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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Local and systemically delivered antimicrobials and surgical treatment of peri-implantitis

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This review of adjunctive systemic or local antimicrobials as an adjunct to surgical treatment of peri-implantitis included 4 RCTs. The included studies only included a total of 200 pateints and were all considered to be at high risk of bias. The studies antimicrobial and treatment protocols also showed marked variation. Consequently, there is little evidence available on the effectiveness of local or systemic antimicrobials as adjuncts to surgical treatment of peri-implantitis

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Sodium bicarbonate for the management of oral mucositis

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This review of the effectiveness of sodium bicarbonate in the prevention and management of oral mucositis included 11 RCTs. The included studies were small, hetrogeneous and suggested little benefit from the use of sodium bicoarbonate mouthwashes.

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Restorative survival rate -self-adhesive resin cement versus selective-etch, total-etch and self-etch adhesives

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This review assessing the durability of self-adhesive resin bonding, postoperative sensitivity, and the overall survival rate of indirect restorations compared to total-etch, selective-etch, and self-etch adhesives includes 9 RCTs.

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Autogenous dentine graft for implant placement

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This review comparing autogenous dentine graft (ADG) to other bone graft materials for implant placement included 9 studies five of whihc were RCTs. The findings suggest that ADG has similar outcomes to other bone graft material howevr the limited number and quality of the availabel studies means tha findings should be interpreted cautiously.

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Deep caries removal – Selective or stepwise?

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This review comparing stepwise removal (SWR) and selective removal (SCR) of deep carious lesions in primary and permanent teeth included 9 RCTs. The findings suggest that SCR may be more succesful than SWR but they should be interpreted cautiously because of the limited number of studies for some outcomes.

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Chlorine dioxide mouthwash for halitosis

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This review investigating the efficacy of chlorine dioxide mouthwashes in patients with halitosis included 10 RCTs. The findings suggest a potential benefit in the short-term. However the included studies are hetrogeneous and all have some concerns regarding bias so additional high quality well reported studies are needed.

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Mandibular overdentures – stud or ball retained?

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This review of the clinical performance and self-reported patient outcomes of ball and stud attachments as mandibular overdenture retainers included 17 studies. While greater patient satisfaction was seen with the stud type almost all of the included studies were considered to be at high risk of bias so the findingas should be interpreted cautiously.

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Oxycodone for acute dental pain?

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This review of the efficacy of oxycodone for post-operative acute dental pain included 13 studies. the findings showed that NSAIDs are generally superior for post-surgical dental pain, with a better adverse effect profile,so the need for oxycodone in dentistry is limited.

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Apical surgery versus non-surgical root canal treatment or retreatment

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This review of apical surgery compared with non-surgical root canal treatment or retreatment for teeth with apical periodontitis included 5 studies.None of the included studies were at low risk of bias so the findings should be viewed very cautiously.

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Inferior alveolar nerve block 2% mepivacaine versus 4% articaine – trial

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This well conducted randomised controlled trial assessed inferior alveolar nerve block (IANB) success of 2% mepivacaine and 4% articaine in patients with symptomatic irreversible pulpitis (SIP) in mandibular molars during access cavity preparation and instrumentation.

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