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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White spot lesions – treatment options

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This review and network meta-analysis of seven treatments for white spot lesions (WSLs) included 36 clinical RCTs published since 2007. The findings suggest that self-assembling peptide P11-4 and resin infiltration had a positive effect on WSLs but the findings should be interpreted cautiously.

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Orthodontic retainers and retention strategies

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This Cochrane review update evaluating different retention strategies used to stabilise tooth position after orthodontic braces included 47 RCTs. However, only 11 RCTs were at low risk of bias and the overall assessment of the certainty of the evidence is low to very low which means that firm recommendations on orthodontic retention strategies cannot be made.

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Oral leukoplakia – malignant transformation rate

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This review of the rate of malignant transformation (MT) of oral leukoplakia and potential risk factors included 26 mainly retrospective studies. The findings indicate a MT of 7.2% (95%CI; 5.40 to 9.10%) similar to those of another recent review whihc estimated MT as 9.8% (95%CI; 7.9 to 11.7%).

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Virtual reality distraction interventions for dental anxiety in paediatric patients

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This review of virtual reality (VR) distraction interventions in alleviating dental anxiety in paediatric patients included 12 RCTs. The findings suggest VR could be an effective approach to alleviating dental anxiety in paediatric patients.

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Peri-implantitis – adjunctive measures to non-surgical peri-implant therapy

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This review of the effectiveness of patient-performed or administered adjunctive measures to non-surgical peri-implantitis therapy included 9 RCTs. A wide range of interventions were tested but the studies were mainly small with only one being at low risk of bias. Consequently addition high quality well conducted studies are needed on both the prevention and treatment of peri-implant disease.

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Elf Break

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  The Dental Elves are taking a short break . Our next blog will appear on the 29th May.        

Peri-implantitis – surgical treatment methods

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This review comparing the effectiveness of different surgical methods for peri-implantitis included 13 parallel group RCTs. However, a wide variety of interventions were tested and the studies were generally small providing very low certainty evidence. Consequently additional high quality well reported studies are needed.

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Bioactive glass for periodontal defects

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This review aimed to assess the effect of bioactive glass on bone and periodontal regeneration and included 20 RCTs. The included studies were small, involved numerous comparisions with only two being at low risk of bias. The findings showed a statistically signiciant benefit for probing depth with bioglass but this may not be clinically significant and the limited quality of thei included studies mean the findings should be interpreted cautiously.

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Mouthwashes and gingival healing after surgical procedures

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This review of the effect of different mouthwashes on gingival healing used after oral surgery in adults included 13 RCTs. The trials assessed 12 different products and concentrations and only one RCTs was considered to be at low risk of bias so the findings should be interpreted cautiously.

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