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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Top Dental Elf Blogs: Jan – Mar 2021

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Blogs on burning mouth syndrome, pain control following third molar surgery and the possible association between serum zinc levels and recurrent apthous unceration were the most popular blogs during January – March 2021.

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Orthodontic treatment with fixed appliances – How long does it take?

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iStock_000002551343XSmall colourful braces on teeth

This review of the the treatment duration required to achieve whole-arch alignment of the mandibular dentition using fixed appliances included 35 RCTs. The pooled duration for whole-arch alignment in the mandible was 263.0 days/8.8 months (95%CI: 6.2 to11.3 months). Mandibular incisor alignment was achieved in 100.7 days/3.4 months (95%CI: 2.8 to 3.9 months).

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Tricalcium phosphates for infra-bony periodontal defects

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This review of the clinical efficacy of tricalcium phosphates (-containing) biomaterials in the treatment of periodontal infra-bony defects includes 16 RCTs. While the findings suggest improvements in pocket depth and clinical attachment level only 6 of the studies contributed to the meta-analyses and the number of events and studies are small so the findings should be viewed cautiously.

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Mobile applications and behaviour change in orthodontic patients

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This RCT looked at whether Mentalization Based Treatment for Adolescents reduced self-harming beahviour

This review of the effectiveness of mobile applications and social media-based interventions in inducing behaviour change among orthodontic patients included 16 RCTs. While the findings suggest some limited beneficial changes in orthodontic patients the interventions are very hetrogeneous and not based on clear behavioural change theory.

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Topical fluorides for early childhood caries

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This review of the caries preventive effectiveness of topical fluorides in the primary dentition included 24 RCTs with 10 RCTs contributing to a network meta-analysis (NMA). While the NMA did allow a ranking of effectiveness the number of studies involved was small and 17 of the 24 studies were considered to be at high risk of bias.

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Bioactive toothpastes for dentine hypersensitivity

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This review of the effectiveness of toothpastes containing bioactive glass,applied either at-home or in-office for the treatment of dentine hypersensitivity included 15 studies. The included studies showed marked variation in the length of follow up, and the concentration of the bioactive material so meta-analyses was not possible.

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Ventilator-associated pneumonia: Does toothbrushing with chlorhexidine reduce risk?

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This review of the effect of toothbrushing and chlorhexidine on the incidence of ventilator-associated pneumonia (VAP) in patients on mechanical ventilation included 7 RCTs. The findings showed that toothbrushing and chlorhexidine reduced VAP,length of stay and duration of ventilation. However the findings should be interpreted cautiously because of study quality.

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Curcumin as an adjunct to scaling and root planing for chronic periodontitis

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Tumeric, curcumin

This review of the effectiveness of oral curcumin products in reducing gingival inflammation and probing pocket depth in adults included 27 RCTs.The findings suggest that curcumin products were as effective as other products. However, a majority of the studies are small and none are at low risk of bias.

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Hypomineralised second primary molars

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HSPM Molar-Incisor hypomineralisation

This review of the the worldwide prevalence of hypomineralised second primary molars (HPSM) includes 37 studies conducted between 1979 and 2020. The findings indicate a HSPM prevalence worldwide of 6.8% (4.98% to 8.86%).

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Oral lichen planus and malignant transformation

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Lichen_planus

This review of high quality studies of oral lichen planus malignant transformation rate included 10 observational studies. The findings found a higher level of malignant transformation in higher quality studies 2.28% (95%CI; 1.49 to 3.20) compared with reviews including lower quality studies 1.14% (0.84 to 1.49).

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