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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Peri-implantitis – Surgical treatment with or without adjunctive graft material

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This review of the surgical treatment of peri-implantitis alone or in combination with adjunctive graft material included 5 small RCTs. The findings suggest improvements in marginal bone level (MBL) with graft material but the findings should be interpreted very cautiously because of the limited amount and quality of the evidence.

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Adjunctive therapies during supportive periodontal care

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This review of adjunctive therapies during supportive periodontal care (SPC) in patients with residual/relapsing pockets included 12 studies that currently provide insufficient/poor evidence to determine the efficacy of adjunctive strategies to improve SPC.

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Antibiotics for dental infections – Short or long duration courses?

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This review comparing short (3–5 days) or longer courses (≥7 days) of antibiotics for the treatment of dental infections in general practice only included one small RCTs. No differences were seen between short an dlong courses but the findings should be interpreted cautiously becaise of the limited data available.

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Metronidazole for treatment of non-periodontal dental infections

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This review of whether metronidazole used as monotherapy or in addition to a β-lactam antibiotic offers any additional benefit over β-lactam monotherapy in non- periodontal dental infections includes 3 RCTs. The findings suggest that metronidazole does not provide superior clinical results compared to β-lactam antibiotics for the treatment of non-periodontal dental infections. However the evidence is limited and of low quality.

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Dental erosion in children and gastro-oesophageal reflux disease

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This review of the association between gastro-oesophageal reflux disease (GERD) and dental erosion in children included 13 observational studies. The findings suggest positive association association between GERD and dental erosion in children however this should be interpreted cautiously because of the wide variety of diagnostic methods used in the included studies.

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Periodontal treatment for preventing cardiovascular disease in people with periodontitis

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This Cochrane review update on the effects of periodontal therapy for primary or secondary prevention of CVD in people with chronic periodontitis includes 2 studies which provide very low certainty evidence. No additional studies have been included since the last update in 2019.

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Oral erythroplakia: malignant transformation rate

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This review of the malignant development rate of oral erythroplakia and associated risk factors included 10 studies involving a total of 441 patients. Meta-analysis of 3 studies suggest a malignant development rate = 19.9% (95%CI; -1.6% to 41.4%).

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Burning mouth syndrome – topical interventions

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This review assessing the effectiveness of topical interventions in the management of burning mouth syndrome (BMS), based on the core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) includes 8 RCTs and higlights the need to apply standardised outcome measures in future studies.

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Early and delayed dental implant loading

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This review of the outcomes of early and delayed loading of dental implants included 18 RCTs. The findings suggest that early and delayed loading protocols had similar clinical outcomes. However none of the included studies was at a low risk and 13 of the 18 studies were considered to be at high risk of bias. While the findings are similar to other reviews teh availabel evidence is of low to very low certainty.

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Caries prevention in older adults

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This review of the effectiveness of professionally applied fluoride therapy in preventing and arresting dental caries in older adults aged 60 years or above included 7 studies. The findings suggest that 5% NaF varnish, 38% SDF solution, and 1.23% APF gel were effective in preventing root caries but the studies were varied in treatment protocols, intervention method and follow-up period so more research in needed.

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