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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.
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 -
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. -
Saknas det avsnitt?
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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, -
Plant it low and watch it grow? Is that serving our patients?
Should we keep our crowns flat to avoid ‘interferences’?
How about guiding teeth - how can we recreate and build in guidance and the correct cuspal inclination in our indirect work?
https://youtu.be/b2KA84dXhnI
Watch PDP196 on Youtube
As part of Occlusion month I am joined by my dental technician Graham Entwistle and Occlusion geek Dr Mahmoud Ibrahim. We discuss foundational occlusal concepts relevant to our daily indirect restorations.
Protrusive Dental Pearl: Bleeding papilla? Use the HOW technique to QUICKLY stop bleeding - insert a Wedge obliquely (Haemostasis with Oblique Wedge technique) as taught by Dr Sunny Sadana from Drecomposite.com
Treatment Planning Symposium 16th November HYBRID EVENT
Basics of Occlusion Live 2 Day Hands-On Course with Jaz and Mahmoud
Need to Read it? Check out the Full Episode Transcript below!
Highlights of this Episode: 0:00 Introduction 03:31 Protrusive Dental Pearl 05:16 Introduction - Graham Entwistle + Mahmoud Ibrahim 08:25 Guiding Teeth 11:40 Why is Guidance important? 16:35 What information should we provide our technicians? 20:00 Excursions and Patient Case 28:00 Complex crown creation 33:33 To Facebow or not to Facebow? 34:40 A Technician’s POV 49:50 What is the Technician aiming for? 51:06 Perfect Contacts - technician perspective 53:23 Final Thoughts
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: 180 Occlusion (Occlusal functional concepts)
Dentists will be able to:
1. Understand the importance of guidance and occlusion in crown design, ensuring restorations contribute positively to occlusal function and patient well-being. 2. Improve communication strategies with dental technicians, including providing crucial details such as shim holds and occlusal plane guidance, to ensure optimal restorations. 3. Make informed decisions about the distribution of occlusal forces to prevent damage and maintain functional integrity in prosthetic designs.
If you liked this episode, you’ll love PDP137 - Q&A with a Dental Technician
Click below for full episode transcript:
Teaser: If there's one thing people take away from this podcast, it's this point right here, which can easily be missed, okay? When we send a bite to our technician, whether it's a physical bite or a digital bite, more often than not, okay, it's wrong.
Jaz's Introduction:Welcome to Occlusion Month on Protrusive Dental Podcast 2024. I've just been a little bit excited for this theme. It's one of my favorite themes to discuss because it was Occlusion, learning Occlusion. It's what allowed my dentistry to become more fun. Allow me to move away from single tooth dentistry and through a series of episodes this month, we're going to help you do the same. Ultimately occlusion is just really good restorative dentistry.
It's part of the package, but It's perceived as it's like this dark art, this incredibly confusing thing. I think sometimes it's pitched that way to sell more courses, etc. But me and Mahmoud want to convince you that occlusion is easy. It can be simplified. Have faith, stick with us this month, and we hope to demystify some elements of occlusion.
In today's episode, we're covering a theme whereby when you have a guiding tooth. Now, when I said guiding tooth, what did you think of? You probably thought of a canine, canine guidance. So let's talk about that scenario, okay? Let's say you're replacing a canine either with direct restorative material or a crown.
Crown's easier to discuss. If you're replacing a canine with a crown or even an implant, how do you design the occlusion on that tooth? How do you ensure that you get the correct guidance from that tooth. Now, actually the real world scenario is not canine guidance because very few of our patients are actually canine guided. -
There is something very satisfying about a well fitting denture.
I am joined by our resident Dental Student, Emma Hutchison, to demystify removable prosthetics.
https://youtu.be/1hQGjKUa6MU
Watch PS009 on Youtube
Which joint position should we use for dentures? Is this important?
How do you calculate the freeway space?
What are we actually recording during a Wax Jaw Registration for complete dentures?
Don’t miss the special exam revision notes on Removable Pros available exclusively in the Protrusive Guidance app! (Join the free Students 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, check out PDP162 - Occlusion for Complete Dentures
Click below for full episode transcript:
Jaz's Introduction: I think we all remember that phase at dental school where we were just confused by everything related to dentures. It was especially confusing because dentures are kind of like one of the first things you do as you're a dental student. So to you it felt like being thrown in the deep end anyway.
Jaz's Introduction:For many of us the denture confusion lives on and continues throughout our career. Hopefully with some of the older episodes in Protrusive we managed to make dentures more tangible. And I myself have been enjoying doing some cobalt chrome dentures, something I didn't get to do much during dental school. But today in this Protrusive Students Section, and I mean students lightly because this whole segment, the Protrusive Students Series, whilst we release some revision notes for students every time we release an episode, what we discover here is revision.
Sometimes good to revise topics, go back to basics, so if you're a young dentist or revisiting back into dentistry, or at any stage of being a dental student, this episode and all of the series of protrusive students should be relevant to you. Especially one we did a while ago about adhesive dentistry for beginners.
Lots of qualified dentists said how much they enjoyed that one because it was nice to just go back to basics. In this one, once again with our protrusive student Dr. Emma Hutchison, she asked me about all things that confuse her as a student when it comes to dentures. And because she's relatively new to clinic, Most of the questions he asked was related to complete dentures.
So I hope you enjoyed this recap and this revision on the different stages of complete dentures. What are we actually trying to achieve in the various stages and what is important and what's not important? Hope you enjoy and I'll catch you in the outro.
Main Episode:Emma Hutchison, welcome again to the Protrusive Student section. This time we're going to cover removal. But just tell us, we're recording this way in advance because we don't want to interfere with your exams and stuff. How are you getting on? What's your last few weeks been like?
[Emma]Yeah, the last week I've only seen one patient, which was actually my flatmate, and didn't need anything done. And so he just got a scaling polish, a bit of PMPR, and that was him really. So nothing too exciting in terms of patients, but just I've got my exam dates now, so it's really becoming real, so just keeping my head down and getting through lectures and really starting to study now, so.
[Jaz]What kind of learner are you, Emma? You know there's different types of learners and stuff, I won't give you any ideas, just in terms of self discovery, how do you like to learn?
[Emma]I'd say I need to listen to things, I need to be told by someone who's talking to me, and I need to be able to translate that into something that I can understand myself, -
The first EVER ‘Prospective’ episode of Protrusive - I interviewed new-grad Dr Triman Ahluwalia in 2023, then again 7 months later in 2024 to see how he gets on with his first year as a *real* Dentist ;)
We uncover what it feels to be a freshly qualified Dentist, the pressures and fears that come with procedures such as endo and surgical extractions, but what we can do as growing clinicians to overcome these hurdles.
https://youtu.be/9NtKCIVfMLs
Watch IC052 on Youtube
This episode is packed with lots of top tips to help you in your journey from the ground up, or as a reminder for those that have been there and done that, that we are forever learning on our journey and there’s always something out there to help us become better Dentists.
Need to Read it? Check out the Full Episode Transcript below!
Highlights of this Episode:02:02 Introduction to Dr Triman (2023)03:32 Experiences at Dental School07:15 Procedures You Fear + Sectioning Teeth11:25 Thoughts on Social Media in Dentistry15:26 Documenting Work16:30 Future Career Plans18:00 Additional Comments from Triman19:03 Back to the Future: 2024 Triman Update21:50 Dental Photography Progress23:08 Tricky Dental Procedures Update27:46 The Good and the Bad of DFT32:26 Career Path in Dentistry34:49 Triman’s Top Tips37:06 Wrapping Up
Don’t forget to check out the Protrusive App where you can find more awesome tutorials on becoming a more efficient and effective practitioner.
If you liked this episode, you will also like IC029 - Young Dentist Thrival Guide
This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on on the Ultimate Eduction Plan, including Premium clinical workthroughs and Masterclasses.
Click below for full episode transcript:
Jaz's Introduction: Welcome to the first ever Protrusive Prospective episode. You see, I interviewed Dr. Triman Ahluwalia in his first month of being a real dentist, i. e. newly qualified. I then interviewed him again seven months later to see how he got on.
Jaz's Introduction:Hello Protruserati, I'm Jaz Gulati, and welcome back to your favorite dental podcast. Every year we make an episode to help those who are in their first year, i. e. they've just qualified and they're entering the big bad world dentistry. And this is a interesting one because I've never done a prospective episode whereby I've told the guest to wait six, seven months and then we'll continue the recording.
Just to see if the perspective has changed. I think this is essential listening and watching for those who are literally about to enter the first year of dental school, or maybe you're returning to work again after some time off, or maybe you just want to gain some insight into the mind of the newly qualified dentist.
Maybe you mentor some dentists, by the way, speaking of mentorships and big things, Intaglio is almost out. For those of you who don't know, Intaglio is a new platform we're making to allow one on one mentorship. Look, it doesn't matter. How much money you paid to these courses doesn't matter how many continuums or diplomas you've done.
When you have that specific case and you need someone to sit down with to discuss that case, step by step for a good hour or even two hours, the course organizes the diploma teachers. They are busy. They don't have the time to do one on one, which is why we created this platform to allow mentors and mentees to connect and allow fair exchange.
Because you know what when a mentee needs help they really value it and they value that one on one time so Intaglio is coming soon and also a big update number two is I'm in my new studio I've now moved from reading to West London quite close to Heathrow it's like little India it's called Southall. I'm close now to my parents my in laws we get lots of support for family so that was a big reason I'm still working in Reading. But yeah, it's been a crazy time with moving. - Visa fler
