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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How common is root canal treatment?

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This review of prevalence of root filled teeth in the adult population worldwide included 76 observational studies. The findings suggest that 8.2% (95%CI; 7.3% to 9.1%) of teeth has been root filled and that 55.7% (95%CI; 49.6% to 61.8%) of people had at least one tooth root filled.

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Periodontal disease in pregnancy – How common is it?

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This review of the prevalence of periodontal disease among pregnant women included 20 studies. The findings suggest an overal prevalence of 40% (95%CI; 15 to 100%) based on 3 studies using the same assessment criteria.

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Glass ionomer restorations and caries prevention

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This review of the effectiveness of glass ionomer cement (GIC) restorations in preventing new caries in primary or permanent dentitions included 10 RCTs. The findings suggest that GIC restorations have a better preventive effect that other materials but the amount and quality of evidence is limited.

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Dental implant placement in patients on anticoagulant or antiplatelet therapy

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The use of dental implants has steadily increased and in recent years the largest increase has been noted in patients aged between 65-74 years.  This age group are also likely to be on long-term prescription of antiplatelet and oral anticoagulants as prophylaxis against thromboembolic events. Dental implant placement as a surgical procedure presents a risk [read the full story…]

Radiotherapy and dental implant survival

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This review assessing the effect of radiotherapy on the survival of dental implants in patients with head and neck cancer included 7 studies involving a total of 441 patients. implant survival rate was lower in irradiated patients with odds ratio = 4.77 (95%CI; 2.57 to 8.89) based on 4 studies.

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Pre-treatment mouthwash to reduce patient to dentist infections

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This Cochrane review of the effects of preprocedural mouth rinses used in dental clinics to minimise incidence of infection in dental healthcare providers included 17 RCTs. The studies measured only reduction in level of bacterial contamination in aerosols with no studies evaluating viral or fungal contamination.The evidence was of low or very low certainty.

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Summer Break

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  The Dental Elf is taking a short ‘summer’ break  and will be back on the 5th September

Miswak use for periodontal health in adults

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This review of the effectiveness of the miswak in reducing plaque and gingivitis in adults included 9 RCTs. The included studies were small with the findings indicating that the miswak reduced plaque and gingivitis scores to a level comparable to toothbrush in the short term.

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Temporomandibular disorders – management with psychological therapies

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This Cochrane review of the effects of psychological therapies in people (aged 12 years and over) with painful temporomandibular disorders (TMD)lasting 3 months or longer included 22 RCTs. Cognitive behaviour therapy (CBT) was the most frequently studied but overall there was insufficient evidence on which to base a reliable judgement about the efficacy of psychological therapies for painful TMD

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Adult dental anxiety – management strategies

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This review of current management strategies for adult patients with dental anxiety in the dental clinic included 54 studies. Most of the psychotherapeutic behavioural strategies provided some benefits but there was limited supporting evidence for some approaches. Pharmocological approaches were not included.

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