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  • What’s the best way to reduce post-op pain after extractions? And why should we never use the term “painkiller” with patients? What to do when you hear the dreaded *crack* of a tuberosity?



    In this episode we talk about all things post-operative extraction complications! And I’m joined by one of the nicest guys in dentistry - Dr. Nekky Jamal 



    Complications are something we ALL experience, so this episode is great for any dentist. Whether you're brushing up on dry socket prevention, mastering post-op communication, or just curious about advanced healing hacks, tune in for real-world advice to make extractions smoother - for both you and your patients




    https://youtu.be/BvB3hDESYDY
    Watch PDP210 on Youtube



    Protrusive Dental Pearl: The "Niche Kebab" concept encourages dentists to narrow their focus by reducing the variety of procedures they perform and prioritizing those they genuinely enjoy. By evaluating every new skill or treatment added and strategically dropping less-loved procedures, dentists can avoid overextension and the "jack of all trades, master of none" pitfall. 



    Learn how to Extract Impacted 3rd Molars, don't miss out on Third Molars Online and use the coupon code ‘protrusive’ to get 15% off!



    Key Takeaways




    Pain management is about setting realistic expectations.



    Dexamethasone can be beneficial but must be used cautiously.



    Dry socket is often overhyped; proper care can prevent it.



    Effective communication can alleviate patient anxiety and prevent misunderstandings and complaints.



    Preoperative care can help manage pain expectations.



    Understanding the signs of infection is essential for diagnosis.



    Chlorhexidine rinses can significantly reduce dry socket risk.



    Patients appreciate being informed about their unique dental situations. PRF can significantly reduce the incidence of dry socket.



    Dentists should embrace new techniques like PRF to enhance patient care.



    Patient involvement in post-surgical care is crucial for healing.



    Dentists should not hesitate to refer complex cases to specialists.




    Highlights of this episode:




    02:54 Protrusive Dental Pearl



    04:05 Dr. Nekky Jamal 



    08:39 Managing Post-Extraction Pain and Swelling



    21:37 Infection



    25:02 Identifying Dry Socket and How to Prevent it



    28:30 Case Selection and Communication



    37:13 Mitigating Dry Socket with Platelet-Rich Fibrin (PRF)



    39:47 The Importance of Nicheing in Dentistry



    43:19 Cryotherapy and Post-Surgery Care



    47:32 Handling Tuberosity Fractures



    55:08 Patient Consent 



    57:55 Litigation and Patient Communication




    This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. 



    This episode meets GDC Outcomes A, C and D.



    AGD Subject Code: 310 ORAL AND MAXILLOFACIALSURGERY (Exodontia)



    Dentists will be able to:




    Identify and differentiate common postoperative complications, and recognise the  key symptoms associated



    Evaluate the ethical and clinical considerations of case selection for extractions



    Communicate effectively with patients regarding potential complications




    If you loved this episode, be sure to check out another epic episode with Dr. Nekky Jamal - Wisdom Teeth Extractions – SURGICAL TOP TIPS

  • In this special recap, we’ll explore 12 key lessons from 2024 —insights that have shaped our practice, validated our protocols, and sometimes, inspired small but meaningful changes.



    Happy New Year from Team Protrusive! As we kick off 2025, we want to express heartfelt gratitude for your incredible support throughout 2024.



    What were the standout moments that shaped your learning this year?



    Which episodes gave you that “aha” moment?



    Whether you’re a seasoned listener or just jumping in, this recap will help solidify the lessons that you can apply to your practice every day.




    https://youtu.be/OxfRmNhQ7Wk
    Watch PDP209 on Youtube



    Protrusive Dental Pearls: 



    Take time to reflect on your goals for 2025 and consider what sacrifices you're prepared to make to achieve them. Emphasizing the importance of writing down both your objectives and the trade-offs they require, align your time and priorities with your personal and professional aspirations. 



    “You overestimate what you can achieve in a year and underestimate what you can accomplish in ten years.”  Productivity is about knowing how badly you want something and what you're willing to sacrifice to achieve it.



    Take a deep dive into this literature: Clinical considerations for increasing occlusal vertical dimension: a review 



    Australian Dental Journal - 2012 - Abduo - Clinical considerations for increasing occlusal vertical dimension a reviewDownload



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this episode:




    01:08  Protrusive Dental Pearl



    06:25 Value Your Skills



    11:54 Importance of Photography and App Launch



    14:42 Audio Notes in Dentistry



    16:41 Rubber Dam Mastery



    18:07 Composite Techniques and Innovations



    21:07 Onlays vs Full Crowns



    25:54 Best Bonding Agents



    28:55 Digital Dentures Revolution



    31:24 Mastering Vertical Dimension



    32:29 Perfecting Posterior Composites



    34:58 Creating Awesome Dentures



    36:27 Extraction Techniques and Avocado Analogy



    37:47 Looking Forward to 2025




    Here are some episodes and webinars mentioned in this episode that are definitely worth checking out:




    Value Your Skills – How to Stop Underselling Yourself – AJ006



    Your Occlusion Questions Answered by Dr Michael Melkers – PDP015



    Cracked Teeth and Dentistry’s Tough Questions with Dr Lane Ochi – PDP175



    NEVER Write Notes Again! How I Use AI for Awesome and Efficient Dental Records – PDP181



    Canine Guidance vs Group Function – Does it Matter?! – PDP182



    Class II Composites WITHOUT a Wedge + Contact Opening Technique – PDP188



    Onlays Vs Full Crowns – Decision Making 2024 – PDP189



    Quick and Slick Rubber Dam



    Vertipreps for Plonkers 



    Premium Clinical Videos 



    My Productivity Secrets Revealed Webinar REPLAY



    Deep and Dark Class III Restorations



    Which Generation Bonding Agent is the Best? 2024 Adhesive Systems – PDP192



    Digital Dentures for Every Dentist – The Death of Impressions? – PDP195



    [OCCLUSION MONTH] Vertical Dimension – Don’t Be Scared! – PDP197



    How to Place Posterior Composites without Destroying Your Anatomy – PDP200



    Making Awesome Dentures – Border Moulding and Beyond – PDP205



    Exodontia for Beginners – Extractions via Avocados! – PS012




    Take your practice to the next level with DigitalTCO, Dental Audio Notes, and the Greater Curve.



    This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan, including Premium clinical workthroughs and Masterclasses.







    Click below for full episode transcript:



    Jaz's Introduction: Happy New Year, Protruserati. 2025, from all of us here at Team Protrusive, honestly, thank you so much for an awesome 2024 and looking forward to so much in 2025. In this episode, we're going to look back at all the gems from 2024 and looking forward to 2025. So I'll give you at least 12 takeaways, 12 key lessons from the episodes of 2024.



  • Saknas det avsnitt?

    Klicka här för att uppdatera flödet manuellt.

  • Are you focusing enough on pink aesthetics in smile design?



    What role does gingiva play in achieving a truly stunning smile?



    When should you refer for recession around lower incisors or upper canines?



    Can you get the gum to grow back through orthodontics? And how about class 5 restorations? Should we do them, or should we work on the gingival recession first?



    In this episode, Jaz is joined by the expert Dr. Tidu Mankoo, who shares his extensive knowledge on the importance of gingival health in aesthetic dentistry. They dive into the crucial role of the dento-gingival complex. 




    https://youtu.be/Ao_vgJ-IbOg
    Watch PDP208 on YouTube



    Protrusive Dental Pearl: Shade Matching




    Composite button technique - a small blob of composite is applied to a dry tooth without etching or bonding to assess shade match and translucency, avoid excess thickness, which can affect opacity and aesthetics (Jason Smithson’s Tip: take a black-and-white photo to evaluate the composite's value and ensure it matches the natural teeth)



    Using a custom composite shade guide like Smile Line by Style Italiano for more precise shade matching.




    Key Takeaways




    Gingival architecture plays a vital role in aesthetics.



    Dentists should focus on patient-centered care.



    Understanding tooth position is key to treatment planning.



    Orthodontics can sometimes resolve gingival issues without surgery.



    Communication with patients is essential for effective treatment.



    Aesthetic dentistry requires a comprehensive approach.



    The dental field is evolving, and practitioners must adapt. Root coverage procedures can be effective with proper techniques.



    Understanding prognosis is crucial for successful treatment outcomes.



    Aesthetic considerations are a primary reason for root coverage.



    Restorative dentistry should consider the position of the gingiva.



    Crown lengthening should not expose root surfaces unnecessarily.



    Mucogingival surgery plays a vital role in implant aesthetics.



    Education and training are essential for dental professionals.




    Need to Read it? Check out the Full Episode Transcript below!



    Highlights for this episode:




    4:29 Protrusive Dental Pearl



    6:16 Dr. Tidu Mankoo's Journey and Inspirations



    11:48 Reflections on Comprehensive Dentistryand Lifelong Learning



    15:59 Balancing Work and Family in Dentistry



    17:52 Understanding Gingival Architecture



    19:49 Creating a Harmonious Smile



    21:52 Addressing Gingival Aesthetics & Limitations



    26:56 Orthodontics and Surgical Interventions



    29:40 Root Coverage Procedures



    33:49 The Value of Early Diagnosis and Referral



    35:01 Indications for Root Coverage



    36:03 Root Coverage vs. Class V Restorations



    39:50 Managing Gingival Zenith Irregularities



    41:23 Role of Mucogingival Surgery inImplant Success



    47:47 Course on Mucogingival Surgery with IAS




    This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. 



    This episode meets GDC Outcomes B and C.



    AGD Subject Code: 780 ESTHETICS/COSMETIC DENTISTRY



    (Esthetic diagnosis and treatment of intraoral soft tissues) 



    Dentists will be able to -




    Discuss when and how to manage gingival recession, including the role of root coverage procedures.



    Explore the anatomy and function of the dento-gingival complex and its influence on smile aesthetics.



    Promote the value of early diagnosis and timely referrals to specialists for successful treatment.




    🚨 Join the Ultimate Masterclass on Implant Soft Tissue and Complex Cases! 🚨



    📅 Dates: April 2024🌟 Event: Implant Soft Tissue and Complex Case Masterclass



    Join this two-day masterclass to elevate your skills in:



    ✅ Implant soft tissue management



    ✅ Root coverage and crown lengthening



    ✅ Complex case planning and aesthetics



    If you loved this episode, be sure to check out PDP035 - Case Acceptance in Smile Design with Dr Gurs Sehmi







    Click below for full episode transcript:



  • In this episode, we focus on the link between periodontal disease and the systemic effects on the human body. There’s more to oral hygiene than just saving our teeth, so let’s dive into this fascinating episode with Dr Reena Wadia to learn more about the importance of perio and how it is associated with the rest of our health.




    https://youtu.be/fldpB_8h2Dc
    Watch GF024 on Youtube



    Key Takeaways:




    There is a strong link between gum health and systemic health.



    Diabetes and cardiovascular disease are key conditions linked to gum health.



    Understanding correlation vs. causation is crucial in dental practice.



    Effective communication with patients can improve treatment outcomes.



    Treating pregnant patients for periodontal health is safe and beneficial.



    Proper diagnosis is essential for effective dental treatment.



    Patients are often unaware of the links between gum health and overall wellness.



    Motivating patients with health benefits can enhance compliance.



    Evidence-based dentistry is vital for accurate patient information. Add the word diagnosis to templates for clarity.



    Team collaboration (dental and medical practices) enhances patient care effectiveness.



    Screening for conditions like diabetes can save lives.



    Holistic care in dentistry is becoming increasingly important.



    A periodontal protocol is crucial for consistent care.




    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this episode: 




    3:50 Introduction to Dr Reena Wadia



    7:14 Systemic Link



    12:24 Under Investigation



    13:54 Using this with our Patients



    17:04 Birthweight-related Studies and Pregnancy



    20:14 Make a Periodontal Diagnosis



    23:34 Medicine and Dentistry Collaboration



    26:29 Understanding the Patient



    29:14 HbA1c Machine



    32:19 The Perio Handbook




    This episode is eligible for 0.5 CE credits via the quiz on Protrusive Guidance. 



    This episode meets GDC Outcome A, B and D.



    AGD Code: 490 PERIODONTICS (Pathophysiology of periodontal disease) 



    Aim: To enhance dentists' understanding of the link between periodontal health and systemic diseases, enabling them to integrate evidence-based periodontal care into their clinical practice.



    Learning Outcomes:




    Knowledge and Application: Dentists will gain a thorough understanding of the bi-directional relationship between periodontal disease and systemic conditions such as diabetes and cardiovascular disease, and learn how to apply this knowledge in clinical practice to improve patient outcomes.



    Patient Education: Dentists will acquire practical strategies for effectively educating patients about the systemic implications of periodontal health, using analogies, visual aids, and evidence-based communication methods.



    Holistic Treatment Planning: Dentists will learn how to incorporate systemic health considerations, such as screening for diabetes or collaborating with medical professionals, into their periodontal treatment plans to deliver comprehensive care.




    Enhance your knowledge with Dr. Reena Wadia's Perio School and establish a habit of implementing Perio protocols in your practice. Don't forget to grab a copy of the Perio Handbook by Dr. Reena for valuable insights!



    If you enjoyed this episode, check out: Communication Masterclass for Periodontal Disease [B2B] – PDP086







    Click below for full episode transcript:



    Teaser: When you hear stories like that, it's like, could that have been undiagnosed diabetes, heart attack, et cetera, et cetera. So I feel so privileged being able to have that ability to do that test on our patients. And yeah, it's not the nicest thing to say to someone, you might have diabetes, but actually like that could save someone's life.



    Teaser:The guidelines now are, for example, for diabetics, once they've been diagnosed with diabetes, they're supposed to see their dentist, but they need to push it more, because they definitely push the eye appointments,

  • What are the steps involved in Functional Crown Lengthening?



    Which scenarios/teeth are best for this type of surgery?



    What is biologic width and why should we care?



    Is Bone sounding a diagnostic test, or just a genre of music?



    The answer to these questions and a lot more can be found in this packed episode with Dr Hiten Halai. We cover the right protocols when crown lengthening and understand the difference between aesthetic and functional crown lengthening. 




    https://youtu.be/KRlEtz16I8c
    Watch PDP207 on Youtube



    Protrusive Dental Pearl - Bone Sounding



    Using a periodontal probe, go into the depth of the sulcus, pushing deeply until you hit bone, all while recording the measurement with the probe. This measurement will then guide you on how to carry out your crown lengthening procedure. Push hard to pass the connective tissue and ensure you are touching the bone.



    Not using AI to write your notes and letters for you yet? Save hours every day and save money using this affiliate link for DigitalTCO: Click Here 



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this Episode:03:19 Protrusive Dental Pearl06:10 Introduction - Dr Hiten Halai12:56 Functional Crown Lengthening15:41 Understanding Crown Lengthening Types18:42 University of Dental Instagram22:38 Biologic Width aka Supra-crestal Tissue Attachment25:51 Functional Crown Lengthening: Practical Considerations31:09 Assessments & Keratinised Tissue35:47 Understanding Tissue Phenotypes39:16 Case Study: Premolar Treatment43:17 Bone Sounding and Biologic Width46:58 Shape of Gingivectomy50:31 Flap Designs52:37 Burs for Crown Lengthening56:13 Healing and Restoration Timelines58:31 Learning and Training Opportunities



    Key Takeaways:




    Hiten's journey began with a passion for periodontics during dental school.



    Managing time effectively is crucial for specialists with busy schedules.



    Functional crown lengthening is often underutilized in practice.



    Aesthetic crown lengthening can lead to complications if not done correctly.



    Understanding biologic width is essential for successful crown lengthening procedures.



    Preoperative assessments are critical for determining candidacy for crown lengthening.



    The type of gingival tissue affects surgical outcomes and healing.



    Proper surgical techniques can prevent complications and ensure better healing.



    Postoperative care is vital for achieving desired aesthetic results.



    Continuous education and mentorship are important for dental professionals.




    This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. 



    This episode meets GDC Outcome C.



    ADG Code: 490 PERIODONTICS (Mucogingival management) 



    Aim: To enhance knowledge and practical understanding of crown lengthening procedures, with a focus on distinguishing between aesthetic and functional crown lengthening, and the importance of biologic width in achieving predictable clinical outcomes.



    Learning Outcomes:




    Identify the key differences between aesthetic and functional crown lengthening and the clinical scenarios in which each is most appropriate.



    Demonstrate an understanding of biologic width and its significance in the success of crown lengthening procedures, including the impact on long-term periodontal health.



    Apply the principles of bone sounding to accurately assess the need for crown lengthening and ensure optimal restoration outcomes, minimising risks such as gingival recession and bone loss.




    If you liked this episode, check out: PDP079 - Crown Lengthening







    Click below for full episode transcript:



    Teaser: Despite what the University of Instagram tells you, all cases cannot be treated by laser gingivectomy. And that is the truth. Four or five years down the line, when there has been enough time for that tissue to relapse, what happens is they'll come back with that persistent inflammation. And actually the management of it is much more complex now.



  • Application points, luxation vs elevation, avoiding common mistakes - this one's an episode that I wish I had when I was at dental school!



    How do you know when you've found the application point during extractions?



    What are the key protocols that can help make your extractions more efficient?




    https://youtu.be/rOBPnCTyAwM
    Watch PS012 on Youtube



    This week's Protrusive Student episode is all about exodontia - and again I'm joined by Emma Hutchison, our Protrusive Student Ambassador, to discuss some tips and tricks on how to make extractions that little bit easier.



    Jaz also shares a memorable analogy—could removing a stone from an avocado be the perfect way to describe an extraction?!



    Key Takeaways



    Tactile feedback is crucial during tooth extractions.




    Understanding application points can improve extraction techniques.



    Using the right amount of pressure is essential to avoid breaking teeth during extraction.



    Luxators are typically used to sever the PDL before extraction.



    Atraumatic extraction techniques are important for preserving bone for future implants.



    Luxators should not be used as elevators.



    Understanding the mechanics of elevators is crucial for effective extractions.



    The ‘six second rule’ helps in assessing extraction progress.



    Having a plan for extractions can prevent complications.



    Communicating with patients about the extraction process is essential.



    Avoid tunnel vision; consider the surrounding teeth during extractions.



    Breaking interproximal contacts can simplify extractions.



    Always check the patient's medical history before procedures.



    An audible checklist can prevent mistakes during extractions.




    Need to Read it? Check out the Full Episode Transcript below!



    Highlight of this episode:




    00:00 Introduction



    02:07 Catching Up with Emma



    05:58 Teeth are like avocados!



    11:13 Understanding Application Points in Extractions



    17:01 Luxators vs. Elevators: Techniques and Safety



    24:10 Extraction Technique



    25:08 The Six-Second Rule



    28:04 Having a plan



    29:58 Common Mistakes and  How to Avoid Them



    38:17 Conclusion and CE Certification




    This episode is eligible for 0.75 CE credit via the quiz on below. 



    This episode meets GDC Outcomes B and C.



    AGD Subject Code: 310 Oral and Maxillofacial Surgery (Exodontia)



    Dentists will be able to -



    1. Recognise essential steps to establish secure application points



    2. Develop approaches for patient communication around extraction procedures, potential risks, and expected outcomes



    3. Implement the “6-second rule” and other practical techniques to streamline extractions and troubleshoot common challenges



    If you loved this episode, make sure to watch Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth [B2B] – PDP085







    Click below for full episode transcript:



    Jaz's Introduction: This episode on basics of extractions is the episode I wish I had when I was learning extractions when I was a student. But also what I've found from this Protrusive Student series is that so many dentists are listening to them and they're commenting and they're enjoying and they're liking it.



    Jaz's Introduction:What I've discovered is that it's so good to just reconnect with basics and actually by listening to these kind of episodes you do sometimes pick a few things up or it's validation.



    It helps to validate some techniques, some ideas, some protocols that you're already using. It's also a wonderful way to see how far you've come. Sometimes we move so far in our career that we forget what it's like to have those struggles like we did when we were a student. So the reason I gave you that little preamble is because now from this episode, most Protrusive Student episodes, I think, will be eligible for CPD or CE credits.



    And so this one is eligible for 0. 75 CE credits or 45 minutes, if you're in the UK. Protrusive Education is a PACE approved education pro...

  • Are you confident in diagnosing white patches?



    Which white patches need an URGENT referral?



    How do you tell the difference between lichen planus, lichenoid reactions, and other common lesions?



    Dr. Amanda Phoon Nguyen is back with another amazing episode, this time diving deep into the world of oral white patches. Jaz and Amanda explore the most common lesions you’ll encounter, breaking down their appearance, diagnosis, and management.



    They also discuss key strategies to help you build a strong differential diagnosis, because identifying the right lesions early can make all the difference in patient care.




    https://youtu.be/xlQpuQu2Hl0
    Watch this full episode on YouTube



    Protrusive Dental Pearl: A new infographic summarizing Dr. Amanda Phoon Nguyen’s key teachings. Jaz describes it as an easy-to-follow "cheat sheet" designed to simplify complex ideas and make it easier to apply the concepts discussed in the episode.



    You can download the Infographic for free inside Protrusive Guidance 'Free Podcasts + Videos' section.



    Key Takeaways




    White patches in the oral cavity can be classified into normal variants, non-pathological patches, and potentially malignant disorders.



    It is important to identify the cause of the white patch and differentiate between different types.



    Referrals should be made based on the characteristics of the white patch and the urgency of the situation.



    Clinical photographs are valuable in referrals and can aid in triaging patients.



    Ongoing monitoring is important for potentially malignant disorders. Lichen planus can have different types and presentations, and a biopsy may be necessary for certain cases.



    Enlarged taste buds, particularly in the foliate papillae, are usually bilateral and not a cause for concern.



    Oral lichenoid lesions can be triggered by dental restorative materials or medications, and a change in dental material may sometimes improve the condition.



    Smoker's mouth can present with white patches and inflammation in areas where smoke gathers, and counseling patients to reduce smoking is important.



    Oral submucous fibrosis, often caused by areca nut chewing, requires regular review and counseling patients to stop chewing the nut. 




    Need to Read it? Check out the Full Episode Transcript below!



    Highlights for this episode:




    01:22 Protrusive Dental Pearl



    05:13 Dr. Amanda Phoon Nguyen Introduction



    07:39 White Patches Introduction



    09:16 Understanding Geographic Tongue



    12:44 Keratosis vs. Leukoplakia



    19:02 Proliferative Verrucous Leukoplakia



    22:18 Referral Tips for General Dentists



    29:56 Understanding Leukoplakia



    33:17 Urgent and Non-Urgent Referrals



    34:37 Patient Communication



    39:17  Discussing Erythroplakia 



    41:03 Oral Lichen Planus: Diagnosis and Management



    47:50 Enlarged Taste Buds



    49:47 Oral Lichenoid Lesions vs Oral Lichen Planus



    53:43 Smoker's Mouth



    55:14 Oral Submucous Fibrosis



    57:23 Learning more from Dr. Amanda Phoon Nguyen 




    This episode is eligible for 1 CE credit via the quiz below. 



    This episode meets GDC Outcomes B and C.



    AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Diagnosis, management and treatment of oral pathologies)



    Dentists will be able to -




    Identify the cause of a white patch and differentiate between different types.



    Understand when and how to make referrals based on the characteristics of the white patch and the urgency of the situation.



    Appreciate the importance of ongoing monitoring for potentially malignant disorders, including when to consider a biopsy.




    For those interested in visual case studies and deeper insights into oral lesions and conditions, follow Dr. Amanda on Instagram and Facebook!



    If you loved this episode, be sure to check out another epic episode with Dr. Amanda - Prescribing Antifungals as a GDP – Diagnosis and Management – PDP151







    Click below for full episode transcript:



  • What are the key steps and nuances to make awesome Dentures that your patients will love?



    In this episode, Jaz probes Removable Pros legend Dr Mike Gregory to break down the process. From border molding to primary impressions and the teamwork between dentists and technicians, Mike reveals the key steps to making great dentures.




    https://youtu.be/snM3PerQ1ko




    For example, be sure to include a note on the lab sheet for the technician: "Preserve full peripheral depth and width of the sulcus on this impression, to about 2-3mm." This ensures the correct functional width is maintained when the final tray or denture is created.



    Protrusive Dental Pearl: When checking denture occlusion, it's crucial to keep the patient relaxed. Mike suggests one simple trick: ask the patient to close their EYES before closing their teeth. This can sharpen their senses, helping to improve the bite assessment.



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this Episode:




    02:07 Protrusive Dental Pearl



    03:31 Mike Gregory's Journey into Dental Technology



    10:09 Understanding Border Moulding



    13:19 Technician's Role in Denture Creation



    15:45 Improving Communication with Technicians



    18:34 Special Trays and Custom Trays



    25:58 The Role of Green Stick



    29:04 Denture Impressions



    31:35 Boxing and Beading Techniques



    35:08 Additive vs. Reductive Rest Seats



    40:46 Guide Planes



    42:43  Creating Undercuts for Dentures



    45:10 Final Tips and Best Practices



    48:54 Learn More with Mike Gregory




    This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. 



    This episode meets GDC Outcomes B and C.



    AGD Subject code: 670 REMOVABLE PROSTHODONTICS   



    Aim: To explore the intricate process of denture creation and provide practical insights on improving denture fit, occlusion, and collaboration between dentists and technicians.



    Dentists will be able to: 



    1. Understand the key elements of denture creation, including border molding and primary impressions.



    2. Learn the significance of maintaining peripheral sulcus depth and width in denture impressions for functional accuracy.



    3. Gain insight into the role of special trays, custom trays, and impression materials in denture fabrication.



    4. Recognize the importance of clear communication between dentists and technicians in achieving optimal denture outcomes.



    If you liked this episode, you’ll love Suction Lower Complete Dentures – Improve your Removable Prosthodontics – PDP073







    Click below for full episode transcript:



    Teaser: This huge misconception that if you get suction on an impression, that impression is the perfect impression to make a denture. But you know, and I know if you take an impression, you fill somebody's mouth with algae, you get suction. You have to break the seal to get it out. That doesn't mean you've got the right depth.



    Teaser:It doesn't mean you've got the right borders. You've just created a vacuum and that's the worry that people create suction. I think this is it. This is going to be the great denture. But if you create suction, take the impression out of the mouth and look at it. It's going to be big. You can picture this, can't you?



    It's going to look big, it's going to look like you've just pushed everything out the way. I used to think dentists were rubbish, which is really tough, but as a technician you've seen model after model that's garbage. And then you think, these poor guys are taking impressions, but they don't know what they're doing wrong.



    How do I do it better? If you were taught maybe not brilliantly as an undergraduate, or you didn't love it as an undergraduate, so you didn't really focus on it. How do you ever get better? You need to be re taught.



    Jaz's Introduction:Let's face it guys, dentures are a bit of a dark art. You only get so much exposure at dental school, and when you come to the real world, you're faced with flabby ridges,

  • Implant crowns should be out of occlusion, right? Think again! 



    In my experience, single tooth implant crowns when I see them are IN occlusion and holding shim - even when this was not intended by the Restorative Dentist.



    When this happens, should we be adjusting the implant crown? Or perhaps the adjacent tooth? *shock horror*



    And how often would this need to be repeated?



    This podcast will show you a better way to manage implant occlusion!




    https://youtu.be/l8WOiamk06M
    Watch PDP204 on Youtube



    In this episode, I’m thrilled to chat with Professor Riaz Yar, an occlusion expert and mentor who greatly influenced me early in my career. Together, we’ll debunk common myths and dive into practical approaches to managing implant occlusion.



    Even if implants aren’t part of your practice, understanding occlusion on implants is crucial for patient care. Tune in as we uncover best practices and clear up misconceptions to help you achieve better results for your patients!



    Protrusive Dental Pearl: Dr. Pav Khaira has created a free implant assessment form, now available to the Protrusive community. Accessible at www.protrusive.co.uk/implant - this responsive PDF includes key areas like patient goals, biotype, and occlusion, with an 8-minute video guide for easy use.



    Key Takeaways



    -Implant occlusion is a major factor in implant failure.-Understanding the biology of the implant system is crucial.-Functional loading is more important than static loading!-Chewing dynamics can reveal important insights about occlusion.-Guidelines for occlusion should be followed but adapted to individual cases.-Patient education on post-implant care is essential.-Shared loading on implants is vital for their longevity.



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this Episode:




    01:34 Protrusive Dental Pearl



    02:47  Introducing Professor Riaz Yar



    05:07 Understanding Implant Failure Causes



    08:04 Analyzing Implant Occlusion and Peri-Implantitis



    10:27 The Chewing Gum Test



    13:20 Guidelines and Challenges with Implant Occlusion and Lab Protocols



    17:33 Bone Regeneration and Functional Guidance



    19:22 Dynamic Movements and Occlusion Analysis



    23:48 Practical Tips for Implant Bridges



    28:19 Patient Guidelines for Implant Care




    Join Riaz for an innovative implant restorative program developed with top dentists (Nik Sissodia, Martin Wanendeya, Sanjay Sethi, and Nik Sethi), designed to enhance your skills in implant restoration.



    Check out Riaz's one-day course on implant occlusion at profriazyar.com and Elevate Dental. Sign up now and boost your implant expertise!



    This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance. 



    This episode meets GDC Outcomes B and C.



    AGD Subject code: 690 IMPLANTS



    Dentists will be able to: 




    Recognize key factors that contribute to implant failure and how occlusion plays a role.



    Utilize practical approaches, such as the Chewing Gum Test, to assess and manage implant occlusion (function) effectively.



    Discuss guidelines for implant occlusion and understand the challenges involved in lab protocols.




    If you liked this episode, be sure to watch An Idiot’s Guide to Restoring Single Implant Crowns Part 1 and Part 2







    Click below for full episode transcript:



    Teaser: If you overload it, the risk is that you're going to get bone loss around the neck of the tooth, just from a biological perspective. That then means, okay, how do you apply those forces? And so if you apply those forces to a tensile at an angle, that's definitely going to occur. But static forces, it's still going to get some transference through it.



    Teaser:So it's about understanding how to manage those forces. The one, the thing that I noticed, if it's an issue is screw loosening of the crown and an implant that tells me straight away, I have some of axia loading on my implant. So I need to deal with that straight away.

  • Why are principals and associates always at loggerheads with each other? Why can it be almost impossible to find the right associates to work at our amazing practice, but also almost impossible to find that amazing practice to work at as an associate? 



    Join myself and Dr Sarika Shah on this episode where we learn more about self leadership and the ways to prioritise our values to help us find the right working relationships and places of work to be a part of. Let’s figure out how to bring all members of a team together and create the zen we are all in search for while working in our day to day lives. 




    https://youtu.be/-ua1PAB6A90
    Watch IC054 on Youtube



    Protrusive Dental Pearl:



    Be willing to accept rejection. A ‘no’ from a patient today is often a yes tomorrow. Plant seeds for high quality dentistry and you will find yourself harvesting many of these seeds at a later date. Those who fear rejection routinely offer less than their best, which cheats patients out of rightfully making their own economic decisions - inspired by Dr Lane Ochi (the ORIGINAL Dental Geek!)



    Check out Flourish as a Female: https://www.flourishasafemale.com/



    Use discount code ‘protrusive’ (No financial interest)



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this Episode:02:18 Protrusive Dental Pearl04:30 Introduction - Dr Sarika Shah10:10 Transition to Private Dentistry13:40 Practice Ownership17:20 Managing the Practice24:55 Internal Leadership29:40 Principals vs Associates Friction41:56 Women in Dentistry47:15 Supportive Partners55:25 Top Advice from Sarika58:28 Flourish



    This episode is eligible for 1 CE credit via the quiz on the Protrusive Guidance App. 



    This episode meets GDC LEARNING OUTCOMES A and B



    AGD Subject Code 550 Practice Management and Human Relations



    Aim:To explore the importance of self-leadership and effective communication in building successful relationships between dental associates and principals, enhancing teamwork, and optimising practice performance.



    Dentists will be able to: 




    Identify key principles of self-leadership and apply them to improve personal and professional development within their practice.



    Understand the impact of effective communication and aligned values on maintaining strong, respectful relationships between associates and principals in a dental setting.



    Develop strategies to enhance emotional intelligence, ensuring improved patient care and better collaborative relationships in their practice environment.




    If you liked this episode, be sure to check out IC025 - Parenthood and Dentistry







    Click below for full episode transcript:



    Teaser: And when this respect is gradually lost, that relationship is most likely going to break down within three years. Okay, there's research behind this. I've read a lot around this. So what it there is, is there's three phases to this. The first phase is like- because even when I went out there to approach women, to approach some of these women are still around. And I think they're awesome. They're powerhouses. But when I went to them to ask for help, I got nothing. And it's not like I just asked once. I asked a few times. I asked several women and I got nothing. So the majority of my mentors and coaches have now been male.



    Jaz's Introduction:Principals versus associates. Why is there so much beef? I'm constantly seeing on the dental social media groups that principals are bashing associates. They're saying like, where are all the good associates gone? I'm really struggling to find a decent, honest, hardworking associate. On the flip side, the associates are searching for trustworthy, kind, caring principals that are willing to mentor and provide an environment where you can flourish.



    That seems to be a bit of a pipe dream. So who's right? Are they both right? Or maybe all the associates and principals that are happy, that are in very, very happy teams.

  • Is Sodium Hypochlorite still the best irrigant for endodontics? Or do we have something novel and superior?



    How can we improve the efficacy of our endodontic irrigation?



    What % of NaOCl should we be using?




    https://youtu.be/z5h2FzHpG68
    Watch PDP203 on Youtube



    Dr. Brett Gilbert rejoins Jaz Gulati to tackle all things endodontic irrigation after a brilliant episode on pre-emptive endodontics.



    Advanced activation and delivery systems could change the game—are we on the brink of a major shift in endodontics?



    Protrusive Dental Pearl: Before performing a molar extraction, challenge yourself to first complete an endodontic access on the tooth. This will enhance your understanding of the canal anatomy and improve your precision in sectioning the tooth. By visualizing the canals and the pulpal floor, you'll refine your angulation for more accurate sectioning.



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this Episode:




    02:09 Protrusive Dental Pearl



    04:23 Is Sodium Hypochlorite Still The Gold Standard?



    06:54 The Role of Surfactants in Irrigation



    07:58 Concentration of Sodium Hypochlorite



    09:47 Chlorhexidine: Is There Still a Place?



    11:32 Advanced Disinfection Technologies



    21:31 Evidence-Based Techniques in Endodontics



    25:22 GP Pumping




    This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance. 



    This episode meets GDC Outcomes B and C.



    AGD Subject code: 070 Endodontics (Endodontic infections, microbiology and treatment)



    Dentists will be able to: 



    1. Gain insight into the role of sodium hypochlorite in endodontic disinfection and assess its effectiveness compared to new innovations.2. Discover the cutting-edge irrigation methods, including surfactants, ultrasonic activation, and laser-assisted irrigation, and their impact on endodontic outcomes.3. Explore emerging technologies and innovations that could revolutionize endodontic irrigation.



    If you liked this episode, be sure to watch the 1st Part - ‘PDP202 - Elective Endodontics? It's all about Communication’







    Click below for full episode transcript:



    Teaser: When you use a lower percentage, you really aren't reducing or eliminating the risk of sodium hypochlorite accident. If you get 3% sodium hypochlorite out the end of the root, it's going to cause a sodium hypochlorite accident, as will 6%. If you're trying to eliminate risk using a lower concentration, I don't think it's as effective as you think, but you are taking away some of the strength that you're looking for to kill the bacteria and dissolve the tissue. So my advice would be go full.



    Teaser:We recognize that training our general dental colleagues on endo is paramount because we don't want the option of implant to come in place of saving the natural tooth simply because of fear or the fact that they just don't feel well enough trained to do the endo. So I believe as a dental community, the more we feel comfortable and proficient in endo, the more teeth we save and the better our patients are.



    Jaz's Introduction:Is sodium hypochlorite still the best thing in irrigation? If it is, what percentage should we be using? This one might actually surprise you. Is there ever a time when to use chlorhexidine. Whatever irrigant we're using, how can we improve its effectiveness?



    Hello, I'm Jaz Gulati and welcome to the part two with Dr. Brett Gilbert. How awesome was he? Please do check it out if you haven't already. We talked about elective endodontics or preemptive endodontics. I love the clarity and the passion in which he speaks with. And he definitely continues it on into this episode. He's so knowledgeable, he's so passionate about endodontics in general, but especially the innovation in irrigation.



    Because after all, endodontic success is all about killing those bugs. And Brett has so much experience in trying all the different things out there. And towards the second half of this episode,

  • What's the difference between radiolucency and burnout? 



    When's the best time to use a bitewing vs a periapical radiograph? 



    When should we pick up the bur for interproximal caries?



    Have you heard about the 4 white lines an OPG radiograph? 




    https://youtu.be/wCV3U8-OAvI
    Watch PS011 on Youtube



    This episode is packed full of great tips and techniques that will help you understand how to produce great radiographs as well as being able to properly figure out what they are trying to tell us. Radiographs can be tricky, whether that's due to them being flipped, upside down or due to cone cut, that's why this will help shine some light on how to get comfortable with radiographs as well as how to manage our patients after we know what we are dealing with.



    Need to Read it? Check out the Full Episode Transcript below!



    Don’t miss the special notes on Radiology and Radiography for Students available exclusively in the Protrusive Guidance app! (Join the free Students Section)



    This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD for Dentists waiting for you on the Protrusive App!



    For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content.



    If you love this episode, check out PS003 - Routine Checkup







    Click below for full episode transcript:



    Teaser: This episode is the bare basics of radiography and radiology, i.e. the taking of the radiograph and the interpretation. How do you really know if that radiolucency you see is cervical burnout or is it actually caries? What are the four white lines on an OPG radiograph and why are they important? And why you should be really careful with radiographic interpretation? And it's really important to marry the clinical picture, because that's how you come up with a clinical diagnosis.



    [Jaz]Hello Protruserati, I'm Jaz Gulati and welcome back to your favorite dental podcast. This is for young dentists, students, but a lot of qualified dentists have been really enjoying this basic series, this Protrusive Student series.



    And so what we're going to do from the next episode is we're going to make it CE eligible. The next episode is actually on basics of extraction, but before we do that extraction, we need a radiograph. And it's a topic that you guys asked for on the YouTube comments. So there we have it. And remember, if you are a dental student, make a free Protrusive account.



    Go to protrusive.app and then email your username or your name on the platform to [email protected]. And you're going to get access to a secret area, which has a bit more of the premium goodies inside. Every PS episode, we have some student notes to provide you as well, made by Emma Hutchison, our Protrusive student. And the ones today are all about radiography and radiology. Hope you enjoyed the main episode, I'll catch you in the outro.



    Main Episode:Emma Hutchison, our Protrusive Student. Welcome back to the student's edition of the podcast. I know you've got exam results coming up and you're going on your elective soon. How exciting.



    [Emma]Yes, very exciting. So I'm just finishing up the last bits and bobs of my elective project and then I'm going traveling for two months. So, I should also get my exam results next week sometime when I'll be away. So, hopefully everything's good.



    [Jaz]We're all rooting for you. We know, you know, fingers crossed you'll do well and you'll report back to us. If anyone in Asia is a dental student or a dentist, and you happen to see Emma walking in a mall, an air conditioned mall, take a selfie with her and tag us on Protrusive. Let's see if this social experiment works. Let's see how much we're spending. That'd be cool, right?



    [Emma]Yeah, it would have to be an air-conditioned place because I'm from Scotland, so I'm not going to do well with the heat over there at all.



    [Jaz]Excellent. Well,

  • Does ‘elective’ or ‘pre-emptive’ endodontics have a role in Restorative Dentistry?



    It almost feels dirty to me as I try my best to PRESERVE pulp vitality!



    But sometimes this bites you, and you wish you had carried out root canal treatment before cementing that crown.



    At what point can pre-emptive root canal be justified in a world where MTA and biodentine exist?




    https://youtu.be/9Gc_yik9fDU
    Watch PDP202 on Youtube



    In this episode, Jaz sits down with renowned endodontist Dr. Brett Gilbert to delve into the intriguing world of elective or pre-emptive endodontics. Together, they explore challenging cases where teeth with uncertain pulpal health may require root canal treatment, whether due to caries or crown prep. Dr. Gilbert sheds light on patient communication strategies, the role of bioactive materials like biodentine and bioceramic sealers, and how to make crucial decisions about preserving pulp vitality.



    Protrusive Dental Pearl: Dr. Pav Khaira suggests using Alvogyl, commonly used for dry sockets, to treat pericoronitis! After cleaning and disinfecting the area, place a small amount under the operculum for immediate relief and to soothe inflammation.



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this Episode:




    3:01 Protrusive Dental Pearl



    03:55 Dr. Brett Gilbert's Journey and Philosophy



    07:17 Elective or Pre-emptive Endodontics



    11:06 Radiographic Measurement



    11:40 Real-Life Encounters 



    15:29 Discussing Treatment Options and Patient Communication



    20:28 Can Biodentine Prevent Root Canal?



    22:45 Materials and Techniques in Endodontics



    26:16 Death of Gutta-percha?




    This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance. 



    This episode meets GDC Outcomes B and C.



    AGD Subject code: 070 Endodontics (Endodontic infections, microbiology and treatment)



    Dentists will be able to: 



    1. Learn what elective or preemptive endodontics entails and recognize scenarios where root canal treatment may be required due to caries or crown preparation, and how to approach them.2. Discover effective strategies for explaining treatment options to patients, improving trust and decision-making.3. Gain insights into the use of bioactive materials like biodentine and bioceramic sealers, and their benefits in preserving pulp vitality.



    If you liked this episode, you’ll love Post Operative Pain after Endodontics – Prevention and Management – GF017







    Click below for full episode transcript:



    Teaser: I do believe in these instances, you are justified to recommend the treatment. You're not demanding it. You're not saying it's dogma, but you're having a conversation so the patient understands. Because what happens if you don't is you do your work, you're doing it in best faith. Patient winds up in pain, and they become very angry.



    Teaser:They become agitated, and they want to blame the dentist. And without a conversation, without a dialogue, they're clueless, and all of a sudden, they just think you did something wrong. You are a human, and you are the doctor. Speak to yourself. Let the words flow out so that you can explain all the different possibilities in a way that the patient feels heard, understood, but also nurtured, and at the same time you realize this is biology. We are not in control.



    Jaz's Introduction:In a world where we want to do everything to preserve pulp vitality, is it ever appropriate to carry out elective endodontics? Another terminology that our guest today, Dr. Brett Gilbert shared with me is preemptive endodontics.



    For example, you have a tooth with dubious pulpal prognosis. And you know that by prepping it for a crown or by removing the caries, this tooth may need root canal treatment. Is it okay to just go ahead and do the root canal so it doesn't bite you in the behind in the future? You see, I was always taught to do everything possible to preserve pulp vitality.



  • Are single-use diamond burs more efficient at cutting?



    When should we throw away a bur and pick up a fresh one? How long are they supposed to last? (it's measured in minutes!)



    Are expensive brands a con?



    Tiny, but one of the most important tools of our trade…BURS! In a world full of different identifying numbers and names, it can get confusing and even overwhelming. 




    https://youtu.be/Ol0_XcIbSD8
    Watch PDP201 on Youtube



    That’s why on today’s episode, we welcome Günter and Marcela from Intensiv, a globally recognised manufacturer of dental burs, where they take great pride in bringing the latest tech to help make our dental procedures that much easier and effective.



    In this episode, we cover how diamonds are sourced, what the differences are in colours of burs and how the grain size of diamonds can change our results. There’s lots of amazing tips and tricks here given by the team at Intensiv, so you’ll definitely walk away from this one with something new up your sleeve.



    Need to Read it? Check out the Full Episode Transcript below!



    HIGHLIGHTS of this Episode:



    01:24 Protrusive Dental Pearl



    02:03 Introduction to Team Intensiv



    05:40 Understanding Bur Codes



    10:49 Bur Colours



    15:10 When to Use Different Grit Diamonds



    18:40 Single Use Burs vs Reusable Burs



    24:59 Sourcing Diamonds



    29:18 Fixing the Diamonds to the Metal Shank



    32:40 Is my bur fit for purpose?



    37:30 Drilling Zirconia



    39:30 Final Tips



    41:20 Contact Intensiv



    This episode is eligible for 0.75 CE credit via the quiz below.



    AGD Code: 250 Operative (restorative) Dentistry (Preparation Technology)



    GDC Learning Outcome:  C



    Learning Outcomes




    Identify the appropriate dental burs for different procedures, considering grit size and material composition, to ensure efficient and safe treatment.



    Evaluate the impact of bur selection on patient comfort and procedural outcomes, minimising trauma and maximising efficiency during dental treatments.



    Implement best practices for the maintenance and replacement of burs to ensure optimal performance and longevity, thereby improving clinical results and patient satisfaction.




    If you liked this episode, you will aslso like: PDP117 - Dental Ceramics in 2022 – Which Ceramic Should I Use







    Click below for full episode transcript:



    Teaser: Are single use burs better or really more cost effective than our traditional multi use burs? I think the answer is actually going to surprise you. And my biggest pet peeve, the thing I hate the most, is using a bur and it has like zero cutting efficiency. I work in a clinic where we share our burs and we have like different bur kits made up.



    Jaz's Introduction:And so sometimes I use a bur and I hadn't inspected it and I find that, oh my goodness, this is taking way longer than it should. And of course I have to ask my nurse to go to the stock room to get a brand new bur. But this is frustrating. Like when you are using a bur with less cutting efficiency. It is annoying and it's actually downright dangerous for the tooth. So how can you tell? Is there an objective way to tell and subjectively, how can you tell exactly the moment when you should bin a bur? So you avoid that horrible scenario.



    Hello, Protruserati. I'm Jaz Gulati and welcome back to your favorite dental podcast. I'm joined today by Günter Smailus and Marcella Roba who represent Intensiv. Intensiv is a Swiss based company which specializes in diamonds, so who better to find out more about the use of diamond burs and everything to do with diamonds. It's a very geeky episode, but I feel diamond burs and diamonds in dentistry, we use them so much, we rely on them so much. I think it's worth an episode, it's worth discussing about different diamonds in dentistry.



    I have no financial interest with Intensiv, this is not a sponsored episode. But this is very much for the pursuit of knowledge and disseminating information to Protruserati, i. e. you guys,

  • Last Live Occlusion Course of 2024 - Book Now: https://courses.iasortho.com/courses/gb/occlusion



    POV: You spend a fortune on a composite anatomy course and are excited to implement on Monday morning.



    However, every time you apply those concepts, you end up drilling it away because it’s proud in the occlusion!



    It essentially now looks like a tooth coloured version of the amalgam you just removed!



    Your nurse’s eyes are like pools of fire - that’s half her lunch break gone.



    This happens a few more times until you realise that you’re missing a trick…



    Enter this podcast to save your career! ;)




    https://youtu.be/5MVvknCNV-8
    Watch PDP200 on Youtube



    Dr Jaz Gulati and Dr Mahmoud Ibrahim will teach you how to radically minimize adjustments on your daily restorations.



    Key Takeaways:



    Always check the patient's occlusion before starting any restoration.



    Utilize shim stock to ensure accurate occlusal contacts post-restoration.



    Pre-op visual checks are crucial for successful composite placement.



    Don't compromise on the anatomy of the restoration for aesthetics.



    Use thinner articulating paper for more precise occlusal markings.



    Communicate effectively with your dental nurse about new protocols.



    Involve your senses to assess the quality of your restorations.



    Document occlusal marks pre and post-restoration for reference.



    Adjustments should be minimal if pre-op checks are thorough.



    Educate patients about their occlusion to manage expectations.



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this Episode:05:24 Introduction - Dr Mahmoud Ibrahim08:42 Posterior Composite14:15 Shim Stock Foil16:35 Effects of Numbing on Occlusion18:23 Lower First Molar Example22:06 Shim Stock revisited26:22 Lateral Excursions30:32 Fissure Staining?31:56 Old Restoration as a Guide35:33 Restoration Techniques and Adjustments38:03 Tips and Tricks43:28 Event Discussion45:09 The Importance of Marginal Ridges46:25 Anatomy or aNOTomy?48:17 Post-Op Checklist: Final Adjustmentsand Polishing Tips54:19 Wrapping Up: Using Your Senses in Dentistry56:43 Outro



    This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance App.



    This episode meets GDC Outcomes A and C.



    AGD Code: 250 Operative (Restorative) Dentistry (Direct restorations)



    Dentists will be able to:




    Evaluate and manage occlusion during posterior composite restorations, ensuring that patient bite and interdigitation are maintained post-procedure.



    Effectively use shim stock foil and articulating paper to achieve precise contact points and occlusal balance, minimizing the need for post-restoration adjustments.



    Apply practical techniques, such as using occlusal stamps and soft flex discs, to streamline posterior composite restorations while improving the durability and aesthetics of the final result.




    If you liked this episode, check out: IC046 - 4 Ways and 6 Great Reasons to Document Your Dentistry







    Click below for full episode transcript:



    Teaser: The cuspal inclines and using visual references that I take before I prep the tooth. So I'll look at where the marginal ridge is compared to the base of the cavity. Where's the bottom of the fissure pattern on the adjacent tooth, for example. Use those visual references and then the angle of the cusp. The angle of the cusp is probably, for me at least, one of the most important ones.



    Teaser:Some patients are like princess and the pea, whereas other patients are like everything feels amazing. And the very last thing you check is how does that feel? That's like the last. Why are we getting patients to feel their bite?



    They shouldn't like become obsessed about their bite. We're kind of edging them closer every time we say, how does it feel? How does it feel? They're feeling their bite. Something that really should be not really present for them, if you like.



    Once you get quicker and slicker,

  • Follow THESE protocols to eliminate teeth whitening sensitivity in your practice - your patients will love you.



    Have you ever had a patient who had to stop whitening due to severe sensitivity?



    Should we be whitening when there are active carious lesions? (the answer might surprise you)




    https://youtu.be/IC3wMpfLo30
    Watch PDP199 on Youtube



    In this episode, Dr. Linda Greenwall is back with another phenomenal episode as we dive into this common concern. Together, we discuss practical tips and effective strategies and protocols to help patients achieve radiant smiles without pain.



    Protrusive Dental Pearl: We’ve made an infographic to summarise this awesome episode. This one is available freely under the episode in our Protrusive Guidance App.



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of the episode:




    03:06 Dr. Linda Greenwald's Background and Experience



    07:09 Teeth Whitening: A Global Perspective



    08:31 Diagnosing Teeth Sensitivity



    14:28 Managing Non-Carious Cervical Lesions (NCCLs)



    22:30 Using Sensodyne for Sensitivity Management



    24:36 Exploring Different Sensodyne Products



    26:26 Bruxism and Occlusal Forces: Mechanisms of Sensitivity



    29:39 Role of Hydration and Tray Design



    32:57 Whitening Limitations: Cervical Whitening and Medication Impact



    36:41 Dehydration and Discoloration



    42:03 Therapeutic Uses of Whitening Trays



    48:53 Upcoming Events and Final Thoughts




    Dr. Linda Greenwald invites the Protruseratis to the "Future Dentistry" conference on November 1st at the BDA, featuring dental AI, restorative, orthodontics, and implant innovations.



    This episode is eligible for 1 CE credit via the quiz on the Protrusive Guidance App.



    This episode meets GDC Outcomes A and C.



    AGD code 780 ESTHETICS/COSMETIC DENTISTRY (Tooth whitening/bleaching)



    Dentists will be able to:



    1. Understand the causes of teeth sensitivity during whitening treatments and conduct thorough diagnostics.



    2. Implement pre-whitening protocols such as treating non-carious cervical lesions and recommending desensitizing toothpastes.



    3. Gain insights into preventative measures for managing sensitivity in whitening treatments.



    If you love this, be sure to check out Dr. Linda’s other Protrusive Episodes: Finally, Some Clarity on Teeth Whitening for Under-18s with Linda Greenwall – PDP096 and ICON Resin Infiltration – Step by Step FULL PROTOCOL – PDP140







    Click below for full episode transcript:



    Teaser: Any discolored tooth needs a periapical radiograph, really, really important, because you are looking for undiagnosed periapical lesions. And most dentists don't know, if there is an undiagnosed periapical lesion and you put whitening gel into, so you take oxygen, and you shove it into an anaerobic area, you are going to have max of sensitivity-



    Teaser:Because I think a lot of dentists are afraid of doing that because they're afraid of not being able to adequately bleach the cervical area.



    So here's another point. You can't adequately bleach the cervical area. It's never going to be the same shade. And that's a myth- The last two millimeters of the bleaching tray. So that actually tray is not rubbing on the cervical area. And they found it improved sensitivity and made no difference to the whitening effect whatsoever. So you can do that.



    Jaz's Introduction:Protruserati, this just might be the most actionable and impactful piece of content you'll ever consume on the topic of teeth whitening sensitivity to really help our patients to whiten better without having the horrible side effect of teeth sensitivity.



    I don't know about you, but for some patients it can be so bad that after about three days they don't whiten ever again. And you have to have that awkward conversation with the patient. But now, following Dr. Linda Greenwald's protocols, We can eliminate teeth sensitivity. Like, we could have spoken for like hours and hours and hours.



  • It’s Friday and you’re fitting the last patient’s crown. It is completely shy of the bite - but it looks good. The patient says ‘it feels great! I can hardly feel anything!’



    Do you cement it (plant it low?) and let it grow? Is that acceptable?



    How about the 'GABS occlusal philosophy?'



    Is ‘centric relation’ full of unicorns and rainbows?



    What is an efficient protocol in ‘checking the occlusion’?




    https://youtu.be/Nmx1C8WDSjA
    Watch PS010 on Youtube



    Join us in this episode where we discuss some key techniques to help ensure we are managing occlusion as a primary focus when dealing with restorative treatment. This episode is packed with essential tips that are perfect for dental students and professionals alike. 



    Don’t miss the special notes on Occlusion, CR & All Things Confusing available exclusively in the Protrusive Guidance app! (Crush Your Exams section)



    Need to Read it? Check out the Full Episode Transcript below!



    This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD for Dentists waiting for you on the Protrusive App!



    For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content.



    If you love this episode, be sure to recap PDP109 - Articulating Paper is Lying to Us







    Click below for full episode transcript:



    Teaser: Here we are, a little bit late, but this is the Protrusive Students version for Occlusion Month. We've got our Protusive student, Emma Hutchison, who once again has done a wonderful job to create these student notes.



    Jaz's Introduction:You can download these for free on the community, there's a special students area, and you can also catch up with the previous nine other Protrusive student notes, bespoke notes, just for students. Very visual and written by Emma herself, inspired by what she's learning at uni and also what she's learning online. Head over to protrusive. app to check that out.



    Hello, Protruserati. I'm Jaz Gulati and welcome back to your favorite dental podcast. This episode is huge. Like when I was a dental student, anything to do with occlusion was mega confusing. Like even down to adjusting a basic composite. Like you've just placed a composite, and you're picking up the bur, and you have no idea what you're doing. Was it just me, or is that you as well?



    Well, how about we cover in this episode for the benefit of students, and of course, anyone in dentistry, or dentists can actually learn something from this episode, I think. We need to talk about some specific protocols taught to me that I'm sharing with you guys, and we go deeper into what actually happens if you start leaving teeth out of occlusion, i. e. You restore a tooth and now that tooth is no longer actually touching the opposing tooth. It's no longer contributing to the patient's occlusion.



    Is it always a sin? Is it acceptable? And how do you actually go about avoiding that? Like, how can you actually be more precise in your occlusal adjustment? We also, of course, talk about the influence of different thicknesses of articulating paper and why you should avoid using thick papers. There's a lot to unpack here, so let's join the main interview and I'll see you in the outro.



    Main Episode:Okay, Emma, you just had some exams. Okay, so welcome back. How was it? How did it go?



    [Emma]It was okay. I think they're always going to be a bit rough. This year I had two written papers. I had one multiple choice paper, which was okay. And then the second one was like a multiple short answer, which is always the trickier of the two, I think, for me anyway.



    But they changed the format of our MSA short answer one this year. So it was just a wee bit different. They changed it from, I think, 20 questions worth 10 marks to 15 questions worth 13 marks or something like that. So it was just a wee bit different to what I'm used to.



  • “Defensive Dentistry and the fear culture is the number 1 cause of anxiety amongst Dentists”



    How can we instead foster a culture where we can focus on growth and supporting each other?



    Does Dentistry have a social media problem?




    https://youtu.be/wsiENbuIXcE
    Watch IC053 on Youtube



    Join us on this episode with Dr Mehy Lo-Presti as we navigate dentistry and social media, the pros and cons of using the online world as part of our portfolio and how we can remove anxiety through effective communication.



    2 Events to Attend:



    DentoRama 18th October



    Treatment Planning Symposium (Hybrid Event) 16th Nov



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this Episode:02:05 Introduction - Dr Mehy Lo-Presti06:42 Mehy Early On12:04 Dento-Rama15:30 Social Media in Dentistry20:35 Life Before Social Media21:25 Social Media is a Business 23:40 What Causes Anxiety for Dentists?29:45 Overcoming the Fear Factor34:45 Fast Tracking to Success41:20 Wrapping Up47:14 Booking the Event and Getting in Touch



    This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.



    GDC LEARNING OUTCOMES: A



    AGD Code 770 (Self Improvement)



    Dentists will be able to:




    Gain insights into how social media affects clinical practice, patient perceptions, and professional image, learning how to use these platforms responsibly.



    Manage the pressures of online validation, minimising the impact on their mental health and maintaining a healthy work-life balance.



    Develop stronger communication methods both online and offline, ensuring clearer patient education, reducing complaints, and fostering better relationships within the dental team.




    For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. This includes videos on Overlay preps and the famous 'Vertipreps for Plonkers' series.



    If you liked this episode, check out IC035 - Best Practices in Social Media for Dentists







    Click below for full episode transcript:



    Teaser: It depends again, what you want to show, who you want to be in social media. I always have this debate. I asked this many times in my events. Is it okay to share your personal life and your professional life at the same time? And some people will say yes. And, but there are consequences of that. And the consequences is that-



    Teaser:I don't believe in fast tracks. I don't believe in that things can go very quick because you're going to miss a lot of learning in the process. So I think exploring and making mistakes and allowing yourself to fail. It's something that. It will make you grow way faster. People are happy in their jobs when they feel that they are treated as adults.



    And this is something I learned from the employees from Google and Netflix and all these super fancy offices. They understood that people don't care if you give them free food, they have a gym, you have cinema, you have all this super cool things in their office. So if you don't treat them as adults and you don't give them this freedom, they won't be happy.



    Jaz's Introduction:What's the number one thing holding you back as a clinician? What's holding you back from growing as a dentist and actually sleeping well at night time? It is an F word. Me and my guest today, Dr. Mehy Lo-Presti, we believe that fear is holding us back. When all of our decision making and all of our judgments and our communications are processed through this filter of fear and our dentistry is fear driven and therefore defensive. This is what may thought was the number one contributor of anxiety for dentists.



    Hello, Protruserati, I'm Jaz Gulati, and welcome back to the Protrusive Dental Podcast. This is an interference cast, where we discuss more of the non clinical themes, which are super important, because we touch on communication, we touch on fulfillment, and we also touch on social media, because we can't avoid it.

  • JOIN US on 16th November for Treatment Planning Symposium 2024 - Online Event OR In-Person - you decide!




    https://youtu.be/G5ebbUl0sDg
    Watch PDP198 on Youtube



    Implants are great but they are not always the best solution for our patient.



    There are many times a bridge or denture may serve the patient’s goals, aesthetics and budget better.



    So how do we decide between bridges and dentures?



    Is it acceptable to use root filled tooth as a bridge abutment?



    Are single tooth posterior dentures risky? Or do patients love them?



    How do we begin to communicate aspects of replacing teeth with our patients?



    Join me with our guest Dr Michael Frazis as we discuss the art form of communication with our patients and some outlandish cases including roundhouse bridges. This will really help upskill you on dealing with patients with missing teeth.



    Protrusive Dental Pearl: Failure is inevitable for our Dentistry, but try to set yourself up for smaller failures and not giant catastrophes! The real magic is in proper case selection. Practise at the EDGE of your comfort zone, but NOT out of your depth.



    20% OFF Guaranteed on RipeGlobal Fellowship Programs + Free access to their portal - Click here to register for this! protrusive.co.uk/rg20



    Follow Dr Michael Frazis on Instagram



    This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.



    This episode meets GDC LEARNING OUTCOMES: A and C



    AGD Subject Code: 610 Fixed Prosthodontics



    Dentists will be able to:




    Demonstrate improved decision-making skills in treatment planning, particularly regarding non-implant tooth replacement options.



    Apply communication strategies to better explain treatment options, manage patient expectations, and gain informed consent, especially in high-risk cases involving implants, bridges, or challenging restorations.



    Recognize red flags and understanding the risks involved in specific dental procedures (such as implant failure or the use of root-filled teeth as abutments) and how to mitigate these risks through careful case selection and patient education.




    For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. This includes videos on Overlay preps and the famous 'Vertipreps for Plonkers' series.



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this Episode:00:01:37:00 Protrusive Dental Pearl00:03:51:05 Introduction - Dr Michael Frazis00:10:43:10 Growth in Dentistry00:14:10:10 Non Implant Tooth Replacement Options00:18:15:10 Treatment Planning Bridges and Dentures00:24:35:10 Ideal Treatment vs Budget00:30:15:10 Single Tooth Dentures00:36:58:10 Thin Implants vs Bridges00:39:25:10 Bridge Spans00:49:20:10 Root Filled Teeth as Bridge Abutments00:55:35:10 Failures01:05:35:10 Wrapping Up - Contact Michael



    If you liked this episode, check out PDP132 - Resin Bonded Bridges







    Click below for full episode transcript:



    Teaser: I'm doing that bridge 11 times out of 10. If they're a patient that has money to burn and they want their teeth to be individual, they want to be able to floss their teeth because that's just what they have as their goal. I will go crown implant- And I don't think we as dentists tell patients that. If there's something you can do as a clinician to mitigate that risk, could you use that word, tell them what it is. So to give you a concrete example, when I'm taking out a tooth, I will say-



    Jaz's Introduction:Implants are awesome, but they're not for everyone. Now this could be financial. This could be something to do with their medical history. And actually there are some scenarios where a bridge or a denture can be superior. And so many of these scenarios, we need to help the patient decide between a denture and a bridge. We're going to do a deep dive into decision making and treatment planning when it comes to these modalities. I'm joined by Dr.

  • Treatment Planning Symposium 16th November Hybrid event: https://www.protrusive.co.uk/rx



    Are you still afraid of raising the Vertical Dimension? You cannot break free from the shackles of single tooth Dentistry if you don’t get comfortable with vertical dimensions changes in Restorative Dentistry.




    https://youtu.be/Nb-LTyzRKuU
    Watch PDP197 on Youtube



    In this episode, Dr. Jaz Gulati and Dr. Mahmoud Ibrahim  simplify the complex topic of increasing vertical dimension. 



    What is a safe limit of increasing the vertical dimension?



    They cover the essentials of joint health, muscle stability, and the importance of centric relation (does it actually matter?)



    Protrusive Dental Pearl: Use Duralay copings for guide planes to ensure stable dentures with a single path of insertion. While eyeballing the prep can be challenging, he suggests requesting acrylic copings from the lab for precise preparation. He explains that technicians survey models to identify undercuts and determine the path of insertion, and instead of manual prepping, he advises using lab-created reduction copings and acrylic jigs to simplify and accurately guide the preparation process. 



    Need to Read it? Check out the Full Episode Transcript below!



    Highlights of this episode: 




    02:05 Protrusive Dental Pearl  Acyrlic Copings for Guide Planes



    03:57 Dr. Mahmoud Ibrahim’s Introduction



    06:05 Personal Experiences with Vertical Dimension



    08:45 Challenges and Techniques in Vertical Dimension



    14:17 Clinical Considerations (Restorative Dentistry) and Research



    21:15 How to Assess OVD Loss?



    24:35 Factors to Consider in Increasing the Vertical Dimension



    28:41 Treatment Planning: Orthodontics vs. Restorative Management



    32:21 Assessing Cases for Vertical Dimension



    34:39 Joint Position and Vertical Dimension



    39:47 Occlusal Appliances Prior to Increasing Vertical Dimension 



    45:26 Joint Relationship



    50:49 Reproducibility and Stability in Occlusal Planning



    53:00 Summary and Final Thoughts on Vertical Dimension




    This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.



    AGD code: 180 Occlusion  (Occlusal therapy)



    This episode meets GDC Outcomes A and C.



    Dentists will be able to:



    1. Explore key clinical considerations and current research in restorative dentistry related to vertical dimension, enhancing your ability to make informed decisions.



    2. Understand the relationship between joint position and vertical dimension, and how to assess and manage this relationship effectively.



    3. Recall the guidelines for assessing the vertical dimension and the safe limit for this in dentate patients.



    If you liked this, you will also like Functionally Generated Path Technique – Conforming to Funky Occlusions – PDP168







    Click below for full episode transcript:



    Teaser: But it can also help you stage treatments, right? It's a great technique to learn because it allows you then to stage those more comprehensive cases. So one of the most useful things about opening vertical dimension is gaining space for your material without having to prep teeth that they're usually already quite worn. Now that is a huge benefit for anterior teeth, but also can come into play on back teeth.



    Jaz's Introduction:I used to be petrified of opening the bite, i.e any kind of treatment that would increase the patient's vertical dimension would be way out of my comfort zone and it really made me worried like, is the patient going to adapt?



    Are they going to get joint pain? Am I perhaps increasing the vertical dimension too much? And so for the first 18 months of my career, I was focusing on conformative dentistry. Not having to change the vertical dimension, just accepting the patient's bite for what it is and working with it. You know, a filling here or a crown there.



    And back then it mostly was small and large composites. I was still finding my feet, I wasn't confident with indirect dentistry,