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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Resin infiltration for enamel development defects and WSLs

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This review of resin infiltration for enamel development defects and WSLs included 11 studies (7 RCTs) of limited quality. They suggest it may be a feasible treatment option, but high quality studies are needed.

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Dentine hypersensitivity: do mouthwashes help?

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This review of mouthwashes for the management of dentine hypersensitivity included 7 small studies all at high risk of bias. While minor benefits in patients’ subjective perception were seen the limited quality of the study means these findings should be interpreted with caution.

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Stepwise and partial-caries-removal –reduces longer term pulpal complications?

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occlusal caries, molar teeth

This review of stepwise or partial caries removal for deep caries suggesting included 5 studies ( 2 RCTs) of limited quality. Findings suggest better pulpal outcomes with these approaches compare with traditional treatment.

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Amalgam outperforms composite in range of posterior cavity types

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This review of failure rate of single-unit prostheses versus direct restorations in vital posterior teeth included 14 studies (5 RCTs) finding that composite had a significantly higher failure rate than amalgams, regardless of the remaining tooth structure. For teeth with fewer than 2 remaining walls, direct restorations presented significantly higher failure rates than crowns .

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Intrusive luxation in permanent teeth

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PDS scores at follow up showed gains were maintained

This review of treatments for teeth with intrusive luxation included 8 studies. The studies were all considered to be at high risk of bias and suggested that spontaneous re-eruption should be the treatment of choice. However the small number of studies and limited quality means these findings should be interpreted with caution.

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Cavity liners for posterior resin based composites?

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This Cochrane review of liners under posterior composite restoration included 8 RCTs identifying little evidence to show that they reduced sensitivity and no evidence of an effect on longevity of restorations.

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Oral care for critically ill ventilated patients

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38 RCTs were included in this Cochrane review update of oral health care in ventilated patients. High quality evidence was found to show that chlorhexidine mouthwash or gel reduces the risk of developing ventilator-associated pneumonia in critically ill patients from 25% to about 19%.

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Oral health-related quality of life improved in children following dental treatment under general anaesthesia.

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The authors suggest a number of factors that may lead to increased prevalence, including depression, childhood trauma, low self-esteem and genetic risk.

20 studies were identified for this review of oral health related quality of life in children following general anaesthetic (GA). While a majority demonstrated an improvement following GA most are based on convenience samples and are of limited quality so more high quality research is needed.

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Temporomandibular disorders: high prevalence of otologic signs and symptoms

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This review of otologic signs & symptoms in patients with temporomandibular disorders included just 8 studies and highlights a high frequency but the findings should be interpreted with caution because of the limited quality of available studies.

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Endodontic retreatment: Surgical or non-surgical approach?

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20 RCTs are included in this Cochrane review update of endodontic retreatment. The available evidence is of low quality so further research is needed to understand the effects of surgical versus non-surgical approaches, and to determine which surgical procedures provide the best results.

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