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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Dentine hypersensitivity: Is low-level light therapy effective?

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This review assessing the efficacy of low-level light therapy (LLLT) on dentine hypersensitivity included 35 studies 27 of which were RCTs. The findings showed an immediate, interim and persistant benifical effect compared to placebo. However the certainty of the evidence was only low to very low.

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Topical hyaluronic acid for recurrent aphthous stomatitis

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This review of the efficacy of topical hyaluronic acid (HA) for reducing the signs and symptoms of recurrent aphthous stomatitis (RAS) included 9 studies 8 of which were RCTs. The findings suggest that HA may be a potential treatment option for RAS but the evidence is of very low certainty.

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Periodontitis: Adjunctive amoxicillin and metronidazole with full-mouth scaling and root planing

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This review of whether amoxicillin and metronidazole used as an adjunct to full-mouth scaling and root planing improved clinical outcomes included 11 RCTs. While the findings indicate significant improvements in clinical attachment level and pocket probing depth they may not be clinically important.

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Proximal caries diagnostic measures

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This review of diagnostic accuracy and reliability of commonly used caries detection methods for proximal caries included 36 studies the majority (31) being conducted in-vitro. A limited number of studies were available to assess most of the diagnostic tests and how the findings from in-vitro studies translates to the the clinical situation needs to be considered cautiously.

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Occlusal caries diagnostic measures

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This review of the diagnostic performance of commonly used methods for occlusal caries diagnoses included 37 studies the majority (29) being conducted in-vitro. While summary diagnostic performance datafor a muber of diagnistic methods is provided it should be treated cautiously as th data is limited in many areas.

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Which retrograde root filling material?

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This Cochrane review update of different materials used for retrograde root filling in children and adults requiring retrograde filling included 8 RCTs. However the studies are all at high risk of bias so provide insufficient evidence for the benefits of any one material.

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Autumn Break

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  The Dental Elves are taking a short break and will be back on the 18th October.            

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Periodontitis: Locally delivered anti-microbials as an adjunct to surgical periodontal treatment

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This review of the effectiveness of locally delivered adjunctive antibiotic treatment during periodontal surgery on clinical outcomes included 9 RCTs. While the findings suggested that adjunctive locally delivered antibiotics could improve some clinical sutcomes they evidence was limited and of very low certainty.

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Osteoradionecrosis and tooth extraction before radiotherapy

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This review of the osteoradionecrosis rate in patients with head and neck cancer having toothth extraction performed before radiotherapy included 8 mainly retrospective studies. The pooled incidence rate was estimated at 2.2% (95% CI: 0.6% to 3.9%) although none of the studies controlled for other risk factors.

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Platelet-rich fibrin and third molar post extraction problems

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This review of the effectiveness of leukocyte-and platelet-rich fibrin (L-PRF) and advanced-platelet-rich fibrin (A-PRF) in mandibular third molar extraction included 10 RCTs. While the findings suggest some benefits the studies are small and limited in number so the findings should be interpreted cautiously.

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