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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COVID-19 Dental Elf Blogs -4

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This blog pulls together a number of our blogs on COVID-19 publishing since July. We also include links to our other COVID-19 relevant blogs published since March 2020.

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Root caries: detection and diagnosis

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This Cochrane review assessing the diagnostic test accuracy of index tests for the detection and diagnosis of root caries in adults included 4 studies and 4997 root surfaces. The studies were all at high risk of bias meaning the available evidence is of very low certainty

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Malocclusion, orthodontic treatment and oral health

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This review looked at both the impact of malocclusion and the impact of orthodontic treatment on oral health. While a large number of studies met the inclusion criteria the heterogeneity of the studies their outcome measures and a a lack of studies to specifically address the questions of this review.

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Access flap procedures or subgingival debridement for periodontitis?

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Periodontal disease Periodontitis

This review comparing access flaps (AF) and subgingival debridement in achieving probing depth (PD) reduction in patients with periodontitis included 18 studies reported in 36 publications. While the results demonstrated a statistically significant improvement in PD reduction between AF and subgingival debridement this may not be clinically important.

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Smoking and its impact on non-surgical periodontal therapy

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This review of the impact of smoking on clinical outcomes of non-surgical periodontal treatment included 17 cohort studies of whihc 11 were prospective. The findings suggest statistically significant smaller improvements in the smoking that non-smoking group. However, any differences are modest and my not be clinically important.

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Powered toothbrushes and plaque control in orthodontic patients

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Typically, fixed appliance orthodontic treatment can last 18-24 months. As the presence of orthodontic appliance encourages plaque accumulation the maintenance of good oral hygiene is important is prevent adverse oral health outcomes.  The small head sizes of powered toothbrushes are considered to assist effective oral hygiene and have been sown to benefit oral health. The [read the full story…]

Photodynamic therapy as an adjunct to non-surgical periodontal treatment

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This review of the adjunctive effects of lasers or antimicrobial photodynamic therapy (aPDT) to non-surgical periodontal treatment included 17 RCTs. The studies were small and hetrogeneous including just 701 patients in total and of low quality providing very limited evidence.

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Periodontitis: Locally delivered antimicrobials as an adjunct to non-surgical treatment

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This review of of locally delivered antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis included 50 RCTs. While the findings indicate statistically significant benefits for probing pocket depth and clinical attachment level (CAL) at 6-9 months and for CAL at 12-60 months their clinical importance can be questioned. In addition most of the studies(47) were considered to be at high risk of bias.

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Periodontitis: Systemic antimicrobials as an adjunct to non-surgical treatment

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This Cochrane review of the effects of systemic antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis identified 45 RCTs. However the evidence is of very low certainty to inform tclinicians and patients if adjunctive antibiotics are beneficial.

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Dental bleaching in-office: What concentration of hydrogen peroxide?

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This review of difference concentrations of hydrogen peroxide for in-office dental bleaching on colour change and bleaching sensitivity included 25 RCTs. The findings indicate that low and medium hydrogen peroxide concentrations had lower risk and intensity of bleaching sensitivity and no difference in colour change efficacy compared with high concentrations.

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