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 whitening: Tray-delivered gels showed a slightly better whitening efficacy

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This review of tooth whitening included 13 randomised studies and suggests that tray-delivered carbamide peroxide gel provided better whitening efficacy than HP-based products. However the available evidence is very heterogeneous and short term.

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Do analgesics before dental treatment reduce post treatment pain in children?

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This Cochrane review found 5 RCTs of pre-op analgesics prior to dental treatment for children under local anaesthetic. The evidence as insufficient to determine a benefit but there may be a benefit prior to orthodontic band placement. Further high quality studies are needed.

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Third molar removal: antibiotics reduced risk of dry socket

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This review of antibiotic prophylaxis for the removal of third molars included 22 RCTs and suggest that antibiotic use lowered the infection risk by 60%. The number pf patients needed to treat to prevent one infection was 14 (95%CI;11-19).

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Anterior open bite might be corrected with crib therapy

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This review of the use of habit-interception appliances to improve anterior open bite (AOB) included 11 controlled studies only 2 of which were randomised. The limited available evidence suggests that crib therapy could be considered as an effective treatment for the correction of AOB in growing patients.

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Periodontal disease and glycaemic control in diabetics

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This review of the impact of periodontal treatment in diabetics in this latest in a long list of publications on this topic . This review only includes 7 trials and supports the effectiveness of periodontal therapy in glycemic control in type 2 diabetic patients and periodontitis. Other more detailed reviews are available.

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Dental Implants: survival rate in irradiated patients

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40 studies were identified for this review of dental implants in irradiated patients. While survival rates were good, they were lower than in non-irradiated areas. As the majority of the included studies were retrospective the findings should be viewed cautiously.

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Oral leukoplakia: very limited evidence for treatments

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The aim of this Cochrane review was to assess the effectiveness, safety and acceptability of treatments for oral leukoplakia in preventing oral cancer.

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Fluoride mouthrinse: regular supervised use reduces tooth decay in children

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This Cochrane review includes 37 RCTs and found regular supervised use of fluoride mouthrinse by children and adolescents is associated with a large reduction in caries increment in permanent teeth.

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Temporomandibular joint arthrocentesis with hyaluronic acid- evidence limited.

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This review of intra-articular injections of hyaluronic acid (HA) for temporomandibular disorder only identified 8 small studies of limited quality providing no consensus that HA injections were better than other agents.

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