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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Direct anticoagulant agents: management before invasive dental procedures

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This review of the evidence of bleeding events following invasive oral procedures in patients using direct anticoagulant agents (DOACs) identified 21 studies but no RCTs. The review found no important differences in bleeding events in patients who continued versus patients who discontinued DOAC therapy.

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Chlorhexidine mouthwash: Do anti-discolouration systems reduce effectiveness?

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This review of the effectiveness of chlorhexidine mouthwash with an anti-discoloration system (ADS) is effective in preventing extrinsic tooth surface discoloration included 13 RCTs with the findings suggesting that ADS reduces staining but did not affect its properties with respect to gingival inflammation and plaque scores.

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Periodontal treatment and glycaemic control in diabetes

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This review of the efficacy of scaling and root planning (SRP) and SRP + adjuvant treatments in improving glycaemic control in patients with type 2 diabetes mellitus and chronic periodontitis included 14 RCTs suggesting some benefit in the short term.

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Toothbrushing in intensive care: Does it reduce the risk of ventilator-associated pneumonia?

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This review of whether toothbrushing-based oral health measures, performed in intensive care units, can reduce the risk of ventilator-associated pneumonia (VAP) included 12 RCTs with the findings suggesting a positive effect.

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School dental screening for improving dental health

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The review found that adding family-based interventions to school-based interventions may reduce the onset of smoking by 4-25%.

This Cochrane review update of the effectiveness of school dental screening programmes on overall oral health status and use of dental services included 7 RCTs providing very low-certainty evidence that is insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance.

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Oral Cancer: Elective neck dissection or watch and wait?

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Bariatric surgery and marked weight loss is likely to improve knee complaints but there is a need for high quality studies

There is an ongoing debate about the management of patients with oral cavity squamous cell carcinoma and clinically negative cervical lymph nodes. Some clinicians favour preventive elective neck dissection (END) which although is linked with favourable survival has an adverse effect on quality of life while others adopt a wait and watch policy. The aim [read the full story…]

Oral mucositis in cancer patients: the effect of oral supplementation

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This review of of the effects of oral supplementation on the prevention and/or treatment of oral mucositis in patients with cancer undergoing chemotherapy and/or radiotherapy included 12 RCTs and suggest that Zinc supplements may be beneficial.

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Caries progression rates in Western populations

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This review of progression rates in the primary and permanent dentition included 43 studies the majority in permanent teeth(32) providing an estimate of caries incidence rate of 0.11 (95%CI; 0.09–0.13) per person- year at risk.

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Caries experience and dental care in children with and without learning disabilities

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People with autism, learning disabilities or other neurodevelopment conditions may be finding the outbreak even more stressful as it can mean a great deal of change and disruption to daily routines.

This review of caries experience and dental care provision in children with and without learning disabilities included 25 cross sectional studies with findings suggesting no overall difference in caries levels between the two groups.

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High fluoride toothpaste for arresting and preventing root caries

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This randomised trial comparing 5000ppm fluoride tootpaste v 1450ppm paste in adults aged 60 and above demonstrated fewer new root canal lesions in the 5000ppm group at 2 years.

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