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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Interdental cleaning devices with active substances

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This review of the efficacy of interdental cleaning devices (ICDs) used with active substances, as adjuncts to toothbrushing included 7 RCTs. However, none of the available studies was at low risk of bias and all were small. While the findings suggest s benefit from using ICDs with active substances the evidence is of very low certainty so additional high qiality well reported trials are needed.

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Nano-hydroxyapatite for caries prevention

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This review of the efficacy of fluoride-free nano-hydroxyapatite agents (nHA) to enhance remineralisation or hamper demineralisation of enamel caries included 10 small studies. 5 studies were in-vivo and 5 in-situ but they were of short duration with 7 being at high risk of bias so provide very low certainty evidence. Additional high quality well reported studies are needed to assess nHA.

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Post endodontic pain: Is it affected by irrigation technique?

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This review of whether ultrasonic irrigation results in less postoperative root canal treatment pain than conventional irrigation included 6 RCTs. The suggests less pain with ultrasonic irrigation for the first 48 hours but no difference at 72 hours.

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Composite resin restorations in posterior teeth – incremental or bulk fill?

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Composite filling

This review of the performance (retention/fracture) of bulk-fill and incremental filled composite restorations place in the posterior teeth of adult patients included 14 RCTs. Only 4 of the studies were at low risk of bias and while no difference was shown between the two approaches but the number of failures was small small.

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Sealants for primary molar teeth

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This Cochrane review of the effects of sealants compared to no sealant or a different sealant in preventing pit and fissure caries on the occlusal surfaces of primary molars in children. Nine small RCTs were included providing limited evidence of low to very low certainty.

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Interproximal enamel reduction in orthodontics

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This review of the effectiveness of Interproximal enamel reduction (IPR) techniques used in orthodontics included 10 small studies. The included studies were small and of very low to low quality so the findings should be viewed cautiously.

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Oral examination for detecting oral cancer

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This review of the diagnostic accuracy of visual inspection compared with biopsy (gold standard) for the diagnosis or oral cancer and oral potentially malignant dissorders included 18 studies. For malignant lesions the pooled sensitivity was 88% (95%CI; 73% to 95%) and specificity 81%(95%CI; 51% to 95%).

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Cranio-mandibular manual therapy for temporomandibular disorders

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TMJ, Temporomandibular

This review of cranio-mandibular manual therapy (CMMT) on pain and maximum mouth opening in people with temporomandibular disorders included 6 RCTs. While the available evidence supports the use of CMMT it is of very low quality so should be interpreted cautiously.

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Metastatic lesions in the oral and maxillofacial region

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Patients with cancer and comorbid depression have worse anxiety, pain, fatigue, and functioning than do other patients with cancer.

This review of metastatic neoplasms in the oral cavity included 217 observational studies from 33 countries. The 348 cases identified arose from 29 primary sites the most common being lung (21%) and breast (12%).

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Internal bleaching of endodontically treated discoloured teeth

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This review of different bleaching agents used for internal bleaching of endodontically treated discoloured teeth included 8 studies. While the findings suggest all agents had a positive effect the quality of the avaiiable studies is low so the findings should be interpreted cautiously.

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