparative efficacy of interproximal oral hygiene aids included 22 RCTs and suggests that interdental brushes and water-jets ranked highest for the reduction of gingival bleeding. Although the quality of the available evidence is limited.

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Chemomechanical caries removal in primary teeth

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This review of the effectiveness of chemomechanical caries removal in primary teeth identified 15 studies with 10 contributing to the quantitative analysis. The findings suggest this approach is less painful but takes longer than traditional approaches.

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