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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Keratocysts: conservative treatment approaches?

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29 mainly retrospective studies were included in this review of conservative management approaches for odontogenic keratocysts. While the findings suggest use of decompression followed by enucleation data for recurrence were lower than those found in previous reviews of the topic. High quality prospective studies are needed.

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Fixed appliance orthodontics: extraction or non-extraction and soft tissue changes

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52 studies were identified for this review of the effect of extraction or non-extraction fixed orthodontic treatment of soft tissue profiles . However they were mainly poor quality retrospective studies providing very low quality evidence suggesting that tooth extractions might be associated with differences in the soft tissue profile compared to non-extraction treatment.

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Bleeding after dental extraction: no evidence from randomised trials

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This update of a 2016 Cochrane Oral Health Group review of interventions for post extraction bleeding was unable to identify any published or ongoing trials assessing interventions. Well conducted and reported randomised controlled trials are needed on this question.

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Slow-release fluoride devices for caries prevention: insufficient evidence

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This review of slow-release fluoride devices for caries prevention updates an earlier Cochrane review of the topic. However no new trials have been identified providing insufficient evidence to assess their effectiveness.

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Autotransplantation of teeth to the anterior maxilla?

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This review of the success rates for autotransplantation of teeth into the anterior maxilla includes 17 studies. While the findings suggest high survival rates there is a lack of agreement of success criteria and the quality of the evidence is low.

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Buffering local anaesthetics to reduce dental injection pain?

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14 RCTs were included in this review of the effect of buffering local anaesthetics in reducing infiltration pain and anaesthesia onset time in dentistry. While slight reductions in onset time was seen in inflamed tissues and for IAN block these were not considered to be clinically significant. However the overall quality of the evidence was low.

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Photodynamic therapy for oral lichen planus?

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This review of photodynamic therapy (PDT) for management of symptomatic of oral lichen planus included 5 small studies of limited quality that suggest PDT may be beneficial.

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Dental anxiety: Non-pharmacological treatment may be beneficial

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Should we be paying more attention to anxiety in people with psychosis?

This review of non-pharmacological intervention to reduce mental distress, pain, and analgesic use in adults undergoing dental treatment included 29 RCTs. The findings suggest positive benefits for the interventions examined with no significant differences between the various interventions.

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Orthognathic surgery: limited evidence on antibiotic prophylaxis?

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2 reviews and 2 RCTs were discussed in this review of the effect of antibiotics on postoperative infections in orthognathic surgery. There is a lack ofclarity on the preferred antibiotic and the optimal duration of administration.

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Antiseptic oral sprays: Do they improve oral health?

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20 RCTs involving a total of 720 patients were included in this review of antiseptic oral sprays in the control of dental plaque and gingivitis. The findings suggest then can reduce plaque levels in the short term.

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