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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Tooth extraction: factors affecting anxiety and fear

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This review of factors affecting fear and anxiety in adult patients undergoing tooth extraction included 16 studies and identified a number of factors associated with anxiety although there are concerns over the quality of the available studies.

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Composite restorations: direct or indirect placement?

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Only 3 RCTs could be identified for this review of the long-term performance of direct versus indirect composite inlays/ onlays in posterior teeth. the limited quality of the studies provide insufficient evidence to recommend direct over indirect techniques.

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Endocrown restorations – little evidence to support this approach

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This review of endocrown restorations identified 8 studies only 3 of which were clinical. These 3 clinical studies were very small and two of them were retrospective providing very low quality evidence to support their effectiveness.

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Third molars: insufficient evidence for removal of impacted asymptomatic disease-free teeth

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This update of an earlier Cochrane review comparing retention or extraction of of asymptomatic disease-free impacted third molars only identified 2 studies of low to very low quality evidence providing insufficient evidence to inform practice.

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Periodontal treatment: effectiveness of intra-pocket anaesthesia

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This review of intra-pocket anaesthesia for patients having scaling and root planing included 11 trials and demonstrated a benefit over placebo.

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Anticoagulant therapy and dental extractions

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This review the bleeding risk of patients continuing or discontinuing oral anticoagulant therapy found no increase bleeding risk in those continuing anticoagulant therapy.

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Removable dental prostheses: Limited evidence on clinical performance

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Only 19 small studies were identified for this review of the survival rate of removable dental prostheses. the Heterogeneity of the studies and evaluation criteria made comparisons difficult so findings should be interpreted with caution.

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Gingival retraction methods and their impact on gingival health?

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This review looked at the impact of gingival retraction on periodontal health. Only 10 small studies were available so which no method seems significantly superior the quality of the available evidence is limited.

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Silver Diamine Fluoride can arrest caries in children

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This review of silver diamine fluoride (SDF) to arrest caries included 19 studies and suggest that 38% SDF can arrest 81% ( 68-89%) of active caries. . However none of the available studies was at low risk of bias so the findings should be interpreted cautiously.

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Mandibular implant overdentures: effect on nutritional status may be limited

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This review considered the effect of mandibular implant overdentures on the nutrition and nutritional status of older adults. Six small studies were included, overdentures were not seen to have an effect on BMI, albumin or vitamin B12 six months
 after treatment.

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