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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Vitamin B for the treatment of mouth ulcers

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This review of the efficacy of vitamin B in treating mouth ulcers included 16 RCTs published since 2010. All the included studies were published in Chinese with the findings that treatment was more effective in patients treated with vitamin B.

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Periodontal disease: Does it increase risk of Alzheimer’s disease and mild cognitive impairment?

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Participants who reported higher levels of depression and social isolation had greater risk of loneliness, along with people living alone with dementia.

This blog on a review evaluating the association between periodontal disease (PD), Alzheimer’s disease (AD) and mild cognitive impairment (MCI) was written by the Scottish Special Care StRs following a critical appraisal workshop. The review included 13 studies and suggests a link between PD and AD/MCI, but the evidence is limited.

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CAD-CAM systems and complete dentures

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This review compare the clinical outcomes of complete denture fabrication with CAD-CAM technology and conventional techniques included just 6 small clinical studies. While the findings suggest better performance with CAD-CAm approaches the available evidence is limited and very weak and short term.

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Articaine: Safety and efficacy compared to lidocaine

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This review assessing the safety and efficacy of articaine for routine dental treatment compared to lidocaine included 12 RCTs involving a total of 919 patients. The findings indicate that articaine is is a safe and efficacious local anaesthetic for all routine dental procedures.

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Occlusal reduction and post-endodontic pain

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This review analysing the influence of occlusal reduction on postoperative pain levels after endodontic treatment includes 12 RCTs. The findings suggests no difference was seen in post-treatment pain levels after occlusal reduction.

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Composite resin or amalgam fillings for permanent posterior teeth

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This updated Cochrane review of the efficacy and safety of direct composite fillings versus amalgam fillings included 8 RCTs. Low‐certainty evidence suggests that composite resin restorations may have almost double the failure rate of amalgam restorations.

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Topical anaesthesia: Does it reduce pain perception of local anaesthetic injections?

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This review of the effectiveness of topical anaesthesia in in reducing pain during local anaesthetic injections for dental procedures included 22 RCTs. Statistically significant differences were seen during needle puncture with topical anaesthetic use in the maxilla and palate but not the mandible.

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Intraoral stents to reduce oral toxicity of radiotherapy

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This review assessing the effectiveness of intraoral stents in reducing toxicities in oral cavity induced by radiotherapy in head and neck region included 7 small studies. While the analysis suggests a beneficial effect from the use of intraoral stents the included studies only provide verylow certainty evidence so further high-quality RCTs are needed.

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Denture stomatitis: Are natural products effective?

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This review comparing topical natural substances with conventional antifungals in the treatment of denture stomatitis included 17 studies 14 of which were RCTs. A wider range of natural products were tested and showed similar efficacy to antifungals however, almost all the studies were at high risk of bias so the certainty of the evidence is very low.

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Fibre or metal posts for restoring endodontically treated teeth?

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This review evaluating the difference between fibre and metal posts for endodontically treated teeth included 10 studies 6 of which were RCTs. The findings suggest no differences in outcomes between the two main types of post assessed. However, the evidence is of low certainty.

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