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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Dental caries and genetics – is there a link?

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This review assessing the agreement of dental caries experience between monozygotic (MZ) and dizygotic twins (DZ) included 19 studies. While the findings indcate a possible a genetic influence the certainty of evidence is very low so the findings should be interpreted very cautiously.

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Orofacial injuries in people with cerebral palsy

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This review of the prevalence of orofacial injuries in patients with cerebral palsy (CP) included 12 studies. Ten studies were included in a meta-analysis which estimates the assess the prevalence of orofacial injuries in patients with CP at 34% (95%CI; 18 – 25%).

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Narrow v regular diameter dental implants for mandibular overdentures

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This review comparing the use of narrow-diameter and regular diameter dental implants for supporting mandibular overdentures included 8 studies reported in 12 publications. While the findings suggest no differences between narrow and regular implants supporting mandibular overdentures the findings should be viewed cautiously as the quality of evidence is limited in quality and quantity and also short-term in nature.

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Sialendoscopy – success rates

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This review of the efficacy and safety of sialendoscopy in the treatment of obstructive diseases of the major salivary glands included 91 studies. The findings indicate and overall success rate of 80.9% (76.6 to 84.6 %) although all the included studies are observational, mainly retrospective and at medium to high risk of bias.

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Tilted implants to support fixed partial dentures

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This review of marginal bone loss and implant survival rate of tilted implants compared with those of axial implants for implant-supported fixed partial dentures (ISFPDs) included 9 studies. The findings suggest no different in survival rates between the two implant types but the possibility of more marginal bone loss with tilted implants.The quality of evidence is low.

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Intraoral scanning v conventional impressions – patient related outcomes

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This review comparing patient-related outcomes of intraoral scanning and conventional impression methods included 13 studies. Nine of the included studies were RCTs and all were considered to be at unclear risk of bias. The findings indicated a patient preference for digital scanning over conventional impression techniques.

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Photobiomodulation for post-operative pain, swelling and trismus after third molar surgery

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This review of the effects of photobiomodulation (PBM) on pain, oedema, and trismus after extraction of impacted mandibular third molars included 33 RCTs. However 30 of the included studies were considered to be at high risk of bias, and while the results suggested small benefits for PBM in relation to reduction of pain and swelling these were not considered to be clinically important.

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Caries in HIV-infected children and adolescents

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This review assessing whether caries severity is higher in HIV-infected children and adolescents than in those who uninfected included 16 studies. While the review suggests a higher caries severity in those infected with HIV the certainty of the evidence is low with the majority of studies not providing information on potential confounders.

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Eruption of maxillary incisors after surgical removal of supernumerary teeth

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Thte review of the percentage of impacted maxillary incisors that successfully erupt after surgical removal of supernumerary teeth included 15 studies. With the exception of one study all were retrospective with meta-analysis indicating a mean eruption success of 57.6% (95%CI; 47.8 to 67.0%). However the certainty of the evidence is very low to low.

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Stress of root canal treatment in patients and dentists

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This review to determine whether root canal treatment causes greater stress than other dental treatments, especially extractions, in patients and providers of dental treatment included 23 studies. The findings suggest that root canal treatment was more psychologically stressful for patients than routine restorative or cleaning procedures however a majority of the included studies (52%) were at high risk of bias.

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