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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Patient expectations of orthodontic treatment – research currently of poor quality

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This review of patient expectations of orthodontic treatment included 13 studies but found that the methodological quality was poor so recommended that future studies are needed based on well constructed theory.

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Amoxicillin and metronidazole as an adjunct to scaling and root planning for periodontitis?

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This review of the adjunctive use of amoxicillin and metronidazole with scaling and root planing for the management of periodontitis found improved clinical outcomes in terms of pocket depth and clinical attachment level with their use.

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Tooth autotransplantation: review suggests good survival but evidence limited

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Only 5 small studies were included in this review of the long term outcomes of tooth autotransplantation. All but one was retrospective so the findings which suggest 81% survival at 6 years should be interpreted with caution.

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Bisphosphonate-related osteonecrosis of the jaw treatments– little evidence available

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This Cochrane review of bisphosphonate related osteonecrosis of the jaw only identified one small RCT. The trial compared the use of hyperbaric oxygen (HBO) as an adjunct to standard care. While it suggested a benefit for HBO it was under powered and at high riisk of bias

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Periodontal disease and glycaemic control in diabetics

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11 systematic reviews were included in this overview of review of periodontal disease and glycaemic control in diabetics. The primary studies that underlying these systematic reviews have important limitations. Therefore larger higher quality studies are needed.

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Irrigants for pulpectomy in primary teeth- little evidence available

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This review of irrigants for pulpectomy in primary teeth only identified 7 small RCTs providing little conclusive evidence. More high quality studies are needed.

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Third molars: single dose of preoperative antibiotic reduced infection

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10 RCTs were included in this review of preoperative antibiotics for removal of third molars. The use of antibiotics significantly reduced the odds of surgical site infection or alveolar osteitis (OR = 0.30; 95% CI, 0.19 to 0.47; P≤.00001)

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Furcation involvement may double risk of tooth loss in periodontitis

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This review of the impact of furcation involvement on tooth loss in periodontal disease found 21 pro- and retrospective studies. The data suggests that the risk of tooth loss may be doubled where there is furcation involvement.

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Oral health promotion in dental practices

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44 studies were included in the review of oral health promotion in dental practice that was undertaken to the recent NICE guidance on this topic. The results of this review suggest that the psychology of behaviour change is the key to oral health promotion and greater emphasis on teaching oral health professionals about health psychology would make oral health promotion in the dental surgery more effective.

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Little evidence for antibiotic use in irreversible pulpitis

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This is the latest update of this Cochrane review of the effectiveness of antibiotics for irreversible pulpitis. Only 1 small RCTs is available which provides insufficient evidence to determine whether antibiotics reduce pain or not compared to not having antibiotics

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