Comment (May) – perhaps the thumb technique wasn't so bad!

I would like, if I may, to add some personal comments to the excellent editorial on the ‘thumb technique’ in the May issue.

The late and inspirational Bernie Kieser is mentioned and I, no doubt along with all of his past students, remember Bernie quoting these papers purporting to show how restoration overhangs, and other so-called plaque retention factors, led to worsening periodontal conditions, and then showing us radiographs of such overhangs with no bone loss, while elsewhere in the same mouth there was bone loss around teeth which had no restorations! As Bernie used to say, a plaque retention factor is only a problem if the patient can't clean it; it's not a plaque retention factor if there is no plaque on it. As you rightly point out, in this respect a lump of calculus is no different from an amalgam overhang but, of course, Bernie was always misquoted in this respect, as you also mention.

Another late, great and inspirational clinician was Bernie's compatriot Aubrey Sheiham, who died suddenly in 2015; Aubrey was also a notorious challenger of received wisdom and he, in fact, published a study way back in 1971 showing that there were no significant differences in gingivitis at sites with and without restoration overhangs,¹ as did Leon in 1976² and Grasso et al in 1985.³