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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Irreversible pulpitis: Do larger volumes of local anaesthetic improve success of inferior alveolar nerve blocks?

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This review of the efficacy of 1.8 and 3.6 mL of the same anaesthetic solution for inferior alveolar nerve blocks (IANBs) for treating mandibular teeth with irreversible pulpitis included 4 RCTs (280 teeth). The findings show arger volumes of local anaesthetic solutions significantly increase the success rate of IANBs.

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Aromatherapy and dental anxiety

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This review of the efficacy of aromatherapy on dental anxiety included 17 studies (11 RCTs, 6 CCTs). The evidence suggets aromatherapy may reduce dental anxiety and has comparable effects on dental anxiety compared to music intervention but the evidence is limited and of low to very low certainty

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Boric acid as an adjunct to non-surgical periodontal therapy?

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Non-surgical periodontal treatment is the mainstay of treatment for the management of periodontitis. A number of adjunctive treatments have been used to improve outcomes including, local and systematic antibiotics and photodynamic therapy.  It has been suggested that boric acid may be beneficial as boron compounds have antimicrobial, anti-inflammatory and immune regulatory effects and beneficial effects [read the full story…]

Vibration devices: Do they reduce pain linked to dental injections in children?

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This review evaluating the effect of vibration devices on paediatric dental injection pain reduction identified 6 RCTs. The findings suggest that the use of the DentalVibe was not effective but the evidence ws of low quality.

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Articaine local anaesthesia and the risk of hyperaesthesia in third molar surgery

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This review of the risk of hyperaesthesia with articaine compared with other local anaesthetics in lower alveolar nerve block for lower third molar removal included 13 studies.The findings suggest that the use of articaine does not increase the risk of hyperaesthesia.

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Endodontic retreatment:Post-operative pain in single or multiple visits

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This review assessing the postoperative pain after non- surgical endodontic retreatment in a one visit compared to multiple visits included 4 RCTs. The availabe evidence suggests little difference between teh two approaches.

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Betel quid and areca nut chewing and oral cancer prognosis

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This review of the links between the habit of betel quid and areca nut (BQ-AN) chewing and the prognosis of oral cancer included 11 observational studies. The findings suggest that lower 5-year survival is seen in those with a BQ-AN chewing habit.

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Third molar extractions: Which anaesthetic solution for the best pain control?

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This review of the effectiveness of different anaesthetic solutions for pain control immediately after the extraction of lower third molars included 45 studies.13 studies were included in a network meta-analys whch suggested 5% bupivacaine reduces pain in patients during and immediately after the removal of lower third molars.

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Prevalence of temporomandibular joint disorders

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This review was to evaluate the prevalence of temporomandibular joint disorders (TMD) among the general population. 21 studies involving a total of 11,535 patients were included with the findings suggesting a prevalence of 29.3% (95%CI; 6.1–72.3%) in adults assessed using the RDC/TMD Criteria.

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Light-based tests for early caries detection

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This Cochrane review aimed to estimate the diagnostic test accuracy of different illumination tests for the detection and diagnosis of enamel caries in children or adults. 24 datasets from 23 studies were included with optical coherence tomography showing the most potential but more research is needed.

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