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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Orthodontic bonding – failure rates with different techniques

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This review of the failure rates of different orthodontic bonding materials included 80 studies with 34 contributing to the quantitative component. The findings suggest little difference between the self-etch primer and conventional acid-etch primer and a poorer performance for glass ionomer compared with self-cure resin. However the findings should be interpreted cautiously because of the low certainty of the available evidence.

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Anterior open bite self-correction after cessation of non-nutritive sucking habits

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This review of whether self-correction of anterior open bite (AOB) occurred after stopping non-nutritive sucking habits after 4 years of age included 5 studies. The studies reported a range of self-correction of AOB from 50-100% however the studies were all at high risk of bias providing evidence of very low certainty.

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Adjunctive chlorhexidine for gingival health in orthodontic patients

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This review of the efficacy of chlorhexidine (CHX) products in maintaining gingival health in orthodontic patients with fixed appliances included 20 RCTs only 1 of which was at low risk of bias. The findings showed a benefcial effect on gingival parameters with CHX mouthwash at 1-3 months but the findings should be interpreted cautiously.

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Fluoride varnish for prevention of white spot lesions during orthodontic treatment

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This review evaluating the preventive effect of regular applications of fluoride varnish (FV) on the development of white spot lesions (WSL) during orthodontic treatment included 7 RCTs. Meta-analyses demonstrated a reduction in the risk of WSL with regular FV applications but the certainty of evidence was very low.

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Smartphone application for dental anxiety in adolescents

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In this blog we look at a RCT investigating the effect of a smartphone App on dental anxiety, communication, cooperation, and satisfaction among Brazilian adolescent patients. The findings show a reduction in anxiety from 22.8% to 6.5% in the test group compared with a reduction form 20.7% to 18.8% in the control group.

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Pulpotomy v root canal treatment in permanent teeth

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This review of pulpotomy ( partial or full) v root canal treatment (RoCT) in permanent teeth with pulpitis included 2 RCTs involving 957 teeth. The findings suggests no difference in pain at 7 days or in success rates at 1 and 5 years but the evidence is limited.

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Adverse Childhood Experiences (ACEs) and oral health

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This review of the relationship between adverse childhood experiences (ACEs) exposure and oral health among adults included 4 cross-sectional studies with the findings indicating an association between ACEs and poor oral health.

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Chewing gum for pain during and after orthodontic appliance installation

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This review of the efficacy of chewing gum in reducing pain intensity in patients undergoing fixed orthodontic treatment included 16 RCTs. The findings suggest , chewing gum was significantly more effective than both pharmacologic agents and placebo in reducing orthodontic pain 24 hours. However the evidence is of very low certainty.

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Pulpal and periapical pathosis after placing indirect coronal restorations

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This review investigating the incidence of and influential factors on pulp necrosis and periapical pathosis of vital teeth following indirect restorations included 37 studies. The findings suggest an overal incidence of pulpal necrosis of 5.02% (3.70 to 6.52%).

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Mouthwashes, microorganisms and gingivitis in orthodontic patients

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This review of the efficacy of mouthwashes on oral microorganisms and gingivitis in orthodontic patients included 32 RCTs. While the findings suggest short-term benefits with adjunctive mouthwash use the findings should be intertpreted cautiously as only one RCT was at low risk of bias and for almost all outccomes the certainty of evidence was rated as very low to low.

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