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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Global prevalence of edentulism in the over 45s

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This review summarising global data on the prevalence of edentulism and dental caries of people aged ≥45 years living in the community included 86 studies. The estimated global prevalence of edentulism in those ≥45 years was 22% (95%CI; 19 to 24%).

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Omega-3 fatty acids as an adjunct to non-surgical periodontal therapy

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This review assessing the adjunctive effect of omega-3 (ω-3) fatty acids and non-surgical periodontal therapy (SRP)on probing pocket depth (PPD) and the clinical attachment level (CAL) included 10 RCTs. The findings suggest that adjunctive ω-3 fatty acids provides a 0.39 mm improvement in PPD and 0.41 mm of CAL gain.

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Air polishing in supportive periodontal treatment

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This review comparing of air polishing devices with conventional periodontal therapy (hand instrumentation and/or ultrasonic debridement), in patients undergoing periodontal maintenance therapy included 14 RCTs. The findings suggest that they have comparable clinical efficay although the evidence is of low certainty.

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Recurrent aphthous stomatitis – topical interventions

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This review of the efficacy and safety of topical interventions used for recurrent aphthous stomatitis included 72 studies assessing 29 different interventions. Most of the interventions did not demonstrate significant differences with limitednumbers of studies for some interventions and overal limitations in the quality of the evidence.

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Manual toothbrushes – efficacy of new and used brushes

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Today we take a look at a review comparing the anti-plaque and anti-gingivitis efficacy of new and worn manual brushes. The review included 8 RCTs and suggest that new and worn toothbrushes present similar anti-plaque and anti-gingivitis efficacy. However, the evidence is of very low to low certainty.

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Nursing home oral health care measures and pneumonia

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The study highlights that there is limited understanding by family carers and older people of funding arrangements, and it often falls to the care home providers to supply information.

This Cochrane review update of the effects of oral care measures in preventing nursing home-acquired pneumonia inlides 6 RCTs. Low-certainty evidence suggests that professional oral care may reduce mortality compared to usual care when measured at 24 months but evidence for other effects is inconclusive.

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Alveolar osteitis – local management interventions

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This Cochrane review update looked at local interventions used for the prevention and treatment of alveolar osteitis (dry socket) following tooth extraction. 49 RCTs were included providing moderate certainty evidence for chlorhexidine rinses and gel for probably reduction in dry sockets.

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Silver diamine fluoride to arrest caries in cavitated primary molars

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This review of the efficacy of silver diamine fluoride (SDF) in controlling caries progression in cavitated primary molars included 9 RCTs. The findings found an overall effect in preventing caries progression = 33% (95%CI; 26 to 40%) at 12 months.

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Peri-implantitis – How common is it?

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This review aiming to estimate the overall prevalence of peri-implantitis included 57 studies (18 cross-sectional,18 longitudinal, 17 cohort studies, 3 RCTs and 1 case-control). Meta-analysis found an ooverall patient level prevalence of 20% (95%CI; 16.6 to 23.7%). However most of the studies used convenience samples and there was a marked heterogeneity in the diagnostic criteria used so the findings should be viewed cautiously.

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Burning mouth syndrome treatments – network meta-analysis

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This review of all treatments for the relief of pain associated with burning mouth syndrome (BMS) as compared with no intervention or placebo included 44 RCTs. There was moderate certainty evidence that clonazepam is likely to reduce the pain of BMS compared with placebo.

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