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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Occlusal caries prevention: Seal or varnish?

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This large, well-conducted study in a primary care setting found a small, but not statistically significant difference, between fissure sealants and fluoride varnish for the prevention of caries in first permanent molars at 36 months.

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Chlorhexidine mouthrinse: Reduced plaque and gingivitis when used as adjunct to mechanical oral hygiene procedures

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51 studies were included in this Cochrane review of chlorhexidine mouthwash as an adjunct to mechanical oral hygiene measures. The review provides high quality evidence for a large reduction in the build-up of plaque at 4 to 6 weeks or 6 months. There is also high quality evidence of a moderate reduction in gingivitis in patients with mild gingivitis which may not be clinically important.

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Bruxism: Are botulinum toxin injections helpful?

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Only 5 small low quality studies were included in this review of botulinum toxin (BoNT-A ) injections for sleep bruxism. 3 of the included studies were RCTs and while a potential benefit from use of BoNT-A treatment was suggested the findings should be treated very cautiously.

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Sinus lift with dental implants: to graft or not to graft

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The Scottish Dental Registrars on a recent review of dental implants combined with sinus augmentation (sinus lift): what is the merit of bone grafting?

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Temporomandibular lavage for temporomandibular disorders

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This review of TMJ lavage for temporomandibular disorders only included 5 small RCTs a majority of which were at high risk of bias. While the findings suggest a benefit from lavage this should be interpreted cautiously because of the limited quality of the available evidence.

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Dental pulp testing: insufficient evidence to evaluate clinical performance

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This review of pulp sensibility and vitality tests identified 8 studies (4 Cohorts, 4 Case-controlled) . The number of studies matching the inclusion criteria did not provide a sufficient foundation to evaluate the clinical performance of pulp vitality tests.

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Oral mucositis in cancer patients: no benefit from chlorhexidine mouthwash

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This review of chlorhexidine (CHX) for prevention & treatment of oral mucositis included 12 RCTs with 9 contribution to the meta-analysis. CHX was not significantly effective in preventing mucositis or reducing its severity.

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Chlorhexidine gels and rinses reduce dry socket after third molar extraction

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This review of the effectiveness of chlorhexidine for prevention of dry socket after third molar removal includes 18 RCTs. The finding suggest a 47% (95%CI,38-55) reduction in cases following its use.

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Anxiety and pain during dental treatment

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35 studies investigating 47 clinical groups were included in this review of the association between dental anxiety and pain during dental treatment. The findings suggest a consistent impact on pain through the entire period of dental treatment.

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Resin-bonded fixed dental prostheses: 5 year survival and complication rates

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This review of survival and complication rates of resin-bonded fixed dental prosthesis included 209 studies. The findings suggest overall survival rates of 91.3 % (95%CI; 88–93.7) . The quality of the available studies suggest that this should be interpreted cautiously.

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