Clinical experience, misunderstood concepts and frequently asked questions. Notes from many years of practice.
Before agreeing to an extraction it is worth knowing what saving the tooth achieves: in a 10-year cohort of 132 root canal treated teeth, 91.6 percent were still retained at the end of follow-up. Which situations genuinely require removal, and which have alternatives.
In post-implant recovery, soft tissue usually closes in one to two weeks and bone integration generally takes 2-6 months; long-term plaque control follows.
A dental implant is a titanium or zirconia screw that replaces the root of a missing tooth; across 18 prospective studies, 10-year survival was 96.4%.
Restorative work is judged in restoration-years, not promises: in controlled trials, posterior resin composite restorations were lost at a rate of 1.55 per 100 restoration-years, and across five trials with 627 restorations annual failure ran 0 to 5.4 percent for direct and 0 to 15.5 percent for indirect composite.
The six-month rule has been tested directly: the INTERVAL randomised trial followed 2,372 adults across 51 UK dental practices for four years and found no evidence of a difference in gum health between six-month, risk-based and 24-month recalls. What a checkup is actually for, and how often you need one.
Five-year survival of tooth-supported single crowns was 96.8% for monolithic zirconia, 97.3% for veneered zirconia and 97.1% for metal-ceramic across 64 studies. A zirconia crown shows no dark line at the gum.
The effect is real and it is temporary: a randomised trial in 48 bruxism patients measured masseter thickness by ultrasound and found significant reduction at 1 and 3 months, with treated and untreated groups back to similar values by 6 months. What it treats, and what it does not.
A semi-erupted wisdom tooth is a third molar that has broken through the gum only partly, leaving a tissue flap that traps plaque and can cause pericoronitis.
An honest gap first: the 2 randomised trials in Cochrane's review of routine scale and polish did not assess adverse effects at all. What is measured is flossing, across 8 trials with 585 participants.
