Is that broken-down first permanent molar really down to poor brushing — or is it Molar Incisor Hypomineralisation?

When is the right time to take a first permanent molar out — and how do you read it off the X-ray?

And how do you tell a parent their child needs an adult tooth removed — without losing them?

First permanent molars of poor prognosis are one of the genuine head-scratchers of general practice — full of ifs, buts and timing. In this episode Jaz sits down with Dr Nicole Sturzenbaum, a paediatric dentist and the owner and clinical director of Toothbeary in Richmond, London, to work through the whole decision: getting the diagnosis right (molar-incisor hypomineralisation versus caries), reading the extraction window off an OPG, the restorative ladder from sealant to stainless steel crown, when to bring in the orthodontist, and how to handle the conversation with anxious parents. There’s no one-size-fits-all answer — but there is a clear way to think about it.

Protrusive Dental Pearl: Painless Polishing for Anxious Kids

The mechanical clean is what frightens children (and plenty of adults) — the scaler, the bristle brush, the gritty prophy paste. For the polishing part, a colourless plaque-dissolving foam gel does the job without any of it. It fizzes wherever there is plaque, so you can hand the child a mirror and show them exactly where to brush; it leaves the teeth satin-smooth, reduces gingival inflammation, and is painless and non-invasive.

Two caveats: it does not remove calculus — you still need a hand or ultrasonic scaler for that — and you should agitate the gel gently at the gingival margin for the full effect. It is especially useful for orthodontic and adolescent patients because it reaches the nooks around brackets, which is where post-orthodontic white-spot lesions start.

Product: Magic3 (3% hydrogen peroxide, colourless plaque indicator), by Dr Wyman Chan — protrusive.co.uk/magic3.

What You’ll Take From This Episode

• Diagnosis first — MIH or caries? The distinction changes the plan, the prognosis and the whole conversation with the family.

• Reading the extraction window off an OPG — why chronological age tells you nothing, and what the second molar’s bifurcation tells you instead.

• The restorative ladder — seal, composite, preformed metal crown, or plan the extraction: matching the least invasive option that will actually hold.

• When to involve the orthodontist — essential or desirable, which teeth come out, and managing the space afterwards.

• Getting sensitive molars numb — why MIH teeth are so hard to anaesthetise, and the comfort stack that helps.

Highlights of This Episode

• 00:00     TEASER
• 00:59     First Permanent Molars of Poor Prognosis in Children
• 02:51     Painless Chemical Polishing for Kids (Protrusive Dental Pearl)
• 04:53     Meet Dr Nicole Sturzenbaum, Paediatric Dentist
• 11:49     MIH or Caries? Getting the Diagnosis Right
• 15:14     What Is MIH? Causes, Grades and 'Cheese Molars'
• 17:23     When to Extract a First Molar: Reading the OPG
• 20:08     Sealant, Composite or Crown for MIH Molars
• 22:32     Stainless Steel Crowns for Hypomineralised Molars
• 25:52     Do You Need an Orthodontic Opinion Before Extraction?
• 29:15     Talking to Parents About Removing an Adult Tooth
• 31:56     Anaesthesia Tips for Sensitive MIH Molars
• 36:14     Managing the Space After First Molar Extraction
• 41:15     Balancing and Compensating Extractions Explained
• 47:53     Early Orthodontics and Prevention at Toothbeary
• 51:15     OUTRO

From the Guest

Dr Nicole Sturzenbaum is a paediatric dentist and the owner and clinical director of Toothbeary, a paediatric dental practice in Richmond, London. 

????  Toothbeary — paediatric dentistry, sedation & early orthodontics, Richmond, London

References & Further Reading

• EAPD guidance (cited on the episode). European Academy of Paediatric Dentistry policy documents on MIH (Lygidakis et al., best clinical practice guidance for clinicians dealing with children presenting with MIH) and on paediatric local analgesia (Kühnisch et al., 2017).

• Preoperative analgesia for MIH (further reading). Vicioni-Marques, F., Paula-Silva, F. W. G., Carvalho, M. R., Queiroz, A. M., Freitas, O., Duarte, M. P. F., Manton, D. J., & Carvalho, F. K. (2022). Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar: a triple-blind randomized clinical trial. Journal of applied oral science : revista FOB, 30, e20210538. https://doi.org/10.1590/1678-7757-2021-0538

Want more?

If you enjoyed this episode, check out: Zirconia vs Metal Hall Crowns vs Conventional with Dr Tim Keys – PDP227

Tags

#PDPMainEpisodes #OrthoRestorative

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C.

AGD Subject Code: 430 Pediatric Dentistry.

Aim & Learning Outcomes

Aim: To help general dentists diagnose, assess and manage first permanent molars of poor prognosis in children — recognising molar-incisor hypomineralisation, timing extraction from radiographic development, and choosing between restoration and extraction with the wider team.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Differentiate molar-incisor hypomineralisation from caries of hygiene origin, and explain how that distinction changes management and communication.

• Apply radiographic developmental assessment — the second molar’s bifurcation and the presence of third molars — to judge the timing of first permanent molar extraction.

• Select an appropriate management pathway, from sealant and composite through preformed metal crown...

Tetracycline staining darker than your darkest shade tab — is bleaching even worth attempting, or is it veneers by default?

A single dark, root-filled central incisor — can you fix it without picking up a drill at all?

And how do you talk a patient through weeks, shades and cost so they actually consent to the slow, non-invasive route?

This is Part 2 of the trayless whitening series with Dr Wyman Chan — inventor of trayless teeth whitening and the Get2Smile system — and Dr Elvis Law, who now runs around 90% of his whitening trayless. Part 1 covered the science and the everyday protocol; this part applies it to the three cases dentists find hardest, with the costing and consent conversations that make them work.

Protrusive Dental Pearl: Treating Family and Friends

Almost every clinician has a story about a case that went wrong on a family member, a friend, or a loved one. It’s not a random fluke. When we treat someone we love, we put our guard down — we relax the checklist, skip a step, get driven by emotion, and lose our judgement.

So if you must treat family and friends, stay razor-sharp and treat them exactly as you would a stranger. Be extra vigilant, extra hot on your protocols, and take the emotion out of it. If that tooth needs a root canal, it needs a root canal — don’t bend the plan to preserve pulp vitality that was never the right call. The best pearl is not to treat loved ones at all; the real-world one is to not lose your judgement when you do.

What You’ll Take From This Episode

• The frosted glass model — a patient-ready way to explain white spots: enamel is clear glass, dentine is a yellow sponge, and acid has turned the glass frosty.
• A two-stage white spot protocol — remineralise and condition the gums first, then whiten trayless, and why a dirty tray would have sabotaged the result.
• Whitening tetracycline staining — realistic timelines, why darker teeth lift faster, and how to frame it honestly against veneers.
• The non-vital tooth without a drill — whiten every tooth to target, then paint the single dark tooth to match, and why leakage (not the bleach) causes rebound.
• Costing and consent — charging “almost by time,” staged reviews, and matching invasiveness to the mouth in front of you.

Highlights of This Episode

• 00:00     Teaser
• 01:05     Trayless Whitening Part 2: Recap of Part 1
• 03:55     Protrusive Dental Pearl: Treating Family and Friends
• 06:55     Whitening White Spot Lesions After Orthodontics
• 11:55     Whiten First or Restore First? Cavitated Anterior Caries
• 18:35     The Frosted Glass Analogy: Explaining White Spots to Patients
• 21:05     A Two-Stage White Spot Protocol: Remineralise, Then Whiten
• 32:57     Midroll
• 36:23     Whitening Tetracycline-Stained Teeth
• 40:03     Costing and Consent: Bleaching vs Veneers
• 46:23     Whitening a Non-Vital Yellow Central Incisor
• 47:43     Why Root-Filled Teeth Rebound After Bleaching
• 53:13     Trayless Single-Tooth Whitening Without a Drill
• 1:00:43   How to Access Trayless Whitening and Training
• 1:03:40   Outro

From the Guest

Dr Wyman Chan is the inventor of trayless teeth whitening and the Get2Smile system, with a PhD in the efficacy and safety of teeth whitening and a whitening clinic in London’s West End. Dr Elvis Law trained in safe dental bleaching under Dr Wyman Chan and now runs the majority of his whitening trayless.

Start Offering Trayless Whitening for Your Office

UK Dentists:

In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes.

Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses.

At checkout, use code: DOCSUMMER20

International Dentists wishing to offer Get2Smile, please enquire from Dr Chan's website. The international version uses 10% formulation applied for 15 minutes, twice daily.

???? Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026.

Saturday 5th September London, UK CPD EVENT:

????Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases.

???? Royal Asiatic Society, London NW1 2HD

The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases.

Want more?

If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all..

Tags

#PDPMainEpisodes

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

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

This episode meets GDC Outcomes C

AGD Subject Code: 780 Esthetics/Cosmetic Dentistry.

Aim & Learning Outcomes

Aim: To give dental practitioners a practical, non-invasive approach to three difficult whitening presentations — post-orthodontic white spot lesions, tetracycline staining, and a discoloured non-vital tooth — together with the expectation-setting and consent conversations that make treatment succeed.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe how enamel demineralisation produces white spot lesions and explain, in patient-friendly terms, why a repair-then-whiten sequence addresses both the surface and the underlying tooth colour.
• Apply a staged, non-invasive protocol to manage white spot, tetracycline and non-vital discolouration cases, selecting an appropriate route by matching invasiveness to the individual patient.
• Articulate realistic expectations on shade, timeline and cost, and use them to obtain informed consent for an extended, reviewable whitening course.

Tetracycline staining darker than your darkest shade tab — is bleaching even worth attempting, or is it veneers by default?

A single dark, root-filled central incisor — can you fix it without picking up a drill at all?

And how do you talk a patient through weeks, shades and cost so they actually consent to the slow, non-invasive route?

This is Part 2 of the trayless whitening series with Dr Wyman Chan — inventor of trayless teeth whitening and the Get2Smile system — and Dr Elvis Law, who now runs around 90% of his whitening trayless. Part 1 covered the science and the everyday protocol; this part applies it to the three cases dentists find hardest, with the costing and consent conversations that make them work.

Protrusive Dental Pearl: Treating Family and Friends

Almost every clinician has a story about a case that went wrong on a family member, a friend, or a loved one. It’s not a random fluke. When we treat someone we love, we put our guard down — we relax the checklist, skip a step, get driven by emotion, and lose our judgement.

So if you must treat family and friends, stay razor-sharp and treat them exactly as you would a stranger. Be extra vigilant, extra hot on your protocols, and take the emotion out of it. If that tooth needs a root canal, it needs a root canal — don’t bend the plan to preserve pulp vitality that was never the right call. The best pearl is not to treat loved ones at all; the real-world one is to not lose your judgement when you do.

What You’ll Take From This Episode

• The frosted glass model — a patient-ready way to explain white spots: enamel is clear glass, dentine is a yellow sponge, and acid has turned the glass frosty.
• A two-stage white spot protocol — remineralise and condition the gums first, then whiten trayless, and why a dirty tray would have sabotaged the result.
• Whitening tetracycline staining — realistic timelines, why darker teeth lift faster, and how to frame it honestly against veneers.
• The non-vital tooth without a drill — whiten every tooth to target, then paint the single dark tooth to match, and why leakage (not the bleach) causes rebound.
• Costing and consent — charging “almost by time,” staged reviews, and matching invasiveness to the mouth in front of you.

Highlights of This Episode

• 00:00     Teaser
• 01:05     Trayless Whitening Part 2: Recap of Part 1
• 03:55     Protrusive Dental Pearl: Treating Family and Friends
• 06:55     Whitening White Spot Lesions After Orthodontics
• 11:55     Whiten First or Restore First? Cavitated Anterior Caries
• 18:35     The Frosted Glass Analogy: Explaining White Spots to Patients
• 21:05     A Two-Stage White Spot Protocol: Remineralise, Then Whiten
• 32:57     Midroll
• 36:23     Whitening Tetracycline-Stained Teeth
• 40:03     Costing and Consent: Bleaching vs Veneers
• 46:23     Whitening a Non-Vital Yellow Central Incisor
• 47:43     Why Root-Filled Teeth Rebound After Bleaching
• 53:13     Trayless Single-Tooth Whitening Without a Drill
• 1:00:43   How to Access Trayless Whitening and Training
• 1:03:40   Outro

From the Guest

Dr Wyman Chan is the inventor of trayless teeth whitening and the Get2Smile system, with a PhD in the efficacy and safety of teeth whitening and a whitening clinic in London’s West End. Dr Elvis Law trained in safe dental bleaching under Dr Wyman Chan and now runs the majority of his whitening trayless.

UK Dentists:

In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes.

Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses.

At checkout, use code: DOCSUMMER20

The Trayless whitening system is called Get2Smile.

International Dentists wishing to offer Get2Smile, please enquire from Dr Chan’s website. The international version uses 10% formulation applied for 15 minutes, twice daily.

???? Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026.

Saturday 5th September London, UK CPD EVENT:

????Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases.

The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases.

Want more?

If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all..

Tags

#PDPMainEpisodes

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

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

This episode meets GDC Outcomes C

AGD Subject Code: 780 Esthetics/Cosmetic Dentistry.

Aim & Learning Outcomes

Aim: To give dental practitioners a practical, non-invasive approach to three difficult whitening presentations — post-orthodontic white spot lesions, tetracycline staining, and a discoloured non-vital tooth — together with the expectation-setting and consent conversations that make treatment succeed.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe how enamel demineralisation produces white spot lesions and explain, in patient-friendly terms, why a repair-then-whiten sequence addresses both the surface and the underlying tooth colour.
• Apply a staged, non-invasive protocol to manage white spot, tetracycline and non-vital discolouration cases, selecting an appropriate route by matching invasiveness to the individual patient.
• Articulate realistic expectations on shade, timeline and cost, and use them to obtain informed consent for an extended, reviewable whitening course.

Why would a dentist who owns a whitening lab — and holds four patents on making bleaching trays — tell you to skip the tray?

Trayless whitening does not mean strips. It means the patient puts in a retractor and paints the gel directly onto the teeth, twice a day, for half an hour. No impression, no lab bill, no two-week wait, and no soft plastic reservoir quietly absorbing your peroxide.

This is Part 1 of a two-part conversation with Dr Wyman Chanand Dr Elvis Law, recorded live in their central London whitening practice. Wyman has done nothing but whitening since 2002, has a PhD on the efficacy and safety of whitening processes, and — despite owning the lab that makes the trays — now does most of his cases without one. Elvis trained under him and reckons around 90% of his own cases are now trayless.

Part 1 is the mechanism, the protocol and an honest list of who it doesn’t suit. Part 2 takes it into the hard cases.Protrusive Dental Pearl: Let the Patient Pick the ShadeMost of us ask “how white do you want to go?”, get a laugh about Hollywood white or Simon Cowell white, then hold a B1 tab against the canine and call that the destination. Try flipping it.

Under corrected light, record where the patient is now. Then hand over the whole shade guide, arranged by value, and let them choose the tab they want to reach. Photograph both.

This is the VITA Shade guide arranged by value:

B1 → A1 → B2 → D2 → A2 → C1 → C2 → D4 → A3 → D3 → B3 → A3.5 → B4 → C3 → A4 → C4

Two things change. You now know the target precisely instead of inferring it, and you can track progress against a fixed reference. Most patients land on B1 — it’s the last shade before the bleach range, and it reads natural rather than veneered. Some will point at 0M1 and that’s a different conversation, which is exactly the point.

Because whatever they choose dictates how many weeks, how much gel and how many reviews the case needs — and therefore what it should cost. A single flat whitening fee assumes every case takes the same work. They don’t. Someone starting at C4 who wants a bleach shade can get there, but it takes more gel, more time, more reviews and probably a protocol change along the way. Price that honestly.

Only you can decide what the tiers look like in your practice. But it might be worth sitting down as a team of dentists and therapists and asking: how are we delivering whitening? Two tiers? More? Based on what?

What You’ll Take From This Episode

• Conscious bleaching — why an awake patient with an open mouth is a completely different chemical situation to a sealed tray worn overnight, and what that does to sensitivity.
• The formulation constraint — peroxide needs acid to stay stable on the shelf, which is why pre-mixed products lean acidic and why two-component gels exist at all.
• The full trayless protocol — wear schedule, spacing, patient positioning, review intervals and what to troubleshoot first when a case is behind.
• Who it doesn’t suit — an honest contraindications list, including the one objection patients raise most often and the answer to it.
• Tray hygiene as a clinical instruction — the reason results vary so much between patients using the identical gel.
• An A3.5 to B1 case — start to finish in three weeks, with the review points and the maintenance plan.

Highlights of This Episode

• 00:00     TEASER
• 01:05     Trayless Teeth Whitening Explained
• 03:40     Protrusive Dental Pearl: Let Patients Pick Their Whitening Shade
• 06:05     Meet the Guests: A Career Built on Teeth Whitening
• 10:27     What Is Trayless Whitening? (It's Not Whitening Strips)
• 13:44     Why Whitening Trays Waste Your Bleaching Gel
• 15:37     Are Whitening Strips Acidic? Gel Formulation Explained
• 19:17     Conscious Bleaching and Whitening Sensitivity
• 24:43     When NOT to Use Trayless Whitening
• 29:05     The Trayless Whitening Protocol: 30 Minutes Twice a Day
• 32:55     Midroll
• 42:45     How to Clean Whitening Trays Properly
• 50:02     A3.5 to B1 in Three Weeks: A Case Walkthrough
• 56:16     Tooth Porosity and the 45-Degree Recline Rule
• 1:02:09   Whitening Top-Ups and the Five-Year Guarantee
• 1:06:49   How to Price Teeth Whitening and Let Patients Pick the Shade
• 1:07:45   OUTRO
• 1:12:56   What's Coming in Part 2

Start Offering Trayless Whitening for Your Office

UK Dentists:

In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes.

Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses.

At checkout, use code: DOCSUMMER20The Trayless whitening system is called Get2Smile.International Dentists wishing to offer Get2Smile, please enquire from Dr Chan's website. The international version uses 10% formulation applied for 15 minutes, twice daily.

???? Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026.

Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases.The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases.

Want more?

If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all.

Tags

#PDPMainEpisodes 

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

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

This episode meets GDC Outcomes C.

AGD Subject Code: 780 Esthetics/Cosmetic Dentis...

Why would a dentist who owns a whitening lab — and holds four patents on making bleaching trays — tell you to skip the tray?

Trayless whitening does not mean strips. It means the patient puts in a retractor and paints the gel directly onto the teeth, twice a day, for half an hour. No impression, no lab bill, no two-week wait, and no soft plastic reservoir quietly absorbing your peroxide.

This is Part 1 of a two-part conversation with Dr Wyman Chan and Dr Elvis Law, recorded live in their central London whitening practice. Wyman has done nothing but whitening since 2002, has a PhD on the efficacy and safety of whitening processes, and — despite owning the lab that makes the trays — now does most of his cases without one. Elvis trained under him and reckons around 90% of his own cases are now trayless.

Part 1 is the mechanism, the protocol and an honest list of who it doesn’t suit. Part 2 takes it into the hard cases.

Protrusive Dental Pearl: Let the Patient Pick the Shade

Most of us ask “how white do you want to go?”, get a laugh about Hollywood white or Simon Cowell white, then hold a B1 tab against the canine and call that the destination. Try flipping it.

Under corrected light, record where the patient is now. Then hand over the whole shade guide, arranged by value, and let them choose the tab they want to reach. Photograph both.

This is the VITA Shade guide arranged by value:

B1 → A1 → B2 → D2 → A2 → C1 → C2 → D4 → A3 → D3 → B3 → A3.5 → B4 → C3 → A4 → C4

Two things change. You now know the target precisely instead of inferring it, and you can track progress against a fixed reference. Most patients land on B1 — it’s the last shade before the bleach range, and it reads natural rather than veneered. Some will point at 0M1 and that’s a different conversation, which is exactly the point.

Because whatever they choose dictates how many weeks, how much gel and how many reviews the case needs — and therefore what it should cost. A single flat whitening fee assumes every case takes the same work. They don’t. Someone starting at C4 who wants a bleach shade can get there, but it takes more gel, more time, more reviews and probably a protocol change along the way. Price that honestly.

Only you can decide what the tiers look like in your practice. But it might be worth sitting down as a team of dentists and therapists and asking: how are we delivering whitening? Two tiers? More? Based on what?

What You’ll Take From This Episode

• Conscious bleaching — why an awake patient with an open mouth is a completely different chemical situation to a sealed tray worn overnight, and what that does to sensitivity.
• The formulation constraint — peroxide needs acid to stay stable on the shelf, which is why pre-mixed products lean acidic and why two-component gels exist at all.
• The full trayless protocol — wear schedule, spacing, patient positioning, review intervals and what to troubleshoot first when a case is behind.
• Who it doesn’t suit — an honest contraindications list, including the one objection patients raise most often and the answer to it.
• Tray hygiene as a clinical instruction — the reason results vary so much between patients using the identical gel.
• An A3.5 to B1 case — start to finish in three weeks, with the review points and the maintenance plan.

Highlights of This Episode

• 00:00     TEASER
• 01:05     Trayless Teeth Whitening Explained
• 03:40     Protrusive Dental Pearl: Let Patients Pick Their Whitening Shade
• 06:05     Meet the Guests: A Career Built on Teeth Whitening
• 10:27     What Is Trayless Whitening? (It’s Not Whitening Strips)
• 13:44     Why Whitening Trays Waste Your Bleaching Gel
• 15:37     Are Whitening Strips Acidic? Gel Formulation Explained
• 19:17     Conscious Bleaching and Whitening Sensitivity
• 24:43     When NOT to Use Trayless Whitening
• 29:05     The Trayless Whitening Protocol: 30 Minutes Twice a Day
• 32:55     Midroll
• 42:45     How to Clean Whitening Trays Properly
• 50:02     A3.5 to B1 in Three Weeks: A Case Walkthrough
• 56:16     Tooth Porosity and the 45-Degree Recline Rule
• 1:02:09   Whitening Top-Ups and the Five-Year Guarantee
• 1:06:49   How to Price Teeth Whitening and Let Patients Pick the Shade
• 1:07:45   OUTRO
• 1:12:56   What’s Coming in Part 2

UK Dentists:

In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes.

Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses.

At checkout, use code: DOCSUMMER20

The Trayless whitening system is called Get2Smile.

International Dentists wishing to offer Get2Smile, please enquire from Dr Chan’s website. The international version uses 10% formulation applied for 15 minutes, twice daily.

???? Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026.

Saturday 5th September London, UK CPD EVENT:

Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases.

The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases.

Want more?

If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all.

Tags

#PDPMainEpisodes 

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

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

This episode meets GDC Outcomes C.

AGD Subject Code: 780 Esthetics/Cosmetic Dentistry.

Aim & Learning Outcomes

Aim: To give dental practitioners a mechanism-led understanding of external tooth whitening delivered without a tray — how gel containment and contact time influence sensitivity and efficiency, how formulation constrains the delivery method, and how to select, sequence and price a whitening case around the patient’s chosen target shade.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe how containment and contact time influence bleaching sensitivity, gingival irritation and the proportion of active gel that reaches the tooth.
• Apply a structured protocol for tray-free external whitening, including wear scheduling, patient positioning, review intervals and technique troubleshooting.
• Differentiate between patients suited to tray-based and tray-free delivery, and justify a fee structure derived from the patient’s target shade rather than a flat rate.

What should you actually focus on in year one: the flawless dentistry on your feed, or something far less glamorous?

How do you tell a patient their nerve might die — without it sounding like YOUR fault?

And when a patient says “just do whatever you think” — what do you say back?

This is the conversation every new dentist needs and every experienced one recognises. Our guest is Dr Emma Hutchison — a former dental nurse who trained at the University of Glasgow, and has been the face of the Protrusive Students series across her studies. We recorded in her final weeks of dental school, right on the threshold of practice, and talked through everything the syllabus skips: the safe-beginner mindset, what to learn (and what to ignore) early on, how to protect your standards under time pressure, which cases to take on, and how to talk to patients about risk, cost and consent so the words actually land. If you’re fresh out, this one hits hard. If you’re an oldie, it’s a trip down memory lane — and a reminder of how far you’ve come.

 https://youtu.be/gjJiDVP4w-4 

Watch PDP276 on YouTube

Protrusive Dental Pearl: Predict the Complication Before It Happens

A communication pearl for every deep restoration. When a filling sits close to the nerve — a big cavity, a crack — name the likely complication before it happens. Show the patient the images, then tell them what to expect: a twinge to cold or hot that can linger a few days, so keep taking painkillers and keep the area clean. And warn them what a red flag looks like: a severe throbbing ache keeping them up at night, or pain out of the blue without eating or drinking, means the nerve is struggling and they should call you.

Do this and, if the complication ever arrives, you look like the expert who called it — not someone something went wrong for. Skip it and reception fields the panicked calls instead. It reassures the patient, lowers your callback rate, and quietly reduces your risk profile. Obvious, easy to forget, and worth saying out loud every single time.

What You’ll Take From This Episode

• The safe-beginner mindset — why qualifying is the driving licence, not the destination, and how the happiest dentists keep getting 1% better.
• Just-in-time learning — study for the cases actually in your diary, not the obscure pathology you won’t meet for years.
• Get good before you get fast — master the bread and butter, protect a little extra time early, and reflect on every procedure.
• Clever hacks vs cutting corners — how to tell the difference, and why every shortcut quietly rewires the habit.
• Consent that works — getting patients to own the problem, and giving a clear recommendation instead of a fifteen-item menu.

Highlights of This Episode

• 00:00  Teaser
• 01:05  The Things Dental School Doesn’t Prepare You For
• 03:05  Communication Pearl: Predict the Complication Before It Happens
• 05:35  Life as a Final-Year Dental Student on Outreach
• 09:55  Why You’re Only a “Safe Beginner” When You Qualify
• 13:45  Master Bread-and-Butter Dentistry Before the Fancy Stuff
• 16:05  Just-in-Time Learning: Study for the Cases in Front of You
• 18:05  Get Good Before You Get Fast (and Protect Your Time)
• 19:45  Clever Hacks vs Cutting Corners: Don’t Lose Your Standards
• 24:14  Midroll
• 27:46  The Skills to Nail in Your First Year as a Dentist
• 30:11  Which Cases to Take On — and Learning From Mistakes
• 35:46  How to Explain Risk and Get Patients to Own the Problem
• 41:26  When Patients Refuse the Ideal Treatment: Start With Their Goal
• 44:26  Treatment Planning Without the Overwhelm: Loom & “Guess Who”
• 47:36  Claim Your CPD & Become the Next Protrusive Student
• 47:38  Outro

Dr Emma Hutchison came to dentistry the long way round — from a dental nursing background into dental school at the University of Glasgow, with final-year outreach on the Kintyre peninsula in Campbeltown. She has been the face of the Protrusive Students series throughout her studies, and this episode marks her crossing from student to newly qualified dentist. On behalf of the whole Protruserati: we’re proud of you, Emma.

Become the next Protrusive Student: with Emma qualifying, we’re looking for the next keen student who wants part-time work, an income while studying, and to contribute to Protrusive — or a nudge if you know one. DM the team inside the Protrusive Guidance app.

Resources & Mentions From This Episode

• Quick & slick rubber dam — the in-app video series on quadrant isolation, for building the rubber dam habit from day one.
• 21-Day Photography Challenge — the in-app challenge that walks you through capturing every clinical photo, including the dreaded occlusal shots, in your first three weeks.
• Loom School — in-app training on async, Loom-video treatment planning (roughly 90 minutes of CPD across around 15 bite-sized lessons).

Access the above masterclasses and more when you subscribe to the Ultimate or Infinity plan.

Want more?

If you enjoyed this episode, check out: Periodontics for Beginners – PS008

#PDPMainEpisodes #CareerDevelopment #Communication 

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

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

This episode meets GDC Outcomes A and D.

AGD Subject Code: 770 Self-Improvement 

Aim & Learning Outcomes

Aim: To give early-career dentists a practical framework for the transition from dental school to independent practice — how to keep developing, how to protect clinical standards under time pressure, and how to communicate risk and treatment options as part of valid consent.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Apply a “just-in-time” approach to continuing development, prioritising the competencies relevant to the cases in front of them over isolated advanced techniques.
• Differentiate time-saving efficiencies from quality-compromising shortcuts, and describe strategies to maintain clinical standards early in practice.
• Apply structured communication techniques to explain procedural risk, establish a patient’s treatment goal, and make a clear, defensible recommendation as part of va...

What if two inexpensive finger-prick tests told you more about a patient’s gum disease and implant prognosis than anything on the radiograph?

And here’s the uncomfortable one: if the science is this clear, is not checking starting to look like a medico-legal risk? Especially for imlpant surgery!

This is a conversation with Dr Tif Qureshi— the dentist who changed how the profession thinks about the lifelong patient, the envelope of function, and Align, Bleach, Bond. He’s gone down a new rabbit hole: metabolic health. In general practice he’s now doing blood tests — HbA1c and vitamin D — and making the case that the mouth isn’t connected to the body, it is the body. This isn’t about becoming a “biological dentist” (as you’ll hear, Tif is refreshingly blunt about the wilder end of that world). It’s about respecting the biology, screening sensibly, and helping patients where we’re genuinely placed to help.

 https://youtu.be/mt1MXLFCTp0 

Watch PDP275 on YouTube

Protrusive Dental Pearl: Test Yourself First

Before you even think about introducing blood tests for your patients, ask whether you’re checking your own biomarkers at a sensible interval. The deepest way to understand this topic is to learn it on yourself and your family first — run your own HbA1c, vitamin D, iron, and liver and kidney markers, and see what the data tells you.

Start quarterly, like hygienist visits, then stretch to six-monthly or annual once things look good. Getting invested in your own numbers is what makes better food and lifestyle choices actually stick — and it’s the honest starting point for ever offering this to a patient.

What You’ll Take From This Episode

• The metabolic lens — why one disordered glucose-and-insulin system sits under so much chronic and dental disease, and why dentistry is well placed to act on it.
• Sugar, redefined — why patients who avoid sweets still get decay, and how frequency of starchy carbs drives the problem.
• The two biomarkers that matter most — what HbA1c and vitamin D each tell you about caries, perio and healing.
• How to run it in practice — finger-prick logistics, what to test, and how to raise it on the medical history form.
• The medico-legal case — why documenting these markers can protect you before implant, graft and perio work.

Highlights of This Episode

• 00:00  Why Dentists Should Care About Blood Tests
• 06:00  Metabolic Disease: The Root Cause Dentists Miss
• 13:00  Why Starchy Carbs Cause Decay, Not Just Sugar
• 15:50  HbA1c and Caries: What the SHIP Study Shows
• 21:00  Insulin Resistance: The Hidden Driver of Gum Disease
• 26:00  How to Talk to Patients About Diet Without Scaring Them
• 31:00  Why Vitamin D Deserves a Place in Dentistry
• 34:00  Vitamin D, Implant Failure and Perio Risk
• 37:00  Blood Tests as Medico-Legal Defence
• 42:00  What Dentists Should Test: HbA1c and Vitamin D
• 44:00  How In-Practice Blood Testing Actually Works
• 50:00  The Mouth Is the Body: Screening, Not Diagnosing
• 51:00  Is This Biological Dentistry? An Honest Answer
• 57:00  How to Learn Blood Testing for Your Practice

From the Guest

Dr Tif Qureshi qualified from King’s College London in 1992 and is a Past President of the British Academy of Cosmetic Dentistry. He is Founder and Clinical Director of IAS Academy, best known for pioneering Align, Bleach, Bond and Progressive Smile Design, and as a teacher of the Dahl concept. His current focus is metabolic health in general practice.

????  IAS Academy — Align, Bleach, Bond, the Dahl concept, and blood-testing / metabolic health training

Coming soon: Join Dr. Tif in one-day metabolic health programme. He has spent years connecting the dots between what’s happening in the mouth and what’s happening in the body. The results are undeniable: better outcomes, stronger case acceptance, and a rock-solid medico-legal position.

This one-day course will change the way you practise. For good.????Metabolic Health in Dentistry

References & Further Reading

Studies and sources referenced in this episode:

• Song I-S, et al. Severe Periodontitis Is Associated with Insulin Resistance in Non-abdominal Obese Adults. J Clin Endocrinol Metab, 2016;101(11):4251–4259. Insulin resistance as an independent risk factor for severe perio in normal-weight adults.
• Botelho J, et al. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients, 2020;12(5):1471. Vitamin D across caries, periodontitis, orthodontic and surgical outcomes.
• Schmolinsky J, Kocher T, Rathmann W, Völzke H, Pink C, Holtfreter B. Diabetes status affects long-term changes in coronal caries – The SHIP Study. Sci Rep. 2019 Oct 30;9(1):15685. doi: 10.1038/s41598-019-51086-z. PMID: 31666549; PMCID: PMC6821733.

Want more?

If you enjoyed this episode, check out: Why do some Dentists find Dahl Distasteful? – PDP016. 

#PDPMainEpisodes #BeyondDentistry #Communication

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C and A.

AGD Subject Code: 730 Oral Medicine, Oral Diagnosis, Oral Pathology

Aim & Learning Outcomes

Aim: To help dental practitioners understand the link between metabolic health and oral disease, and to evaluate whether simple in-practice biomarker screening has a place in their care of patients.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe how disordered glucose and insulin metabolism relates to caries, periodontal disease and healing outcomes, and explain what HbA1c and vitamin D each indicate.
• Apply a structured, non-alarmist approach to discussing diet and biomarker screening with patients, within the professional boundary of screening rather than diagnosing or prescribing.
• Evaluate the clinical and medico-legal case for documenting relevant biomarkers before periodontal and surgical treatment, and identify when to refer to a medical colleague.

What if two inexpensive finger-prick tests told you more about a patient’s gum disease and implant prognosis than anything on the radiograph?

And here’s the uncomfortable one: if the science is this clear, is not checking starting to look like a medico-legal risk? Especially for imlpant surgery!

This is a conversation with Dr Tif Qureshi — the dentist who changed how the profession thinks about the lifelong patient, the envelope of function, and Align, Bleach, Bond. He’s gone down a new rabbit hole: metabolic health. In general practice he’s now doing blood tests — HbA1c and vitamin D — and making the case that the mouth isn’t connected to the body, it is the body. This isn’t about becoming a “biological dentist” (as you’ll hear, Tif is refreshingly blunt about the wilder end of that world). It’s about respecting the biology, screening sensibly, and helping patients where we’re genuinely placed to help.

Protrusive Dental Pearl: Test Yourself First

Before you even think about introducing blood tests for your patients, ask whether you’re checking your own biomarkers at a sensible interval. The deepest way to understand this topic is to learn it on yourself and your family first — run your own HbA1c, vitamin D, iron, and liver and kidney markers, and see what the data tells you.

Start quarterly, like hygienist visits, then stretch to six-monthly or annual once things look good. Getting invested in your own numbers is what makes better food and lifestyle choices actually stick — and it’s the honest starting point for ever offering this to a patient.

What You’ll Take From This Episode

• The metabolic lens — why one disordered glucose-and-insulin system sits under so much chronic and dental disease, and why dentistry is well placed to act on it.
• Sugar, redefined — why patients who avoid sweets still get decay, and how frequency of starchy carbs drives the problem.
• The two biomarkers that matter most — what HbA1c and vitamin D each tell you about caries, perio and healing.
• How to run it in practice — finger-prick logistics, what to test, and how to raise it on the medical history form.
• The medico-legal case — why documenting these markers can protect you before implant, graft and perio work.

Highlights of This Episode

• 00:00  Why Dentists Should Care About Blood Tests
• 06:00  Metabolic Disease: The Root Cause Dentists Miss
• 13:00  Why Starchy Carbs Cause Decay, Not Just Sugar
• 15:50  HbA1c and Caries: What the SHIP Study Shows
• 21:00  Insulin Resistance: The Hidden Driver of Gum Disease
• 26:00  How to Talk to Patients About Diet Without Scaring Them
• 31:00  Why Vitamin D Deserves a Place in Dentistry
• 34:00  Vitamin D, Implant Failure and Perio Risk
• 37:00  Blood Tests as Medico-Legal Defence
• 42:00  What Dentists Should Test: HbA1c and Vitamin D
• 44:00  How In-Practice Blood Testing Actually Works
• 50:00  The Mouth Is the Body: Screening, Not Diagnosing
• 51:00  Is This Biological Dentistry? An Honest Answer
• 57:00  How to Learn Blood Testing for Your Practice

From the Guest

Dr Tif Qureshi qualified from King’s College London in 1992 and is a Past President of the British Academy of Cosmetic Dentistry. He is Founder and Clinical Director of IAS Academy, best known for pioneering Align, Bleach, Bond and Progressive Smile Design, and as a teacher of the Dahl concept. His current focus is metabolic health in general practice.

????  IAS Academy — Align, Bleach, Bond, the Dahl concept, and blood-testing / metabolic health training

Coming soon: Join Dr. Tif in one-day metabolic health programme. He has spent years connecting the dots between what’s happening in the mouth and what’s happening in the body. The results are undeniable: better outcomes, stronger case acceptance, and a rock-solid medico-legal position.

This one-day course will change the way you practise. For good.????Metabolic Health in Dentistry

References & Further Reading

Studies and sources referenced in this episode:

• Song I-S, et al. Severe Periodontitis Is Associated with Insulin Resistance in Non-abdominal Obese Adults. J Clin Endocrinol Metab, 2016;101(11):4251–4259. Insulin resistance as an independent risk factor for severe perio in normal-weight adults.
• Botelho J, et al. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients, 2020;12(5):1471. Vitamin D across caries, periodontitis, orthodontic and surgical outcomes.
• Schmolinsky J, Kocher T, Rathmann W, Völzke H, Pink C, Holtfreter B. Diabetes status affects long-term changes in coronal caries – The SHIP Study. Sci Rep. 2019 Oct 30;9(1):15685. doi: 10.1038/s41598-019-51086-z. PMID: 31666549; PMCID: PMC6821733.

Want more?

If you enjoyed this episode, check out: Why do some Dentists find Dahl Distasteful? – PDP016. 

#PDPMainEpisodes #BeyondDentistry #Communication

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C and A.

AGD Subject Code: 730 Oral Medicine, Oral Diagnosis, Oral Pathology

Aim & Learning Outcomes

Aim: To help dental practitioners understand the link between metabolic health and oral disease, and to evaluate whether simple in-practice biomarker screening has a place in their care of patients.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe how disordered glucose and insulin metabolism relates to caries, periodontal disease and healing outcomes, and explain what HbA1c and vitamin D each indicate.
• Apply a structured, non-alarmist approach to discussing diet and biomarker screening with patients, within the professional boundary of screening rather than diagnosing or prescribing.
• Evaluate the clinical and medico-legal case for documenting relevant biomarkers before periodontal and surgical treatment, and identify when to refer to a medical colleague.

Why is the lower first primary molar the one that always seems to flare up?

When should you reach for silver diamine fluoride instead of the drill — and when is a child’s cooperation telling you to change the plan entirely?

And how do you actually do a pulpotomy, step by step, without it blowing up under the crown?

This is a paediatric dentistry masterclass with Dr Nidhi Kotak — “The Baby Tooth Dentist,”. It’s built for the general dentist who treats children and wants clearer rules: when to fill versus crown, how to read the radiograph, silver diamine fluoride, local anaesthetic and behaviour guidance, isolation, and a full pulpotomy and stainless steel crown technique. The through-line is simple — in children you decide fast, protect the airway, and treat for predictability rather than heroics.

Protrusive Dental Pearl: Strategic Flexibility

You cannot be rigid when treating children. The mindset shift is to stop asking “what should be done for this child?” and start asking “what can be done for this child?” With children you have to be fast and efficient, and curveballs are constant — sometimes the parent is harder to manage than the child. So the plan has to bend.

The worked example: you planned a conventional prepped stainless steel crown, but cooperation drops mid-appointment. Rather than abandon the visit, switch to a no-prep whole-crown approach and protect the tooth anyway. It stays in the child’s best interest — and it’s far kinder to your own mental health. It’s a mindset worth carrying into all of dentistry, not just children’s.

What You’ll Take From This Episode

• When to fill vs crown — the surface rule for baby molars, why crowns are so predictable in children, and where composites still work.
• The “D” devil tooth — why the lower first primary molar flares up, and why mesial caries on a D is an automatic crown.
• Pulpotomy indications — the signs that say vital pulpotomy, the ones that say extraction, and why a pulp exposure in a primary tooth is an automatic pulpotomy.
• SDF, sedation and isolation — arresting decay without drilling, matching sedation to the child, and protecting the airway.
• The pulpotomy technique — a full step-by-step from caries removal to cementing the stainless steel crown, including the modern medicament choice.

Highlights of This Episode

• 00:00  TEASER
• 00:59  Pediatric Dentistry for GDPs: The Strategic Flexibility Mindset
• 07:24  Why GDPs Struggle Treating Children
• 08:19  When to Fill vs When to Crown a Baby Tooth
• 12:18  Class II vs Stainless Steel Crown: The Surface Rule
• 13:41  Reading Pediatric Radiographs & When to Take Bitewings
• 19:15  SDF vs Fluoride Varnish: When to Use Each
• 22:37  Resin Infiltration (Icon) for Children’s Teeth
• 25:15  Pulpotomy in Primary Teeth: When It’s Indicated
• 26:19  The “D” Devil Tooth: Why Mesial Caries Means a Crown
• 27:31  Hall Crowns and the Modified Whole Crown Technique
• 27:48  Midroll
• 38:39  Local Anaesthetic & Behaviour Guidance in Children
• 40:38  Sedation Options: Oral, Nitrous & Intranasal
• 46:22  Rubber Dam vs Isolite: Isolation for Kids
• 48:59  How to Do a Pulpotomy: Step-by-Step Technique
• 58:03  OUTRO

Dr Nidhi Kotak is a dual US and Canadian board-certified paediatric dentist — a Diplomate of the American Board of Pediatric Dentistry and a Fellow of the Royal College of Dentists of Canada. 

Follow Dr. Nidhi for more paediatric dentistry tips ????  @babytoothdentist on Instagram

Want more?

If you enjoyed this episode, check out: Zirconia vs Metal Hall Crowns vs Conventional with Dr Tim Keys – PDP227

#PDPMainEpisodes #EndoRestorative

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C 

AGD Subject Code: 430 Pediatric Dentistry.

Aim & Learning Outcomes

Aim: To give dental practitioners a clear, decision-led approach to restorative paediatric dentistry — how to choose between filling, crowning, pulpotomy and extraction, how to manage caries conservatively, and how to carry out a pulpotomy and stainless steel crown safely.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Differentiate the presentations that indicate a direct restoration, a stainless steel crown, a vital pulpotomy, or an extraction in the primary dentition, using clinical and radiographic findings.
• Describe minimally invasive and behaviour-management options in children — silver diamine fluoride, fluoride varnish, resin infiltration, local anaesthesia, sedation and isolation — and select them appropriately for the individual child.
• Apply a step-by-step technique for a vital pulpotomy and stainless steel crown in a primary molar, including the current choice of medicament and cementation.

Why is the lower first primary molar the one that always seems to flare up?

When should you reach for silver diamine fluoride instead of the drill — and when is a child’s cooperation telling you to change the plan entirely?

And how do you actually do a pulpotomy, step by step, without it blowing up under the crown?

This is a paediatric dentistry masterclass with Dr Nidhi Kotak — “The Baby Tooth Dentist,”. It’s built for the general dentist who treats children and wants clearer rules: when to fill versus crown, how to read the radiograph, silver diamine fluoride, local anaesthetic and behaviour guidance, isolation, and a full pulpotomy and stainless steel crown technique. The through-line is simple — in children you decide fast, protect the airway, and treat for predictability rather than heroics.

Protrusive Dental Pearl: Strategic Flexibility

You cannot be rigid when treating children. The mindset shift is to stop asking “what should be done for this child?” and start asking “what can be done for this child?” With children you have to be fast and efficient, and curveballs are constant — sometimes the parent is harder to manage than the child. So the plan has to bend.

The worked example: you planned a conventional prepped stainless steel crown, but cooperation drops mid-appointment. Rather than abandon the visit, switch to a no-prep whole-crown approach and protect the tooth anyway. It stays in the child’s best interest — and it’s far kinder to your own mental health. It’s a mindset worth carrying into all of dentistry, not just children’s.

What You’ll Take From This Episode

• When to fill vs crown — the surface rule for baby molars, why crowns are so predictable in children, and where composites still work.
• The “D” devil tooth — why the lower first primary molar flares up, and why mesial caries on a D is an automatic crown.
• Pulpotomy indications — the signs that say vital pulpotomy, the ones that say extraction, and why a pulp exposure in a primary tooth is an automatic pulpotomy.
• SDF, sedation and isolation — arresting decay without drilling, matching sedation to the child, and protecting the airway.
• The pulpotomy technique — a full step-by-step from caries removal to cementing the stainless steel crown, including the modern medicament choice.

Highlights of This Episode

• 00:00  TEASER
• 00:59  Pediatric Dentistry for GDPs: The Strategic Flexibility Mindset
• 07:24  Why GDPs Struggle Treating Children
• 08:19  When to Fill vs When to Crown a Baby Tooth
• 12:18  Class II vs Stainless Steel Crown: The Surface Rule
• 13:41  Reading Pediatric Radiographs & When to Take Bitewings
• 19:15  SDF vs Fluoride Varnish: When to Use Each
• 22:37  Resin Infiltration (Icon) for Children’s Teeth
• 25:15  Pulpotomy in Primary Teeth: When It’s Indicated
• 26:19  The “D” Devil Tooth: Why Mesial Caries Means a Crown
• 27:31  Hall Crowns and the Modified Whole Crown Technique
• 27:48  Midroll
• 38:39  Local Anaesthetic & Behaviour Guidance in Children
• 40:38  Sedation Options: Oral, Nitrous & Intranasal
• 46:22  Rubber Dam vs Isolite: Isolation for Kids
• 48:59  How to Do a Pulpotomy: Step-by-Step Technique
• 58:03  OUTRO

Dr Nidhi Kotak is a dual US and Canadian board-certified paediatric dentist — a Diplomate of the American Board of Pediatric Dentistry and a Fellow of the Royal College of Dentists of Canada. 

Follow Dr. Nidhi for more paediatric dentistry tips ????  @babytoothdentist on Instagram

Want more?

If you enjoyed this episode, check out: Zirconia vs Metal Hall Crowns vs Conventional with Dr Tim Keys – PDP227

#PDPMainEpisodes #EndoRestorative

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C 

AGD Subject Code: 430 Pediatric Dentistry.

Aim & Learning Outcomes

Aim: To give dental practitioners a clear, decision-led approach to restorative paediatric dentistry — how to choose between filling, crowning, pulpotomy and extraction, how to manage caries conservatively, and how to carry out a pulpotomy and stainless steel crown safely.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Differentiate the presentations that indicate a direct restoration, a stainless steel crown, a vital pulpotomy, or an extraction in the primary dentition, using clinical and radiographic findings.
• Describe minimally invasive and behaviour-management options in children — silver diamine fluoride, fluoride varnish, resin infiltration, local anaesthesia, sedation and isolation — and select them appropriately for the individual child.
• Apply a step-by-step technique for a vital pulpotomy and stainless steel crown in a primary molar, including the current choice of medicament and cementation.

More adults are having ortho, and more GDPs are providing it. So which risks should you be discussing with every single patient — and which ones depend on the person in the chair?

When a case is heading for a big overjet or a tricky rotation, is that a conversation you have at the start, or one you scramble to explain halfway through?

And what actually makes a consent form legally valid — the signature, or everything around it?

This episode brings together two perspectives you don’t often hear in the same room. Dr Zaid Esmail is a specialist orthodontist and founder of the Online Orthodontic Academy, who mentors GDPs through fixed and aligner cases. Dr Neel Jaiswal  returns for the dento-legal view — he’s a dentist and the founder of Professional Dental Indemnity (PDI). Together with Jaz, they get very specific about what individualised consent looks like in practice, and how to build a process your patients remember and a court respects.

Protrusive Dental Pearl: Make Your Patient Feel Unique

It might be your 100th, 500th or 1,000th case — but for the patient in the chair, this is a significant event. Never forget that. A routine extraction is routine for you; for them it’s a big deal, and remembering that makes you a better communicator.

To make a specific risk stick, make the patient feel unique. Point to their OPG: “Your sinus here is actually really interesting,” or “Did you know your roots are unusually long?” Patients remember a risk framed as if they’re a special case far better than a generic warning. Make it personal, and the consent becomes memorable.

What You’ll Take From This Episode

The whole episode turns on one idea: generic, templated consent is no longer defensible — the skill is individualising the form to the patient in front of you. Premium members get the full breakdown; here’s the shape:

• The layers of valid consent — consent is like an onion; a signed form and a documented conversation each cover a gap the other leaves open.
• Individualising risk from the records — how the OPG and photos turn a generic warning (resorption, devitalisation, recession, relapse) into a patient-specific one.
• The two-appointment consent flow — records, individualised risks, thinking time, and why you sign or initial every line.
• The Class II Div 2 overjet trap — the case that looks like simple crowding and ends in a big overjet, and how to consent for it before you start.
• When to treat, add an option, or refer — the GDC line on offering all options, and building alternatives into the form.

Highlights of This Episode:

• 00:00  Teaser
• 01:01  Consent in Orthodontics: Why It Has to Be Individualised
• 02:59  Protrusive Dental Pearl: Make Your Patient Feel Unique
• 07:58  What Makes Orthodontic Consent Different
• 10:08  How Much Ortho Litigation Comes From Consent?
• 11:53  What Makes Consent Valid and Patient-Specific
• 12:26  Individualising Ortho Risk from the OPG
• 13:11  Using the ClinCheck as a Consent Tool
• 14:40  How to Structure the Consent Appointment
• 15:30  Root Resorption, Devitalisation, Recession and Relapse
• 19:37  Should You Initial Every Line of a Consent Form?
• 21:50  Midroll
• 27:11  Building a Multi-Layered Consent Process
• 29:31  Consenting for Fees, Relapse and Retainers
• 34:41  The Class II Div 2 Overjet Trap
• 37:51  When Should a GDP Refer an Ortho Case?
• 40:31  How to Learn Orthodontics with Mentorship
• 47:01  Outro

Dr Zaid Esmail is a specialist orthodontist. He founded the Online Orthodontic Academy to teach GDPs orthodontics — assessment, diagnosis and treatment planning across fixed appliances and aligners — with one-to-one case mentorship. He’s extended a 10% discount to the community with the code PROTRUSIVE.

????  Online Orthodontic Academy — online ortho mentorship, fixed & aligners, Level 7 Diploma

Dr Neel Jaiswal returned for the dento-legal perspective. He’s a dentist and the founder of Professional Dental Indemnity (PDI), which introduces dentists to insurance-based indemnity cover.

Request a Quote for Insurance and Get £100 off

????  Professional Dental Indemnity (PDI) — insurance-based dental indemnity

Want more?

If you enjoyed this episode, check out: Consent Is Like An Onion – Are You Consenting Your Patients Correctly? – PDP113

Tags

#PDPMainEpisodes #OrthoRestorative #Communication 

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

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

This episode meets GDC Outcomes A

AGD Subject Code: 565 Documentation & Risk Management 

Aim & Learning Outcomes

Aim: To help dental practitioners obtain valid, individualised consent for orthodontic treatment — identifying the risks that apply to every patient, tailoring them to the individual, and structuring a consent process that is both comprehensible to the patient and defensible in law.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe the elements that make orthodontic consent valid and patient-specific, including the material-risk standard and the role of reasonable alternative treatments.
• Apply a structured, multi-layered consent process — individualising risk from the clinical records and documenting the discussion — to an individual orthodontic patient.
• Identify the case types and clinical situations that warrant additional consent, an alternative option, or onward referral to a specialist.

More adults are having ortho, and more GDPs are providing it. So which risks should you be discussing with every single patient — and which ones depend on the person in the chair?

When a case is heading for a big overjet or a tricky rotation, is that a conversation you have at the start, or one you scramble to explain halfway through?

And what actually makes a consent form legally valid — the signature, or everything around it?

This episode brings together two perspectives you don’t often hear in the same room. Dr Zaid Esmail is a specialist orthodontist and founder of the Online Orthodontic Academy, who mentors GDPs through fixed and aligner cases. Dr Neel Jaiswal  returns for the dento-legal view — he’s a dentist and the founder of Professional Dental Indemnity (PDI). Together with Jaz, they get very specific about what individualised consent looks like in practice, and how to build a process your patients remember and a court respects.

Protrusive Dental Pearl: Make Your Patient Feel Unique

It might be your 100th, 500th or 1,000th case — but for the patient in the chair, this is a significant event. Never forget that. A routine extraction is routine for you; for them it’s a big deal, and remembering that makes you a better communicator.

To make a specific risk stick, make the patient feel unique. Point to their OPG: “Your sinus here is actually really interesting,” or “Did you know your roots are unusually long?” Patients remember a risk framed as if they’re a special case far better than a generic warning. Make it personal, and the consent becomes memorable.

What You’ll Take From This Episode

The whole episode turns on one idea: generic, templated consent is no longer defensible — the skill is individualising the form to the patient in front of you. Premium members get the full breakdown; here’s the shape:

• The layers of valid consent — consent is like an onion; a signed form and a documented conversation each cover a gap the other leaves open.
• Individualising risk from the records — how the OPG and photos turn a generic warning (resorption, devitalisation, recession, relapse) into a patient-specific one.
• The two-appointment consent flow — records, individualised risks, thinking time, and why you sign or initial every line.
• The Class II Div 2 overjet trap — the case that looks like simple crowding and ends in a big overjet, and how to consent for it before you start.
• When to treat, add an option, or refer — the GDC line on offering all options, and building alternatives into the form.

Highlights of This Episode:

• 00:00  Teaser
• 01:01  Consent in Orthodontics: Why It Has to Be Individualised
• 02:59  Protrusive Dental Pearl: Make Your Patient Feel Unique
• 07:58  What Makes Orthodontic Consent Different
• 10:08  How Much Ortho Litigation Comes From Consent?
• 11:53  What Makes Consent Valid and Patient-Specific
• 12:26  Individualising Ortho Risk from the OPG
• 13:11  Using the ClinCheck as a Consent Tool
• 14:40  How to Structure the Consent Appointment
• 15:30  Root Resorption, Devitalisation, Recession and Relapse
• 19:37  Should You Initial Every Line of a Consent Form?
• 21:50  Midroll
• 27:11  Building a Multi-Layered Consent Process
• 29:31  Consenting for Fees, Relapse and Retainers
• 34:41  The Class II Div 2 Overjet Trap
• 37:51  When Should a GDP Refer an Ortho Case?
• 40:31  How to Learn Orthodontics with Mentorship
• 47:01  Outro

Dr Zaid Esmail is a specialist orthodontist. He founded the Online Orthodontic Academy to teach GDPs orthodontics — assessment, diagnosis and treatment planning across fixed appliances and aligners — with one-to-one case mentorship. He’s extended a 10% discount to the community with the code PROTRUSIVE.

????  Online Orthodontic Academy — online ortho mentorship, fixed & aligners, Level 7 Diploma

Dr Neel Jaiswal returned for the dento-legal perspective. He’s a dentist and the founder of Professional Dental Indemnity (PDI), which introduces dentists to insurance-based indemnity cover.

Request a Quote for Insurance and Get £100 off

????  Professional Dental Indemnity (PDI) — insurance-based dental indemnity

Want more?

If you enjoyed this episode, check out: Consent Is Like An Onion – Are You Consenting Your Patients Correctly? – PDP113

Tags

#PDPMainEpisodes #OrthoRestorative #Communication 

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

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

This episode meets GDC Outcomes A

AGD Subject Code: 565 Documentation & Risk Management 

Aim & Learning Outcomes

Aim: To help dental practitioners obtain valid, individualised consent for orthodontic treatment — identifying the risks that apply to every patient, tailoring them to the individual, and structuring a consent process that is both comprehensible to the patient and defensible in law.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe the elements that make orthodontic consent valid and patient-specific, including the material-risk standard and the role of reasonable alternative treatments.
• Apply a structured, multi-layered consent process — individualising risk from the clinical records and documenting the discussion — to an individual orthodontic patient.
• Identify the case types and clinical situations that warrant additional consent, an alternative option, or onward referral to a specialist.

Are you the kind of person teaching would energise — or quietly drain?

Is a PGCert in dental education actually worth it, or just wishy-washy theory?

And the honest question nobody asks out loud: does it pay anything?

This is an Interference Cast — the non-clinical arm of the podcast — with Dr Rima Hussain, a general dentist who teaches restorative dentistry to undergraduates at King’s a couple of days a week. It’s a candid look at what a career in dental education actually involves: how to get in, who thrives and who burns out, what the work is really like, and the honest truth about the pay and the rewards. The bigger theme: dentistry is a career you can mould in endless directions — and for the right person, teaching is one of the most energising of them.

What You’ll Take From This Episode

The full self-assessment and the step-by-step route into a teaching role are in the Premium Notes. Here’s the shape of what we cover:

• Are you built for the classroom? — the two-camp self-check (energised vs drained) that predicts whether teaching will recharge you or wear you down.
• How to actually land a role — the ‘BDJ Jobs’ plus pick-up-the-phone route, and why “who you know” so often cuts through the application process.
• Relatability as a strength — why being closer to a student’s level can beat decades of experience for an absolute beginner.
• Back to basics — the “monkey see, monkey do” risk from YouTube and AI, and what the tutor’s real job becomes.
• The honest pay-and-balance picture — why you don’t do it for the money, what you do get, and how teaching and practice keep each other fresh.

Highlights of This Episode

• 00:00  Teaser
• 01:08  Should You Teach Dentistry? How to Know If It’s for You
• 04:39  How a General Dentist Gets Into Dental Education
• 06:15  Signs You’re Suited to Teaching Dentistry
• 08:52  Is a PGCert in Dental Education Worth It?
• 12:07  How to Land a Clinical Teaching Post at a Dental School
• 14:38  Why a Relatable Tutor Beats Decades of Experience
• 16:52  How Dental Students Have Changed Since COVID
• 19:20  Is Social Media and AI Helping or Hurting Dental Students?
• 21:55  Midroll
• 26:43  Why “Back to Basics” Beats Chasing Advanced Techniques
• 29:20  How to Get a Teaching (or Associate) Job: Pick Up the Phone
• 31:50  Why Dental Tutors Quit After Six Months
• 36:29  The Most Rewarding Part of Teaching Dentistry
• 38:46  Teaching, Practice and Pay: How to Avoid Burnout
• 44:39  Outro

From the Guest

Dr Rima Hussain is a general dentist who also teaches restorative (conservative) dentistry to undergraduates at King’s College London — a route she fell into via tutoring as a teenager and has been in since 2019. Her advice for anyone curious: you’re probably already teaching in some form, so try it; the worst case is you find it isn’t for you.

????  Reach Rima on Instagram

References & Further Reading

Mentioned in this episode:

• Rath T. StrengthsFinder 2.0. Gallup Press, 2007. The strengths-assessment book referenced for the “Learner” theme and the idea of building your career around your natural strengths. “Learner” is one of its 34 themes; the assessment is now delivered as CliftonStrengths.
• BDJ Jobs. The British Dental Journal jobs board where clinical tutor and academic posts are advertised, usually with short application windows.

Want more?

If you enjoyed this episode, check out: 2 Years Out of Dental School – Insights for New Grads – IC066

#InterferenceCast #CareerDevelopment #BeyondDentistry

Listen, Subscribe, Earn CPD

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

This episode meets GDC Outcomes B 

AGD Subject Code: 770 Self-Improvement 

Aim & Learning Outcomes

Aim: To help dentists evaluate a part-time career in dental education — what the role involves, how to obtain one, and how to sustain it alongside clinical practice.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Identify the personal attributes and expectations that distinguish dentists who thrive in clinical teaching from those who do not.
• Describe the practical routes into a dental-school teaching post, including where posts are advertised and how a direct, proactive approach can work.
• Recognise the workload, financial and work-life-balance realities of part-time teaching, and strategies to avoid burnout while balancing teaching and practice.

Are you the kind of person teaching would energise — or quietly drain?

Is a PGCert in dental education actually worth it, or just wishy-washy theory?

And the honest question nobody asks out loud: does it pay anything?

This is an Interference Cast — the non-clinical arm of the podcast — with Dr Rima Hussain, a general dentist who teaches restorative dentistry to undergraduates at King’s a couple of days a week. It’s a candid look at what a career in dental education actually involves: how to get in, who thrives and who burns out, what the work is really like, and the honest truth about the pay and the rewards. The bigger theme: dentistry is a career you can mould in endless directions — and for the right person, teaching is one of the most energising of them.

What You’ll Take From This Episode

The full self-assessment and the step-by-step route into a teaching role are in the Premium Notes. Here’s the shape of what we cover:

• Are you built for the classroom? — the two-camp self-check (energised vs drained) that predicts whether teaching will recharge you or wear you down.
• How to actually land a role — the ‘BDJ Jobs’ plus pick-up-the-phone route, and why “who you know” so often cuts through the application process.
• Relatability as a strength — why being closer to a student’s level can beat decades of experience for an absolute beginner.
• Back to basics — the “monkey see, monkey do” risk from YouTube and AI, and what the tutor’s real job becomes.
• The honest pay-and-balance picture — why you don’t do it for the money, what you do get, and how teaching and practice keep each other fresh.

Highlights of This Episode

• 00:00  Teaser
• 01:08  Should You Teach Dentistry? How to Know If It’s for You
• 04:39  How a General Dentist Gets Into Dental Education
• 06:15  Signs You’re Suited to Teaching Dentistry
• 08:52  Is a PGCert in Dental Education Worth It?
• 12:07  How to Land a Clinical Teaching Post at a Dental School
• 14:38  Why a Relatable Tutor Beats Decades of Experience
• 16:52  How Dental Students Have Changed Since COVID
• 19:20  Is Social Media and AI Helping or Hurting Dental Students?
• 21:55  Midroll
• 26:43  Why “Back to Basics” Beats Chasing Advanced Techniques
• 29:20  How to Get a Teaching (or Associate) Job: Pick Up the Phone
• 31:50  Why Dental Tutors Quit After Six Months
• 36:29  The Most Rewarding Part of Teaching Dentistry
• 38:46  Teaching, Practice and Pay: How to Avoid Burnout
• 44:39  Outro

From the Guest

Dr Rima Hussain is a general dentist who also teaches restorative (conservative) dentistry to undergraduates at King’s College London — a route she fell into via tutoring as a teenager and has been in since 2019. Her advice for anyone curious: you’re probably already teaching in some form, so try it; the worst case is you find it isn’t for you.

????  Reach Rima on Instagram

References & Further Reading

Mentioned in this episode:

• Rath T. StrengthsFinder 2.0. Gallup Press, 2007. The strengths-assessment book referenced for the “Learner” theme and the idea of building your career around your natural strengths. “Learner” is one of its 34 themes; the assessment is now delivered as CliftonStrengths.
• BDJ Jobs. The British Dental Journal jobs board where clinical tutor and academic posts are advertised, usually with short application windows.

Want more?

If you enjoyed this episode, check out: 2 Years Out of Dental School – Insights for New Grads – IC066

#InterferenceCast #CareerDevelopment #BeyondDentistry

Listen, Subscribe, Earn CPD

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

This episode meets GDC Outcomes B 

AGD Subject Code: 770 Self-Improvement 

Aim & Learning Outcomes

Aim: To help dentists evaluate a part-time career in dental education — what the role involves, how to obtain one, and how to sustain it alongside clinical practice.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Identify the personal attributes and expectations that distinguish dentists who thrive in clinical teaching from those who do not.
• Describe the practical routes into a dental-school teaching post, including where posts are advertised and how a direct, proactive approach can work.
• Recognise the workload, financial and work-life-balance realities of part-time teaching, and strategies to avoid burnout while balancing teaching and practice.

Could a “normal” sleep study still be missing your patient’s airway problem?

Why do women and children with real symptoms keep scoring “mild”?

Should a mouth-breathing child see a myofunctional therapist — or an ENT first?

And which four questions screen a child for sleep problems in under a minute?

The roof of the mouth is the floor of the nose — so ENT and dentistry should be in constant dialogue. In practice, they rarely are. In this one, Dr David McIntosh — an Australian ear, nose and throat surgeon with a deep niche in sleep-disordered breathing — makes the case for why that has to change, and gives dentists practical ways to screen and refer. He is direct, analogy-rich and doesn’t mince words; expect a few positions that cut against the grain of how sleep apnoea is usually handled.

Protrusive Dental Pearl: When the Numbers Mislead

Dentists love data — the AHI, the cut-offs (over 5 is mild, over 30 is severe). But take those numbers with a pinch of salt: the thresholds are arbitrary, and a single score tells you nothing about why a patient has the problem.

They don’t account for individual variability — especially in women and children, where a mild score can sit right alongside significant symptoms. Read the number with the anatomy and the phenotype — the clinical signs and the airway assessment — never instead of them.

What You’ll Take From This Episode

This conversation reframes sleep-disordered breathing from a number on a report into something you can localise and refer. 

• A sleep study tells you IF, not WHY — sleep-disordered breathing is the whole spectrum; a normal study doesn’t mean normal breathing.
• Phenotyping the airway — map the individual anatomical causes instead of trusting a single score.
• Why women get missed — the gender bias built into standard adult screening tools, and what to ask instead.
• The four-question filter for children — snore, mouth breathe, stop breathing, wake up tired: any ‘yes’ means refer.
• Treat the cause before the function — why myofunctional therapy comes after the obstruction is cleared, not before, and how expansion and surgery are matched to the anatomy.

Highlights of This Episode

• 00:00  Teaser
• 01:00  Why ENT and Dentistry Should Be Talking
• 02:51  Protrusive Dental Pearl: When Sleep Data Misleads You
• 03:46  Meet the ENT Who Works With Dentists
• 06:00  Sleep Physician, ENT or Dentist: Who Should Lead?
• 07:26  Why Children and Adults Are Completely Different
• 08:58  Sleep-Disordered Breathing Is Not the Same as Sleep Apnoea
• 09:39  Why a Normal Sleep Study Doesn’t Mean Normal Breathing
• 10:01  Same AHI, Different Cause: A Tale of Two Patients
• 12:54  Why One Night’s Sleep Study Isn’t Enough
• 13:44  Where the AHI Cut-Off Numbers Really Came From
• 15:27  CPAP Explained: A Bridge, Not a Cure
• 18:27  When Snoring Hides Something Serious
• 19:10  What Phenotyping the Airway Actually Means
• 20:27  Splint, CPAP, or Both?
• 21:33  Why a CBCT Can Miss a Deviated Septum
• 25:32  Is STOP-Bang Enough to Screen for Sleep Apnoea?
• 26:06  Why the Epworth Sleepiness Scale Is a Blunt Tool
• 26:50  Why STOP-Bang Is Biased Against Women
• 31:17  Sleep Apnoea in Women: Mild on Paper, Severe in Life
• 32:05  Midroll
• 36:56  The Triad: Airway, TMD and Orthodontics
• 37:12  The Three Most Common Causes of Night-Time Grinding
• 39:41  The Four Questions That Screen a Child for Sleep Problems
• 41:03  Tired vs Not Tired: The Sign That Changes Everything
• 43:36  Should You Refer to Myofunctional Therapy Before an ENT?
• 45:58  The Hidden Dangers of Forcing Nasal Breathing
• 52:28  Maxillary Expansion vs Surgery: Which One Fixes It?
• 54:51  How Dentists Can Assess Adenoids
• 56:25  Save the Child First: The Drowning Analogy
• 57:56  Where Dentistry and ENT Go From Here
• 1:00:05  Outro – New-Look Premium Notes & CPD Outro

From the Guest

Dr David McIntosh is an ear, nose and throat surgeon (MBBS, FRACS, PhD) with a special interest in sleep-disordered breathing and airway obstruction. A self-described compulsive educator, he is the author of several books on Amazon — including dENTal health, on the connection between ENT and dental disease, and Snored to Death, on the lesser-recognised causes of obstructive sleep apnoea in adults.

References & Further Reading

Sources discussed in this episode:

• Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Medicine, 2000;1(1):21–32. The 22-item PSQ; a score above 0.33 suggests sleep-disordered breathing.

Loved This Episode? Try Next

Airway Dentistry with Jeff Rouse – PDP229

Listen, Subscribe, Earn CPD

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

This episode meets GDC Outcomes C

AGD Subject Code: 730 – Oral Medicine, Oral Diagnosis, Oral Pathology (Sleep medicine)

#PDPMainEpisodes #OralSurgeryandOralMedicine

Aim & Learning Outcomes

Aim: To help dental practitioners recognise sleep-disordered breathing across the whole airway, screen adults and children appropriately, and refer at the right time and to the right clinician.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Differentiate sleep-disordered breathing from obstructive sleep apnoea, and explain why a normal sleep study does not exclude clinically significant breathing problems.
• Apply a structured screening approach for adults and children, including recognising why standard adult tools under-detect sleep-disordered breathing in women and children.
• Evaluate when to refer for specialist airway assessment, and articulate why addressing anatomical obstruction should precede functional (myofunctional) therapy.

Could a “normal” sleep study still be missing your patient’s airway problem?

Why do women and children with real symptoms keep scoring “mild”?

Should a mouth-breathing child see a myofunctional therapist — or an ENT first?

And which four questions screen a child for sleep problems in under a minute?

The roof of the mouth is the floor of the nose — so ENT and dentistry should be in constant dialogue. In practice, they rarely are. In this one, Dr David McIntosh — an Australian ear, nose and throat surgeon with a deep niche in sleep-disordered breathing — makes the case for why that has to change, and gives dentists practical ways to screen and refer. He is direct, analogy-rich and doesn’t mince words; expect a few positions that cut against the grain of how sleep apnoea is usually handled.

Protrusive Dental Pearl: When the Numbers Mislead

Dentists love data — the AHI, the cut-offs (over 5 is mild, over 30 is severe). But take those numbers with a pinch of salt: the thresholds are arbitrary, and a single score tells you nothing about why a patient has the problem.

They don’t account for individual variability — especially in women and children, where a mild score can sit right alongside significant symptoms. Read the number with the anatomy and the phenotype — the clinical signs and the airway assessment — never instead of them.

What You’ll Take From This Episode

This conversation reframes sleep-disordered breathing from a number on a report into something you can localise and refer. 

• A sleep study tells you IF, not WHY — sleep-disordered breathing is the whole spectrum; a normal study doesn’t mean normal breathing.
• Phenotyping the airway — map the individual anatomical causes instead of trusting a single score.
• Why women get missed — the gender bias built into standard adult screening tools, and what to ask instead.
• The four-question filter for children — snore, mouth breathe, stop breathing, wake up tired: any ‘yes’ means refer.
• Treat the cause before the function — why myofunctional therapy comes after the obstruction is cleared, not before, and how expansion and surgery are matched to the anatomy.

Highlights of This Episode

• 00:00  Teaser
• 01:00  Why ENT and Dentistry Should Be Talking
• 02:51  Protrusive Dental Pearl: When Sleep Data Misleads You
• 03:46  Meet the ENT Who Works With Dentists
• 06:00  Sleep Physician, ENT or Dentist: Who Should Lead?
• 07:26  Why Children and Adults Are Completely Different
• 08:58  Sleep-Disordered Breathing Is Not the Same as Sleep Apnoea
• 09:39  Why a Normal Sleep Study Doesn’t Mean Normal Breathing
• 10:01  Same AHI, Different Cause: A Tale of Two Patients
• 12:54  Why One Night’s Sleep Study Isn’t Enough
• 13:44  Where the AHI Cut-Off Numbers Really Came From
• 15:27  CPAP Explained: A Bridge, Not a Cure
• 18:27  When Snoring Hides Something Serious
• 19:10  What Phenotyping the Airway Actually Means
• 20:27  Splint, CPAP, or Both?
• 21:33  Why a CBCT Can Miss a Deviated Septum
• 25:32  Is STOP-Bang Enough to Screen for Sleep Apnoea?
• 26:06  Why the Epworth Sleepiness Scale Is a Blunt Tool
• 26:50  Why STOP-Bang Is Biased Against Women
• 31:17  Sleep Apnoea in Women: Mild on Paper, Severe in Life
• 32:05  Midroll
• 36:56  The Triad: Airway, TMD and Orthodontics
• 37:12  The Three Most Common Causes of Night-Time Grinding
• 39:41  The Four Questions That Screen a Child for Sleep Problems
• 41:03  Tired vs Not Tired: The Sign That Changes Everything
• 43:36  Should You Refer to Myofunctional Therapy Before an ENT?
• 45:58  The Hidden Dangers of Forcing Nasal Breathing
• 52:28  Maxillary Expansion vs Surgery: Which One Fixes It?
• 54:51  How Dentists Can Assess Adenoids
• 56:25  Save the Child First: The Drowning Analogy
• 57:56  Where Dentistry and ENT Go From Here
• 1:00:05  Outro – New-Look Premium Notes & CPD Outro

From the Guest

Dr David McIntosh is an ear, nose and throat surgeon (MBBS, FRACS, PhD) with a special interest in sleep-disordered breathing and airway obstruction. A self-described compulsive educator, he is the author of several books on Amazon — including dENTal health, on the connection between ENT and dental disease, and Snored to Death, on the lesser-recognised causes of obstructive sleep apnoea in adults.

References & Further Reading

Sources discussed in this episode:

• Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Medicine, 2000;1(1):21–32. The 22-item PSQ; a score above 0.33 suggests sleep-disordered breathing.

Loved This Episode? Try Next

Airway Dentistry with Jeff Rouse – PDP229

Listen, Subscribe, Earn CPD

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

This episode meets GDC Outcomes C

AGD Subject Code: 730 – Oral Medicine, Oral Diagnosis, Oral Pathology (Sleep medicine)

#PDPMainEpisodes #OralSurgeryandOralMedicine

Aim & Learning Outcomes

Aim: To help dental practitioners recognise sleep-disordered breathing across the whole airway, screen adults and children appropriately, and refer at the right time and to the right clinician.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Differentiate sleep-disordered breathing from obstructive sleep apnoea, and explain why a normal sleep study does not exclude clinically significant breathing problems.
• Apply a structured screening approach for adults and children, including recognising why standard adult tools under-detect sleep-disordered breathing in women and children.
• Evaluate when to refer for specialist airway assessment, and articulate why addressing anatomical obstruction should precede functional (myofunctional) therapy.

Have you ever dreaded walking into a beautiful practice with lovely patients — purely because of who you share the surgery with?

What do you actually do, in the moment, when your assistant rolls their eyes at a request for rubber dam?

And should you be friends with your assistant at all — or does that cross a line you’ll regret?

This is an Interference Cast — a non-clinical but deeply practical episode — with Dr. Sarah Braun, a dentist in Australia and a fellow Protrusive Guidance member who DM’d to suggest this very topic. No course, no book, nothing to sell: just two clinicians comparing notes (and the odd scar) on the one relationship that quietly shapes your whole working life. It sits inside this month’s theme of the relationships that support your career.

What You’ll Take From This Episode

The full breakdown is in the Premium Notes; here’s the shape of the thinking that runs through the episode:

• Engagement is the whole game — the assistant relationship sets the mood of the room, the patient’s experience, and whether good people stay.
• Speak their language — appreciation only lands if it’s delivered in the form that particular person actually values.
• Appreciation is a verb — specific, named praise lands far harder than a vague “good job.”
• Let them, let me — you don’t control how someone reacts in the moment; you only control your response to it.
• Lead the room — dentistry is a performance, and the room takes its emotional cue from whoever is leading it.

Highlights of this episode:

00:00 TEASER01:13 Why This One Relationship Can Make or Break You03:49 A Non-Clinical Interference Cast: What to Expect04:47 Meet the Guest: Nine Years In, City to Country07:01 A Week in Private Practice09:15 How Much Does the Dentist–Assistant Relationship Matter?11:01 Engagement at Work: The Gallup Lens12:30 People Remember How You Made Them Feel14:21 When the Relationship Turns Toxic15:23 The Power Imbalance You Might Not See18:11 The First-Day Conversation20:52 Keeping Your Assistant Engaged22:23 Specific Praise Beats a Vague “Good Job”23:55 Midroll27:37 You Can Only Control Yourself29:34 The Eye-Roll Moment: Let Them, Let Me31:23 Off Days vs Patterns32:12 Appreciation, Gifting & Speaking Their Language35:32 Run the Relationship Like It Matters36:48 Friends With Your Assistant, or Keep Your Distance?39:08 A Best Friend at Work: The Engagement Link41:15 Advice for New Grads: Start With Time Management44:26 Teaching as a Tool: Show Your Working Out48:05 Wrap-Up & a Healthy Debate48:37 CPD Outro & the Protrusive Vault

References & Further Reading:

Sources and further reading from this episode:

• Chapman G. The Five Love Languages. Northfield Publishing, 1992. The five ways people give and receive appreciation — words of affirmation, quality time, acts of service, receiving gifts, and physical touch — applied here to the dentist–assistant relationship.
• Robbins M, Robbins S. The Let Them Theory. Hay House, 2024. The “let them / let me” reframe for releasing what you can’t control and owning your own response.
• Rath T. StrengthsFinder 2.0. Gallup Press, 2007. The CliftonStrengths assessment; “Learner” is one of its talent themes, referenced in the discussion of teaching as a way to engage your assistant.
• Gallup employee-engagement research. The Gallup Q12 engagement survey (including the validated “I have a best friend at work” item) and Gallup’s State of the Global Workplace reports. Source of the workforce-engagement framing in this episode. Exact figures vary by year — see Reviewer Note.

Want more?

If you enjoyed this episode, check out: How to Find a Mentor in 5 Seconds Flat! – IC058. 

#InterferenceCast #CareerDevelopment #Communication #BeyondDentistry

Listen, Subscribe, Earn CPD:

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

This episode meets GDC Outcomes A and B

AGD Subject Code: 550 Practice Management and Human Relations

Aim & Learning Outcomes:

Aim: To help dental practitioners understand and strengthen the working relationship between dentist and dental assistant — recognising its impact on team engagement, patient experience and personal job satisfaction, and building practical habits to improve it.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Explain how the working relationship between a dentist and a dental assistant affects team engagement, the patient experience, and clinician wellbeing.
• Identify practical strategies for communicating appreciation and recognition in ways suited to the individual, and for involving an assistant according to their preferences.
• Apply self-management and emotional-regulation approaches to leading the surgery and responding constructively to interpersonal friction.

Have you ever dreaded walking into a beautiful practice with lovely patients — purely because of who you share the surgery with?

What do you actually do, in the moment, when your assistant rolls their eyes at a request for rubber dam?

And should you be friends with your assistant at all — or does that cross a line you’ll regret?

This is an Interference Cast — a non-clinical but deeply practical episode — with Dr. Sarah Braun, a dentist in Australia and a fellow Protrusive Guidance member who DM’d to suggest this very topic. No course, no book, nothing to sell: just two clinicians comparing notes (and the odd scar) on the one relationship that quietly shapes your whole working life. It sits inside this month’s theme of the relationships that support your career.

What You’ll Take From This Episode

The full breakdown is in the Premium Notes; here’s the shape of the thinking that runs through the episode:

• Engagement is the whole game — the assistant relationship sets the mood of the room, the patient’s experience, and whether good people stay.
• Speak their language — appreciation only lands if it’s delivered in the form that particular person actually values.
• Appreciation is a verb — specific, named praise lands far harder than a vague “good job.”
• Let them, let me — you don’t control how someone reacts in the moment; you only control your response to it.
• Lead the room — dentistry is a performance, and the room takes its emotional cue from whoever is leading it.

Highlights of this episode:

00:00 TEASER01:13 Why This One Relationship Can Make or Break You03:49 A Non-Clinical Interference Cast: What to Expect04:47 Meet the Guest: Nine Years In, City to Country07:01 A Week in Private Practice09:15 How Much Does the Dentist–Assistant Relationship Matter?11:01 Engagement at Work: The Gallup Lens12:30 People Remember How You Made Them Feel14:21 When the Relationship Turns Toxic15:23 The Power Imbalance You Might Not See18:11 The First-Day Conversation20:52 Keeping Your Assistant Engaged22:23 Specific Praise Beats a Vague “Good Job”23:55 Midroll27:37 You Can Only Control Yourself29:34 The Eye-Roll Moment: Let Them, Let Me31:23 Off Days vs Patterns32:12 Appreciation, Gifting & Speaking Their Language35:32 Run the Relationship Like It Matters36:48 Friends With Your Assistant, or Keep Your Distance?39:08 A Best Friend at Work: The Engagement Link41:15 Advice for New Grads: Start With Time Management44:26 Teaching as a Tool: Show Your Working Out48:05 Wrap-Up & a Healthy Debate48:37 CPD Outro & the Protrusive Vault

References & Further Reading:

Sources and further reading from this episode:

• Chapman G. The Five Love Languages. Northfield Publishing, 1992. The five ways people give and receive appreciation — words of affirmation, quality time, acts of service, receiving gifts, and physical touch — applied here to the dentist–assistant relationship.
• Robbins M, Robbins S. The Let Them Theory. Hay House, 2024. The “let them / let me” reframe for releasing what you can’t control and owning your own response.
• Rath T. StrengthsFinder 2.0. Gallup Press, 2007. The CliftonStrengths assessment; “Learner” is one of its talent themes, referenced in the discussion of teaching as a way to engage your assistant.
• Gallup employee-engagement research. The Gallup Q12 engagement survey (including the validated “I have a best friend at work” item) and Gallup’s State of the Global Workplace reports. Source of the workforce-engagement framing in this episode. Exact figures vary by year — see Reviewer Note.

Want more?

If you enjoyed this episode, check out: How to Find a Mentor in 5 Seconds Flat! – IC058. 

#InterferenceCast #CareerDevelopment #Communication #BeyondDentistry

Listen, Subscribe, Earn CPD:

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

This episode meets GDC Outcomes A and B

AGD Subject Code: 550 Practice Management and Human Relations

Aim & Learning Outcomes:

Aim: To help dental practitioners understand and strengthen the working relationship between dentist and dental assistant — recognising its impact on team engagement, patient experience and personal job satisfaction, and building practical habits to improve it.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Explain how the working relationship between a dentist and a dental assistant affects team engagement, the patient experience, and clinician wellbeing.
• Identify practical strategies for communicating appreciation and recognition in ways suited to the individual, and for involving an assistant according to their preferences.
• Apply self-management and emotional-regulation approaches to leading the surgery and responding constructively to interpersonal friction.

Can you safely skip the glide path with modern reciprocating systems?

What is the best file system for a GDP who wants predictable endodontic results?

And perhaps the biggest question of all: does the file system matter as much as we think it does?

In Part 2 of the Endo Showdown, Dr Samuel Johnson returns to tackle some of the most common questions dentists have about file systems, glide path preparation, retreatment, and endodontic workflow. From practical negotiation tips to choosing a system that works in your hands, this episode focuses on the decisions that can make endodontics simpler, safer, and more predictable.

Protrusive Dental Pearl

Cut your gutta-percha at the level of the canal orifice and thoroughly clean the pulp chamber before placing the coronal restoration.

⚠️ Leaving gutta-percha and sealer coronally can compromise the coronal seal and promote leakage.

✅ Use isopropyl alcohol to clean resin-based sealer residue before bonding. Water is effective for cleaning bioceramic sealers.

Key Takeaways

• Establish a glide path before shaping whenever possible.
• D-Finders can negotiate difficult canals more predictably than traditional K-files.
• Intermediate files such as size 12 or 12.5 can help bridge the jump from size 10 to size 15.
• Straight-line access reduces file binding and improves shaping efficiency.
• Avoid forcing glide path files to working length.
• Gates Glidden drills may be unnecessarily aggressive for routine coronal flaring.
• Consistency with one file system is often more important than chasing the latest product.
• WaveOne Gold remains a simple and user-friendly option for many GDPs.
• Rotary and reciprocating systems can both achieve successful outcomes when used appropriately.
• A good glide path is often more important than the type of motion being used.
• Hand files and Hedström files remain valuable during retreatment.
• Mechanical GP removal near the apex increases the risk of extrusion.
• Solvents are best reserved for residual gutta-percha rather than used at the start of retreatment.
• Understanding motor settings, torque, and RPM improves file safety and efficiency.
• Knowing when to refer is a sign of clinical maturity, not weakness.
• Clear consent and expectation management reduce stress for both clinician and patient.

Highlights of this episode:

• 00:00 Teaser
• 01:09 Introduction
• 02:15 Protrusive Dental Pearl: Coronal GP Removal & Pulp Chamber Clean-Up
• 03:59 Glide Path File Protocol & Canal Negotiation
• 06:24 Access Cavity Design & Coronal Flaring in RCT
• 08:38 File Taper & Canal Preparation Philosophy
• 09:54 Managing Difficult Canals in Endodontic Treatment
• 11:48 When to Introduce the Glide Path File
• 13:24 Using Intermediate File Sizes
• 15:39 Useful Negotiation & Shaping Tips
• 17:19 Choosing a File System
• 20:19 Rotary vs Reciprocating in Clinical Practice
• 21:29 Motor Settings & File Control
• 21:40 XP-Endo & Specialised File Designs
• 22:05 Endo Motor Ads
• 24:44 XP-Endo & Specialised File Designs
• 25:16 Retreatment Files & GP Removal
• 26:08 Preferred Gutta-Percha Removal
• 31:21 Recommended System for Simplicity
• 32: 44 Building Skills Faster in Endodontics
• 36:13 Consent & Managing Expectations
• 41:51 Reciproc vs WaveOne Gold
• 42:22 Preferred Retreatment Protocol
• 43:33 Using Rotary Files in Reciprocation
• 45:12 Curved Canals & Shaping Efficiency
• 46:32 Can Reciproc Blue Bypass the Glide Path?
• 49:29 Outro

Want more?

Check out the previous episode with Dr. Samuel Johnson: Working Lengths and Troubleshooting Apex Locators – PDP216

???? Looking for an endomotor?

Upgrade your endodontic workflow with the Woodpecker Endo Radar Pro. Head to protrusive.co.uk/endomotor and use coupon code PROTRUSIVE at checkout to claim an exclusive discount and your choice of complimentary file system.

???? Subscribe to Dr. Samuel Johnson’s amazing YouTube Channel: I Love The Pulp for more helpful endodontics tips and tricks. 

#PDPMainEpisodes #EndoRestorative

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

This episode meets GDC Outcomes C

AGD Subject Code: 070 – Endodontics

Aim: To enhance clinicians’ understanding of glide path preparation, rotary and reciprocating instrumentation, canal negotiation, retreatment strategies, and risk management in contemporary endodontic practice.

Dentists will be able to –

• Dentists will be able to evaluate the role of glide path preparation in improving shaping efficiency and reducing procedural errors.
• Dentists will be able to compare practical considerations when using rotary and reciprocating file systems.
• Dentists will be able to apply safe and predictable approaches to canal negotiation, retreatment, and clinical decision-making.

Can you safely skip the glide path with modern reciprocating systems?

What is the best file system for a GDP who wants predictable endodontic results?

And perhaps the biggest question of all: does the file system matter as much as we think it does?

In Part 2 of the Endo Showdown, Dr Samuel Johnson returns to tackle some of the most common questions dentists have about file systems, glide path preparation, retreatment, and endodontic workflow. From practical negotiation tips to choosing a system that works in your hands, this episode focuses on the decisions that can make endodontics simpler, safer, and more predictable.

Protrusive Dental Pearl

Cut your gutta-percha at the level of the canal orifice and thoroughly clean the pulp chamber before placing the coronal restoration.

⚠️ Leaving gutta-percha and sealer coronally can compromise the coronal seal and promote leakage.

✅ Use isopropyl alcohol to clean resin-based sealer residue before bonding. Water is effective for cleaning bioceramic sealers.

Key Takeaways

• Establish a glide path before shaping whenever possible.
• D-Finders can negotiate difficult canals more predictably than traditional K-files.
• Intermediate files such as size 12 or 12.5 can help bridge the jump from size 10 to size 15.
• Straight-line access reduces file binding and improves shaping efficiency.
• Avoid forcing glide path files to working length.
• Gates Glidden drills may be unnecessarily aggressive for routine coronal flaring.
• Consistency with one file system is often more important than chasing the latest product.
• WaveOne Gold remains a simple and user-friendly option for many GDPs.
• Rotary and reciprocating systems can both achieve successful outcomes when used appropriately.
• A good glide path is often more important than the type of motion being used.
• Hand files and Hedström files remain valuable during retreatment.
• Mechanical GP removal near the apex increases the risk of extrusion.
• Solvents are best reserved for residual gutta-percha rather than used at the start of retreatment.
• Understanding motor settings, torque, and RPM improves file safety and efficiency.
• Knowing when to refer is a sign of clinical maturity, not weakness.
• Clear consent and expectation management reduce stress for both clinician and patient.

Highlights of this episode:

• 00:00 Teaser
• 01:09 Introduction
• 02:15 Protrusive Dental Pearl: Coronal GP Removal & Pulp Chamber Clean-Up
• 03:59 Glide Path File Protocol & Canal Negotiation
• 06:24 Access Cavity Design & Coronal Flaring in RCT
• 08:38 File Taper & Canal Preparation Philosophy
• 09:54 Managing Difficult Canals in Endodontic Treatment
• 11:48 When to Introduce the Glide Path File
• 13:24 Using Intermediate File Sizes
• 15:39 Useful Negotiation & Shaping Tips
• 17:19 Choosing a File System
• 20:19 Rotary vs Reciprocating in Clinical Practice
• 21:29 Motor Settings & File Control
• 21:40 XP-Endo & Specialised File Designs
• 22:05 Endo Motor Ads
• 24:44 XP-Endo & Specialised File Designs
• 25:16 Retreatment Files & GP Removal
• 26:08 Preferred Gutta-Percha Removal
• 31:21 Recommended System for Simplicity
• 32: 44 Building Skills Faster in Endodontics
• 36:13 Consent & Managing Expectations
• 41:51 Reciproc vs WaveOne Gold
• 42:22 Preferred Retreatment Protocol
• 43:33 Using Rotary Files in Reciprocation
• 45:12 Curved Canals & Shaping Efficiency
• 46:32 Can Reciproc Blue Bypass the Glide Path?
• 49:29 Outro

Want more?

Check out the previous episode with Dr. Samuel Johnson: Working Lengths and Troubleshooting Apex Locators – PDP216

???? Looking for an endomotor?

Upgrade your endodontic workflow with the Woodpecker Endo Radar Pro. Head to protrusive.co.uk/endomotor and use coupon code PROTRUSIVE at checkout to claim an exclusive discount and your choice of complimentary file system.

???? Subscribe to Dr. Samuel Johnson’s amazing YouTube Channel: I Love The Pulp for more helpful endodontics tips and tricks. 

#PDPMainEpisodes #EndoRestorative

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

This episode meets GDC Outcomes C

AGD Subject Code: 070 – Endodontics

Aim: To enhance clinicians’ understanding of glide path preparation, rotary and reciprocating instrumentation, canal negotiation, retreatment strategies, and risk management in contemporary endodontic practice.

Dentists will be able to –

• Dentists will be able to evaluate the role of glide path preparation in improving shaping efficiency and reducing procedural errors.
• Dentists will be able to compare practical considerations when using rotary and reciprocating file systems.
• Dentists will be able to apply safe and predictable approaches to canal negotiation, retreatment, and clinical decision-making.

Is one safer than the other? Does reciprocation really reduce file separation? Are you choosing your system because it suits the canal anatomy, or because it is simply the one you were taught?

Endodontic file systems can feel like a maze of brands, tapers, alloys, motions and marketing claims. But beneath all that noise, the real question is much more practical: what is your file doing inside the canal, and what compromise are you accepting?

In this episode, Dr Samuel Johnson returns to unpack the Endo Showdown: rotary versus reciprocating files. We cover file motion, glide paths, shaping philosophy, NiTi metallurgy, cyclic fatigue, torsional fatigue, and why no system is perfect.

Protrusive Dental Pearl

A palliative root canal can be useful for an unrestorable tooth if disinfecting the canal allows infection to heal and natural bone to recover before extraction and future implant planning.

⚠️ Do not dismiss root canal treatment purely because the tooth is not a long-term functional restoration.

✅ Where appropriate, consider whether endodontic disinfection could improve the future implant site by allowing natural bone healing.

Key Takeaways

• The purpose of shaping is not simply to scrape canal walls; it is to create space for irrigant flow.
• Irrigation is the most important part of root canal disinfection.
• Rotary files move in a continuous 360-degree rotation.
• Reciprocating files cut in one direction and reverse before excessive stress builds up.
• Modern reciprocation is designed to cut, release and gradually progress apically.
• File choice is not just about motion; metallurgy, taper, design and operator experience all matter.
• NiTi hand files with strong shape memory may be problematic in curved canals because they want to straighten.
• Martensitic heat-treated files are more flexible and can better follow canal curvature.
• Unwinding flutes are a warning sign that a file may be close to separation.
• Inspect files regularly during treatment, especially in curved, calcified or difficult canals.
• A glide path is essential before introducing larger rotary or reciprocating files.
• Without a glide path, a shaping file may create its own path, risking ledging, transportation or perforation.
• “Grabby” files pull themselves into the canal; this can be useful in experienced hands but risky if forced.
• Reciprocating systems can feel simpler and safer, but they are not foolproof.
• Cyclic fatigue happens when a file repeatedly bends around a curve until microcracks form.
• Torsional fatigue happens when part of the file binds while the motor continues to turn.

Highlights of the episode:

• 00:00 Teaser
• 00:47 Introduction
• 02:13 Protrusive Dental Pearl: Palliative Root Canal Treatment
• 05:30 Main Question: Rotary vs Reciprocating Files
• 06:31 Hybrid File Motions
• 08:19 File Choice Is More Than Motion
• 10:26 Purpose of Shaping in Endodontics
• 11:10 Chemo-Mechanical Preparation
• 11:34 Rotary Motion in Root Canal Treatment
• 11:45 Origins of Reciprocation
• 12:21 Balanced Force Technique
• 18:00 NiTi K-Files vs Stainless Steel K-Files
• 22:37 Practical Advice: Inspect the File
• 23:40 Rotary Can Also Be a One File System
• 24:24 Reciprocation and Sense of Safety
• 24:47 “Grabby” Files
• 24:53 Midroll
• 33:54 Choosing Between Rotary and Reciprocating
• 35:20 Cyclic Fatigue
• 37:41 Endo Radar Pro Ads
• 40:20 Torque and RPM in Endodontics
• 41:41 Why Reciprocation Advances
• 42:56 Debris Extrusion in RCT
• 43:34 Benefits of Rotary Systems
• 44:13 Tactile Feedback in Root Canal Treatment
• 45:21 Outro

Want more?

Check out previous episode with Dr. Samuel Johnson: Working Lengths and Troubleshooting Apex Locators – PDP216

???? Looking for an endomotor?

Upgrade your endodontic workflow with the Woodpecker Endo Radar Pro. Head to protrusive.co.uk/endomotor and use coupon code PROTRUSIVE at checkout to claim an exclusive discount and your choice of complimentary file system.

#PDPMainEpisodes #EndoRestorative

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

This episode meets GDC Outcomes CAGD Subject Code: 070 Endodontics

Aim: To improve dentists’ understanding of rotary and reciprocating endodontic file systems, including file motion, glide path creation, file metallurgy, fatigue mechanisms, irrigation principles, and practical steps to reduce procedural risks.

Dentists will be able to –

• Understand the clinical differences between rotary and reciprocating file motions and how these may influence endodontic workflow
• Recognise key risk factors for file separation, including cyclic fatigue, torsional fatigue, file distortion and inappropriate file use
• Apply practical principles around glide path creation, irrigation, file inspection and system selection in endodontic treatment

Where do peptides, resin infiltration, fluoride varnish and SDF actually fit in modern practice?

Is hydroxyapatite toothpaste a genuine alternative to fluoride, or just another dental trend?

And when you see that suspicious grey occlusal shadow, do you seal it, explore it, or actively surveil it?

In part two of this modern caries management episode, Jaz continues the conversation with Prof. Avijit Banerjee on minimal intervention dentistry. This episode moves beyond diagnosis and communication into the practical management of early and progressing caries lesions, including peptides, SDF, hydroxyapatite toothpaste, fissure sealing, xerostomia, root caries and selective caries removal.

Protrusive Dental Pearl

Use the Contemporary Caries Management Implementation Pack as a chairside aid to turn the episode into daily clinical action.

⚠️ Learning the evidence is not enough if it never makes it into your patient conversations, risk assessment or treatment planning.

✅ Print it, laminate it, and use it to support communication, diagnosis, active surveillance and minimally invasive decision-making.

Disclaimer: This is an educational resource produced by Team Protrusive, derived from the two-part Protrusive Dental Podcast episode featuring Prof. Avijit Banerjee. Its contents were not written, reviewed, or endorsed by Prof. Banerjee; they represent Team Protrusive’s own interpretation of the material discussed. It is intended as a practical summary and is not a substitute for primary sources. We strongly encourage all clinicians to consult the latest Clinical Practice Guidelines before making treatment decisions.

Key Takeaways:

• Peptides are designed to infiltrate early enamel lesions and create a scaffold for mineral deposition.
• Peptide technologies still need minerals from saliva, toothpaste, mouthwash or other sources to work.
• Fluoride supports remineralisation; it acts more like the “mortar” than the “bricks”.
• Early E1 lesions are usually managed with prevention, fluoride, oral hygiene, diet control and biofilm control.
• Deeper enamel lesions, such as progressing E1 or E2 lesions, may be suitable for resin infiltration or peptide infiltration.
• SDF is better suited to cavitated lesions where arrest and stabilisation are needed.
• In the UK, SDF is licensed for dentine sensitivity, so caries arrest is an off-label use.
• SDF can be very useful for children, older adults, medically compromised patients and care-home patients.
• The main downside of conventional SDF is black staining, especially on anterior teeth.
• Hydroxyapatite toothpaste has more science behind it than charcoal-style fad toothpastes.
• Fluoride toothpaste remains the preferred baseline recommendation when patients are happy to use fluoride.
• A suspicious grey occlusal lesion should be assessed in the context of the patient’s overall caries risk.
• In selected cases, a tiny exploratory opening can act like a diagnostic biopsy.
• Sealing fissures on the same tooth being restored can be sensible when the fissure pattern is deep.
• For severe xerostomia and root caries risk, consider high-fluoride regimes, close recalls, trays or dentures as carriers for remineralising agents.

YouTube Highlights:

• 00:00 Teaser
• 01:17 Introduction
• 02:17 Pearl: Caries Management Implementation Pack
• 05:54 What are Peptides?
• 14:42 SDF: Silver Diamine Fluoride
• 14:55 Early Enamel Lesion Pathway
• 15:11 When to Consider Resin or Peptide Infiltration
• 15:51 Best Use Case for SDF
• 20:14 Hydroxyapatite Toothpaste
• 21:18 Fluoride Safety and Evidence
• 27:00 Midroll
• 40:53 Preventive vs Therapeutic Sealants
• 42:09 Severe Xerostomia and Root Caries
• 44:40 Using Trays or Dentures as Carriers
• 45:48 Tooth Mousse and CPP-ACP
• 47:11 Artificial Saliva
• 47:46 Why the Patient Has Dry Mouth Matters
• 49:35 Current Position on Stepwise Excavation
• 50:09 Selective Caries Removal
• 51:15 Deep Caries Guidelines
• 53:01 Materials Are Not Everything in Caries Management
• 55:59 Further Learning Resource 
• 56:44 Outro

Want more?

Check out part one of this modern caries management series for communication, diagnostics, triangulating data and deciding which caries detection tools are actually worth using.

???? Download the Contemporary Caries Management Implementation PackHead to protrusive.co.uk/MID to access the free implementation pack, including key communication points, diagnosis guidance, management flowcharts and evidence links.

Professor Avijit Banerjee’s recommended reading and ongoing work:

• New textbook: A Clinical Guide to Advanced Minimum Intervention Restorative Dentistry (Banerjee A., Elsevier, 2024) — the most comprehensive single reference for modern MIOC and MID.

????  uk.elsevierhealth.com (ISBN 978-0-443-10971-3)

Resources mentioned in this episode:

S3 Guidelines: https://pmc.ncbi.nlm.nih.gov/articles/PMC13099699/ 

???? Interested in Proximal Resin Infiltration?

• Explore The Iconic Method with Cat Edney: a free 1-hour webinar on 24 June 2026, followed by a hands-on 1-day Birmingham course on 4 July 2026 covering Icon resin infiltration, tooth whitening and NIRI-guided enamel management, with verifiable CPD available. 
• Don’t miss out!DMG Icon Proximal discount for dental professionals at protrusive.co.uk/dmg

#PDPMainEpisodes #BreadandButterDentistry 

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

This episode meets GDC Outcomes C

AGD Subject Code: 250 Operative (Restorative) Dentistry

Aim: To improve dentists’ confidence in modern minimal intervention caries management by applying risk-based decision-making, active surveillance, appropriate use of remineralising and arresting therapies, and evidence-informed restorative strategies.

Dentists will be able to –

• Assess early and progressing caries lesions using patient risk, clinical signs, symptoms and radiographic findings.
• Select appropriate non-operative, microinvasive and stabilisation strategies, including fluoride, peptides, resin infiltration, sealants and SDF.
• Manage high-risk patients, including those with xerostomia or root caries risk, using prevention, recall planning and patient-specific delivery methods.

Why does the word monitoring mean nothing to a patient — and how does swapping it for active surveillance change everything from your notes to your indemnity to your government policy meetings?

Is it overtreatment to act on an E2 lesion — or is “watch and wait” actually the lazy answer dressed up as minimally invasive?

And what should you actually do with AI caries detection that flags shadows your eye doesn’t see?

In this episode, Professor Avijit Banerjee — Professor of Cariology & Operative Dentistry at King’s College London, Honorary Consultant at Guy’s & St Thomas’, and First Dean of the Faculty of Dentistry at the College of General Dentistry — sits down with Jaz for what is genuinely one of the most important caries conversations on the podcast. Part one of two.

Avijit doesn’t do soft answers. The drill-fill-bill model is broken. “Monitoring” needs to go. “Treatment planning” is antiquated terminology medics dropped twenty-five years ago. And AI in caries diagnosis? Useful — but the moment it gets things wrong, you are the one with indemnity, not the software.

What you walk away with is a framework (MIOC), a decision filter (three factors that decide whether to pick up a bur), and a vocabulary shift you can implement tomorrow. Part two covers peptides, SDF, hydroxyapatite, stepwise excavation, and managing caries in xerostomia.

Protrusive Dental Pearl: Delete the Word “Monitor” from Your Vocabulary

Stop saying monitor. Start saying active surveillance.

⚠️ Active surveillance must not mean passive delay — document your reasoning, risk assessment, and what would trigger intervention.

✅ Explain it to patients as structured, proactive care: clinical checks, radiographs, risk review, behaviour support, and timely action if things change.

Key Takeaways

• Minimum intervention oral care is bigger than minimally invasive dentistry.
• MIOC is prevention-based, person-focused, susceptibility-related, and delivered by the whole oral healthcare team.
• MID is only one part of MIOC: operative dentistry when a tooth actually needs intervention.
• The four MIOC domains are: identify the problem, prevent lesions and control disease, provide minimally invasive operative care, then reassess.
• A care plan is more useful than a treatment plan because it includes justification, prevention, behaviour change, and review.
• Ask patients what matters to you, not just what’s the matter with you.
• Cavitation, cleansability, and lesion activity should guide whether to intervene operatively.
• A cavitated lesion that cannot be cleaned is much more likely to remain active.
• Smooth surface lesions may sometimes be made cleansable without conventional drilling.
• Restorations are not just about filling holes; they help recreate a cleansable tooth surface.
• There is no single perfect caries detection technology — clinical examination and good radiographs remain fundamental.
• If using NIRI, fluorescence, scanners, or AI, understand how the technology works and where it fails.
• AI should support diagnosis, not replace clinical judgement.
• For uncertain early lesions, triangulate: clinical findings, radiographs, risk, technology, and patient factors.
• Proximal resin infiltration has a role in the right patient and situation, especially as part of a wider prevention-led strategy.

Highlights of This Episode

• 00:00 Teaser
• 02:17 Protrusive Dental Pearl: Active Surveillance, Not Monitoring
• 09:14 Minimum Intervention Oral Care vs Minimally Invasive Dentistry
• 11:28 Core Principles of MIOC
• 11:48 Domain 1: Identify the Problem
• 12:46 Domain 2: Prevention of Lesions and Control of Disease
• 13:18 Microinvasive Care Options
• 14:41 Domain 3: Minimally Invasive Operative Dentistry
• 16:38 Why “Active Surveillance” Matters
• 18:24 MIOC as a Practical Framework
• 19:43 Applying MIOC in Patient Communication
• 22:38 Sustainability & Salutogenesis
• 29:05 When to Pick Up a Drill
• 30:23 Biofilm as the Engine of Caries
• 31:33 Purpose of a Restoration in Caries Management
• 36:13 Caries Detection Technologies
• 42:44 Watch and Wait vs Detect and Manage
• 01:02:52 Outro

Professor Avijit Banerjee’s recommended reading and ongoing work:

• New textbook: A Clinical Guide to Advanced Minimum Intervention Restorative Dentistry (Banerjee A., Elsevier, 2024) — the most comprehensive single reference for modern MIOC and MID.

????  uk.elsevierhealth.com (ISBN 978-0-443-10971-3)

???? Interested in Proximal Resin Infiltration?

• Don’t miss out! DMG Icon Proximal discount for dental professionals at protrusive.co.uk/dmg
• Explore The Iconic Method with Cat Edney: a free 1-hour webinar on 24 June 2026, followed by a hands-on 1-day Birmingham course on 4 July 2026 covering Icon resin infiltration, tooth whitening and NIRI-guided enamel management, with verifiable CPD available. 

Loved This Episode? Try this next:

Is Caries Detector Dye BS? – PDP138

#PDPMainEpisodes #BreadandButterDentistry 

Listen & Earn CPD

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

This episode meets GDC Outcomes A and C

AGD Subject Code: 250 Operative Dentistry (Caries Detection and Prevention)

Aim & Learning Outcomes

Aim: To equip dental practitioners with a contemporary, evidence-informed framework for the diagnosis and non-operative or minimally invasive management of dental caries — with a particular focus on the decision-making that determines whether operative intervention is justified.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe the four underpinning principles and four clinical domains of Minimum Intervention Oral Care (MIOC), and articulate the difference between MIOC and minimally invasive dentistry.
• Apply a structured decision filter — incorporating cavitation, cleansability, and lesion activity — to determine whether a carious lesion requires operative intervention or microinvasive/non-operative management.
• Differentiate between passive monitoring and active surveillance, and use appropriate language in clinical communication, care planning, and contemporaneous notes

Are those flawless before-and-after cases the reality of everyday practice—or just the highlight reel?

And why aren’t we talking more openly about the failures, frustrations, and imperfect outcomes that every dentist experiences?

In this episode, Dr Artem Mkrtichyan joins Jaz for a refreshingly honest conversation about the realities of modern dentistry. Known for his candid and relatable social media posts, Dr. Artem has built a following by sharing what many dentists think—but rarely say out loud: dentistry is hard, results aren’t always perfect, and social media often paints an unrealistic picture of the profession.

Key Takeaways

• Social media has become a powerful tool for dentists to connect and share experiences.
• Mistakes in clinical practice are common and should be openly discussed.
• Rural practice may not always lead to higher income as expected.
• Success in dentistry is subjective and varies for each individual.
• Continuous learning and skill development are crucial for career growth.
• Financial freedom in dentistry is not guaranteed and varies widely.
• Networking and mentorship can significantly impact career progression.
• Social media can be leveraged to attract patients and build a personal brand.

Highlights of this episode:

• 00:00 Teaser
• 00:18 Introduction
• 02:24 Meet Dr Artem Mkrtichyan
• 05:27 Rejections And Resilience
• 09:03 Why Honesty Wins
• 10:58 Rural Dentistry Reality
• 14:58 Handling Online Criticism
• 16:01 Associate Vs Owner Myth
• 18:05 Midroll: Protrusive App
• 22:48 Dentistry Money Reality
• 26:57 Design Your Career Path
• 28:00 Standing Out In Saturated Markets
• 29:27 Content Marketing Strategy
• 31:46 Veneer Minimum Ethics
• 33:48 Final Advice And Community

If this episode resonated with you, don’t miss “I Committed Fraud – Learn from My Mistakes” – PDP248

#InterferenceCast #BeyondDentistry

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.

What if the problem is not that occlusion is too complex, but that it was taught in the wrong order?

How do you make sense of worn teeth, bite scans, shimstock, leaf gauges, provisionals and T-Scan without getting overwhelmed?

And which small ideas can genuinely change the way you diagnose, plan and restore?

In this episode, Jaz is joined by Dr. Mahmoud Ibrahim for a brilliant occlusion-focused conversation. They each bring five clinical “pearls” that helped occlusion finally click for them — from facially generated treatment planning to checking the contralateral side, muscle palpation, provisionals and digital occlusal data.

Protrusive Dental Pearl

Create a PowerPoint or Keynote library of your clinical photos so you can quickly show patients relevant examples during consultations.

⚠️ Avoid hunting through random folders chairside — it feels clunky and breaks the flow of the conversation.

✅ Build a scrollable visual library of cracks, before-and-afters, complications, direct restorations, overlays, crowns and consent examples to support clearer patient communication.

Key Takeaways

• Occlusion becomes easier when it is placed inside the treatment planning sequence, not treated as a separate subject.
• Facially generated treatment planning starts with where the upper teeth need to be for aesthetics.
• Once the central incisors are planned, the rest of the occlusion becomes easier to organise.
• Worn teeth that are still in occlusion are often in the wrong position.
• Anterior wear may be caused by tooth position, contact time, contact force, or a combination of all three.
• Gingival levels can reveal whether worn lower incisors have over-erupted.
• Digital bite scans are useful, but they are not always a perfect representation of the patient’s bite.
• Shimstock remains one of the most valuable and inexpensive tools for checking true occlusal contacts.
• After fitting a restoration, checking the contralateral side first can reveal whether the new restoration is high.
• Anterior guidance should be steep enough to separate the back teeth, but shallow enough to allow the lower incisors room to move.
• Muscle palpation should assess the quality and symmetry of contraction, not just whether the muscles exist.
• Always assess the opposing tooth before placing composite, ceramic or an indirect restoration.
• A leaf gauge can help create a more repeatable jaw position when planning more complex occlusal cases.
• Provisionals are essential for testing aesthetics, function, vertical dimension and occlusion before committing to final restorations.

Highlights of the Episode:

• 00:00 Teaser
• 00:56 Introduction
• 03:36 Pearl: Build a Clinical Photo PowerPoint
• 12:48 Pearl 1: Facially Generated Treatment Planning
• 15:56 Pearl 2: Worn Teeth in Occlusion Are in the Wrong Position
• 18:05 Why Tooth Position Matters
• 18:22 Three Causes of Wear to Consider
• 19:34 Pearl 3: Digital Bite Scans Are Not Always Accurate
• 20:24 Why Shimstock Still Matters in Digital Dentistry
• 24:18 Pearl 4: Check the Contralateral Side After a Restoration
• 26:27 Pearl 5: The First Movement of Opening Is Not Pure Rotation
• 28:27 Midroll
• 33:10 Pearl 6: Healthy Occlusion Should Have Coordinated Muscle Contraction
• 35:22 Why Muscle Palpation Is a Useful Data Point
• 38:18 Practical Muscle Assessment Tip
• 38:58 Pearl 7: Always Look at the Opposing Tooth
• 39:33 What to Check Before an Indirect Restoration
• 39:44 Why the Opposing Tooth Matters
• 41:13 Pearl 8: Leaf Gauge for Finding a Repeatable Jaw Position
• 42:43 What a Leaf Gauge Is
• 44:33 Pearl 9: Provisionals Reduce the Fear of Complex Cases
• 47:49 Pearl 10: T-Scan Adds Objective Occlusal Data
• 53:16 Course Options and Learning Pathway
• 55:59 Outro

✨Connect with Dr. Mahmoud on Instagram

???? Want to make occlusion more practical?

• Bulletproof is designed to take occlusion from abstract theory to real-world clinical application — covering posterior crowns, quadrant dentistry, PROPER conformative dentistry, occlusal risk assessment, shimstock, leaf gauges and daily protocols you can use straight away.
• The next Bulletproof course takes place on 26th–27th June at London Heathrow (Radisson Blu Hotel)
• Don’t miss it — find out more at bulletproofdentistry.com

➡️Check out more episodes on occlusion: Indirect Restorations For Guiding Teeth – PDP196

#PDPMainEpisodes  #OcclusionTMDandSplints

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

This episode meets GDC Outcomes C

AGD Subject Code: 180 Occlusion

Aim: To help dentists improve their understanding and clinical application of occlusion by recognising key diagnostic signs, using practical occlusal assessment tools, and applying occlusal principles to restorative treatment planning.

Dentists will be able to –

• Apply facially generated treatment planning principles when assessing occlusal and restorative cases.
• Identify how tooth position, contact time and contact force contribute to tooth wear and restoration risk.
• Use practical occlusal assessment methods such as shimstock, contralateral checking, muscle palpation, leaf gauges, provisionals and T-Scan data.

Are those beautiful fissures and stains actually helping the patient… or just us?

Why does that “perfect” restoration suddenly need 20 minutes of occlusal adjustment after rubber dam removal?

And how can we make functional, predictable composites without burning time or stress?

In this episode, Dr. Vishaal Shah shares a refreshingly practical approach to posterior composites. From understanding the basics, to simplifying anatomy and improving efficiency, this is a grounded, clinically focused conversation on how to deliver restorations that actually serve the patient.

Protrusive Dental PearlMatch your composite anatomy to the patient’s dental age and opposing dentition before you start building.

⚠️ Overbuilding cusps in a worn dentition will create occlusal interferences and wasted adjustment time✅ Assess space, wear, and occlusion first—then design the restoration accordingly

Key Takeaways

• Function, efficiency, and occlusal compatibility should guide every restoration
• Dental age (wear) is more important than chronological age when planning anatomy
• Always assess the opposing tooth before designing cusps and fissures
• Use the whole arch—not just the contralateral tooth—as your anatomical guide
• Follow the central fissure line across the quadrant to orient your restoration
• Avoid textbook anatomy in worn dentitions—adapt to what’s present
• Large MOD composites often act as interim restorations before crowns
• Build proximal walls first to establish contact and control final contour
• Use composite slump (with a microbrush) to naturally form proximal curvature
• Base layer height should match the deepest fissure level of adjacent teeth
• Map out fissures and cusps before building to improve accuracy and speed
• Start with the most difficult cusp first to reduce fatigue-related errors
• Proper planning before drilling reduces occlusal errors and remakes

Highlights of the Episode:

• 00:00 Teaser
• 01:08 Introduction
• 01:50 Pearl: Matching Anatomy to Dental Age
• 05:32 Posterior Composite: Start with Basics, Not Complexity
• 10:42 Efficient Approach to Large Restorations
• 14:22 Efficiency vs Ideal Posterior Restorations
• 19:25 Building Proximal Walls First
• 20:55 Using Putty Stents for Missing Cusps
• 23:54 Midroll
• 27:15 Using Putty Stents for Missing Cusps
• 27:25 Matrix System Selection
• 28:06 No Pre-Wedging Philosophy
• 29:06 Managing Composite Overhangs
• 30:46 Matrix Ring Differences
• 32:45 Interjection
• 37:03 Matrix Ring Differences
• 37:43 Proximal Wall Technique for Posterior Composite
• 41:03 Base Layer Strategy in Posterior Restorations
• 42:23 Mapping Anatomy Before Composite Build-Up
• 43:13 Cusp Build-Up Approach
• 45:03 Minimal Adjustment Philosophy
• 46:43 Final Philosophy: Keep It Simple
• 48:00 Learning Opportunities
• 49:54 Outro

???? Want to level up your posterior composites?Dr. Vishaal Shah runs hands-on courses focused on simplifying and mastering everyday restorations.???? Visit www.levelupdentistry.com to explore courses and upcoming training opportunities.

More about posterior restorations:Check out more episodes on occlusion and restorative dentistry: How to Place Posterior Composites without Destroying Your Anatomy – PDP200

#PDPMainEpisodes  #BreadandButterDentistry 

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

This episode meets GDC Outcomes C

AGD Subject Code: 250 Operative Dentistry

Aim: To enhance clinicians’ understanding of efficient, functional posterior composite techniques with a focus on anatomy, occlusion, and practical workflow.

Dentists will be able to –

• Assess dental age and occlusal compatibility when planning posterior composites
• Apply simplified, efficient techniques to build functional posterior restorations
• Select appropriate materials and matrix systems to optimise contact, contour, and outcomes

What’s actually involved in MRI of the TMJ?

Can you use any MRI machine, or is the choice of imaging center crucial?

And who should be reporting on these scans — does it really matter? (Hint: yes, it does!)

Dr. Kevin Lotzof, a straight-talking radiologist, joins Jaz for a controversial deep dive into the role of MRI in Temporomandibular Disorders. While many experts downplay its importance, Kevin argues that TMJs are under-imaged and under-diagnosed — and that we may be missing critical pathology.

They explore the practicalities of imaging, how to set expectations with your patients, and why strong but differing views in TMD care can ultimately help you refine your own clinical approach.

 Protrusive Dental Pearl: Adopt the mindset of “Find the cancer today.”When carrying out examinations—whether soft tissue or extraoral—approach it with the intention of detecting oral or skin cancers early. This mindset helps clinicians look beyond just teeth, catch unusual or suspicious lesions, and potentially save lives.

Key Takeaways

• TMJ is often overlooked but is crucial for overall health.
• MRI is essential for accurate TMJ diagnosis.
• Cone beam CT cannot replace MRI for TMD assessment.
• Patients with headaches may have undiagnosed TMD.
• Education on TMJ imaging is lacking among dental professionals.
• Asymptomatic patients should still be scanned for TMJ issues.
• The quality of imaging directly impacts diagnosis accuracy.
• Patients often feel anxious about MRI procedures.
• Understanding patient perspectives can improve care.
• There is a need for better collaboration between dentists and radiologists.

Highlight of the episode:

• 00:00 Teaser
• 00:55 Intro
• 05:20 Protrusive dental pearl
• 06:36 Interview with Dr. Kevin Lotzof
• 09:38 Under-Imaging and Differing Perspectives
• 13:27 Access and MRI Centers in the UK
• 17:51 TMJ MRI: Patient Expectations
• 22:17 Midroll
• 25:53 Open MRI Machines
• 27:26 Ideal Candidates for MRI Imaging
• 29:55 Cone Beam CT vs. MRI
• 31:53 Screening and Asymptomatic Patients
• 38:43 Centers with Reliable TMJ Imaging
• 41:27 Encouragement for General Dentists
• 46:33 Outro

Where to Get Reliable TMJ Imaging

⭐ Top Pick:

• Orion, Wimpole Street, London(Full contact details available via the Protrusive Guidance App)

????️ Other London Options:

• Spire Bushey, Circle Hendon, Cavell, Kings Oak, Circle Healthcare Center 

Learn more about TMJ radiographic imaging in PDP223: Understanding TMD Radiographic Imaging – Pano vs CBCT vs MRI

#PDPMainEpisodes #OcclusionTMDandSplints #CareerDevelopment

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

This episode meets GDC Outcomes A and C.

AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Imaging techniques)

Aim: To highlight the importance of MRI in the diagnosis and management of temporomandibular joint (TMJ) disorders, ensuring safe and effective orthodontic and restorative treatment planning.

Dentists will be able to:

1. Explain why MRI is superior to clinical examination and CBCT in diagnosing TMJ pathology.
2. Identify the key indications for TMJ MRI, including both dental and non-dental symptoms.
3. Recognize the limitations of poor imaging technique and reporting in TMJ diagnosis

Are zirconia implants just hype from biological dentistry… or something more?

Do ceramic implants really integrate as well as titanium?

And should we already be offering patients a choice?

Zirconia implants are no longer a fringe concept—they’re entering mainstream conversations. In this episode, Dr. Pav Khaira returns to break down the science, clinical decision-making, and real-world application of zirconia vs titanium implants. From corrosion and osteoimmunology to occlusion and case selection, this is a practical, evidence-led discussion for clinicians navigating modern implant options.

???? Prioritize quality sleep—it sharpens decision-making, improves mood, and reduces irritability (6–7 solid hours beats longer, disrupted sleep).

➡️ Remember, stress comes from how we respond, not the situation itself—focus on what you can control and let go of the rest.

???? Lean on your support system and make time for reflection and gratitude—they help reframe pressure and build resilience.

• Zirconia implants integrate just as well as titanium, with comparable clinical outcomes
• Early healing may be slightly faster around zirconia, but long-term results are similar
• Titanium can corrode over time, releasing particles linked to peri-implantitis
• Zirconia does not corrode, removing this biological risk factor
• Modern implant thinking focuses on osteoimmunology, not just osseointegration
• Zirconia implants are often one-piece → no microgap and improved crestal bone stability
• Surgical placement must be highly precise—zirconia is less forgiving than titanium
• Guided osteotomy is strongly recommended for ceramic implants
• Fracture risk in modern zirconia implants is low when manufactured correctly
• Hot isostatic pressing significantly increases zirconia strength and reduces defects
• Case selection is critical—limited bone or complex angulation may favour titanium
• Zirconia implants are typically cement-retained only
• Excess cement remains a risk factor for peri-implant disease → manage carefully
• Zinc phosphate cement is useful due to radiopacity and bacteriostatic properties
• Angled screw correction (titanium) is predictable only up to ~15 degrees
• Patient preference for metal-free dentistry is a growing driver of zirconia demand

• 00:00 Teaser
• 00:49 Introduction
• 02:32 Protrusive Dental Pearl: Advice for Dentists during challenging times
• 05:14 Basics: What Are Implants Made Of?
• 07:13 Osseointegration: Zirconia vs Titanium
• 08:28 Why Zirconia? Biological Rationale
• 11:13 Clinical Advantages of Zirconia Implant
• 14:09 Zirconia Implants Limitations in Clinical Use
• 17:45  Case Selection: When to Use Zirconia Implant
• 19:16 Fracture Risk: Myth vs Reality
• 21:30 Midroll
• 24:51 Fracture Risk: Myth vs Reality
• 25:29 Importance of Manufacturing Zirconia Implants
• 27:49 Weaknesses & Clinical Considerations of Zirconia Implants
• 30:49 Occlusal Programming for Implants
• 32:24 Screw vs Cement Retention in Implants
• 34:07 Angle Screw Correction (titanium Context)
• 36:20 Cement Choices for Zirconia Implants
• 38:27 Market Share & Future Trends of Zirconia Implants
• 40:25 Learning Resources for Zirconia Implants
• 41:51 Medico-Legal Considerations of Zirconia Implants
• 47:37 Training & Education Pathways for Zirconia Implants 
• 48:25 Outro

Explore Dr. Pav Khaira’s Academy of Implant Excellence— training designed to help you truly understand the why behind implant dentistry, not just follow protocols. Hands-on options, mentorship, and advanced training available.

✨Follow Academy of Implant Excellence on Instagram: https://www.instagram.com/academyofimplantexcellence

• Book: Zirconia: Material Properties and Surgical Principles for Dental Implants and Restorations

???? Check out more episodes on implant complications and treatment planning

• Implant Occlusion that Makes Sense – PDP 204
• Implant Assessment for GDPs: from Space Requirement to Ridge Preservation – PDP052

#PDPMainEpisodes

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

This episode meets GDC Outcomes C

AGD Subject Code: 690 Implants

Aim: To improve understanding of zirconia implants, including biological considerations, clinical indications, limitations, occlusal principles, consent, and material-related decision-making.

Dentists will be able to –

• Describe the clinical and biological considerations when comparing zirconia and titanium implants
• Identify key case selection factors and limitations for zirconia implant treatment
• Apply practical principles for occlusion, cementation, consent, and risk reduction in implant dentistry

Why do so many high-achieving dentists still feel unfulfilled?

Are we too harsh on ourselves without even realising it?

And what if the way we speak to ourselves is the real problem?

In this episode, Jaz sits down with Dr Aditi Bhalla—a Prosthodontist and Integrative Psychotherapist, with over 15 years in dentistry and extensive training in mental health, mindfulness, and movement—to explore compassion-focused dentistry. They unpack burnout, perfectionism, fear-driven practice, and how understanding your mind could be the key to a sustainable, fulfilling career.

Key Takeaways

• Burnout often stems from perfectionism, shame, and constant self-criticism
• Many dentists tie their self-worth entirely to clinical performance
• Childhood experiences can shape how we respond to stress and pressure
• High-functioning anxiety is common but often goes unnoticed
• NHS-style time pressure and fear of complaints drive chronic stress
• Decision fatigue in dentistry significantly impacts performance and wellbeing
• Social media amplifies comparison and feelings of inadequacy
• There is a growing gap between expectations and real-world dentistry
• Compassion requires courage, wisdom, and commitment—not weakness
• Dentists are good at caring for patients but neglect self-care
• Accepting positive feedback is as important as improving weaknesses
• Emotional awareness is the first step to managing stress effectively
• A “compassion toolkit” helps regulate emotions in real-time clinical scenarios
• Sustainable dentistry requires prevention of burnout, not just coping strategies
• Team culture improves when you recognise the human behind the role
• Compassionate leadership still requires clear boundaries and accountability

Highlights of this episode:

• 00:00 Teaser
• 00:51 Introduction
• 07:50 What “Therapy” Means
• 11:43 Role of Childhood & Trauma
• 13:10 Therapists Need Therapy Too
• 14:40 Breakdown & Burnout in Dentistry
• 16:50 Causes of Burnout in Dentistry
• 19:50 Clinical Stress Factors
• 20:50 Decision Fatigue in Dentistry
• 23:35 Burnout in Modern Dentistry – Why More Now?
• 27:38 Midroll
• 30:59 Burnout in Modern Dentistry – Why More Now?
• 31:11 What is Compassion?
• 32:11 Lack of Self-Compassion in Dentistry
• 33:11 Three Directions of Compassion in Dentistry
• 35:11 Compassion Focused Dentistry (CFD)
• 39:11 Nervous System Awareness
• 41:31 Applying Compassion in DailyDental Practice
• 43:01 Compassion = Emotional Intelligence + Mindfulness
• 43:41 Compassion “Kit Bag”
• 45:11 Compassion in the Team
• 46:41 Creating a Compassionate Practice
• 51:51 Getting Started with Compassion
• 54:12 Outro

???? Want to improve your wellbeing and prevent burnout?Dr Aditi Bhalla runs free workshops and resources via the Dental Wellbeing Hub. You can also explore her work and sign up through her website: draditibhalla.com

• LinkedIn: https://www.linkedin.com/in/draditibhalla/
• Facebook: https://www.facebook.com/draditibhalla
• Dental Wellbeing Hub Instagram: https://www.instagram.com/dentalwellbeinghub

#InterferenceCast #BeyondDentistry

Want more?Check out the episode with Marco Maiolino on perfectionism in dentistry – Stop Being a Perfectionist – it’s OK to Fail – PDP184

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

This episode meets GDC Outcomes B and D

AGD Subject Code: 770 Self-improvement

Aim: To explore the principles of compassion-focused dentistry and how emotional awareness, self-compassion, and team dynamics can improve clinician wellbeing and reduce burnout.

Dentists will be able to –

1. Recognise the role of emotional awareness and self-compassion in managing clinical stress
2. Identify key contributors to burnout in modern dental practice
3. Apply practical strategies to foster a compassionate and sustainable workplace

Are your neck and back quietly dictating how long you can practise?

Do you skip workouts because you “don’t have time”?

And what if your career ended—not by choice, but because your body gave up first?

In this episode, Jaz is joined by Fraser Smith, a sports scientist and nutrition expert, to break down what dentists actually need to do to stay healthy, pain-free, and practising for longer. From EMS training and realistic exercise routines to nutrition and injury prevention, this is a practical guide to protecting your most important asset—your health.

Key Takeaways

• Health is a key pillar of career longevity in dentistry
• Many dentists sacrifice exercise and sleep during high-stress periods
• Short, consistent workouts are more sustainable than long, infrequent sessions
• EMS can be a useful time-efficient adjunct but should not replace a full training programme
• Strength, endurance, and mobility are all essential components of fitness
• Most dentists should start with small, manageable exercise habits and build gradually
• Deadlifts are beneficial but require proper technique and guidance
• Reformer Pilates is a practical option for improving posture and mobility
• Stretching provides short-term relief but must be combined with strengthening
• Most musculoskeletal pain in dentists is due to repetitive strain and weakness
• Movement and gradual strengthening are key to managing and preventing pain
• Ignoring early pain increases the risk of chronic, persistent symptoms
• Nutrition should be balanced and sustainable rather than extreme
• Protein intake is often insufficient in active individuals
• Supplements can support performance but should not replace a good diet
• Long-term success depends on prioritising health as part of professional responsibility

Highlights of this episode:

• 00:00 Teaser
• 00:53 Introduction
• 05:40 What is EMS Training?
• 07:45 Get to know Fraser Smith
• 09:35 What’s the ideal health routine for Dentists?
• 11:56 Deadlifts for Dentists
• 15:01 Stretching & Posture Tips for Dentists
• 18:35 Midroll
• 21:56 Stretching & Posture Tips for Dentists
• 25:41 Balanced Nutrition
• 28:23 Protein Intake Suggestions
• 30:51 Back Pain Management
• 39:09 Outro

????For tailored support with strength, posture, and long-term health,  check out Vive Fitness 

Want more?

Check out episodes on health and longevity in dentistry: My Neck, My Back (Fix Your Posture While Removing Plaque!) – PDP220

#InterferenceCast #BeyondDentistry

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 walkthroughs and Masterclasses.

Why does dentistry have such high levels of stress and burnout?

Why do so many clinicians feel isolated despite working in busy practices?

What are the early warning signs that a colleague might be struggling?

And what can you actually do — practically — if someone is in crisis?

In this powerful and deeply important episode, Professor John Gibson shares his personal story and the mission behind the Canmore Trust. The conversation explores suicide prevention in dentistry, how to recognise warning signs, and the simple but life-saving actions every clinician should know.

Key Takeaways

• Dentistry has a well-recognised issue with stress, burnout, and suicide risk
• Suicide is always multifactorial — never caused by a single event
• Toxic culture, including harassment and unrealistic expectations, contributes to distress
• Social media comparison can amplify feelings of inadequacy and isolation
• Dentistry is uniquely demanding — both intellectually and technically
• Mental health stigma prevents open conversations within the profession
• Neurodivergence is increasingly relevant and often underdiagnosed
• Perfectionism is a key risk trait linked to suicidal thinking
• Working below your moral standards creates significant psychological stress
• Warning signs include changes in temperament, withdrawal, and isolation
• Asking directly about suicide does not increase risk — it can save lives
• Use the “double bounce” approach: ask the question twice if needed
• If someone says yes, act immediately — hospital or emergency services
• You are not responsible for managing the crisis alone
• Early support includes sharing concerns and involving a trusted person
• GP support can be transformative and should not be delayed

Highlight of this episode:

• 00:00 Teaser
• 00:51 Intro
• 04:16 John Gibson Introduction
• 07:15 Understanding the Scale of Suicide in Dentistry
• 09:59 Why Suicide Happens in Dentistry
• 11:13 Key Risk Factors of Suicide in Dentistry
• 12:09 Social Media and Comparison
• 12:52 Isolation
• 13:04 Difficulty of Dentistry
• 14:03 Mental Health Stigma
• 15:22 Neurodiversity
• 18:18 Perfectionism and Moral Conflict in Dentistry
• 21:44 Recognising Warning Signs of Suicide
• 21:46 Midroll
• 25:07 Recognising Warning Signs of Suicide
• 26:21 How to Approach a Suicidal Colleague
• 28:49 Double Bounce Technique
• 30:44 If the Answer is YES
• 33:36 Support and Resources for Dentists
• 34:12 Key Suicide Prevention Steps
• 37:40 Creating a Supportive Workplace
• 39:18 Reflective Space
• 40:00 Daily Positivity Practice
• 42:46 Canmore Trust Podcast
• 42:59 Outro

Learn more about mental health in Dentistry:

Check out more episodes on mental health, burnout, and wellbeing in dentistry.

PDP185 – Mental Health in Dentistry

IC040 – Overcoming Adversities

???? Support and resourcesIf this episode resonated with you or someone you know, explore the Canmore Trust for practical support and guidance:???? thecanmoretrust.co.uk

???? The Canmore Trust Podcast

They also offer helpful resources and podcasts focused on suicide prevention and mental well-being for healthcare professionals.

➡️General Dental Council – Mental Health and Well Being in Dentistry: A Rapid Evidence Assessment

#InterferenceCast #Communication #BeyondDentistry

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

This episode meets GDC Outcomes B

AGD Subject Code: 770 Self Improvement (Mental Health / Stress Management)

Aim: To enhance clinicians’ understanding of suicide risk within dentistry, including contributing factors, warning signs, and practical approaches to supporting colleagues, fostering open conversations, and creating a mentally healthy workplace.

Dentists will be able to –

• Recognise the multifactorial nature of suicide in dentistry and identify key contributing risk factors such as toxic culture, isolation, and stigma.
• Identify behavioural and emotional warning signs of suicide in dental professionals and apply appropriate communication strategies, including direct questioning and empathetic support.
• Implement practical steps to support colleagues in crisis and contribute to a workplace culture that prioritises mental health and wellbeing.

When the data doesn’t match the symptoms, how do you move forward?

And how do you integrate airway into full mouth rehab without compromising function, stability, or predictability?

In this episode, Jaz is joined by Dr. Aston Parmar to explore the real-world application of airway dentistry. They discuss how to help patients own their problem, why sleep testing matters, and how airway influences diagnosis, treatment planning, and long-term outcomes.

Protrusive Dental Pearl

Nasal Breathing and Simple Screening

• Nasal airflow can be a major limiting factor in sleep quality.
• Simple test: flare nostrils → if breathing improves, nasal resistance may be present.
• Nasal dilators can be a cheap, low-risk intervention for selected patients.
• Not all patients need mandibular advancement — sometimes the issue is nasal.
• Second pearl: test snoring improvement by advancing the mandible.
• If forward positioning reduces snoring sound → mandibular advancement may help.

Key Takeaways

• Patients must own their problem before accepting treatment
• Airway dentistry is about risk reduction, not cure
• Apnea-Hypopnea Index (AHI) has limitations—context and patterns matter more than raw scores
• Upper Airway Resistance Syndrome (UARS) is common but underdiagnosed
• Sleep fragmentation can exist even with low AHI scores
• Myofunctional therapy improves compliance and outcomes
• Multi-night sleep testing provides more accurate insights
• Collaboration with ENT specialists improves diagnostic accuracy
• Airway is the bookend of full mouth rehab (start and end)
• Dentistry should be airway-sympathetic, not just tooth-focused
• Mandibular advancement devices are effective but require careful titration
• Morning occlusal guides help reduce bite changes from appliances
• Not all patients need the same pathway—risk stratification is key
• Predictability in dentistry depends on understanding the whole system
• The environment (airway, function, biology) matters more than the teeth

Highlights of this episode:

• 00:00 – Introduction to Upper Airway Resistance Syndrome
• 02:08 – Pearl: Nasal Breathing and Simple Screening
• 07:43 – Recap: Myofunctional Therapy and Indications
• 08:30 – Role of Myofunctional Therapy in Treatment Planning
• 09:40 – Patient Communication and Case Acceptance
• 23:20 – Sleep-Disordered Breathing Spectrum
• 23:50 – Apnea vs Hypopnea and Apnea-Hypopnea Index (AHI) Limitations
• 30:00 – Upper Airway Resistance Syndrome (UARS)
• 35:43 – Management of UARS
• 37:00 – Mandibular Advancement Devices (MAD)
• 39:00 – Maxillary Expansion and Surgical Options
• 41:00 – Treatment Pathway and ENT Involvement
• 44:00 – Risk Assessment in Full Mouth Rehab
• 59:30 – Airway-Sympathetic Dentistry
• 01:02:00 – Treatment Philosophy and Case Selection
• 01:07:00 – Airway as Bookends of Treatment
• 01:09:00 – Managing Side Effects of MAD
• 01:12:00 – Career Insight and Final Reflections

Want to learn more?

Watch part 1 of this episode: PDP262 – Implementing Sleep, Airway and Myo to Restorative Dentistry Part 1

Also, check out Stop Blaming Bruxism with Dr. Sandra Hulac – PDP142

????Master Airway Dentistry in PracticeJoin Dr. Aston Parmar’s course on 8th May in Cardiff

• Learn how to screen, test, and manage airway patients
• Understand real-world workflows and patient communication
• Build confidence in integrating airway into your practice

???? Book via: www.dentalsleep.co.uk

???? Ergonomics Day – Dentistry Without Back Pain!

Join us Saturday, 13th June, Heathrow with Dr. Anikó Ball, world-leading ergonomics expert! Learn proper posture, positioning, and techniques to prevent back problems while practicing dentistry.

???? Hands-on workshop with a mobile dental chair???? Live camera demo on a big screen???? Can’t attend in person? Join online with live stream & replay

???? Early bird tickets even include a full event video!

???? Grab your spot now!

#PDPMainEpisodes #CareerDevelopment #OrthoRestorative

This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance. 

This episode meets GDC Outcome C

AGD Subject Code: 730 – Oral Medicine, Oral Diagnosis, Oral Pathology

Aim

To provide dentists with a practical understanding of airway-focused dentistry, including sleep assessment, risk-based treatment planning, and the integration of airway considerations into full mouth rehabilitation.

Dentists will be able to:

1. Recognize the limitations of AHI and the importance of sleep fragmentation in diagnosis.
2. Understand the role of myofunctional therapy in improving airway function and treatment outcomes.
3. Apply a risk-based approach when integrating airway considerations into restorative and occlusal treatment planning.

You suspect sleep apnea—but since we can’t diagnose it as dentists, how does that influence the care you provide?

What do you do with that information, and who should you be working with to help your patient?

And what if you want to implement airway into your practice—but you’re not in the right environment to do so?

In this episode, Dr. Aston Parmar joins Jaz to break down how to implement airway in everyday dentistry. Together, they explore what happens after screening, how it influences treatment planning, and how dentists can work with other professionals to deliver better care.

 Protrusive Dental Pearl

Use the Mallampati Score as a quick chairside airway screen: have the patient open wide and stick out their tongue. Grade 1 = low risk; higher grades indicate greater Sleep-Disordered Breathing risk. 

⚠️ In TMD patients, limited opening can give falsely high scores. 

✅ Always interpret alongside history and full exam.

Key Takeaways

• Airway management is often overlooked in dental education.
• Sleep testing can significantly improve patient outcomes.
• Dentists should focus on airway health to enhance sleep quality.
• Collaboration with orthodontists can benefit patient care.
• Myofunctional therapy is crucial for both children and adults.
• Early intervention before age six is vital for nasal breathing.
• Tongue function plays a significant role in dental health.
• Breathing patterns can affect orthodontic stability.
• The Malampati score is a key indicator of sleep disorder risk.
• Upper airway resistance syndrome can be difficult to diagnose.
• Collaboration with myofunctional therapists enhances patient outcomes.
• Understanding airway health is essential for total body health.
• Inspiring the next generation of dental professionals is important.

Highlights of this episode:

• 00:00 Teaser
• 00:51 Introduction
• 04:03 Protrusive Dental Pearl: Mallampati Score
• 05:37 Meet Dr. Aston Parmar
• 09:51 Journey into Dentistry
• 17:10 Implementing Training in Practice
• 22:41 First Exposure to Airway Concept
• 30:18 South Wales Dental Sleep Clinic Model
• 30:21 Midroll
• 33:42 South Wales Dental Sleep Clinic Model
• 41:17 Myofunctional Therapy Explained
• 48: 51 Orthodontic Stability and Neutral Zone
• 54:52 Quickfire Screening Red Flags
• 01:02:55 Sleep Apnea Basics
• 01:04:23  Upper Area Resistance Syndrome (UARS)
• 01:08:53 Outro

Want more? Check out Airway Dentistry with Jeff Rouse – PDP229

???? Ergonomics Day – Dentistry Without Back Pain!

Join us Saturday, 13th June, Heathrow with Dr. Anikó Ball, world-leading ergonomics expert! Learn proper posture, positioning, and techniques to prevent back problems while practicing dentistry.

???? Hands-on workshop with a mobile dental chair???? Live camera demo on a big screen???? Can’t attend in person? Join online with live stream & replay

???? Early bird tickets even include a full event video!

???? Grab your spot now!

#PDPMainEpisodes #CareerDevelopment #OrthoRestorative

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

This episode meets GDC Outcome C

AGD Subject Code: 730 – Oral Medicine, Oral Diagnosis, Oral Pathology

Aim: To provide a practical, data-driven framework for identifying airway-related risks, understanding myofunctional therapy, and integrating sleep screening into routine dental assessment.

Dentists will be able to –

1. Recognize key airway and sleep-related risk factors during routine dental examinations.

2. Understand the role of myofunctional therapy in improving airway function and orthodontic stability.

3. Apply simple chairside screening methods to identify patients who may require further airway assessment.

How do they actually work, and what can they do—or not do—for your team?

Could they make life easier for staff without replacing humans, or are they just a gimmick?

In this episode, award-winning dentist and marketing expert Dr. Grant McAree joins Jaz to break down AI receptionists. Together, they explore what an AI receptionist really is, how it integrates with your practice, and the compliance and legal considerations every dentist should know.

They also dive into the bigger picture—who these systems are really for, how patient interactions are managed, and a live demonstration of an AI receptionist in action that shows exactly what it can—and can’t—do for your practice.

Key Takeaways:

• AI receptionists are evolving to provide better patient interactions.
• Data insights reveal significant gaps in patient communication.
• The technology is designed to assist, not replace human receptionists.
• AI can help streamline appointment bookings and patient inquiries.
• Understanding patient needs is crucial for effective AI responses.
• Customization of AI responses is essential for different practices.
• The future of AI in dentistry looks promising but requires careful implementation.
• AI should not be seen as a replacement but as a tool for efficiency.
• Compliance and data storage are critical in patient interactions.
• The integration of AI can lead to improved patient experiences.

YouTube Highlights:

• 00:00 Teaser
• 05:06 Meet Dr. Grant McAree
• 07:32 Grant’s Journey to AI
• 11:03 AI Gold Rush and Inequality
• 11:56 Interjection
• 14:01 AI Gold Rush and Inequality
• 15:59 Compliance and Legal Risks
• 18:42 What an AI Receptionist Does
• 20:54 Midroll
• 24:16 What an AI Receptionist Does
• 26:51 Comparing AI to Human Receptionists
• 32:47 Leads Data and Compliance
• 36:38 Future Adoption and Risks
• 42:46 Additional Features and Learning More
• 43:30 Jaz Call to AI Receptionist
• 46:01 Outro

Unlock the future of patient consultations! ????

Join my free course and learn how to use smart glasses + flamingo camera to give patients a live guided tour of their mouth—showing cracks, stains, and all the details in real time.

✅ Step-by-step setup

✅ Compatible with all loupes

✅ Tips to maximize patient trust and conversion

✅ PDF guides and tutorials included

DM me FLAMINGO on Instagram or Click Here to enroll before I start charging! Don’t miss out on this wow-factor technology.

Check out RoboReception—an AI receptionist and lead tracker that captures interactions and streamlines practice workflow.

If you want to dive deeper into AI, check out Practical AI for Dentistry – Save Time, Achieve More

#InterferenceCast #BeyondDentistry

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

This episode meets GDC Outcomes A

AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS

Aim

To understand the role, capabilities, compliance requirements, and practical integration of AI reception systems in dental practices.

Dentists will be able to –

1. Identify key functions and limitations of AI reception systems in dentistry.
2. Understand compliance and legal risks associated with AI in both NHS and private settings.
3. Recognize practical strategies for integrating AI to support staff without replacing them.

What about a coffee machine for your practice—could that really be deductible?

Or investing in a MSc in Implantology—does that count as a tax write-off?

In this episode, chartered accountant Sebastian Stracey joins Jaz to answer all those “am I naughty if I claim this?” questions that dentists and associates always wonder about. Together, they cover what’s truly deductible, what isn’t, and some surprising exceptions you might not expect.

They also dive into the bigger picture—how principals and associates really compare in terms of income, stress, and responsibility—and Seb shares insights that might change the way you view your career path.

Protrusive Dental Pearl

Check out our free Financial Resilience Webinar Replay on Protrusive Guidance, where Dr. Sunny Sadana and I discuss associate contracts, case acceptance, investing, and fee setting.

Key Takeaways:

• Dentists often forget to claim mobile phone bills as expenses.
• Home office usage can be claimed, especially for associates.
• Keeping detailed mileage logs is crucial for claiming travel expenses.
• Laundry and cleaning expenses for scrubs can be claimed.
• Communication with your accountant is key to maximizing claims.
• Continuing education expenses can be gray areas but may be allowable.
• Gathering evidence for claims is essential to justify them to HMRC.
• Specialization programs can be claimed if they build on existing knowledge.
• Fixed fee services for accountants are beneficial for associates.
• Always discuss your situation with your accountant to ensure compliance. Many new dentists struggle financially during their training.
• Understanding tax obligations is crucial for financial stability.
• VAT regulations can be complex, especially for cosmetic treatments.
• It’s important to save for tax throughout the year, not just at the end.
• Common misconceptions about tax deductions can lead to financial pitfalls.
• Dentists should engage in financial education early in their careers.
• Expense claims can be tricky, especially for gifts and personal items.
• The distinction between personal and business expenses is vital for tax purposes.
• Associates and principals have different financial realities in dentistry.
• Communication and education about finances are essential for dental professionals.

Highlight of this episode:

• 00:00 Teaser
• 00:42 Introduction
• 02:06 Pearl: Free Financial Resilience Webinar Replay
• 04:45 Meet Sebastian Stracey
• 06:56 Common Missed Expenses
• 13:57 Home Internet Claims
• 16:49 Asking Accountants Questions
• 19:07 Claiming Masters Courses
• 26:31 Specialist Training Costs
• 27:30 Midroll
• 30:41 Specialist Training Costs
• 33:28 Saving for Tax Bills
• 36:36 VAT on Cosmetic Work
• 40:06 “Am I Naughty If?” Questions
• 49:10 Wild Expense Attempts
• 50:11 Ways Dentists Can Learn More About Tax and Finance
• 51:56 Associate vs Principal Numbers
• 53:39 Outro

Get expert financial guidance for individuals and businesses with Humphrey & Co—your trusted partners in taxes, planning, and business success

Learn strategies for career security, smart investing, and building wealth—watch Personal Finances for Dentists (IC068)

#PDPMainEpisodes #BeyondDentistry

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

This episode meets GDC Outcomes B.

AGD Subject Code: 550 – Practice Management and Human Resources

Aim: To outline common allowable and non-allowable expense claims for dentists and highlight the importance of documentation, communication with accountants, and financial planning.

Dentists will be able to –

1. Identify commonly missed claimable expenses in dental practice.
2. Recognize expenses that are not allowable under tax rules.
3. Understand the importance of documentation and communication with accountants when claiming expenses.

What if you could audit your own consultations and discover which words, pauses, and stories increase treatment acceptance?

Dr. David Amador joins Jaz for a fascinating episode exploring how AI can transform the way we interact with patients. From auditing conversations to radiographic interpretation, they break down practical applications that improve both communication and patient care.

They also discuss how storytelling, patient trust, and ethical use of AI all come together to boost treatment acceptance — showing that AI isn’t here to replace us, but to make us better.

Key Takeaways

• AI is transforming the way dental practices operate.
• Storytelling is crucial for effective patient communication.
• Building a strong team culture enhances practice success.
• Data security is paramount when using AI tools.
• Continuous training is essential for team development.
• Patient engagement strategies can improve treatment acceptance.
• AI tools can streamline administrative tasks and improve efficiency.
• Understanding patient needs leads to better care outcomes.
• Effective marketing requires a solid online presence and SEO.
• Networking with other professionals can provide valuable insights.

Highlight of the episode

• 00:00 Teaser
• 00:34 Intro
• 02:23 Dr. Amador’s Background and Practice
• 08:14 Using AI for Decision Support
• 10:26 Leveraging AI for Communication and Training
• 15:57 Using AI for Patient Care and Diagnosis
• 21:37 Midroll 1
• 24:58 Using AI for Patient Care and Diagnosis
• 26:11 Leveraging AI for Dental Practice Efficiency
• 27:35 Midroll 2
• 30:20 Leveraging AI for Dental Practice Efficiency
• 32:44 Training and Scaling with AI Tools
• 33:45 Creating SOPs and Playbooks
• 36:53 Enhancing Patient Communication with Personalized Videos
• 40:36 Training and Data-Driven Growth
• 44:52 Outro

AI isn’t the future — it’s your next teammate.

Imagine: while you focus on patient care, AI records your consults, summarizes them, audits your communication, and helps interpret radiographs.

Plaud.ai makes note-taking automatic. Overjet makes diagnostics and patient communication crystal clear.

Check out Midtown Dental Studio — where cutting-edge technology meets genuine care. 

If you found this episode valuable, don’t miss PS015: Communicating Fees, Treatment Plans, and More

#InterferenceCast #CareerDevelopment #Communication

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

This episode meets GDC Outcomes A and B

AGD Subject Code: 550 – Practice Management and Human Relations

Aim: To explore how artificial intelligence (AI) can be used to audit communication, enhance storytelling, and improve patient conversion while maintaining patient-centered care.

Dentists will be able to –

1. Explain how AI tools can support communication, diagnosis, and patient understanding in dentistry.
2. Demonstrate how storytelling and patient-centered communication influence treatment acceptance.
3. Evaluate the ethical, professional, and practical considerations of integrating AI into dental practice.

Which AI tools should you be using in dentistry?

Is it safe to put patient details into AI—and how can it help you save time and reduce stress?

In this episode, Dr. Daz Kasperek joins to make AI in dentistry tangible, even if you’ve never used it before. Together, we cover the basics: from getting started with prompts and AI models to understanding ethical considerations and practical ways AI can streamline your workflow.

They also explore the bigger picture—how AI can improve efficiency, enhance patient communication, and give clinicians more time to enjoy life outside the clinic.

 Protrusive Dental Pearl: A free AI tool called Dental Disrupt Smile Simulator lets you upload a smile photo and instantly generate a realistic smile makeover simulation for patient discussions. It runs as a custom GPT inside ChatGPT, created by Dr. Jason Lipscomb

Key Takeaways:

• AI is revolutionizing the field of dentistry, particularly in diagnosis.
• Prompt engineering is crucial for effective AI interactions.
• Personalization of AI tools can significantly improve their utility.
• AI can automate administrative tasks, potentially reducing the need for receptionists.
• AI can enhance communication between dentists and patients.
• The integration of AI in dentistry is still in its early stages.
• AI can provide personalized recommendations for patient care.
• Voice transcription is a more efficient way to interact with AI.
• The future of dentistry will heavily rely on AI technologies. AI is revolutionizing image creation in dentistry.
• Choosing the right AI model is crucial for effective use.
• Patient confidentiality must be prioritized when using AI.
• AI can transform administrative roles in dentistry.
• AI can assist in personalized education and training.
• The human connection in healthcare cannot be replaced by AI.
• Job roles will evolve rather than disappear due to AI.
• AI’s limitations highlight the importance of clinician expertise.

Episode Highlights:

• 00:00 Teaser
• 01:08 Introduction
• 03:05  Protrusive Dental Pearl – Smile Simulator
• 06:39 Meet Dr Daz Kasperek
• 07:16 AI Adoption and Inequality
• 16:58 Better Prompting with RCT (Role, Context, Task)
• 21:56 AI and Administrative Work in Dentistry
• 30:42 AI Notes in Practice
• 35:05 Midroll
• 38:26 AI Notes in Practice
• 38:49 Smile Simulator Demo
• 41:57 Choosing Your AI Stack
• 49:01 Patient Confidentiality and Data Safety
• 54:38 AI in Dentistry – What It Will Replace
• 01:01:56 What AI Cannot Replace
• 01:04:53 Endo AI Research and Thesis
• 01:07:10 Contact and Resources
• 01:08:17 Outro

If you enjoyed this episode, don’t miss “NEVER Write Notes Again! How I Use AI for Awesome and Efficient Dental Records – PDP181.”

#PDPMainEpisodes #CareerDevelopment 

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

This episode meets GDC Outcomes A and C.

AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS

Aim: To provide dental professionals with a foundational understanding of artificial intelligence (AI) in dentistry, including its practical applications, limitations, and ethical considerations, to improve efficiency, patient communication, and clinical workflow.

Dentists will be able to:

1. Explain what AI is and the difference between an AI model and a prompt.
2. Identify key AI platforms and tools relevant to dentistry and personal use.
3. Apply AI safely in clinical practice while maintaining patient confidentiality.

Wondering how to polish your composites so they shine like a pro?

Curious about practical tips you can implement immediately to level up your smile makeovers?

In this episode, Dr. Charles Brandon shares three game-changing secrets for mastering composite resin. From practical techniques you can apply right away to a conceptual tip that will completely transform the way you polish, Charles leaves no stone unturned.

Get ready for an episode packed with actionable advice, insider knowledge, and inspiration from a dentist whose resin work is truly next-level. Whether you’re refining your layering skills or aiming for that perfect finish, this episode is a must-listen.

Protrusive Dental Pearl: Level up your resin veneers with the Perio Bur (code and more info here)— a long diamond bur for the slow-speed 1:1 handpiece that gives unmatched control, crisp shaping, and beautiful texture. If you use only one bur for finishing composite, make it this one.

Check out this  video of Perio bur in Action on a Real Resin Veneer Case → protrusive.co.uk/periobur

Key Takeaways

• The significance of patient communication and understanding their needs is highlighted.
• Mistakes are seen as learning opportunities that contribute to growth in practice.
• The role of mentorship in navigating challenges in aesthetic dentistry is discussed.
• Aesthetic communication is crucial for patient satisfaction.
• Patients are visually aided, not verbally aided.
• Effective layering techniques can enhance composite work.
• Practice on typodont models to build skills.
• The polish is secondary to proper placement and finishing.
• Understanding composite materials is key to success.
• Start with two shades for layering to minimize complexity.
• Courses should cover the entire process, not just techniques.
• Self-teaching is a valuable way to improve skills.
• Investing in oneself is essential for growth in dentistry.

YouTube Highlights:

• 00:00 Teaser
• 01:10 Introduction
• 02:05 Protrusive Dental Pearl – Using a Perio Bur
• 05:56 Dr. Charles Brandon’s Journey in Dentistry
• 11:42 Challenges and Reflections in Aesthetic Dentistry
• 19:08 Perfect Smile Secret #1: Build from the Bottom Up
• 26:08 Managing Temporaries During a Trial Smile
• 26:48 Midroll
• 30:09 Managing Temporaries During a Trial Smile
• 35:17 Freehand vs. Stent-Based Systems
• 39:19 Perfect Smile Secret #2: More Than Polish
• 44:23 Perfect Smile Secret #3: It’s Not the Composite
• 48:19 Practice and Continuous Learning
• 53:20 Course Offerings and Final Thoughts
• 56:00 Outro

Level Up Your Skills

Practice at home with a simple AliExpress setup (~$200) including a 1:5 & 1:1 handpiece plus micromotor.

Take it further with Dr. Charles Brandon’s composite veneer Masterclass and master the full process from design to finish.

If you enjoyed this episode, check out Minimal Preparation Veneers – PDP219.

#PDPMainEpisodes #AdhesiveDentistry #CareerDevelopment

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

This episode meets GDC Outcomes  C.

AGD Subject Code: 780 ESTHETICS/COSMETIC DENTISTRY

Aim: To equip dentists with practical techniques, workflows, and mindset strategies for delivering high-quality aesthetic dentistry using composite veneers, from patient communication and trial smiles to layering, polishing, and continuous skill development.

Dentists will be able to –

1. Explain the importance of patient communication, trial smiles, and expectation management in aesthetic dentistry.
2. Demonstrate a stepwise workflow for additive composite veneers, including mock-ups, trial duration, and handling of temporaries.
3. Apply layering, finishing, and polishing techniques effectively using minimal composite shades to achieve predictable aesthetic outcomes.

Cost:Access to this CE activity is included with an active Protrusive Guidance membership. Current membership pricing is available at www.protrusive.app.

Cancellation & Refund Policy:Memberships may be cancelled at any time. Access to CE activities remains active until the end of the current billing cycle. Subscription charges are non-refundable once processed. Full details are available at www.protrusive.app.

Do you ever feel financially stretched – despite earning well?

Are you trapped in dentistry’s “golden handcuffs”?

And what would your life look like if you worked because you wanted to… not because you had to?

In this rare solo episode, Jaz steps away from occlusion and restorative dentistry to talk about something just as important: personal finances and career security for dentists.

After going deep down the money rabbit hole — reading books like Rich Dad Poor Dad, The Simple Path to Wealth, and I Will Teach You To Be Rich — Jaz shares how his upbringing, early career decisions, and financial education shaped his beliefs about wealth, freedom, and dentistry.

This isn’t financial advice.It’s a mindset shift.

And for many dentists, it might be the most important episode you hear this year.

Your day list reflects your earning power.

The work you do each day quietly sets the limits of what you can earn.

Exams and single-surface composites create one kind of ceiling; comprehensive cases, ortho, rehab, sedation, and complex restorative work create another.

Upskilling changes that ceiling and gives you far more control over your financial future.

Want more mindset shifts like this?AskJaz — your on-demand dental brain — is built into the Protrusive App.

Key Takeaways

• High income does not guarantee financial security.
• Dentistry can become “golden handcuffs” without asset building.
• Invest in yourself early — skill drives earning power.
• Lifestyle creep quietly erodes freedom.
• Financial independence means practicing because you want to.
• Define your rich life and align spending accordingly.

Highlights of This Episode:

00:00 Why talk about money on a dental podcast?04:12 Perspective and gratitude as dentists10:45 The 45% paycheck-to-paycheck poll16:20 Associates vs principals — the reality22:34 Lifestyle creep explained27:18 Golden handcuffs in dentistry31:10 Growing up with financial scarcity40:02 Investing in yourself early in your career47:55 Index funds and financial resilience55:20 The 20% happiness illusion01:02:18 Defining your rich life01:08:42 Action steps and reflection

#PersonalFinances 

This episode isnot eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan.

If you enjoyed this episode, check out IC022 – Income for Dentists and Jaz’s Top 10 Financial Literacy books inside Protrusive Guidance.

Can it really reduce anxiety, manage chronic pain, or even stop habits like cheek biting?

How can dentists integrate hypnotherapy into their care without stepping outside their scope of practice?

In this episode, Jaz and Dr. Rita Pais break down how hypnotherapy works, who can benefit, and practical ways dentists can incorporate it into patient care.

They also discuss real patient examples, from dental phobia to awake bruxism, showing how a minimally invasive talking therapy can make a real difference in improving habits, reducing stress, and enhancing overall patient outcomes.

Protrusive Dental Pearl: How to Get Patients to Happily Accept a Mouth Prop – Use confident, directive communication paired with a simple analogy and a swallowing expectation to dramatically improve patient acceptance of mouth props.

Key Takeaways

• Hypnotherapy combines hypnosis with therapeutic techniques for health outcomes.
• Cognitive Behavioral Hypnotherapy (CBH) enhances treatment effectiveness.
• Patients must be willing to try hypnotherapy for it to work.
• Chronic pain management can benefit from relaxation techniques in hypnotherapy.
• Hypnotherapy can address dental phobias and habits like nail-biting.
• Awareness of habits is crucial for effective hypnotherapy.
• Finding a qualified hypnotherapist is essential for successful treatment.
• Science-based approaches in hypnotherapy are preferred by practitioners.
• Success stories in hypnotherapy can be very rewarding for practitioners.
• Hypnotherapy can be delivered online or in person, making it accessible.

Youtube Highlights

• 00:00 Teaser
• 00:59 Introduction
• 02:13 Protrusive dental pearl: How to Get Patients to Happily Accept a Mouth Prop
• 05:35 Dr. Rita Pais: Journey into Hypnotherapy
• 06:32 Hypnotherapy and Its Applications
• 08:39 Understanding Hypnotherapy and Pain
• 11:59 How Cognitive Behavioural Hypnotherapy Works
• 15:35 Midroll
• 18:56 How Cognitive Behavioural Hypnotherapy Works
• 20:41 Dental Indications for Hypnotherapy
• 24:41 Finding a Trusted Hypnotherapist
• 26:50 Mock Hypnotherapy Session: Patient Journey
• 30:51 Final Thoughts and Resources
• 32:28 Outro

For dentists looking to refer patients, The Hypnotherapy Directory is one available resource, though it lists all types of hypnotherapy.

For patients or colleagues interested in hypnotherapy referrals or collaboration, check out: Rita Pais Hypnotherapy

If you loved this episode, make sure to watch Hypnotize Your Patients with 3 Quick Techniques – IC015

This episode is eligible for 0.5 CE credit (Self-instruction) via the quiz on Protrusive Guidance. 

This episode meets GDC Outcomes A and C.

AGD Subject Code: 340 ANESTHESIA AND PAIN MANAGEMENT (Anxiolysis)

Aim: To provide dentists with a practical overview of hypnotherapy applications in dentistry, including cognitive behavioural hypnotherapy (CBH), patient selection, and habit/pain management.

Dentists will be able to –

1. Distinguish between hypnosis and hypnotherapy.
2. Explain how cognitive behavioural hypnotherapy integrates CBT and hypnosis.
3. Identify dental indications for hypnotherapy, including phobias, pain, and habits.

Cost:Access to this CE activity is included with an active Protrusive Guidance membership. Current membership pricing is available at www.protrusive.app.

Cancellation & Refund Policy:Memberships may be cancelled at any time. Access to CE activities remains active until the end of the current billing cycle. Subscription charges are non-refundable once processed. Full details are available at www.protrusive.app.

???? Claim your exclusive discount: protrusive.co.uk/website

Do you really need your own website as an associate, or is a strong Instagram profile enough? 

How do you build trust with patients before they even meet you? 

And how can you ensure you are visible to the patients who are now using AI tools like ChatGPT to find their next dentist? 

In this episode, digital marketing expert Rick O’Neill joins Jaz to discuss the evolving landscape of dental marketing. Together, they explore the “Zero Moment of Truth” and the 7–11–4 rule, explaining why a website is the only digital asset you truly own in a world of “rented” social media space. 

They also dive into the future of search, covering how to optimize your presence for both Google and AI, and why authentic video content is the ultimate tool for bridging the “belief gap” with prospective patients.

Key Takeaways:

• Having a purpose beyond profit is crucial for success.
• The ‘I do, we do, they do’ model is effective for team growth.
• Patient behavior has evolved; they research extensively before choosing a provider.
• A personal website is essential for establishing credibility and trust.
• Visual content, including professional photography, enhances personal branding.
• Search engine optimization is vital for attracting local patients.
• Social proof, such as patient testimonials, is more impactful than before-and-after photos alone.
• Messaging is key; it should resonate with the target audience’s pain points.
• Dentists have a responsibility to educate the public about their services.
• Investing in digital marketing can yield measurable returns.

Highlights of this episode:

• 00:00 Teaser
• 00:47 Introduction
• 05:43 Introducing Rick O’Neill: Expert in Digital Presence
• 06:43 Insights from Richard Branson
• 10:15 Entry Into Marketing and Dentistry
• 13:25 Digital Assets for Associates and Practices
• 20:26 Key Elements of an Effective Associate Website
• 26:01 Search Optimization: Making Your Website Discoverable
• 26:48 Midroll
• 30:09 Search Optimization: Making Your Website Discoverable
• 32:40 Dentist’s Role in Content Creation
• 34:19 Importance of Social Proof in Dental Marketing
• 45:02 Building a Personal Brand with a Website
• 48:43 The Future of AI in Dental Marketing
• 52:35 Digital Solutions for Associates and Clinics
• 57:04 Resources for Principals and Associates
• 57:41 Outro

???? Special Community Offer: 50% Off!If you’re nodding along thinking “I need to get serious about my digital presence,” here’s your opportunity.

Protrusive community members get 50% off a professionally designed dental website

???? Head over to: protrusive.co.uk/websiteActivate your 50% discount and get your professional, patient-facing website up and running.

Check out my website to see what a modern associate website can look like.

Want more on building your dental brand? Don’t miss PDP037: Personal Branding for Dentists – Logos and Websites with Shaz Memon

#InterferenceCast #CareerDevelopment #Communication

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

This episode meets GDC Outcomes B and C.

AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS

Aim: To understand the role of personal and practice websites in modern dentistry and how associates and principals can use digital tools to build trust, credibility, and patient engagement.

Dentists will be able to –

1. Explain why a personal website is valuable for dentists and associates.
2. Identify the key elements that make an associate website effective.
3. Describe strategies to use digital assets, SEO, and content for patient trust and conversion.

Has he figured out which niche or specialty he wants to pursue?

Are molar endodontics and surgical extractions still his fear procedures?

And how’s he getting on with those tricky fee discussions and private patient conversations?

Dr Triman Ahluwalia returns for another catch-up — one year after stepping into his first associate position. In this episode, Jaz follows Triman’s journey from new graduate to confident young clinician, exploring what’s changed and what lessons he’s learned along the way.

From building confidence in complex procedures to improving communication and investing in the right tools, this episode is packed with insights every fresh grad and early-career dentist can relate to.

Takeaways

• Investing in photography can enhance documentation and patient engagement.
• Confidence in discussing costs with patients improves with experience.
• Mentorship is vital for growth and learning in dentistry.
• Building a strong portfolio is essential for career development.
• Choosing the right educational path depends on personal learning styles.
• Communication with patients should focus on care rather than costs.
• Dentistry offers diverse pathways for specialization and growth.

Highlights:

• 00:00 Teaser
• 00:30 Introduction
• 03:18 Patient Demographics and Practice Insights
• 06:04 Investing in Photography Equipment
• 10:13  Handling Complex Procedures and Referrals
• 13:20 Choosing the Right Courses for Career Growth
• 17:21 Communicating Costs and Building Confidence
• 18:32 Midroll
• 21:53 Communicating Costs and Building Confidence
• 27:31 Learning from Senior Colleagues and Mentorship
• 31:50 Building and Improving Your Dental Portfolio
• 33:56 Final Reflections and Advice for Young Dentists
• 38:41 Outro

????️ Connect with Dr. Triman Ahluwalia:

Instagram: @drtriman

LinkedIn: Dr Triman Ahluwalia

If you enjoyed this episode, don’t miss Triman’s earlier appearance — I Interviewed a New Grad 7 Months Apart – First Year of Practice (IC052)

#InterferenceCast #Communication #CareerDevelopmentThis episode isnot 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 Walkthroughs and Masterclasses.

Why are so many dentists forced to cancel clinics, not because of burnout or skill, but because of crippling back pain?

And what if this “expected hazard of dentistry” didn’t actually have to be inevitable?

In this episode, Dr. Aniko Ball joins Jaz to challenge the long-held belief that chronic pain is just part of being a dentist. As an expert in dental ergonomics and the Alexander Technique, she reveals why so many clinicians are unknowingly damaging their bodies every single day—and how simple, overlooked changes can completely transform career longevity.

The mission for this episode was simple: deliver five genuinely life-changing, immediately actionable tips to protect your neck, back, and future. No fluff. No theory for theory’s sake. Just practical changes you can implement straight away—starting from your very next clinic session.

If your health matters to you as much as your dentistry, this is an unmissable episode.

Protrusive Dental Pearl: Cut toxic noise, protect time for your health, and optimize the small habits you repeat daily. You only rotate ~10–13 meals—upgrade those, move a little more, sleep a little better. Small, consistent upgrades compound into an unrecognisable year.

Key Takeaways:

• Back pain in dentistry is not inevitable—it is largely the result of cumulative postural habits.
• Most dental pain comes from holding positions the body was never designed to hold, not from single traumatic events.
• Lifting the elbow or shoulder for prolonged periods activates movement muscles, guaranteeing shoulder and upper back pain.
• A finger rest must be used on the non-dominant hand holding the mirror, not just the dominant hand.
• Hovering the mirror is equivalent to holding the arm raised against gravity.
• The spine is not designed for sustained bending or twisting, even slightly.
• Staying vertical is critical—move the patient and the chair, not your spine.
• Traditional loupes often force neck flexion; refractive loupes or microscopes allow upright posture and straight-ahead vision.
• Stool height matters: hips slightly higher than knees, feet flat, heels fully released into the floor.
• If leg weight isn’t given to the floor, the lower back absorbs the load instead.
• Habits outside the clinic—especially looking down at a mobile phone—train the same harmful postural patterns used in dentistry.
• Postural change feels strange at first because bad habits feel comfortable, even when they are damaging.
• Real change requires habit interruption, repetition, and support over several weeks.
• Your body is your most important instrument—protecting it protects your career.

Highlights:

• 00:00 Teaser
• 00:52 Introduction
• 03:36 Pearl – Optimizing Small Habits
• 07:06 Interview with Dr. Aniko Ball: Her Journey on Ergonomics and Dentistry
• 10:00 Challenging Misconceptions in Dentistry
• 17:42 Common Mistakes and Practical Tips for Better Posture
• 28:29 Importance of Refractive Loupes and Microscopes
• 29:53 Midroll
• 33:14 Importance of Refractive Loupes and Microscopes
• 34:18 Communicating with Patients for Better Ergonomics
• 38:06 The Science of Habit Change and Neuromuscular Training
• 42:40 Optimizing Dental Stool Height for Better Ergonomics
• 47:14 The Impact of Mobile Phone Usage on Posture
• 50:53 Key Posture and Ergonomic Takeaways
• 53:35 Full-Day Ergonomics Workshop
• 59:13 Outro

???? This episode is the introduction.The real transformation happens in the room.

???? Join Dr. Aniko Ball for a full-day, full-demonstration workshop and learn how to make your body—and your back—unbreakable.

???? Saturday 13th of June — save the date.

???? protrusive.dental/unbreakable

If this episode resonated with you, My Neck, My Back (Fix Your Posture While Removing Plaque!) – PDP220 is the perfect next watch.

#PDPMainEpisodes ##BeyondDentistry #CareerDevelopment

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

This episode meets GDC Outcomes C.

AGD Subject Code: 130 ELECTIVES 

Aim: To help dentists reduce cumulative musculoskeletal trauma by understanding how posture, habits, and equipment choices directly affect spinal, shoulder, and long-term career health.

Dentists will be able to –

1. Identify common postural habits in dentistry that lead to cumulative trauma and chronic pain.
2. Apply practical ergonomic principles to reduce strain on the spine, shoulders, hips, and neck.
3. Modify daily habits, including non-clinical activities, to support long-term musculoskeletal health.

Cost:Access to this CE activity is included with an active Protrusive Guidance membership. Current membership pricing is available at www.protrusive.app.

Cancellation & Refund Policy:Memberships may be cancelled at any time. Access to CE activities remains active until the end of the current billing cycle. Subscription charges are non-refundable once processed. Full details are available at www.protrusive.app.

What are the key steps to safely remove, treat, and replant a tooth without causing fractures or resorption?

And how do you manage patient expectations and post-op care to maximize success?

In this episode, Dr. Samuel Kratchman and Dr. Shivakar join Jaz to explore intentional tooth replantation—a procedure that rarely gets the spotlight but can completely change treatment options for challenging cases.

They cover everything from case selection and imaging, to managing crowns and fragile teeth, to simple tools and techniques that make this procedure predictable and accessible.

They also dive into patient communication, consent, and how to include this procedure as part of your everyday dental armamentarium, giving you the confidence to consider it when the right case comes along.

Key Takeaways:

• Intentional replantation is a viable alternative to extraction.
• The success rate of intentional replantation is documented at 88-89%.
• Patient education is crucial for successful treatment outcomes.
• The periodontal ligament must be kept moist during the procedure.
• Imaging is essential for understanding tooth anatomy before replantation.
• The procedure can be performed atraumatically with proper technique.
• Replantation can be a last chance for teeth that are difficult to replace with implants.
• A mindset shift is needed in dentistry to prioritize saving natural teeth. Apical infections are often linked to the root tip and surrounding tissue.
• A good coronal seal is essential before any restorative work.
• Common complications include ankylosis and resorption.
• Inflammation can aid in the extraction process by serving the ligament.
• Post-operative care is vital for successful recovery.

Highlights:

• 00:00 Teaser
• 00:48 Introduction
• 03:27 Pearl: PDL is everything 
• 04:54 Interview with Dr. Shivakar Mehrotra
• 07:03 Interview with Dr. Samuel Kratchman
• 11:01 Terminologies and Success Rates of Replantation
• 16:03 Indications of Replantation
• 22:29 Evaluating Radiographs and Clinical Factors
• 28:48 Case Studies and Practical Applications
• 30:51 Midroll
• 34:12 Case Studies and Practical Applications
• 38:08 Management of Apical Infection
• 40:35 Curveball Scenario: Combined Endodontic and Restorative Challenge
• 45:57 Replantation Success Rates and Complications
• 51:06 Radiographic Signs and Extraction Techniques
• 56:03 Postoperative Care and Instructions
• 59:49 Final Thoughts and Resources
• 01:02:14 Outro

???? First replantation case coming up? Do your homework! ????

Before you touch that tooth:???? Read the published protocols

• INTENTIONAL REPLANTATION by Dr. Samuel Kratchman
• Retention and Healing Outcomes after Intentional Replantation

???? Review systematic reviews

• Clinical outcome of intentional replantation with preoperative orthodontic extrusion: a retrospective study by Cho et al
• A Systematic Review of the Survival of Teeth Intentionally Replanted with a Modern Technique and Cost-effectiveness Compared with Single-tooth Implants by Anshul Mainkar 

Keep the learning going! Check out PDP061: Surgical Extrusion for ‘Hopeless’ Teeth.

#PDPMainEpisodes #EndoRestorative #OralSurgeryandOralMedicine

This episode is eligible for 1 CE credit (Self-instruction) via the quiz on Protrusive Guidance. 

This episode meets GDC Outcomes C.

AGD Subject Code: 070 ENDODONTICS (Surgical treatment)

Aim: To understand the indications, technique, and outcomes of intentional replantation for teeth with failed endodontic treatment, emphasizing atraumatic removal and predictable long-term success.

Dentists will be able to –

1. Identify teeth suitable for intentional replantation based on anatomy, root morphology, and prior treatment.
2. Explain the procedural workflow, including atraumatic extraction, extraoral root-end management, and replantation techniques.
3. Counsel patients effectively on prognosis, risks, and postoperative care.

Cost:Access to this CE activity is included with an active Protrusive Guidance membership. Current membership pricing is available at www.protrusive.app.

Cancellation & Refund Policy:Memberships may be cancelled at any time. Access to CE activities remains active until the end of the current billing cycle. Subscription charges are non-refundable once processed. Full details are available at www.protrusive.app.

Could group function and non-working side interferences be driving muscular TMD, headaches, and facial pain?

And can digital occlusal data change how we approach bite adjustment?

Dr. Jeremy Bliss joins the podcast to tackle one of the most controversial topics in dentistry: Selective Grinding/Equilibration for TMD but specifically Disclusion Time Reduction (DTR). With a strong focus on restorative technology, lasers, and T-Scan analysis, Jeremy brings a practical and experience-driven perspective to occlusion and bite therapy.

This episode breaks DTR down from the very beginning—what it is, how it differs from traditional equilibration, and why reducing posterior tooth contact during excursive movements may help certain susceptible patients. The conversation also explores canine guidance vs group function, macro vs micro occlusion, and where DTR fits within evidence-based dentistry when conservative care has failed.

Protrusive Dental Pearl: Don’t buy advanced occlusal or motion-tracking tech unless your type of dentistry, training, lab support, and local backup can fully use the data—otherwise it’s just a Ferrari stuck in traffic.

Key Takeaways: Disclusion Time Reduction (DTR) & T-Scan

• T-Scan: Provides objective data on tooth contact timing and force—impossible to see with the eye or articulating paper.
• EMG: Tracks temporalis and masseter activity to show how muscles respond to occlusion.
• Goal of DTR: Reduce posterior tooth contact during excursions, shifting contact to canines to relax muscles.
• Patient Selection: Best for symptomatic muscular TMD; requires sufficient canine/incisal overlap.
• Clinical Benefits: Reduces headaches, migraines, muscle tension, parafunctional damage, and progressive tooth wear.
• Procedure: Conservative enamel adjustments (0.5–0.75 mm), guided by T-Scan; posterior teeth should disclude in <0.5 sec.
• Implant Care: Prevent early loading to protect bone and restorations.
• Evidence: Supported by systematic review and clinical cases; improves outcomes over traditional occlusal adjustments.

Highlights:

• 00:00 Teaser
• 00:53 Introduction
• 09:51  Pearl: Buying Advanced Technologies
• 11:53 Interview with Dr. Jeremy Bliss
• 18:08 Introduction to Digital Occlusal Analysis
• 22:46 Challenges and Controversies in TMD Treatment
• 26:09 Explaining T-Scan and Its Benefits
• 32:42 Understanding the Anatomy and Physiology of DTR
• 36:25 Techniques and Tools for DTR
• 38:14 Midroll
• 41:35 Techniques and Tools for DTR
• 44:19 The Impact of DTR on Muscle Tension and Pain
• 48:43 Bruxism Cessation After DTR
• 49:50 Importance of EMG in DTR
• 52:05 Case Study: A Life-Changing DTR Treatment
• 56:59 Conclusion and Future Directions
• 01:00:46 Outro

Effectiveness of T-scan Technology in Identifying Occlusal Interferences and its Role in the Management of Temporomandibular Disorders: A Systematic Review

Individual Practice Contact: blissdental.co.uk – contact directly via the website form for information about DTR or patient referrals.

DTR Treatment for TMD with Dr Jaz Gulati in Richmond, London

#PDPMainEpisodes #OcclusionTMDandSplints #CareerDevelopment

To learn more about Disclusion Time Reduction, check out: Occlusograms are Lying To Us! Don’t Trust the ‘Heat Map’ – PDP247 

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

This episode meets GDC Outcomes C

AGD Subject Code: 180 OCCLUSION

Aim: To understand the principles and clinical applications of digital occlusal analysis and Disclusion Time Reduction (DTR) for managing occlusion-related muscular pain, TMD, and improving restorative dentistry outcomes.

Dentists will be able to:

1. Explain the concept of disclusion time and its impact on masticatory muscles.
2. Describe how T-Scan and EMG are used to assess occlusal force, timing, and muscle activity.
3. Identify appropriate patients for DTR and apply objective data to guide safe occlusal adjustments.

Cost:Access to this CE activity is included with an active Protrusive Guidance membership. Current membership pricing is available at www.protrusive.app.

Cancellation & Refund Policy:Memberships may be cancelled at any time. Access to CE activities remains active until the end of the current billing cycle. Subscription charges are non-refundable once processed. Full details are available at www.protrusive.app.

How do you manage the patient who’s begging for a prescription?

And what impact are we having on the gut every time we prescribe unnecessarily?

In this episode, Dr. Jeremy Lenaerts joins Jaz to explore the world of antibiotics in dentistry. Together, they cover when to prescribe, when not to, and why analgesics or local measures are often the better option.

They also dive into the bigger picture—antibiotic resistance, gut health, and how to navigate those tricky conversations when patients demand antibiotics for the wrong reasons.

Protrusive Dental Pearl? Save time and avoid confusion with a ready-made Antibiotics Cheat Sheet that combines the best guidelines into one resource. It covers:

• True indications and contraindications
• Drug interactions
• First, second, and third-line choices
• Doses and duration

???? Download it or find it in the Protrusive Vault if you’re a Protrusive Guidance member.

Key Takeaways

• Antibiotics are often overprescribed in dentistry, with 80% deemed inappropriate.
• The gut microbiome plays a crucial role in overall health and can be negatively impacted by antibiotics.
• Educating patients about the risks of antibiotics is essential for informed consent.
• Local measures should be prioritized over antibiotics for dental infections.
• Antibiotics can lead to antibiotic resistance, affecting both individual and public health.
• The gut microbiome is increasingly recognized as a separate organ essential for health.
• Dentists should consider the long-term effects of antibiotics on gut health when prescribing.
• Patient communication is key in managing expectations around antibiotic prescriptions.
• A balanced diet rich in fiber and fermented foods supports gut health.
• Dentists must navigate the tension between patient demands and clinical guidelines.

Highlights of this episode:

• 00:00 Teaser
• 00:37 Intro
• 02:25 Protrusive dental podcast
• 04:10 Dr. Jeremy’s Journey into Dentistry
• 07:47 Antibiotic Use in Dentistry
• 10:28 True Indications for Antibiotics
• 14:12 Impact of Antibiotics on Gut Health
• 21:09 Clinical Scenarios and Best Practices
• 26:09 Managing Severe Dental Swellings
• 26:28 Midroll
• 29:49 Managing Severe Dental Swellings
• 33:39 Techniques for Anesthetizing Abscesses
• 38:06 Handling Cellulitis and Systemic Infections
• 42:58 Dosage and Safety of Local Anesthetics
• 44:58 Dealing with Dry Sockets and Retreated Teeth
• 47:43 Outro

Updated SDCEP Guidance

For clinicians in the UK, Drug Prescribing for Dentistry is now available through the dedicated website SDCEP Dental Prescribing.

Please note that SDCEP no longer provides updates to the printed guidance, and the Dental Prescribing app is no longer supported or updated—it should be deleted from all devices. The SDCEP Dental Prescribing website is now the authoritative source for the most up-to-date information on prescribing in dental practice.

We are also providing the 2016 PDF version of Drug Prescribing for Dentistry for reference, but users should be aware that this document is no longer maintained and may not reflect the latest clinical guidance.

Download the 2016 PDF here.

If you enjoyed this episode, you’ll also find value in Prescribing Antifungals as a GDP – Diagnosis and Management (PDP151)

#PDPMainEpisodes #Communication #BreadandButterDentistry #CareerDevelopment

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

This episode meets GDC Outcomes C and D.

AGD Subject Code: 340 (Prescription medication management)

Aim: To enhance clinicians’ confidence in the rational prescribing of antibiotics in dentistry, with an understanding of when they are indicated, when they are not, and the broader impact on antimicrobial resistance and gut health.

Dentists will be able to –

1. Identify the true clinical indications for antibiotic use in dentistry.
2. Recognize when local measures (drainage, extraction) are preferable to antibiotics.
3. Explain the impact of antibiotic use on antimicrobial resistance and the gut microbiome.
4. Apply current guidelines (e.g., SDCEP) in clinical scenarios involving dental infections.

Is treating sleep apnea with a CPAP or mandibular advancement device only MASKING the problem?

How does craniofacial anatomy influence airway health, and what should dentists look for?

Dr. Dave Singh joins us to dive into CranioFacial Sleep Medicine. He breaks down how structural issues—like a narrow maxilla, high-arched palate, or limited tongue space—can be root causes of sleep-disordered breathing, rather than just treating symptoms. 

The episode also touches on controversies in orthodontics and presents evidence supporting interventions once thought impossible in adults.

Protrusive Dental Pearl: Obstructive Sleep Apnea is NOT just a “fat old man disease.” If you’re not screening every patient for sleep and airway issues, you’re missing a huge piece of their overall health. Snoring, bruxism, and craniofacial anatomy are all connected, and understanding these links can transform the way you approach patient care.

Key Takeaways:

• Mandibular advancement appliances are not a universal solution. While effective for some patients, they often fail to address the underlying causes of airway collapse.
• Craniofacial sleep medicine focuses on airway etiology, not just symptom control, by identifying why the mandible, tongue, and airway behave as they do during sleep.
• The cranial base plays a foundational role in facial growth, jaw position, and airway size, directly influencing sleep apnea risk.
• A retruded mandible is frequently due to developmental and epigenetic factors, rather than being an isolated mandibular issue.
• Sleep apnea has multiple endotypes—including craniofacial, neurologic, metabolic, and myopathic—requiring individualized treatment planning.
• Bruxism is not a reliable airway-opening mechanism and may be a primitive physiological response to hypoxia rather than a protective behavior.
• Tooth wear can be an early indicator of sleep-disordered breathing, and should prompt clinicians to screen beyond restorative concerns.
• Upper Airway Resistance Syndrome (UARS) can occur even when the apnea-hypopnea index (AHI) is low, particularly in non-obese patients with fatigue, pain, and poor sleep quality.

• Palatal expansion should be understood as a 3D craniofacial intervention, aimed at improving nasal airflow and airway function—not merely widening the dental arch.
• Effective care depends on an integrated, multidisciplinary approach, involving dentists, orthodontists, sleep physicians, ENTs, and myofunctional therapists.

Youtube Highlights:

• 00:00 Teaser
• 01:01 Introduction
• 02:56 Pearl: Debunking Myths About Sleep Apnea
• 04:27 Interview with Professor Dave Singh: Journey and Insights
• 13:23 Craniofacial Development
• 18:53 Epigenetics and Orthodontic Controversies
• 25:52 Diagnosis and Treatment of Sleep Apnea
• 32:49 Understanding Upper Airway Resistance Syndrome
• 34:17 Midroll
• 37:38 Understanding Upper Airway Resistance Syndrome
• 39:45 Diagnosing Sleep Disorders and Treatment Modalities
• 43:58 Exploring Bruxism and Its Hypotheses
• 45:19 CPAP and Alternative Treatments for Sleep Apnea
• 48:12 Managing Upper Airway Resistance Syndrome
• 55:11 Integrative Approach to Sleep Disorder Management
• 57:17 Diagnostic Protocols and Imaging Techniques
• 01:02:25 The Importance of Proper Device Fit and Function
• 01:07:16 Upcoming Events and Further Learning Opportunities
• 01:09:56 Outro

✨ Don’t Miss Out: Practical, anatomy-based approaches to sleep and airway management for dentists and specialists

???? Event: Introduction to Craniofacial Sleep Medicine

???? Location: Marriott Hotel, London Heathrow

???? Course Price: £2,495

???? Early Bird Registration: £1,996

????️ Discount Code: Use “earlybird20” at checkout

???? Learn More: Visit REMA Sleep for details on courses, devices, and craniofacial sleep medicine resources.

???? Try Protrusive AI aka AskJaz today: Explore clinical reasoning and educational support directly within the Protrusive Guidance App!

If you loved this episode, watch 5 Airway Patients In Your Dental Practice Right Now with Dr Liz Turner – PDP226

#PDPMainEpisodes #OcclusionTMDandSplints #BreadandButterDentistry

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

This episode meets GDC Outcome C.

AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Sleep medicine)

Aim: To understand the craniofacial and dental considerations in managing sleep-disordered breathing, including the role of mandibular advancement, palatal expansion, and integrative dental approaches in sleep medicine.

Dentists will be able to –

1. Describe the craniofacial factors contributing to sleep-disordered breathing and upper airway resistance syndrome (UARS).
2. Explain the mechanisms, indications, and limitations of mandibular advancement devices and palatal expansion in dental sleep medicine.
3. Integrate diagnostic findings, craniofacial assessment, and interdisciplinary collaboration to formulate individualized treatment plans for patients with sleep-disordered breathing.

As 2025 comes to a close, we wanted to pause and reflect by revisiting the moments that genuinely shaped how we practise, think, and show up in the clinic.

This Best of 2025 episode starts with restorative and aesthetics, moves through digital workflows, endo, paediatrics, surgery, communication, and finishes with what sustains us over a long career. These are the clips that made me pause, rethink, and quietly adjust how I work – and I hope they do the same for you.

Some of the ideas you’ll hear in this episode include:

• Predictable ways to manage wear and space without over-treating
• Small restorative and material choices that have a big impact long-term
• Practical digital workflows that genuinely improve accuracy and efficiency
• Endo fundamentals that reduce stress and increase consistency
• Clear clinical judgement for paediatrics, surgery, and medical emergencies
• Communication habits that build trust without using jargon
• Simple, sustainable ways to protect your body, health, and curiosity

AskJaz (JazAI) is built to solve a simple problem: knowing what to do next without digging through endless content. Need quick guidance on a tricky case? Not sure which cement to use? Need help with a lab prescription? AskJaz has you covered.????

It provides 24/7 support, allowing you to ask questions at any time and receive clear, direct responses. You can even talk to Jaz in your own language, making the guidance easier to understand and apply—especially in fast-paced clinical situations.

AskJaz is available by upgrading to the Ultimate Clinical Education Plan, where it’s currently included. This gives you full access to AskJaz alongside premium masterclasses, CPD features, and advanced clinical resources inside the app.

If you join or upgrade on or before January 11, AskJaz is included with your Ultimate membership for as long as your account remains in good standing.

From January 12, a new Ultimate+ Plan will launch at a higher price—and that will be the only way new members can access AskJaz.

So if you’ve been thinking about upgrading or joining the app, this is a very good moment.

To every guest who sat down with me this year and shared their knowledge, their stories, their hard-won wisdom — thank you. You made us all better clinicians.

And to you — for listening, for questioning, for caring enough to keep learning even when you’re exhausted, even when the day’s been long, even when it feels like there’s always more to know.

You’re the reason this podcast exists. You’re the reason I keep doing this.

Thank you for being here. Thank you for being part of this community. Thank you for showing up, year after year.

Here’s to 2026. Here’s to more conversations. Here’s to all of us getting just a little bit better.

Until next year, keep learning, keep caring, and keep doing the dentistry that makes you proud.

Does their bite change when they lie down? When they sleep?

And how can you explain centric relation, posture, and deprogramming in a way that patients actually understand?

Dr. Bobby Supple joins Jaz for a powerful episode unpacking one of the most misunderstood topics in occlusion: the daytime chewing bite versus the nighttime airway bite. After spending days with Bobby in his New Mexico clinic, Jaz saw firsthand how simply and elegantly Bobby communicates concepts that usually leave patients — and dentists — confused.

Together, they explore why bite discrepancies exist, what happens when the condyles fully seat, and how aligning Bite One and Bite Two over time can transform patient comfort and restorative outcomes.

Protrusive Dental Pearl 

• When assessing abfractions, always check the patient’s bite in two positions: seated upright and lying back. 
• Posture subtly shifts the condylar position and can change how forces load the tooth.

Want more gems like this? AskJaz — your on-demand dental brain, will be soon baked right into the Protrusive App.

Key Takeaways:

• Every patient has two bites — their upright chewing bite and their horizontal airway bite.
• Posture changes the condylar position more than we realise.
• Clear communication can make complex occlusion concepts instantly understandable.
• Aligning Bite One and Bite Two over time leads to healthier joints and more predictable dentistry.

Highlights of this episode:

• 03:36  Pearl – Assessing Abfractions 
• 06:47 Dr. Bobby Supple’s Journey to Dentistry
• 10:46 Confusion Around Centric Relation
• 13:22 Exploring T-Scan Technology
• 21:40 The Evolution of Digital Occlusion
• 27:05 Effect of Sitting vs. Reclined Position
• 32:03 Airway and Skeletal Asymmetry
• 37:19 Bite Philosophy and Treatment
• 42:10 Orthotics and Long-term Care
• 52:13 Preventive Dental Care
• 58:18 Ask Jaz AI (Beta Launch)

???? Join the world’s leading organization dedicated to occlusion, temporomandibular disorders (TMD), and restorative excellence — the American Equilibration Society (AES).

????️ AES Annual Meeting 2026 – “The Evolution of the Oral Physician”  ???? February 18–19, 2026 · Chicago, Illinois

Papers & Literature: Dr. Bobby’s Top Picks

Evolving digital patterns

Introduction to force scanning

5 ways to use T-Scan

Digital Occlusion–From paper marks to digital force mapping

Discover Dr. Robert Kerstein’s guide to Measured Digital Occlusion and T-Scan technology. 

Dive deeper into occlusion with Dr. Bobby Supple on Occlusion Wars II: Beyond Teeth – PDP101

#PDPMainEpisodes #OcclusionTMDandSplints #BestofProtrusive

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

This episode meets GDC Outcomes C

AGD Subject Code: 180 OCCLUSION

Aim: To enhance clinicians’ understanding of the “two bites” concept, the role of condylar position in occlusal health, the use of T-Scan in diagnosing occlusal force patterns, and the long-term prevention-based approach to managing occlusal stress, abfractions, and TMJ remodeling.

Dentists will be able to –

1. Explain the concept of patients having “two bites” (MIP bite vs. airway/postural bite) and describe how posture influences mandibular position.
2. Identify occlusal stress patterns using clinical examination and digital tools (e.g., T-Scan) to recognise overloads that may contribute to abfractions, cracks, or TMJ symptoms.
3. Apply a long-term, preventive approach to occlusal management that aims to harmonise daytime and nighttime bites while supporting joint remodeling through appropriate orthotic therapy.

What strategies help you stay sane amidst the organized chaos of family life?

How can showing up as your best self benefit both your patients and your children?

Dr. Shandy Vijayan and Dr. Raabiha Maan join Jaz in this nonclinical episode to share their experiences of parenthood in dentistry. From the unique perspectives of two dentist-moms and the dad viewpoint, they discuss the real-life challenges of raising children while maintaining personal well-being.

They also share practical tips, book recommendations, and actionable strategies for self-care and emotional regulation—helping you create a balanced family life while thriving in your career.

During the episode, Jaz also mentions KARRI — a fun, screen-free voice messenger that helps kids stay safely connected with parents and friends, without social media or internet access.

Loved by kids. Trusted by parents. Get 50% off via: www.protrusive.co.uk/karri

Key Takeaways

• Life comes in “seasons”; early parenting (~0–8 yrs) is intense but temporary.
• Reduce clinical load early to focus on children; career focus increases after ~12 yrs.
• Prioritize time with kids over tasks; coordinated parenting schedules help.
• House help significantly reduces stress, frees energy for quality interactions.
• Support networks (family, in-laws, professional communities) are essential.
• Grandparents: allow flexibility; avoid micromanaging childcare.
• Returning to work: stress, costs (GDC, indemnity, childcare), skill gaps, guilt.
• Dentistry = high-performance + emotional labor; manage energy carefully.
• Quick mental reset between work/home recommended; part-time can boost longevity.
• Parent happiness + strong parental relationship = major factor in kids’ emotional regulation.
• Run family like a small business: systems, schedules, clear roles.
• Self-regulation, EQ, and self-care benefit family, patients, and professional life.

Highlights of this episode:

• 00:00 Teaser
• 01:00 Intro
• 02:50 Shandy’s Story: Juggling Multiple Clinics
• 08:11 Raabiha’s Story: Managing a Practice and Family
• 08:58 Interjection
• 16:03 Raabiha’s Story: Managing a Practice and Family
• 18:17 Life Seasons and Reducing Clinical Commitment
• 21:05 The Value of Help and Support Networks
• 27:00 Financial and Emotional Challenges in Dentistry
• 33:03 Midroll
• 36:22 Financial and Emotional Challenges in Dentistry
• 36:24 Balancing Work and Home Life
• 42:26 Time Management and Setting Boundaries
• 46:51 Self-Care and Emotional Regulation
• 53:53 Upcoming Wellness Event
• 59:01 Final Thoughts and Future Ideas
• 59:49 Outro

Ready to take the next step?

• Check out this great resource for new dentists and trainees: Dentistry in a Nutshell
• Join the community at the Dental Mums Network to connect with dentist‑parents balancing clinical work and family life.

Revive 2026 – A Wellness Event Like No Other (6 hours CPD)

???? Saturday 24th January 2026

???? Leonardo Royal Hotel, St Paul’s, London

Revive 2026 is your invitation to pause, breathe, and reconnect- a full-day experience designed for women in dentistry who are ready to start the year with purpose, calm, and clarity.

Loved this? Dive deeper into Parenthood and Dentistry – IC025 (Even If You’re Not a Parent!)

#InterferenceCast #BeyondDentistry #Communication

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

This episode meets GDC Outcome: B

AGD Subject Code: 770 SELF IMPROVEMENT

Aim: To explore strategies for managing work-life balance in dentistry, focusing on early parenthood, emotional regulation, and professional sustainability.

Dentists will be able to –

1. Describe key challenges dentists face balancing clinical practice with early parenthood.
2. Identify practical strategies for maintaining emotional energy, setting boundaries, and creating support networks.
3. Apply approaches to integrate self-care, household management, and EQ development to enhance personal and professional well-being.

Wondering what exams, applications, and documents you’ll need to practice or specialize there?

Curious about how much it costs — and what life as a dentist in the States is really like?

Dr. Hazel Kerr and Dr. Dorrin Reyhani join Jaz for a deep dive into everything you need to know about moving to America as a dentist. Both UK-trained and now faculty at UPenn, they share their personal journeys and break down the full pathway — from exams like the INBDE and TOEFL, to transcripts, personal statements, and application timelines.

They also discuss what it’s like working in the US compared to the UK, including earning potential, patient culture, and training opportunities. Whether you want to complete an advanced standing program, pursue a specialty, or bring your skills back home, this episode gives you a clear roadmap to make it happen.

Key Takeaways

• The journey to becoming a dentist varies significantly by country.
• Specializing in dentistry can open more opportunities than general practice.
• Board certification enhances professional status and may offer insurance benefits.
• International dentists have specific routes to practice in the US.
• Scholarships can significantly reduce the financial burden of dental education.
• Teaching positions can provide pathways to practice without additional costs. Faculty primarily teach and supervise dental students in clinics.
• Early preparation for the INBD exam is crucial for success.
• Clinical experience and a strong portfolio are essential for applications.
• Networking and externships can enhance application prospects.
• Understanding the application process can alleviate stress for international students.
• Cultural differences impact how dental care is valued and perceived.

Highlights of this episode:

• 00:00 Teaser
• 00:55 Introduction
• 04:15 Journey to Specialization
• 12:49 Understanding the Certification and Board Process
• 15:35 Exploring Different Routes for International Dentists
• 18:17 Financial Considerations and Scholarships
• 25:48 US Difficulty and Competitiveness
• 29:35 Choosing Between General and Specialty Routes
• 31:11 Navigating State-Specific Licensing
• 33:28 Teaching and Clinical Responsibilities
• 35:03 Midroll
• 38:24 Teaching and Clinical Responsibilities
• 43:01 Application Process and Exams
• 52:07 Residency and Career Pathways
• 57:39 Application Portals
• 01:00:35 Work Experience Before Specialization
• 01:03:22 Why Dentists Choose to Work in the US
• 01:09:36 Finishing the Program and Looking Ahead
• 01:12:01 Outro

If you enjoyed this episode, you’ll definitely be inspired by The American Dental Dream – PDP002.

#InterferenceCast #CareerDevelopmentThis 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.

Should you sound the alarm? Monitor and wait? Jump straight to treatment?

Cracked teeth are one of dentistry’s most misunderstood diagnoses. Colleagues debate whether to crown or monitor. And that crack you’re staring at? It could stay dormant for years—or spiral into an extraction by next month.

So what separates the teeth that crack catastrophically from those that quietly hold together?

In this episode, I am joined by final-year dental student Emma to crack the code (pun intended) on cracked tooth syndrome. 

We break down the easy-to-remember “position, force, time” framework to help you spot risk factors before disaster strikes, and share a real-world case of a 19-year-old bruxist whose molar was saved by smart occlusal thinking.

If you’ve ever felt uncertain about diagnosing, explaining, or managing cracked teeth, this episode will change how you think about every suspicious line you see.

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

Key Takeaways

• Risk factors include large restorations and bruxism.
• Occlusion plays a significant role in tooth health.
• Diet can impact the integrity of teeth.
• Every patient presents unique challenges in treatment.
• Communication about dental issues is key for patient care.
• Certain teeth are more prone to fractures due to their anatomy.
• The weakest link theory explains why some patients experience more dental issues.
• Patient history is crucial in predicting future dental problems.
• The age and dental history of a patient influence treatment decisions.
• Understanding occlusion is essential for diagnosing and treating cracked teeth.
• The location of a tooth affects the force it experiences during chewing.
• Bruxism increases the risk of tooth fractures.
• Tooth contacts and forces play a critical role in diagnosing issues.
• Opposing teeth can provide valuable insights into tooth health.
• Effective communication is essential in managing cracked teeth.
• Stains on teeth can indicate deeper issues with cracks.
• Monitoring and documenting cracks over time is crucial for patient care.

Highlights of this episode:

00:00 Teaser

00:49 Intro

03:25 Emma’s Dental School Updates

07:18 What is Cracked Tooth Syndrome (CTS)?

10:02 Crack Progression and Severity

12:45 Risk Factors

14:54 Position–Force–Time Framework

21:53 Which Teeth Fracture Most Often?

25:32 Midroll

28:53 Which Teeth Fracture Most Often?

30:37 The Weakest Link Theory

34:05 Diagnostic Tools

37:56 Treatment Planning

39:42 Case Study – High Force Patient

47:27 Communication and Patient Management

51:03 Key Clinician Takeaways

53:03 Conclusion and Next Episode Preview

53:42 Outro

Check out the AAE cracked teeth and root fracture guide for excellent visuals and classification details.

Literature review on cracked teeth – examines evidence around risk factors, prevention, diagnosis, and treatment of cracked teeth.

Want to learn more about cracked teeth? Have a listen to PDP028 and PDP098 – both packed with practical tips and case-based insights.

#BreadAndButterDentistry #PDPMainEpisodes #OcclusionTMDandSplints

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

This episode contributes to the following GDC development outcomes:

• Outcome C  

AGD Subject Code: 250 – Operative (Restorative) Dentistry

Aim: To help dental professionals understand the causes, diagnosis, and management of cracked teeth through a practical, evidence-based approach. It focuses on identifying risk factors using the Position–Force–Time framework and improving patient outcomes through informed communication and tailored treatment planning.

Dentists will be able to:

1. Explain the aetiology and progression of cracked tooth syndrome
2. Identify high-risk teeth and patient factors—such as restoration design, occlusal contacts, and parafunctional habits—that predispose to cracks
3. Communicate effectively with patients about the significance of cracks, prognosis, and monitoring options, improving patient understanding and consent

Teaser: Sometimes, you have a tooth position problem. Sometimes you have a tooth force problem, and sometimes you have a tooth contact time problem. So time, force, position. A crack is an end product of overload. So risk factors for cracked teeth, right?

Teaser: So if we think, again, that is to do with overload, right? When you have a patient who’s got large amalgam restorations, MOD, I don’t remember the last time I removed an amalgam and I didn’t see a crack underneath.

Why is it that maxillary premolars are more likely to crack than mandibular premolars? This is really fascinating. If all you do is remove the crack and put a composite, the composite will also fail through overload eventually. So you must change something about the environment to reduce the crack propagation.

Jaz’s Introduction: I’ve been involved in dental communities for many years now. I run my own community, the Protruserati, Protrusive Guidance. And one of the questions that keep propping up week by week, month by month, year by year… it’s just all seasons, all time, is about cracked teeth management, diagnosis, cracked tooth syndrome, and getting very patient specific, describing the symptoms and signs, and all the discussions are about cracked teeth.

So there’s still obviously some uncertainty about the best way to diagnose and manage cracked teeth, which is why we created this episode. I know it’s part of the PS, Protrusive Student series, but honestly, the way I ended up explaining cracks in my philosophy and the way I think about how cracks form and how the management very much depends on so many patient factors is pretty unique, I think. I don’t think I’ve ever spoken about cracks in this way, and I think it ended up being a really wholesome episode. Again, thanks to some wonderful questions from our student, Emma.

Now, alongside this episode in the show notes, we’ve put together some essential reading and some great PDF, excellent data and visuals on cracked teeth, and I mentioned a good review, literature review on cracked teeth. That’s also referenced in the show notes. If you are watching or listening on Protrusive Guidance, just scroll below and download it.

And if you haven’t yet joined the community, what are you waiting for? We’re waiting for you on protrusive.app. I really enjoyed recording this episode, Emma, and I hope you enjoy listening or watching it. Oh, and this episode is eligible for CE. There was so much substance. So whether you’re gonna collect CPD hours or CE credits, whoever you are in the world, this episode is eligible again through the Protrusive Guidance app. Let’s catch the main episode.

Main Episode:Emma, the Protrusive Student. Welcome back to the Protrusive Dental Podcast. It’s so nice to have you. We’re talking about cracked teeth today. Look, I can talk about cracked teeth for days. It’s something when I, in the early episodes, one of the early episodes, it’s titled I Hate Cracked Teeth.

I still hate cracked teeth. We all hate cracked teeth. No one likes cracked teeth. But you know what? Over the years, I’ve learned so much about cracked teeth, and now I’ve got some things to share with you and I’m really excited to share with you that will really change how you approach cracked teeth and how you communicate cracked teeth and all that kind of good stuff.

But what I wanna start with is what’s more important to you as a student? You are connected to students and young dentists better than I am. You are right there in the trenches, okay? Like asking these questions that no one wants to ask anymore because they’re afraid to ask, right?

Because, hmm, maybe I should know this already, but you have no fear, no shame because you’re a student, it’s fine. So it’s cool. Like, you don’t have to know everything. And so you are in a position to ask, to represent everyone and ask those questions. So firstly, Emma, tell us, give us an update. How’s final year going at uni?

[Emma]Yeah, final year’s going good. Just the same as when I caught up with you a couple weeks ago. It’s just our finals are out the way, so I’ve got a lot more time in the evening to sort of decompress and focus on the things that I know will be in my book the day after. If I’ve got a crown prep or something or something that I need to look up on, I know what I’m gonna be doing.

I can go home and I can focus on that for the next day rather than stressing about exams. But it’s good. It’s going really well....]]> 0:52:45 false https://podcast.show/protrusive/episode/150250410/ 150250410 https://protrusive.co.uk/?p=9525 Jaz Gulati Thu, 27 Nov 2025 11:06:24 -0500 Are you confident in spotting a child at risk of neglect?

Do you know what to do if you witness abuse in your practice?

How can you raise concerns safely while protecting both the child and your team?

This episode with Dr. Christine Park provides tangible actions, practical scripts, and clear guidance for managing challenging scenarios—like seeing an adult hit a child in the waiting room or recognizing neglect in the dental chair. These are situations dental school rarely prepares us for.

Every practice needs clear protocols for safeguarding. This episode acts as a North Star, helping you stay compliant while ethically doing the right thing. If you treat children, you must listen to this episode and share it with every colleague who treats children.

Protrusive Dental Pearl: Find the phone number of your local child safeguarding board / social services. Verify it, then display it where you and your team can quickly access it.

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

Key Takeaways

• Dentists are trained observers of family dynamics.
• Recognizing normal behavior is key in dental care.
• Unconscious observations can guide professionals.
• Feeling uncomfortable about a situation is a valid signal.
• Empowerment comes from trusting your instincts.
• Dental care professionals see many aspects of families.
• It’s important to act on uncomfortable feelings.
• Observation skills are crucial for effective care.
• Children’s interactions reveal much about family health.
• Awareness of discomfort can lead to better outcomes.

Highlights of this episode:

00:00 Teaser

00:59 Intro

02:40 Pearl – Child Protection Hotline

05:23 Dr. Christine Park’s Background and Expertise

08:37 The Role of Dentists in Safeguarding Children

11:19 Practical Scenarios and Guidelines for Safeguarding

15:35 Recognizing Silent Cases of Neglect

17:29 Team Collaboration and Support in Safeguarding

21:58 Guidelines and Policies for Effective Safeguarding

22:03 Midroll

25:24 Guidelines and Policies for Effective Safeguarding

28:32 Handling a Tough Safeguarding Scenario

32:18 Dealing with Poor Oral Hygiene and Neglect

39:12 Managing Parental Reactions and Consent

43:08 The Importance of Safeguarding in Dentistry

45:34 Further Guidance and Resources

46:10 Outro

???? Safeguard your young patients with confidence!

Catch Dr. Christine Park at the Scottish Dental Show in June or via her NES webinars.

Check out the BSPD guidelines on dental neglect —an essential resource for any dentist treating children

✉️ Get in Touch with Dr. Christine:

• General: Christine.park@glasgow.ac.uk
• Patient-info: Christine.park7@nhs.scot

If you loved this episode, don’t miss How to Manage Children in Dental Pain – Paediatric Emergencies – PDP159

#PDPMainEpisodes #Communication #CareerDevelopment

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

This episode meets GDC Outcomes A and D.

AGD Subject Code: 430 PEDIATRIC DENTISTRY (Identification and reporting of child abuse)

Aim: To equip dental professionals with practical knowledge and skills to recognize, respond to, and appropriately escalate safeguarding concerns involving children in dental practice.

Dentists will be able to –

1. Identify key signs and red flags of child neglect, abuse, or welfare concerns in dental patients.
2. Apply clear communication strategies to discuss concerns with parents/caregivers and involve relevant authorities.
3. Follow practice-based and multi-agency procedures for safeguarding, including documenting observations and escalation.

Teaser: We're so well trained in observing, and we're really, really good at knowing what normal is. We know what looks normal to us, and even if we are not consciously aware of what we're seeing, there is always an unconscious part of us. If we see something that doesn't feel right, it will feel uncomfortable.

Teaser:The worst thing is if a dentist or a nurse gets left to deal with it on their own at half past four on a Friday afternoon, when they can’t get through to anybody, and all the rest of the practice are going, not my problem, I’ll see you later.

What do I want that child to think about in years to come? When they’re grown up and they’re an adult and they can look back, do I want ’em to look back and say, that dentist Christine, she saw me and knew I needed help and did X, Y, Z, or, that dentist saw me and knew I needed help and did nothing.

And never want any of my dental colleagues to be the last health professional to see a child that something then horrific happens to.

Jaz’s Introduction: If you treat children, it is your duty to listen to this episode in full, because this is one of those times you get to change a child’s life. You get to potentially save a life, or at the very least, change the entire trajectory of a child’s life.

Safeguarding of children is one of the recommended topics from our regulator, and there’s a really good reason for that. We, as dentists, are in a phenomenal position to be able to look out for nuances and really safeguard the children. They only see their medical doctor when there’s a problem, but they see us more regularly.

And if you treat children, it should be part of your personal development plan to safeguard them. And this episode will give you CPD for that. But forget the CPD, because more importantly, when you see an adult hitting a child in the waiting room, or you see a neglected child in your dental chair and you need to raise concerns, this episode will give you tangible actions, scripts to follow, and good, safe guidance on how to manage these really tricky scenarios, which dental school just does not prepare us for.

This episode with Dr. Christine Park will give you the tools you need to manage these tough scenarios. Now, it’s not a very common thing, thankfully. It’s a bit like mouth cancer. We do screening for mouth cancer every single patient, and we hope not to find it, but when we do find it or are concerned, we refer, we get some expert advice, and we should be doing the same when it comes to safeguarding children.

Every practice needs to have clear protocols in place, and this episode is a great North Star to follow, to help us stay compliant, but also ethically do the right thing. So if you treat children, you must, must, must listen to this episode and share it with every colleague that treats children.

Dental PearlHello, Protruserati. I’m Jaz Gulati, and welcome back to your favorite dental podcast. Every PDP episode I give you a Protrusive Dental Pearl. It’s a very important actionable step I’m giving you for this episode’s pearl. Now, most of us under our computer or near our workstation, we have the phone number to call if the service stops working.

Or if we need IT support, and this is almost like universal for all dental practices I’ve worked in. Now, what all practices don’t have is a phone number for when you are concerned about the wellbeing of a child, when you need to do some safeguarding for children, the phone number of social services near you, or a safeguarding authority for children near you.

Do you have that phone number easy to find somewhere? And I think it’s our duty to have that number easy to reference. It’s a bit like when a dental trauma comes in, we refer to the guidelines, we follow the steps. Well, sometimes with these high-octane, adrenaline-pumping, tough conversations that we have with parents, we need a quick reference of a phone number to call for help, as well as discussing it with the lead nurse, practice manager, the other dentist.

Because when safeguarding and children is concerned, it is an entire practice issue, and it is a community-wide issue. So my top tip is have the phone number. Have a phone number of your local safeguarding authority, and you have to do a bit of work. I would say ask ChatGPT, then verify that what ChatGPT is telling you is correct. You need a local contact to get advice. And I think it’s our ethical duty to do so.

Anyway, let’s check out the main episode with Dr. Christine Park, who really breaks it down. Well, we have scripts. We have tangible actions for you to better look after children. I really hope you never have to use these scripts, but when you do, you’ll be way more prepared and you’ll be able to really help children and change their entire life. Enjoy the learning. I’ll catch you in outro.

Main Episode:Dr. Christine Park, welcome to the Protrusive Dental Podcast. So nice to have you smiling. You’ve got the a nice...]]> 0:45:23 false https://podcast.show/protrusive/episode/150193303/ 150193303 https://protrusive.co.uk/?p=9513 Jaz Gulati Tue, 25 Nov 2025 02:49:22 -0500 Let’s be honest – the occlusion after Aligner cases can be a little ‘off’ (even after fixed appliances!)

How do you know if your patient’s occlusion after aligner treatment is acceptable or risky?

What practical guidelines can general dentists follow to manage occlusion when orthodontic results aren’t textbook-perfect?

Jaz and Dr. Jesper Hatt explore the most common challenges dentists face, from ClinCheck errors and digital setup pitfalls to balancing aesthetics with functional occlusion.

They also discuss key strategies to help you evaluate, guide, and optimize occlusion in your patients, because understanding what is acceptable and what needs intervention can make all the difference in long-term treatment stability and patient satisfaction.

Protrusive Dental Pearl: Harmony and Occlusal Compatibility

• Always ensure restorative anatomy suits the patient’s natural occlusal scheme and age-related wear. If opposing teeth are flat and amalgam-filled, polished cuspal anatomy will be incompatible — flatten as needed to conform.

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

Key Takeaways

• Common mistakes in ClinCheck planning often stem from occlusion issues.
• Effective communication and documentation are crucial in clinical support.
• Occlusion must be set correctly to ensure successful treatment outcomes.
• Understanding the patient’s profile is essential for effective orthodontics.
• Collaboration between GPs and orthodontists can enhance patient care.
• Retention of orthodontic results is a lifelong commitment.
• Aesthetic goals must align with functional occlusion in treatment planning.
• Informed consent is critical when discussing potential surgical interventions. The tongue plays a crucial role in orthodontic outcomes.
• Spacing cases should often be approached as restorative cases.
• Aligners can achieve precise spacing more effectively than fixed appliances.
• Enamel adjustments may be necessary for optimal occlusion post-treatment.
• Retention strategies must be tailored to individual patient needs.
• Case assessment is vital for determining treatment complexity.

Highlights of this episode:

00:00 Teaser

00:59 Intro

02:53  Pearl – Harmony and Occlusal Compatibility

05:57 Dr. Jesper Hatt Introduction

07:34 Clinical Support Systems

10:18 Occlusion and Aligner Therapy

20:41 Bite Recording Considerations

25:32 Collaborative Approach in Orthodontics

30:31 Occlusal Goals vs. Aesthetic Goals

31:42 Midroll

35:03 Occlusal Goals vs. Aesthetic Goals

35:25 Challenges with Spacing Cases

42:19 Occlusion Checkpoints After Aligners

50:17 Considerations for Retention

54:55 Case Assessment and Treatment Planning

58:14 Key Lessons and Final Thoughts

01:00:19 Interconnectedness of Body and Teeth

01:02:48 Resources for Dentists and Case Support

01:04:40 Outro

Free Aligner Case Support!Send your patient’s case number and get a full assessment in 24 hours—easy, moderate, complex, or referral. Plus, access our 52-point planning protocol and 2-min photo course. No uploads, no cost.

[Get Free Access Now]

Learn more at alignerservice.com

If you enjoyed this episode, don’t miss: Do’s and Don’ts of Aligners [STRAIGHTPRIL] – PDP071

#PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative

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

This episode meets GDC Outcomes A and C.

AGD Subject Code: 370 ORTHODONTICS (Functional orthodontic therapy)

Aim: To provide general dentists with practical guidance for managing occlusion in aligner therapy, from bite capture to retention, including common pitfalls, functional considerations, and case selection.

Dentists will be able to –

1. Identify common errors in digital bite capture and occlusion setup.
2. Understand the impact of anterior inclination and mandibular movement patterns on occlusal stability.
3. Plan retention strategies appropriate for aligner and restorative cases.

Teaser: The one thing that we always check initially is the occlusion set correct by the aligner company. Because if the occlusion is not set correctly, everything else just doesn't matter because the teeth will move, but into a wrong position because the occlusion is off from the beginning. I don't know about you, but if half the orthodontists are afraid of controlling the root movements in extraction cases, as a GP, I would be terrified.

Teaser:I don’t care if you just move from premolar to premolar or all the teeth. Orthodontics is orthodontics, so you will affect all the teeth during the treatment. The question’s just how much. Imagine going to a football stadium. The orthodontist will be able to find the football stadium. 

If it’s a reasonable orthodontist, he’ll be able to find the section you’re going to sit in, and if he’s really, really, really good, he will be able to find the row that you’re going to sit in, but the exact spot where you are going to sit… he will never, ever be able to find that with orthodontics.

Jaz’s Introduction: Hello, Protruserati. I’m Jaz Gulati. Welcome back to your favorite dental podcast. I’m joined today by our guest, Dr. Jesper Hatt. All this dentist does is help other dentists with their treatment plans for aligners. From speaking to him, I gather that he’s no longer practicing clinically and is full-time clinical support for colleagues for their aligner cases.

So there’s a lot we can learn from someone who day in day out has to do so much treatment planning and speaking to GDPs about their cases, how they’re tracking, how they’re not tracking, complications, and then years of seeing again, okay, how well did that first set of aligners actually perform? What is predictable and what isn’t?

And as well as asking what are the most common errors we make on our ClinChecks or treatment plan softwares. I really wanted to probe in further. I really want to ask him about clinical guidelines for occlusion after ortho. Sometimes we treat a case and whilst the aesthetics of that aligner case is beautiful, the occlusion is sometimes not as good.

So let’s talk about what that actually means. What is a not-good occlusion? What is a good occlusion? And just to offer some guidelines for practitioners to follow because guess what? No orthodontist in the world is gonna ever get the occlusion correct through ortho. Therefore, we as GPs are never gonna get a perfect textbook occlusion, but we need to understand what is acceptable and what is a good guideline to follow. That’s exactly what we’ll present to you in this episode today.

Dental PearlNow, this is a CE slash CPD eligible episode and as our main PDP episode, I’ll give you a Protrusive Dental Pearl. Today’s pearl is very much relevant to the theme of orthodontics and occlusion we’re discussing today, and it’s probably a pearl I’ve given to you already in the past somewhere down the line, but it’s so important and so key.

I really want to just emphasize on it again. In fact, a colleague messaged me recently and it reminded me of this concept I’m about to explain. She sent me an image of a resin bonded bridge she did, which had failed. It was a lower incisor, and just a few days after bonding, it failed. And so this dentist is feeling a bit embarrassed and wanted my advice.

Now, by the way, guys, if you message me for advice on Instagram, on Facebook, or something like that, it’s very hit and miss. Like my priorities in life are family, health, and everything that happens on Protrusive Guidance. Our network. If you message me outside that network, I may not see it. The team might, but I may not see it.

It’s the only way that I can really maintain control and calm in my life. The reason for saying this, I don’t want anyone to be offended. I’m not ignoring anyone. It’s just the volume of messages I get year on year, they’re astronomical. And I don’t mind if you nudge me. If you messaged me something weeks or months ago and I haven’t replied, I probably haven’t seen it. Please do nudge me.

And the best place to catch me on is Protrusive Guidance. If you DM me on Protrusive Guidance, home of the nicest and geekiest dentists in the world, that’s the only platform I will log in daily. That’s our baby, our community. Anyway, so I caught this Facebook message and it was up to me to help this colleague.

And one observation I made is that the lower teeth were all worn. The upper teeth were really worn, but this resin bonded bridge pontic, it just looked like a perfect tooth. The patient was something like 77 or 80. So it really made me think that, okay, why are we putting something that looks like a 25-year-old’s tooth in a 77-year-old? But even forgetting age and stuff, you have t...]]> 1:04:50 false https://podcast.show/protrusive/episode/150052745/ 150052745 https://protrusive.co.uk/?p=9495 Jaz Gulati Thu, 20 Nov 2025 02:32:45 -0500 Do you have a “hopeless” retained root you’re ready to extract?

Think implants, dentures, or bridges are the only way forward?

What if there’s a way to save that tooth — predictably and biologically?

In this episode, Dr. Vala Seif shares his experience with the Surgical Extrusion Technique — a game-changing approach that lets you reposition the root coronally to regain ferrule and restore teeth once thought impossible to save.

Jaz and Dr. Seif dive into case selection, atraumatic technique, stabilization, and timing, all guided by Dr. Seif’s own SAFE/SEIF Protocol, developed from over 200 successful cases.

Protrusive Dental Pearl: When checking a ferrule, consider height, thickness, and location of functional load. Upper teeth: prioritize palatal ferrule. Lower teeth: prioritize buccal. Tip: do a partial surgical extrusion, rotate the tooth 180°, then stabilize.

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

Key Takeaways

• Surgical extrusion is a technique-sensitive procedure that requires careful planning.
• Case selection is crucial for the success of surgical extrusion.
• A crown-root ratio of 1:1 is ideal for surgical extrusion.
• Patients are often more cooperative when they see surgical extrusion as their last chance to save a tooth.
• Surgical extrusion can be more efficient than orthodontic extrusion in certain cases.
• The importance of ferrule in dental restorations cannot be overstated.
• Proper case selection is crucial for successful outcomes.
• Atraumatic techniques are essential for preserving tooth structure.
• The ‘Safe Protocol’ offers a structured approach to surgical extrusion.
• Patient communication is key to managing expectations.
• Flowable composite is preferred for tooth fixation post-extraction.
• Understanding root morphology is important for successful extractions.

Highlights of this episode:

• 00:00 Surgical Extrusion Podcast Teaser
• 01:07 Introduction
• 02:38 Protrusive Dental Pearl
• 05:53 Interview with Dr. Vala Seif
• 08:57 Definition and Philosophy of Surgical Extrusion
• 15:30 Indications, Case Selection, and Root Morphology
• 21:37 Comparing Surgical and Orthodontic Extrusion
• 25:54 Crown Lengthening Drawbacks
• 28:39 Occlusal Considerations
• 33:53 Midroll
• 37:16 Definition and Importance of the Ferrule
• 43:07 Clinical Protocols and Fixation Methods
• 01:00:01 Post-Extrusion Care and Final Restoration
• 01:05:04 Learning More and Final Thoughts
• 01:09:29 Outro

Further Learning:

• Instagram: @extrusionmaster — case examples, papers, and protocol updates.
• Online and in-person courses in development (Europe + global access).

Loved this episode? Don’t miss “How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique” – PDP061

#PDPMainEpisodes #OralSurgeryandOralMedicine #OrthoRestorative

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

This episode meets GDC Outcomes C.

AGD Subject Code: 310 ORAL AND MAXILLOFACIAL SURGERY

Aim: To understand the biological and clinical principles of surgical extrusion as a conservative alternative to orthodontic extrusion or crown lengthening for managing structurally compromised teeth.

Dentists will be able to –

1. Identify suitable clinical cases for surgical extrusion, including correct root morphology and crown–root ratios.
2. Describe the step-by-step SAFE Protocol for atraumatic surgical extrusion, fixation, and timing of endodontic treatment.
3. Evaluate the advantages, limitations, and biomechanical considerations of surgical extrusion compared with orthodontic extrusion and crown lengthening.

Teaser: I always had a problem with extracting teeth. Not a problem technically, ethically. If highly damaged teeth get properly treated and correctly maintained, they are always going to outlive implants.

[Teaser]So what I’m referring to here is that the most sophisticated and complicated solutions are not always the smartest one. It’s not about most expensive. It’s not about most advanced. It’s not about most complicated. It’s about the best possible for the patient. We must keep that in mind that there is no such thing as a master key that opens up all of the doors for us.

Surgical extrusion, over the years… it actually was presented to dentistry in the early eighties. They were really trying to work on surgical extrusion. And guess who comes out? I have done over 200 cases with a follow-up of up to six, seven years. That is something that you can rely on. In such cases, I take out the tooth and rotate it and put it back in.

No way.

Jaz’s Introduction: Yeah, so you have a retained root and you think this is hopeless and you’re headed towards an implant, denture, a bridge or whatever. But then this episode comes along and reminds you about the power of the surgical extrusion technique. In plain terms, you are partially extracting the root, and now you have the most important thing in restorative dentistry. You have ferrule, you have tooth structure, you can now crown. Whereas before everything was subgingival and it was impossible to restore.

Hello, Protruserati, I’m Jaz Gulati and welcome back to your Favorite Dental Podcast. This is the podcast where you make dentistry tangible and make you fall in love with dentistry again.

Four years ago, with Dr. Peter Raftery, the endodontist, we spoke about this very topic, the surgical extrusion technique. I’ll put that episode in the show notes ’cause that was really valuable as well. But in this episode it is special because it’s an update from someone who’s done more than 200 cases.

So what he believes, and what I also believe, is he is the most experienced clinician in the world when it comes to the surgical extrusion technique. I haven’t seen anywhere in the literature the kind of numbers that he’s done—so, so much.

We can learn from Dr. Vala Seif from Iran, and Protruserati, you’re gonna absolutely love him, right? His storytelling, his analogies. I actually really geeked out and had a great time, and I know you’re gonna love him. Even all the way to the end, the last few seconds, he still gave another tip of how to stop bleeding when you do this technique so you can then add your composite splint to secure the root. He’ll give you that right at the very end. So make sure you don’t miss any of this episode.

Dental PearlNow, every PDP episode I give you a Protrusive Dental Pearl. This one’s an occlusion conceptual one, a biomechanical one when it comes to restorative dentistry, but it’s also very relevant to this episode ’cause a really cool, fascinating technique was advised by Dr. Seif, which I really am excited to share with you.

So firstly, conceptually, the pearl I’m giving is to remember the following: that when you have supragingival structure all the way around 360 degrees, we call that the ferrule. Something a crown can grab onto, and it’s important that this ferrule is as tall as possible vertically—ideally two millimeters plus—but it’s also important that the tooth structure remaining is thick because if it’s very, like, if it’s paper thin, that’s not really a ferrule, that’s not really contributing biomechanically.

Now the conceptual pearl I’m giving to you is to think about the position of the ferrule. If you have three millimeters on the palatal side and one millimeter on the buccal side, then this is still pretty good, especially for upper teeth, because the location of the ferrule is actually really important.

Think of the way that the upper incisors are loaded in a class one and class two patient. When a patient is chewing, the palatal of the upper incisors is taking load in clenching, is taking load in mastication and chewing as the food is pushed into centrals, and as you are cutting and incising, the crown is kind of going in a buccal direction.

The tooth, the crown of an upper incisor, is heading in a buccal direction, and so it is trying to grip onto that palatal tooth structure. And in a lower incisor, the buccal part of tooth structure is gonna be under more strain because the lower incisor is trying to bend inwards.

So why is this important? Well, pragmatically speaking, if you have a scenario where you’re trying to restore a canine and you’ve got lots of tooth structure palatally and not very much tooth structure buccally, then probably you’re gonna still be okay because that palatal tooth structure for an upper tooth, that’s usually more valuable and more precious. It just helps us to remember how teeth are loaded in a biomechanical way.

Now, the absolutely fascinating thing that Dr. Vala Seif spoke about is: let’s say you have a scenario where we have a retained root, like a crown–root fracture, and let’s say you have loads of tooth structure bucca...]]> 1:07:28 false https://podcast.show/protrusive/episode/149971862/ 149971862 https://protrusive.co.uk/?p=9478 Jaz Gulati Tue, 18 Nov 2025 04:05:59 -0500 Are you confident in replacing a single missing central incisor?

When is a denture the right option — and when should you consider a bridge or implant instead?

Why is the single central incisor one of the hardest teeth to replace to a patient’s satisfaction?

In this Back to Basics episode, Jaz and Protrusive Student Emma Hutchison explore the unique challenges of replacing a single central incisor. They break down when each option — denture, resin-bonded bridge, conventional bridge, or implant — is appropriate, and the biological and aesthetic factors that influence that decision.

They also share key communication strategies to help you manage expectations, guide patients through realistic treatment choices, and avoid disappointment when dealing with this most visible and demanding tooth.

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

Key Takeaways: 

• Replacing a single central incisor isn’t just about technical skill — it’s about communication and case selection. 
• Success comes from helping patients understand that a restoration replaces a tooth’s function and appearance, not nature itself. 
• Clear conversations about expectations, limitations, and maintenance are what turn a difficult aesthetic case into a satisfying long-term result.

Highlights of this episode:

00:00 Teaser

00:28 Intro

01:56 From Dental Nurse to Final-Year Student

07:38 Challenges and Considerations in Replacing Central Incisors

12:51 Patient Communication and Treatment Planning

18:33 Discussing Treatment Options and Enamel Considerations

21:16 Communicating Options and Guiding Patient Decisions

25:51 Choosing Between Fixed and Removable Options

27:10 Midroll

30:31 Choosing Between Fixed and Removable Options

31:05 Handling Old Crowns and Patient Communication

34:17 Conventional vs. Resin-Bonded Bridges

37:57 Occlusal Load, Function, and Implant Considerations

43:40 Digital Workflow in Dentistry

45:54 Managing Aesthetic Expectations

48:34 Final Thoughts and Recommendations

52:59 Outro

???? Want to feel confident with prosthodontics?

Explore these essential follow-ups to this episode:

• Dentures vs Bridges with Michael Frazis
• Crowns vs Onlays with Alan Burgin
• Dentures with Finlay Sutton
• RBB Masterclass on the Protrusive Guidance App

Quick, practical lessons to sharpen your planning, communication, and anterior aesthetics — all in your pocket.

#ProsthoPerio #OcclusionTMDandSplints #Communication #BreadandButterDentistry

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

This episode meets GDC Outcomes C.

AGD Subject Code: 610 – Fixed Prosthodontics

Aim: To provide a clear, clinical overview of replacing a single missing incisor — focusing on when to choose a denture, bridge, or implant, and how to communicate realistic expectations.

Dentists will be able to –

1. Identify the key biological, functional, and aesthetic challenges in replacing a central incisor.
2. Compare the indications, advantages, and limitations of dentures, resin-bonded bridges, conventional bridges, and implants.
3. Communicate realistic outcomes, limitations, and maintenance expectations effectively to patients.

Teaser: Have you heard of something called central dominance?

Teaser:No.

So in the face, the central incisors should be the star of the show, should be in the middle, and the centrals should be like twins. When we lose a central incisor, we have to discuss how was that central incisor lost, and most common cause is trauma. The most important predictor success of a resin bonded bridge is the same as it is for veneers. If you’re not sure what the treatment plan should be, you probably haven’t asked a patient enough questions.

Jaz’s Introduction:Welcome to this Back to Basics episode on replacing the single central incisor, why the single central incisor is the most important tooth, obviously, but so that we can just go a little bit deeper into this topic rather than talking about replacement options in general, which you’ve already done on the podcast.

There are certain features which are very special when you’re replacing the central incisor and why it is regarded as the most difficult treatment to deliver in terms of patient satisfaction expectations. We’re joined by the Protrusive student, Emma Hutchison, where we’re gonna go into the basic overview of decision making.

When is a denture appropriate? Is it ever appropriate for an incisor? How about bridges and what type, and what are the implant considerations, and actually choosing between these options? I think one of the biggest takeaways you might get from this is communication. There’s a specific way I communicate to patients about this, and that’s what I think you’ll probably take away the most from this episode.

Hello Protruserati. I’m Jaz Gulati and welcome back to the student edition of your favorite dental podcast. I know we call it Protrusive Students, but young practitioners or those returning back to work often find these episodes very valuable. Of course, we’ve got so much more where this came from.

We’ve got all sorts of genres and topics covered in Protrusive Podcast and recently on YouTube. We’ve done the playlist so you can actually pinpoint the different themes of the podcast. On our app, Protrusive Guidance, head over to protrusive.app if you’re interested in that. It’s the community of the nicest and geekiest dentists in the world. We put some extra videos, not on YouTube, on there as well. Let’s now join Emma, and I’ll catch you in the outro.

Main Episode:Emma Hutchison, the Protrusive Student, welcome back. How are you doing? How is clinics going? Final year, you’ve done your exams, but it’s the actual more clinical exposure. How’s everything going?

[Emma] Mm-hmm. Yeah, it’s going good. So as I was saying last time, it’s just more, lots more experience this year, which is good. So I’m up in Falkirk in Scotland every second week, just Monday till Friday, nine till five, seeing about four or five patients a day. And then the other second week I’m in Glasgow doing more specialized stuff, watching some consultants in restorative and things. So it’s good. It’s good. Just plodding along quite nicely, which is good.

[Jaz] Good. And you obviously have been a dental nurse. So once you’re seeing four to five patients a day, you have this extra level of insight that maybe your colleagues don’t have. Like, in the real world it’s 30, 40 patients sometimes, sometimes 12, sometimes one. Like, it’s such a variation.

‘Cause obviously you’ve been an implant nurse as well. So what advice do you want to give to your colleagues who are maybe listening to this and they’re seeing these four to five patients, and you want to prepare them for the real world? What would you say with your very unique perspective?

[Emma] Yeah, I think when I was working as an implant nurse, I remember speaking to the dentist I was working with and he was saying why he moved to private dentistry initially is just because the real life just isn’t like the gold standards that you’re taught at dental school. In the NHS especially, you’re time restricted.

So I think I do have that in the back of my head. I know that I won’t have the luxury of such long appointments when I graduate. So yeah, I’m just getting myself prepared for the real world. ‘Cause I am gonna do VT or DFT so that I can work in the NHS to start off with and then see where I go from there.

But I do know that in the back of my mind it’s gonna get a lot busier as soon as I start VT practice. So yeah, just that you’re not gonna have the best materials that you do in dental school. I know in Glasgow anyway, we tend to have really quite good materials. Good rubber dam. I know I’ve spoke to you about things like that before, and just that it might not be like that in the real world when I graduate and get out there and start working.

So just to prepare myself for that. I’m aware of it, it’s fine. And I’m just trying to relish the opportunities that I have at the moment and the staff around me that I have as well. I think that’s one thing.

[Jaz] You’ve gotta be like a leech, Emma. You’ve gotta be like a leech, like a sponge.

[Emma] And just ask all the questions whilst you have all these specialists and consultants around you and just take note of everything that they’re saying. Especially the way that people communicate with their patients and pick up little things that they’re saying to their patients and make it your own. So I’m trying not to wish away my last year, so that’s good.

[Jaz] No, enjoy it. Enjoy the comfort and the bu...]]> 0:52:11 false https://podcast.show/protrusive/episode/149875445/ 149875445 https://protrusive.co.uk/?p=9449 Jaz Gulati Thu, 13 Nov 2025 03:27:13 -0500 What if one bad decision completely changed the course of your career?

In this exclusive, members-only episode, Jaz sits down with a fellow dentist from our community who shares his raw, honest story about a moment of misjudgment — committing fraud — and the painful lessons that followed.

This isn’t about blame. It’s about insight, accountability, and redemption.

From the shock of investigation and court hearings, to the struggle of rebuilding trust and identity, this conversation shines a light on what really happens behind closed doors when things go wrong.

The aim of this podcast was to hopefully deter colleagues from temptation which can affect anyone at any time.

This is a members-only podcast episode due to its sensitive nature.

You can access it by creating a free Community account at: https://www.protrusive.app

Highlights of this episode:

00:00 Teaser

00:49 Introduction

05:49 End Screen

Love this episode? Don’t miss Divorce, Alcohol and Rough Patches – Overcoming Adversities (IC040)

#PDPMainEpisodes #BeyondDentistry

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

This episode meets GDC Outcomes A and D

AGD Subject Code: 555 Ethics in Dentistry

Aim: To reflect on the ethical, professional, and emotional lessons learned from a real-life case of dental fraud, highlighting accountability, insight, and rehabilitation while identifying practical steps to prevent similar incidents.

Dentists will be able to –

1. Recognise how workplace pressures, lack of mentorship, and poor oversight can lead to ethical lapses.
2. Understand the legal, professional, and emotional consequences of dishonesty and poor record keeping.
3. Identify support systems, coping strategies, and self-reflective tools to prevent burnout and maintain integrity.

In this episode, I’m joined (in my car, no less!) by Dr. Robert Kerstein, who was back in the UK to teach about digital occlusion and the power of the T-Scan and ‘disclusion time reduction therapy’. We dig into why a patient’s bite can still feel “off” even when everything looks right, how timing is just as important as force, and why splints and Botox don’t always solve TMD.

Robert explains why micro-occlusion is the real game-changer, how scanners could mislead you, and why dentistry still clings to articulating paper.

So if you’ve ever wondered why “perfect” cases still come back with bite complaints, or whether timing data can actually prevent fractures and headaches, this episode will give you plenty to chew on – pun intended.

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

Key Takeaways:

• Micro-occlusion, not just “dots and lines,” is the real driver of patient comfort and long-term tooth health.
• T-Scan measures both force and timing, which scanners and articulating paper cannot capture.
• Many patients show signs of occlusal damage without symptoms.
• Disclusion Time Reduction (DTR) treats TMD neurologically without splints, Botox, or TENS.
• Relying on occlusograms alone for guiding reduction is risky.
• Dentists can reduce post-treatment complaints by balancing micro-occlusion with T-Scan.
• Adopting T-Scan requires proper training.
• CR can be a convenient reference point, but MIP works well in most cases if micro-occlusion is managed.
• Objective, repeatable data builds patient trust and provides medico-legal reassurance.

Highlights of this episode:

• 00:00 Teaser
• 01:13 Intro
• 4:41 Protrusive Dental Pearl –  Removing a Temporarily Cemented Crown
• 06:39 Introduction
• 08:48 Global Training Footprint
• 09:32 What Robert Teaches (DTR & T-Scan)
• 09:55 Occlusion as Neurologic
• 10:33 Macro vs Micro-Occlusion
• 11:33 Neural Pathway
• 15:00 MIP vs CR Framing
• 16:48 Signs Without Symptoms
• 19:16 Silent Majority
• 20:08 Why Treat Asymptomatic Signs
• 20:50 Disclusion and MIP
• 22:28 Occlusogram Caveats
• 24:53 Midroll
• 28:14 Occlusogram Caveats
• 28:29 Why Occlusograms Mislead
• 29:21 Don’t Adjust From Color Alone
• 31:47 What Pressure/Timing Enable Clinically
• 33:02 Prosthetic Reality Check
• 34:46 Patient-Perceived Comfort
• 35:29 Why Isn’t T-Scan Everywhere?
• 36:29 Political Resistance
• 37:42 CR as Utility
• 38:18 MIP and Vertical Dimension.
• 39:48 Macro ≠ Micro
• 41:00 Material Longevity Benefits
• 41:57 T-Scan Training
• 42:58 Three Competencies to Master
• 44:20 Micro-Occlusion Rules
• 44:46 Outro

If you want to get more clued up on TMD, tune into this episode for the latest insights and guidelines! PDP213 – TMD New Guidelines –  however be warned that the guidelines are contradictory to what Dr. Kerstein advises….ah the wonderful world of TMD!

 #OcclusionTMDandSplints #OrthoRestorative

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

This episode meets GDC Outcomes A, C.

AGD Subject Code: 250 – Clinical Dentistry (Occlusion/Restorative)

Aim: to explore the role of micro-occlusion and timing in TMD and restorative success, highlighting how tools like T-Scan provide data that other tools cannot. This episode seeks to give dentists practical insights into diagnosing, preventing, and treating occlusal problems with greater accuracy.

Dentists will be able to:

1. Describe the role of micro-occlusion and disclusion time in TMD symptoms and tooth wear.
2. Recognising the limitations of traditional methods of occlusion adjustment.
3. Understand how objective occlusion data supports comfort, longevity of restorations, and preventive care.

Teaser: Pressure is a force over surface area. And when it gives us the red, the blue, yellow, it's not measuring the force, so it cannot tell us the pressure. So tell us about what the nuances of being careful with the occlusogram and where it fails in the face of something more sophisticated, like the T-scan.

The essence of a scanning technology is that all the teeth are scanned with the patient’s teeth apart. No one’s biting. There’s no forces captured. There’s no contacts. There’s no gathering of teeth banging together or rubbing around. So it completely is falsely representing. These colour coded occlusograms have no force information in them at all.

Anyone who’s used articulating paper, which most of us do, and the T-scan, you still mark the teeth with paper, but you choose the contacts to treat based on the data, not based on where the paper marks look. And very often, the most pressure points of contacts are small, scratchy little marks that dentistry says are light force, which you’re completely wrong because again, the load is applied over area. So if you have a very small area, you have the potential for very high pressure.

Jaz’s Introduction:Protruserati, the occlusogram is lying to us. Does that sound familiar? Well, we welcome back again, Dr. Robert Kerstein. If you remember way back in episode 109, we made an episode called, “Articulating Paper Is Lying to Us,” and you guys absolutely loved it because Arctic paper is lying to us.

You should totally listen to that episode if you haven’t already. And if you haven’t, essentially the arctic paper marks you see on teeth are flawed in the sense that you can’t look at a mark and accurately say that, oh yeah, that’s more force, or that’s less force, or that’s hitting first. You don’t get that data.

And not only that, but you also get false positives when it comes to articulating paper. Now, similarly, I’ve got Robert Kerstein back again talking about the occlusogram. Now the occlusogram is that heat map you see when you do a scan, when you do an intraoral scan of a patient, upper arch, lower arch, and then you do the occlusion.

Most modern scanners will give you some sort of a heat map of the occlusion and we call that an occlusogram. And we may all at the beginning make this mistake, this very simple error, that when you see red on the occlusogram that means high force. Well, we will absolutely and emphatically bust that myth today.

You see the heat map or the occlusogram is just a measure of proximity. How close in space is that cusp to that fossa? And if it’s very close, it’s gonna be red. And if it’s maybe a few microns away, it’ll be a colder colour. Absolutely does not tell you how much force or timing or pressure, none of that stuff. Just contact proximity. So we must be careful in how we interpret that data. It would be misinformation to tell a patient that a certain tooth is having more load because of the colour.

Hello Protruserati. I’m Jaz Gulati and welcome back to your favourite dental podcast. Today’s guest is none other than Dr. Robert Kerstein. Rob Kerstein is like the godfather of digital occlusion. When I was in New Mexico a few months ago with Dr. Bobby Supple, he described Dr. Kerstein as the Einstein of occlusion, and it’s an absolute pleasure to chat with him again.

It’s a different format of the podcast. We’re driving, well, I’m driving, he’s my passenger. And so one of the team members, when they were listening to this, they said, it’s like carpool karaoke vibes. And don’t worry, we will not start doing a little singing and dance in the middle of this episode, but something a bit different, a bit fresh. Me and Dr. Kerstein were on the way to some DTR training in the UK.

DTR is Disclusion Time Reduction, essentially, if you listen to that episode that we did with Nick Yiannios. We talked about frictional dental hypersensitivity, and essentially lots of friction between the back teeth could cause your teeth to become sensitive. So this posterior dental friction is also implicated in TMD, thus resurfacing that old debate: is occlusion a causative factor of TMD?

Now, we all know some CAMs and some reviews that suggest that occlusion has no relationship to TMD. Whereas my guest, Dr. Robert Kerstein, says that TMD is a neurological condition and has everything to do with occlusion, and particularly that muscular TMD group would greatly benefit from an occlusal adjustment or something to change about their occlusion, to reduce that sensory input and their noxious muscular spasms.

And I saw all this freehand. I can’t wait to share my experience of what I witnessed when Dr. Robert Kerstein came to my practice and I treated three patients. So I’ll leave you on that teaser if you like, ’cause we have another episode coming with Dr. Jeremy Bliss talking all about occlusion, TMD and Disclusion Time Reduction, aka DTR.

Dental PearlBut for now, let’s enjoy this episode of occlusogram. And just before we join th...]]> 0:44:59 false https://podcast.show/protrusive/episode/149715333/ 149715333 https://protrusive.co.uk/?p=9421 Jaz Gulati Thu, 06 Nov 2025 00:56:53 -0500 Is social media killing professionalism in dentistry?

Are young dentists really “clowns” online—or is lightheartedness perfectly fine?

Is social media a disease? Where’s the line between humor, banter, and outright disrespect?

In this episode, Jaz is joined by Joseph Lucido from the States to tackle these tough questions head-on. Sparked by a fiery Facebook rant, they dive into whether social media is harming our profession, how dentists should present themselves online, and if there’s still room for fun without crossing the line.

Whether you love or hate dental content on social media, this conversation will make you rethink how we represent our profession to the world.

Shout-out to two US doctors creating excellent, entertaining content on social media

• Dr Brady Smith
• Dr. Nicholas J Ciardiello

Check out the 3-Step Modern Dental Marketing Plan from Clear to Launch Dental — designed to help you simplify your marketing and grow your practice without the overwhelm.

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

Takeaways

• Social media etiquette is crucial for healthcare professionals.
• Avoid controversial topics to maintain professionalism.
• A social media presence is essential for modern dental practices.
• Patients often check social media to verify a practice’s credibility.
• Content should reflect the personality of the dentist and practice.
• Highlight satisfied patients to build social proof.
• Consistency in posting is key to maintaining engagement.
• Separate personal and professional social media accounts.
• Batch content creation to save time and effort.
• Engaging content can lead to more patient inquiries.

Highlights of this episode:

• 00:00 Teaser
• 00:31 Intro
• 01:47 Introducing Joseph Lucido: Social Media Expert
• 03:21 Social Media Etiquette for Dentists
• 06:14 The Importance of Social Media Presence
• 12:04 Balancing Professionalism and Humor Online
• 17:39 Authenticity in Social Media
• 19:51 Balancing Personal and Professional Content
• 21:51 Effective Social Media Strategies
• 25:27 Time Management for Social Media
• 27:26 Do’s and Don’ts of Social Media
• 29:43 The Power of Social Proof
• 30:49 Conclusion and Resources
• 32:47 Outro

Love this episode? Don’t miss Best Practices in Social Media for Dentists – How to Stay Out of Trouble Yet Be Impactful (IC035)

#InterferenceCast #Communication #BreadandButterDentistry

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 walkthroughs and Masterclasses.

Teaser: What is the correct etiquette in 2025 and beyond for social media for dentists?

Teaser:The biggest shortcut a lot of social media questions get would be, we tell a lot of docs, this is social media, it’s social in nature, so your job is not to directly sell 24/7. The most extreme version of yourself is gonna get the most attention. So you might get, oh, look, I’m getting a lot of views. But going back to what I said earlier, it’s, well, what are people thinking when they see this?

Jaz’s Introduction: I saw a rant on Facebook. Obviously it was on Facebook. Where else do rants belong, right? It was saying, what has happened to our profession? What has happened to our beloved dentistry? The kind of crap we’re seeing on social media.

This dentist, who’s basically vexing about the way that he thinks young dentists are portraying themselves on social media, this anonymous poster of course, was saying we’re being clowns, we are disrespecting patients, we’re doing all sorts of unsavory things to get views and likes.

So Protruserati, is this the death of professionalism in dentistry? Is social media a disease? Is there a proper way to conduct yourself on social media, or is a bit of humor and banter and a bit of lightheartedness acceptable?

I’m a bit of an idiot on social media sometimes, but I know someone who does know. Today we’ve got our guest, Joseph Lucido from the States, and I asked him all these tough questions. He knows a thing or two about social media. So in this episode, you’ll find out what is the proper way to conduct yourself and whether Joseph thinks there is a space for idiots like me.

Hello, Protruserati. I’m Jaz Gulati and welcome back to your favorite dental podcast. This is an interference cast. This is a nonclinical arm of the podcast. Hope you enjoy the main interview and I’ll catch you in the outro.

Main Episode:Joseph Lucido, welcome to the Protrusive Dental Podcast. For those who are listening right now, Joseph has sat in this wonderful, you’ve got this wonderful background, that common look of the books behind you, so it makes you look like you’ve got so much authority. And he totally looks badass. But I had to ask him, is this real or is it fake? And actually he reached out, man, this is a very beautiful library behind you. Joseph, welcome to the show, my friend. How are you doing?

[Joseph] I’m doing great. Happy to be here.

[Jaz] Tell us about yourself. You’re not a dentist, but tell me how you are connected to dentistry. What makes you an authority? Talk about social media for dentists today, which I’m really excited to get into.

[Joseph] Sure. Probably starting around eight years old, I wanted to be a dentist. Just being in the dental office, I always loved getting my teeth cleaned. I had a few uncles that were dentists. It was just exciting for me.

And then just through my education, formally marketing degree, and then half of the books behind you are on marketing or psychology. And then it comes down to just different reps over and over and over on different platforms with docs, seeing what works, seeing what doesn’t work. I guess that gives me, I don’t know about the authority, but it gives me a pretty sharp edge on what works and what doesn’t.

[Jaz] Well, I think that does give you authority. The fact that they have skin in the game, the fact that you work with people on this, so you totally have the authority.

Interesting title we’ve opted for, right? Social media clown or healthcare professional. I really like this. When I first read it, I thought, oh crap, he’s onto me. He’s seen my videos. Because sometimes I’m a bit of a clown, and sometimes I’m very professional. I’m really looking for what your thoughts are on this.

So I guess the first place to start is, what is the correct etiquette in 2025 and beyond for social media for dentists? It’s a big topic and we can break it down and go anywhere you like.

[Joseph] Yeah, there’s gonna be a bunch of nuance to it, but the biggest shortcut a lot of social media questions get would be, what is the potential patient, the person viewing this, the followers, what are they gonna think after seeing whatever I post?

That should just be your starting point for everything social media related. Before you post, you want to be intentional in thinking. Now it becomes intuitive after a while to do it the right way, second nature. But from an etiquette standpoint, we wanna be thinking, I don’t wanna post anything that’s too controversial or too polarizing.

Now I’m talking specifically through the lens of a healthcare professional. If you’re trying to get attention some other way, that’s fine. But if we’re talking about being a professional in healthcare, we don’t want to talk about politics or religion. Avoiding these topics can alienate 50% or more of your audience, and it also kind of speaks to your self-awareness. You probably shouldn’t be posting this from a business perspective.

Arguing online, never a good look. Taking a combative stance, anyone who sees that, even if you’re defending yourself, even if you’re 100% in the right, that’s not what you wanna do from an etiquette standpoint.

We tell a lot of docs, this is social media, it’s social in nature, so your job is not to directly sell 24/7. Everyone’s seen the doc that posts and all they’re doing is selling, and you’re not gonna follow them.

[Jaz] So what you mean by that is, “Come in for our new patient Invisalign offer,” and just banging on about it every single day, and that’s it, it’s like repeat.

[Joseph] Even the other post is too much. And what we’d even argue is, the way that we operate it is we have the docs say, you do nothing from an office level organically. You should be fun, entertaining, posting like that, and then we’ll take care of the direct selling, because that’s what our team has experience in.

You don’t have experience in, how do I sell something, specifically the language that needs to be used, the call to actions, where the buttons go. That is so outside of your purview. But what’s inside of you, you’re an expert on you and your off...]]> 0:34:24 false https://podcast.show/protrusive/episode/149648735/ 149648735 https://protrusive.co.uk/?p=9391 Jaz Gulati Tue, 04 Nov 2025 02:39:37 -0500 Cracked teeth — the diagnosis we all hate as Dentists!

How do you decide when to monitor and when to intervene?

What is the recommended intervention at different scenarios of cracks?

Should we be chasing cracks and reinforcing with fibers; is there actually enough long-term data to support that approach?

Over the years, we’ve had some epic episodes on this topic — from Kreena Patel’s “I Hate Cracked Teeth” (PDP028) to Dr. Lane Ochi’s Masterclass on Diagnosis and Management (PDP175).

But in this brand-new episode, Jaz is joined by Dr. Masoud Hassanzadeh to bring it all together — not just the diagnosis of cracks, but their management. They explore when to intervene, the role of fibers in preventing propagation, and even the fascinating possibility that cracks in teeth may have some ability to heal, just like bone!

This one’s a deep dive that will change how you talk to patients — and how you approach cracked teeth in your own practice.

 Protrusive Dental Pearl

Your patient’s history predicts the future!

• Ask if past extractions were difficult → clues you into anatomical challenges.
• Ask how they lost other teeth → if cracks, be proactive with today’s cracks.

History isn’t just background—it’s a clinical tool.

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

Key Takeaways

• Cracks in teeth can be diagnosed using magnification and high-quality imaging.
• Patient factors such as age and muscle strength play a significant role in crack prognosis.
• Symptomatic cracks should be treated to prevent further propagation.
• Understanding the anatomy of the tooth is crucial for effective treatment.
• The healing mechanism of cracks in teeth is possible but varies between enamel and dentin.
• Fibers can be used to strengthen restorations and manage cracks effectively.
• Long-term studies are needed to assess the effectiveness of current crack management protocols.
• The use of fluorescence filters can help identify bacteria in cracks.
• Chasing cracks should be done cautiously to avoid pulp exposure.
• A comprehensive understanding of crack mechanics can improve treatment outcomes.

Highlights of this episode:

• 00:00 Teaser
• 00:47 Intro
• 03:08 Protrusive Dental Pearl – The Importance of Dental History
• 07:18 Interview with Masoud Hassanzadeh
• 08:22 Diagnosing and Managing Cracks
• 21:13 When to Intervene on Cracks
• 25:50 Restoration Techniques and Materials
• 28:30 Chasing Cracks: Guidelines and Techniques
• 36:50 Mechanisms of Crack Healing in Teeth
• 45:11 Exploring the Use of Fibers in Dentistry
• 52:43 Introducing the Book on Cracked Teeth
• 54:57 Percussion-Based Diagnostics (QPD)
• 56:44 Key Takeaways
• 57:21 Conclusion and Final Thoughts
• 01:00:07 Outro

As promised, here are the studies mentioned during the discussion:

1. Why cracks do not propagate as quickly in root dentin: Study 1a & 1b Root dentin has significantly higher fracture toughness compared to coronal dentin—nearly twice as tough, as demonstrated in multiple studies. The key difference lies in their structure and toughness. Root dentin’s unique collagen orientation adds strength, while its fewer lumens and thinner peritubular cuffs make it less brittle. In contrast, coronal dentin has thicker cuffs, which increase brittleness. Unlike coronal dentin, which fractures uniformly, radicular dentin is anisotropic—its fracture behavior varies depending on direction. These structural features give root dentin greater resistance to cracking, making it more durable under stress.
2. Studies on decreasing crack length due to crack repair in enamel. Study 2

3. The importance of the modulus of elasticity of the final restoration in arresting crack propagation. Study 3

4. The role of fiber in restoring cracked teeth and how it can increase fracture strength—even surpassing that of natural teeth. Study 4

5. Decision Making for Retention of Endodontically Treated Posterior Cracked Teeth – A 5-year Follow-up Study

6. The Cracked Tooth: Histopathologic and Histobacteriologic Aspects

Historical Studies on Enamel Crack Healing– 1949 (Sognnaes): The Organic Elements of the Enamel: III. The Pattern of the Organic Framework in the Region of the Neonatal and other Incremental Lines of the Enamel

– 1994 (Hayashi): High Resolution Electron Microscopy of a Small Crack at the Superficial Layer of Enamel

– 2009 (S. Myoung): Morphology and fracture of enamel

Don’t miss out — get instant access to all the research papers discussed here at protrusive.co.uk/cracks!

Dr. Masoud Hassanzadeh has written two essential books every dentist should own:

???? Glossary of Biomimetic Restorative Dentistry???? Your quick-reference guide to the language and principles of biomimetics — explained in a way you can actually use chairside.

???? The Cracked Tooth: A Comprehensive Guide to Cracked Teeth???? Everything you need to know about diagnosis, management, and the science behind one of dentistry’s biggest headaches.

This Easter, join Dr. Jaz Gulati and Dr. Mahmoud Ibrahim for something truly special — a tax-efficient holiday that mixes world-class occlusion training with plenty of family time in Dubai.

???? What’s included? ⏰ 20 hours of hands-on occlusion (mornings only: 9 am–1 pm) ????️ Afternoons & evenings free to enjoy Dubai with your family ???? Pre-learning + online content to deepen your understanding ???? A not-for-profit event — just dentists, families, and fun!

???? Learn more & get your quote at: globaldentalevents.co.uk

???? Make memories with your loved ones while making your CPD hours tax-deductible

Want to level up your knowledge on cracked teeth? ???? Don’t miss PDP098: Cracked Teeth Management with the Direct Composite Splint Technique

#PDPMainEpisodes #EndoRestorative #BreadandButterDentistry

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

This episode meets GDC Outcomes A and C.

AGD Subject Code: 070 ENDODONTICS

Aim: To provide clinicians with practical, evidence-based guidance for diagnosing, monitoring, and restoring cracked teeth, with emphasis on prognosis, risk factors, and restorative decision-making.

Dentists will be able to –

1. Differentiate between enamel and dentine cracks, and recognize when prognosis is hopeless.
2. Apply appropriate diagnostic tools and clinical criteria to decide when to monitor versus intervene.
3. Select suitable restorative strategies and materials to manage cracked teeth effectively.

Teaser: After 48 hours, they started to see that the crack is just decreasing, like it's just healing. Is it really possible? But it is possible. Like how there is a crack healing mechanism in the bone, there is also crack healing mechanism in the tooth. When I started to learn about cracks, actually the studies were not from dentists.

Teaser: They were fracture mechanic engineering that they just studied about the crack, and nowadays there is a new system, it is called quantitative percussion diagnostic, QPD. There is a stress concentration in that point where the crack is started, so we have to distribute the stress in that place, in that plane. That is the important one. If we are just going to remove the crack and put the restoration on it, I’m afraid it’s just going to happen again.

Jaz’s Introduction: Over the years, we’ve had some awesome episodes on cracked teeth. If you go all the way back to PDP028 with Krina Patel, the episode was titled, I Hate Cracked Teeth, and you know what? I still hate cracked teeth. They’re a damn nuisance. They’re everywhere, and it creates major consent and if the tooth goes non-vital, that kind of conversation, which no one likes....]]> 1:00:05 false https://podcast.show/protrusive/episode/149637385/ 149637385 https://protrusive.co.uk/?p=9378 Jaz Gulati Sun, 02 Nov 2025 12:57:00 -0500 With the final places remaining for our Occlusion Getaway, we present the official FAQ Podcast!

Dreaming of combining occlusion learning with a luxury getaway?

Want to earn 56 hours of CPD while soaking up the Dubai sunshine?

Looking for a course where you can master PRACTICAL occlusion in Restorative Dentristry and make it a family-friendly, tax-deductible trip?

Easter 2026 is set to be unforgettable. Join Dr. Jaz Gulati and Dr. Mahmoud Ibrahim for an extraordinary Occlusion Excursion in Dubai — a blend of serious CPD and sunshine that redefines what “continuing education” can be.

We’ve always believed in mixing work and pleasure, and this time, we’re taking it to the next level. Think luxury, learning, and laughter — all under the warm Dubai sun.

Watch IC062 on Youtube

???? What Makes This Course Different?

• 56 hours of CPD/CE credits, including 20 hours hands-on in Dubai
• Full online occlusion curriculum and live webinars before you travel
• Morning workshops (9 AM–1 PM) and free afternoons to explore Dubai

Bring your family (Easter school holidays!) or come solo — many dentists are already flying in from around the world.

REQUEST A QUOTE – Limited Places Remaining as of November 1st 2025!: https://globaldentalevents.co.uk/ 

Spaces are limited and flights are rising, so secure your place early.???? Easter 2026 – Occlusion, sunshine, and CPD in Dubai.

???? 28 March – 4 April 2026

???? Dubai, UAE

????‍⚕️ Dr. Jaz Gulati & Dr. Mahmoud Ibrahim, Organised by Global Dental Events

Highlights:

• 04:06 Meet the Organizers
• 05:59 Why Dubai?
• 10:40 Delegate Experiences and Expectations
• 13:21 Course Pricing and Tax Benefits
• 19:05 Course Itinerary and Logistics
• 24:49 Final Thoughts and How to Join

Are lights and in-office “power whitening” just marketing hype?

And what’s the deal with the infamous white diet – do your patients really need to give up coffee and red wine?

In this episode, I sit down with Dr. Wyman Chan, the man who literally hung up his drills in 2002 to dedicate his career to whitening alone. With over 20,000 cases under his belt (and a PhD in the science behind it), Wyman shares his three golden rules for whitening success: trays, communication, and conscious bleaching.

We’re also joined by Dr. Niki Shah, who brings his own insights into whitening and patient care, making this a conversation packed with both science and clinical experience.

Wyman introduces his latest invention—Magic 3, a fizzing gel that reveals and removes plaque while calming gums. Plus, Wyman busts some of the biggest whitening myths (sorry, “white diet”) and explains why he no longer bothers with internal bleaching.

If you’ve ever wondered how to make whitening safer, more predictable, and less stressful for you and your patients—this is the episode you’ll want to tune in for.

Protrusive Dental Pearl

Innovation in Hygiene with Magic 3 – What is Magic 3?

• A colorless plaque indicator gel developed by Wyman Chan.
• Fizzes on contact with plaque.
• Cleans teeth, removes superficial stains, and softens soft calculus.

Clinical Application

• Alternative to scaling/polishing for routine patients.
• Nervous patients who dislike ultrasonic scalers.
• Children (6+) – safe as a Class I medical device.
• Orthodontic patients – helps prevent white spot lesions.

Learn more at https://protrusive.co.uk/magic3

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

Key Takeaways:

• Teeth whitening success depends on tray design, formulation, technique, and compliance.
• Conscious bleaching helps minimise sensitivity.
• Sensitivity is due to peroxide reaching the pulp.
• Patients should adjust wear time gradually, starting short and increasing if comfortable.
• Communication and treatment planning are crucial to match whitening regimes with lifestyles.
• The “white diet” is not scientifically necessary – normal eating and drinking can resume within minutes.
• External bleaching alone can be effective, even for single dark teeth.
• Tetracycline-stained teeth can respond to whitening with the right protocols.
• The brand is less important than protocol consistency and clinician experience.
• In-office light-assisted whitening adds risk, cost, and chairside time without proven benefit.
• Allergic reactions are more likely caused by gel additives, not peroxide itself.
• Emerging products, such as peroxide-based gels for plaque disruption and gingival health, may complement whitening in the future.

Highlights of this episode:

• 00:00 TEASER
• 1:00 INTRO
• 3:13 PROTRUSIVE DENTAL PEARL
• 07:05 Dr. Wyman Chan Introduction
• 13:32 Niki’s Journey in Dentistry
• 17:03 Whitening Products and Techniques
• 23:09 Three Keys to Whitening Success
• 30:03 Addressing Sensitivity in Teeth Whitening
• 37:43 MIDROLL
• 41:04 Addressing Sensitivity in Teeth Whitening
• 46:15 Whitening as Treatment Planning
• 49:10 Myths and Misconceptions
• 01:00:27 Lights and In-Office Whitening
• 01:03:13 Introducing Magic3: A Revolutionary Dental Product
• 01:16:10 OUTRO

Discover Magic3 and Dr. Wyman Chan’s inventions

If this episode piqued your interest, continue the whitening theme by listening to PDP199 “How To Eliminate Sensitivity During Teeth Whitening”. And don’t miss the upcoming visual follow-up to this episode!

#PDPMainEpisodes #BreadandButterDentistry

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: 780 – Esthetics/Cosmetic Dentistry

Aim: To deepen dentists’ understanding of teeth whitening by exploring evidence-based protocols, tray design, and methods to reduce patient sensitivity. It also aims to challenge common myths and introduce innovations that can improve both patient comfort and clinical outcomes.

Dentists will be able to:

1. Evaluate the importance of tray design, communication, and conscious bleaching as critical factors for safe and effective whitening outcomes
2. Identify the common causes of whitening sensitivity and apply strategies to minimise or prevent pulpal irritation during treatment
3. Assess the evidence behind common whitening myths, including the “white diet” and the use of heat/light for activation.

Teaser: What is the three most important features in getting a good whitening result? Number one, because- is it true that patients should try a white diet when having treatment?

Teaser:I heard of that when I was started bleaching 30 years ago- because I don’t have the drill anymore. They say I can’t do internal bleaching. It’s just because I give myself restriction. I have no drills at my clinic. If you’ve got a good protocol, it works- like I can show you some cases just two weeks. It’s amazing result. Get from a C4 to B1, just two weeks.

Two weeks for Tetracycline staining.

This is a colorless plaque indicator. Remove plaque at the same time. Also reduces gingival inflammation. They say we have nothing like that.

Is this solution a substitute for mechanical plaque?

It’s substitute for mechanical cleaning. To me, there’s no need to do polishing.

Jaz’s Introduction:Protruserati. We have got THE Wyman Chan and how I pull this off, this is the guy who I’ve been watching the whitening space for so many years, and actually he kind of disappeared. Where did Wyman Chan go? Was on the lips of every UK dentist for so many years. But guess what? He is back. Alright, lemme tell you about Wyman Chan.

This guy hangs up his drills in 2002 to solely focus on teeth whitening. That’s it. Imagine that. Right at a time where teeth whitening wasn’t even like a proper thing. So since then he’s been like whitening the teeth of celebrities and all the famous people will go to a central London clinic, get their teeth whitened by him using his formulas, his patented technology and his knowledge.

Like he’s a PhD and he’s so passionate about teeth whitening. The guy’s done over 20,000 whitening cases. I was actually thinking. I don’t even think I’ve seen 20,000 patients in general in my career so far. So that just tells you the volume of teeth whitening he’s done and he’s like a mega geek. Like what he doesn’t know about whitening is not worth knowing.

So we take advantage of that. I literally ask him all of your questions that you submitted on Protrusive Guidance, the usual stuff like is the light thing, is it a fad or is there some science behind it? Do you need to adopt a white diet two hours after whitening to make sure that you get a good effect from teeth whitening?

Like that’s all standard. We actually talked about it before, but we revisit it in this episode. But of course, every episode we have a game changers and there’s a few game changers. About three, well, there’s more than three, but the three that are top of my mind right now while recording this introduction.

One is that for non vital bleaching, imagine you get that black central incisor. Usually the way I would treat it is make sure that the root canal treatment is good, and then re-access the access cavity of course, and place my gel inside and whiten from inside and also outside. Now, what Wyman Chan discusses is a protocol of not doing the internal part of non vital bleaching, doing it externally only, which is very fascinating.

The other cool thing he teaches in this episode is this concept of conscious bleaching, which I’d never come across before, but it makes so much sense. It is the number one thing that reduces and eliminates sensitivity. And I’m a little bit upset that no one told me before. It just makes so much sense. I can’t wait for you to listen to this episode and learn about what is conscious bleaching.

Dental Pearl:And the final game changer is today’s Protrusive Pearl. Hello, Protruserati. I’m Jaz Gulati. And every PDP episode we give you a Protrusive Dental Pearl, something to reflect on, something to digest, something to apply to your patients right away. We have all sorts on here. And today’s pearl is about innovation.

Wyman Chan is just like this awesome guy in whitening and he has got so many patents I didn’t even know about this. And one new invention he’s come up wit...]]> 1:14:44 false https://podcast.show/protrusive/episode/149260867/ 149260867 https://protrusive.co.uk/?p=9282 Jaz Gulati Mon, 20 Oct 2025 00:19:11 -0400 Why should Dentists be talking about screen time with parents?

Are smartphones even safe for children?

What is the right age to give a child their first phone?

Laura Spells and Arabella Skinner join Jaz in this thought-provoking episode to tackle one of today’s biggest parenting challenges: smartphones and social media in young hands. Together they explore the impact of early phone use on children’s health, development, and mental wellbeing—and why healthcare professionals should be paying close attention.

 Protrusive Dental Pearl: Live by your values—not your profession, spouse, or children. Don’t sacrifice for them; choose what aligns with you, so love never turns into resentment.

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

Key Takeaways

• Screen time is a significant public health concern. Mental health issues are rising due to social media exposure.
• Early childhood screen time has long-term effects. Parents need clear guidance on screen time limits.
• Community support is essential for children’s well-being.
• Health professionals must ask about screen time in assessments.
• Regulatory changes are needed for safer screen use.
• The impact of social media on self-esteem is profound. Misinformation about health trends can lead to dangerous practices among youth.
• Dentists play a crucial role in educating patients about safe health practices.
• Parents should engage in conversations about social media with their children.
• Creating a family digital plan can help manage screen time effectively.
• Collaboration among health professionals needs to raise awareness about the dangers of unregulated products.
• Empowering parents with knowledge is essential for effective parenting in the digital age.
• Role modeling healthy behaviors is important for parents.

Highlights of this episode:

• 00:00  TEASER
• 01:18  INTRO
• 03:13 PROTRUSIVE DENTAL PEARL
• 04:54 Introducing Our Guests: Arabella and Laura Spells
• 09:24 Statistics and Scale of the Problem
• 18:09 Early Years and Screen Time
• 22:27 Safer Alternatives and Regulation
• 27:08 MIDROLL
• 30:29 Safer Alternatives and Regulation
• 30:53 Ideal Guidelines for Screen Usage
• 34:01 The Role of Dentists in Addressing Social Media Issues
• 44:59 Parental Guidance and Digital Plans
• 53:53 Final Thoughts and Resources
• 56:06 OUTRO

????Seven Habits of Highly Effective People by Stephen Covey for habits that support balanced parenting and leadership.???? Kindred Squared School Readiness Survey on how early screen use impacts child development. ???? Follow Health Professionals for Safer Screens for practical tips to share with families, and on their Instagram for bite-sized advice???? Support the Smartphone-Free Childhood Campaign to delay smartphone use in children.

If this episode gave you new insights, you’ll definitely benefit from Parenthood and Dentistry (Even if You’re Not a Parent!) – IC025

#InterferenceCast #BeyondDentistry #Communication

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

This episode meets GDC Outcomes A and B.

AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS

Aim: To provide dental professionals with an understanding of the health risks of early smartphone and social media use in children, and how dentists can play a role in safeguarding and guiding families toward safer digital habits.

Dentists will be able to –

1. Recognize the health and developmental impacts of early and excessive screen use.
2. Identify how social media contributes to anxiety, body image concerns, and misinformation (including dental-related fads).
3. Discuss practical strategies that families can use to create healthier digital habits.

Teaser: We have to address the issue in early years because if you've had your child sitting on a screen from day one, by the time they get to eight or nine and they want a smartphone, which is the ubiquity in their pocket, it's really hard to explain to them why they can't have it.

Teaser:What is the right age for a smartphone?

Yeah. We would say that smartphones with full internet connectivity and everything involved and social media, it’s-

This smartphone usage has become almost the norm for every teenager across the country. And of course what a smartphone does is allow people 24 hours to access to the internet, to social media, to all the unfettered things that we need to, they can see. If you think about whole child health, and that’s how we should be approaching health for our children.

Obesity’s gone up. There’s huge linkages between the seditary behavior of being on screens, but not just the seditary behavior. Because actually if you are sitting on social media or you’re sitting on gaming, you are targeted by fast food manufacturers in a way, way more than you would be on TV. You could have a big argument about the quality of what children are doing on screens when they’re 15, 16.

Or they learning to make music. Are they revising and doing things, but for a two, three, 4-year-old, there are no benefits of being exposed. 

Jaz’s Introduction:What a time to be alive as a parent. Back when I was a kid, I would go and play football for hours. My parents, they kind of knew where I was, but there was no way to reach me. And the other thing I remember is that when I was a kid, I wanna go to cinema. And then so you agree with your friends that, look, I’m gonna see you at 11:00 AM, at the cinema on Saturday. And there was none of this like texting and WhatsApp and Snapchat and that kind of stuff, and you would just show up at 11:00 AM on Saturday, and that’s a simple life that we lived.

But now with smart phones and social media, I really worry for our children, which is why I brought some experts on to discuss phone use in children and best practices for screen time and smartphones. And so you are thinking Jaz, what has this got to do with dentistry? Well, we have an active role to play as healthcare professionals.

Early smartphone usage and social media is absolutely detrimental to the health of our children. And as healthcare professionals, we have a duty to know about this and to spread the good word. And many of you, like me, are parents, and we need to hear this stuff. We need training.

We need guidance, and that’s exactly what we bring you today. You’re gonna love our guest, Arabella and Laura. But I wanna say thank you to Protrusive community member, Lydia, Dr. Lydia Roulston. It’s been so nice to chat to you on the app, give each other book recommendations, and you are part of this very organization that’s helping schools and communities to realize the dangers of having smartphones in young hands.

Dental Pearl:I’m so grateful that you’re part of our nice and geeky community. Now, this is an Interference Cast, which is like the nonclinical arm of the podcast, and I usually reserve my Protrusive Pearls for the actual PDP episodes. And as many of you know, I actually struggle when it comes time. I freeze up when it comes time to give a pearl, ’cause I’ve given like 300 in the past.

I’m kind of running out of nuggets. Like obviously there’s an endless amount of dental nuggets and gems out there, but to suddenly pull one out can be a bit tricky. But you know what? I’ve got one from the heart. So even though it’s an icy, I still want to give a pearl. And it’s like from the heart as a parent. In the book, I think it was Seven Habits of Highly Effective People by Stephen Covey.

It talks about being value centered and not being like a profession centered, like your entire world shouldn’t be about being a dentist. Your number plate shouldn’t be dentist. You shouldn’t introduce yourself to, hey, I’m Jaz, I’m a dentist. Like, your identity should not be your profession. The world also shouldn’t revolve around your spouse, nor should your world revolve around your children.

Your world should revolve around your values. And how I’m linking it even more to this theme of parenthood is that, I have a 6-year-old and we go through all the tantrums and behavior issues that all parents do. It’s very normal. And I love talking about being a parent to my patients. I learn a lot from my patients.

I do have an elderly patient base, and so I do get to benefit from their wisdom. And one thing I’ve come to conclude over time is that if you want to do something for y...]]> 0:54:16 false https://podcast.show/protrusive/episode/149141031/ 149141031 https://protrusive.co.uk/?p=9263 Jaz Gulati Mon, 13 Oct 2025 00:36:13 -0400 How can you tell if a root canal treatment is truly successful?

Do you always need cuspal coverage after a root canal?

Are hand files still relevant, or has rotary completely taken over?

And does GP pumping really improve the effectiveness of irrigants like hypochlorite?

Emma returns for another Protrusive Student Series episode as she heads into her final year of dental school. Together, we explore the fundamentals of endodontics – covering restoration choices, success criteria, instrumentation, and irrigation protocols.

This episode breaks down the basics every student and young dentist should understand, while also tackling the common debates and real-world challenges of endo.

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

Key Takeaways

• Understanding the ‘why’ behind dental procedures is crucial for effective practice.
• Both hand files and rotary files have their place in endodontics, especially for beginners.
• Good irrigation techniques are essential for effective endodontic treatment.
• Rubber dam isolation is critical for safe and effective endodontic procedures.
• Learning to determine the master apical file size is a key skill in endodontics.
• The use of EDTA helps in removing the smear layer during root canal treatment.
• Endodontic specialists often use advanced techniques and tools for more efficient treatments.
• Success in endodontics is not just about radiographs, it is sometimes defined by patient comfort and healing.
• Cuspal coverage is often necessary after root canal treatment.
• Patient communication is key to managing expectations.
• Consent forms should be tailored to individual cases.
• Understanding proprioception is important for tooth preservation.

Highlights of this episode:

• 00:00 Teaser
• 00:51 Intro
• 02:50 Emma’s Final Year Reflections
• 04:34 Exploring Specialties
• 07:02 Endodontics: A Student’s Perspective
• 08:15 Rotary vs Hand Files
• 11:45 Step-by-Step Notes for Students
• 14:24 Patency and Recapitulation
• 14:55 Determining Master Apical File Size
• 16:58 Irrigation Protocols and Techniques
• 21:22 Typical Irrigation Protocol
• 23:51 Rubber Dam Importance
• 27:25 Rubber Dam Importance
• 28:21 Role of 17% EDTA
• 28:59 Success Factors in Endodontics
• 29:46 Success Factors in Endodontics
• 30:46 Real-World Endodontic Practices
• and Challenges
• 32:11 Understanding Success and Survival in Root Canal
• 34:26 Successful Outcomes
• 36:24 Success vs Survival
• 38:12 The Debate on Cuspal Coverage and Timing
• 40:48 Proprioception
• 41:54 Pre-Endodontic Build-Up
• 42:29 Direct Cuspal Coverage
• 44:03 Consent and Communication in Endodontic
• 47:25 Conclusion and Future Topics
• 49:02 Outro

Resources mentioned:

• Outcome of primary root canal treatment: systematic review of the literature – Part 1 
• Outcome of primary root canal treatment: systematic review of the literature – Part 2. Influence of clinical factors 
• Radiographic Assessment of the Quality of Root Canal Fillings

Check out Simple Re-RCT Cases – ‘How To’ Guide – PDP233 for more Endodontic insights

#BreadandButterDentistry #EndoRestorative

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

This episode meets GDC Outcome C.

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

Aim: To provide dental students and early-career dentists with a structured understanding of endodontic fundamentals, including instrumentation, irrigation protocols, success factors, and restorative considerations.

Dentists will be able to:

1. Differentiate between hand and rotary file systems and identify their advantages and risks.
2. Evaluate the factors influencing the success and survival of root canal treatment.
3. Recognize when cuspal coverage or pre-endodontic build-ups are required.

Teaser: You go to dental school, you're going to be using hand files. You're gonna get taught with hand files, everything's gonna be hand files, and that's how you're taught in dental school.

Teaser:As long as you understand when you’re doing, you’re trying to like determine tug back and you’re trying to determine the master apical file size, for example, right? Those skills you do with hand files and they’re universal.

The most important thing is more important than the final system – Root canal without rubber dam is like doing heart surgery in the toilet. The thrill of the fill. Okay. You put your GP in and it looks as though it is to length and it doesn’t have any voids in it.

And we think, wow, this is success. Right? But the thing is, when you see a radiograph, the radiograph cannot tell you. Whether rubber dam was used, whether hypochlorite was used, whether the coronal seal was really that good, and what protocols were used in terms of this disinfection.

Jaz’s Introduction:Basics of Endodontics. Welcome back to another Protrusive Student Series. This arm of the podcast is for students, young practitioners, those returning back to practice, or you just love listening to the podcast and you want validation. Welcome new listeners and welcome back to the returning Protruserati. We were joined with our Protrusive Student, Emma.

As she transitions into her final year of dental school, she asked all the right questions. Do you always need cuspal coverage after root canal? What kind of cuspal coverage should we go for? What determines if your root canal has actually been successful? Like we’ve all seen root canal treatments that been there for 30 years and they look questionable on the radiograph.

But there’s no pathology. Does that still count as a success? How about hand files versus rotary? Are hand files obsolete? And lastly, how significant is GP pumping to agitate your arrogance such as hypochlorite? All these questions are much more discussed in this episode.

And as of a few episodes ago, these episodes are also eligible for CPD. So if you want some easy CPD for those who are paying subscribers on the Protrusive Guidance app, don’t forget to answer the quiz. You would’ve done all the hard work of listening. You might as well get the CPD saying so by time December comes, you’re absolutely laughing. Let’s join the main interview and I’ll catch you in the outro.

Main Episode:Emma, welcome back to the podcast, a Protrusive Student. How is your summer going? You know, I mean, I remember specifically this transition from fourth year to fifth year. And it’s really strange because like for you, it is different in a way ’cause you’ve finished your finals, right? You’ve passed.

So congratulations, congratulations once again. But it’s like you’re about to enter the final chapter. It’s a bit emotional the next round when you finish finals and then you have like, you enter the rat race. That’s an even bigger, weirder scenario. But tell us about where your headspace is at the moment.

[Emma]I think for my final year, now that I have my exams over, I’m actually kind of excited. I think a lot of people are finding the same. I find a lot of people at Glasgow say that final year is their favorite year, because you don’t have that stress of exams. You’re more just working as a wee dentist and getting put into different outreach placements and you’re just clinical all day, every day, pretty much. So it’s just purely building on your clinical skills and getting more knowledge. So no more lectures. So I’m actually kind of excited for it. 

[Jaz]I think that’s so cool. I’m very envious of you actually, because in most dental schools, the final year is like this crushing one. I mean, I can remember, the sheer emotions that you experienced during fourth year, but then it all culminates and I think it’s great that you managed to get out the way in fourth year, and I could really just focus. Your focus shift towards how can I get myself prepared for the real world, right? 

[Emma]Yeah, for sure. But definitely this time last year, very nervous. But this year I’m feeling good. I’m feeling excited for it. 

[Jaz]Good. I’m really happy, I think this is the best way because now that your focus is, how can you prepare yourself for the real world of practice? You learn differently. ‘Cause I find like with anything, most of the learning happens right towards the very end. There’s a very valuable amount of learning in any cycle that happens towards the end.

And when you have a traditional model of schooling in dental school, whereby your finals exams are in the final year, you are kind of learning to pass an exam, not learning to serve your patients better, improve your clinical skills to as much as you want to. Yes, that’s always, there is a constant theme in the...]]> 0:47:33 false https://podcast.show/protrusive/episode/148915865/ 148915865 https://protrusive.co.uk/?p=9254 Jaz Gulati Mon, 06 Oct 2025 05:07:00 -0400 How should you  gain consent for ELECTIVE treatments?

Is selling in dentistry something to avoid, or an essential part of patient care?

How much does emotional intelligence really matter for your success and happiness?

Dr. Colin Campbell joins for a powerful episode that dives into consent, sales, and the balance between profit and ethics in dentistry. He also unpacks the huge role of emotional intelligence—not just in clinical practice, but in life.

Expect real talk, strong opinions, and communication gems that can reshape the way you connect with patients and approach your career.

Protrusive Dental Pearl: Read (or listen to) the book Let Them by Mel Robbins — a powerful reminder to take control of your own life and emotions instead of letting outside events dictate them.

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

Takeaways

• Building trust with patients is crucial for effective consent.
• Consent should be a relationship management exercise, not just a legal formality.
• Understanding the patient’s perspective is key to effective communication.
• Elective treatments should be approached with caution and ethical considerations.
• Sales in dentistry is not a dirty word; it’s about providing solutions to patients.
• Emotional intelligence is a vital skill for dentists to develop.
• Good dentistry is about doing what is best for the patient, not just for profit.
• Continuous education and self-improvement are essential for success in dentistry.

HIghlights of this episode:

• 00:00 Teaser
• 00:44 INTRO
• 01:44  Protrusive Dental Pearl
• 02:58 Welcoming Dr. Colin Campbell
• 04:55 Colin’s Background and Philosophy
• 05:36 The Importance of General Dentistry
• 08:40 Finding a Niche vs. Being a Generalist
• 11:14 Understanding Consent in Dentistry
• 17:42 Fear of Losing the “Sale”
• 18:50 Building Trust with Patients
• 22:09 Consent Process Overview
• 22:49 Patient Consultation Process – Building the Bridge to Trust
• 29:00 Developing Emotional Intelligence (EQ)
• 30:00 Patient Consultation Process – The Mechanics
• 30:58 Patient Consultation Process – Exploring Options
• 31:13 Join Protrusive Guidance
• 34:34 Patient Consultation Process – Exploring Options
• 34:36 Patient Consultation Process – Follow-Up and Consent Pathway
• 35:54 Patient Pathways After Consultation
• 36:48 Treatment Plan Letters & Legal Angle
• 38:45 Approach to Consent Letters
• 40:21 Personality Types in Consultations
• 42:21 Systematizing Your Process
• 43:37 Ethics in Elective Treatments
• 53:15 Guidance for New Dentists on Elective Treatments
• 56:33 Interjection
• 57:48 Guidance for New Dentists on Elective Treatments
• 57:56 Sales in Dentistry 
• 01:03:05 Conclusion and Final Thoughts
• 01:05:20 OUTRO

✨ Transform Your Dentistry ✨

???? Campbell Clinic – world-class private care in Nottingham.

???? Campbell Academy – ethical implant training from beginner to expert.

✍️ Colin Campbell Blog – daily insights to challenge & inspire.

If you liked this episode, check out ‘How to Win at Life and Succeed in Dentistry’ with Richard Porter

#PDPMainEpisodes #CareerDevelopment #Communication #BestofProtrusive

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

This episode meets GDC Outcomes A and D

AGD Subject Code: 550 – Practice Management and Human Relations

Aim: To explore the ethical, emotional, and practical aspects of private dentistry, with a focus on gaining valid consent, balancing profit with ethics.

Dentists will be able to –

1. Explain the importance of trust and rapport in the consent process.

2. Recognize the ethical challenges of elective treatments.

3. Outline strategies for building long-term career satisfaction and avoiding burnout.

Teaser: When you think about the number they have per hour, less than five is normal, right? Less than five of these breath holds is normal. Between five and 15 is your mild category. 15 to 30 is moderate, and above 30 is severe. You see patients that have what we call an AHI Apnea-Hypopnea Index of 60, and sometimes these breath holds can be 30 seconds.

Teaser:Profit is oxygen for my business. Get that? It’s essential for life, but it’s not the meaning of life. I do not wake up in the morning going, oh, I’m gonna get some oxygen today, but if I don’t breathe, I’m dead. Right? So we need to-

I don’t think that’s the question. I think the question is what would I do if you or my wife, brother, mother, daughter, son? And so I’d say what you want me to do is use the experience that I have to pigeonhole you as a member of my family.

The world consent is a relationship management. You can’t treat your patient as if they were you. You have to treat them as if they are them. I would like to say to the guys is if you want to be really successful in the industry, both in terms of financially and in terms of the respect you get from your peers and in terms of the satisfaction you get from your job, try and-

Jaz’s Introduction:Gaining consent for elective treatments, selling in dentistry, the monumental role of emotional intelligence for your happiness in your life and your career. Hello, Protruserati. I’m Jaz Gulati and thank you for tuning in to what I think will be a Protrusive Hall of Famer. This episode gave me vibes of Richard Porter.

The OGs will remember way back when we did an episode called How to Win at Life and Succeed in Dentistry, and we talked a lot about emotional intelligence in that episode. Brilliant episode Richard Porter. Do go back in the archives and check it out, and this episode builds so nicely on that. Dr. Colin Campbell is absolutely scintillating inspiring.

I’m so excited for you to be able to listen and watch this from wherever you’re tuning into. Thank you so much. There are some real great gems on communication and some absolute real talk, controversial, real talk from Colin, which I absolutely loved. So if you’re doing a lot of composite veneers, you may wish to skip this episode. Colin does not mince his words.

Dental PearlNow this is a PDP episode, so I owe you a Protrusive Dental pearl. And you know what, I might have actually given you this pearl before. Like recently, maybe I perhaps gave it in a recent episode, but it’s in my head and it’s so relevant for this episode, right? This audiobook, I listen to, “Let them.” Now if you are even slightly into audible books or had a look at which books are on sale right now.

This book Let Them is everywhere. And for good reason, I listen to an audiobook and Mel Robbins, honestly, this audiobook is so, so brilliantly done. You literally feel like she’s talking to you. It’s so easy to listen to, so conversational and my friends, I think this book will change your life. I’m desperately pleading my wife to read this book and she won’t because she doesn’t read.

So as per the philosophy of this book. Let her, let her not read, let her not gain from this book, but let me drip feed the lessons to her. Let me induce a degree of osmosis, informational osmosis, and take control of the situation. So you kind of get a flavor of this book already. I’ll put the link in the show notes.

This book is all about taking control of your life and not letting what happens around you to control you and your emotions. It’s about you taking control of your life. So once again, Let Them by Mel Robbins. I put the link in the show notes. And now let’s check out this absolutely cracking episode with Colin Campbell.

Main EpisodeDr. Colin Campbell, welcome to the Protrusive Dental Podcast. How are you, my friend? 

[Colin]I’m very well, and I’m very excited to be here. Actually. 

[Jaz]You’re the one who’s super excited. 

[Colin]No, no, no. I just spent a few minutes, when I was preparing just eyeing Jaz Gulati and who he was. So I always like to do my research just to get the background because I don’t think we’ve ever met. So I’m really pleased I used to be on. Thank you very much for inviting me. 

[Jaz]Well, I’ve been on the receiving end, some of your lectures, and I want to start by saying that as a public speaker, honestly, up there with one of the most charismatic, energetic and human, like really the way you speak, when I’m listening to you speak, Colin, it’s like no one else in the room.

You are speaking to me honestly, like you have this gift. I dunno if anyone’s told you this. If not, then you need to hear it then, the way you came my radar is dentinal tubules. Maybe in 2019 or something you might done ...]]> 1:04:52 false https://podcast.show/protrusive/episode/148772154/ 148772154 https://protrusive.co.uk/?p=9204 Jaz Gulati Mon, 29 Sep 2025 01:30:00 -0400 Can and should Dentists carry out home sleep testing?

It’s actually super easy and I have been doing it for 18 months!

What happens after you screen them—do you know what to do next? This episode will teach you!

Dr. Jaz Gulati shares his personal journey into incorporating sleep testing in practice—after 1.5 years of doing it, the impact has been nothing short of game-changing.

Joined by clinical sleep scientist Max Thomas in this jam-packed episode, they deep dive into what it really means to go beyond awareness of sleep-disordered breathing. He breaks down the practical steps for dentists who want to do more than just refer—and start making a difference in their patients’ lives.

You’ll learn how to bridge the gap between theory and action, how to screen effectively, and why you play a pivotal role in the patient’s journey to better sleep, more energy, and a healthier life.

Protrusive Dental Pearl: If a patient has been seen gasping, choking, or stopping breathing during sleep — that’s pathognomonic for sleep-disordered breathing.

???? Don’t ignore it — they likely need a sleep study. Ask this in every history!

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

Key Takeaways:

• Understanding obstructive sleep apnea is crucial for dentists.
• Dentists are in a unique position to screen for sleep disorders.
• The Malampati score is an easy tool for assessing airway obstruction.
• Sleep disorder breathing can significantly affect quality of life.
• Patient history is vital in diagnosing sleep apnea.
• Quality of sleep is more important than quantity.
• Dentists should ask specific questions to identify sleep issues. Sleep position can significantly affect sleep quality.
• Screening tools like Stop Bang and Epworth are essential for identifying sleep disorders.
• NHS sleep testing can vary greatly in wait times depending on location.
• Snoring is often a precursor to more serious sleep disorders.
• Dentists can play a crucial role in sleep disorder management.
• CPAP is the gold standard for treating sleep apnea.
• Understanding the legalities of sleep screening is vital for dental professionals. Remote monitoring became essential during COVID-19, shifting paradigms in sleep medicine..
• Remote monitoring helps ensure patients are truthful about their usage of devices.
• Mandibular advancement devices may be more effective for certain patient profiles.
• Patient compliance is crucial, with many struggling to adapt to CPAP.

Highlights of this episode:

• 00:00 Teaser
• 01:15 Intro
• 04:51  Protrusive Dental Pearl
• 05:52 Introducing the Expert: Max Thomas
• 09:39 Importance of Screening and Diagnosis
• 13:41 “Crowding” at the Back of the Mouth
• 14:46 Mallampati Score
• 18:54 Understanding Sleep-Disordered Breathing
• 25:35 Screening Tools and Techniques
• 32:09 Screening Questionnaires
• 37:24 Midroll
• 40:44 Screening Questionnaires
• 40:53 Athlete Sleep Screening and Marginal Gains
• 44: 20 Identifying Patients for Sleep Testing
• 46:15 Snoring: Risk Factor for OSA
• 51:44 Mandibular Advancement Devices and Legalities
• 55:33 Diagnostic and Treatment Options
• 56:57 CPAP: The Gold Standard for Sleep Apnea
• 01:08:33 Retesting Before MAD
• 01:14:41 Dentists Warning about DVLA Implications
• 01:17:18 Final Thoughts and Recommendations
• 01:19:19 Outro

Resources for Screening Sleep Apnea

• S4S Pre-Screening Questionnaire
• Mallampati Score
• Epworth Sleepiness Scale
• STOP BANG Questionnaire

Screening Tools

• The Acupebble Device 
• WatchPAT as an alternative
• Send your sleep test for reporting to Max Thomas – excellent service and affordable
• Max Thomas’ LinkedIn

If you loved this episode, don’t miss Sleep Disordered Breathing and Dentistry – PDP139

#PDPMainEpisodes

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: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Sleep Medicine)

Aim: This episode is aimed at empowering general dentists with the knowledge and practical steps to actively participate in the screening and co-management of sleep-disordered breathing through the integration of home sleep testing in their clinical practice.

Dentists will be able to –

1. Understand the role of general dentists in identifying signs and symptoms of sleep-disordered breathing, particularly obstructive sleep apnea (OSA).
2. Identify when and how to refer appropriately to sleep physicians or medical specialists after screening.
3. Explore collaborative workflows between dentists, sleep scientists, and GPs to ensure effective patient management.

Teaser: When you think about the number they have per hour, less than five is normal, right? Less than five of these breath holds is normal. Between five and 15 is your mild category. 15 to 30 is moderate, and above 30 is severe. You see patients that have what we call an AHI Apnea-Hypopnea Index of 60, and sometimes these breath holds can be 30 seconds.

Teaser:You end up looking at these studies and there’s actually more time spent not breathing than there is breathing. In some areas, you are six weeks away from a test because they’re not only on top of their list, but their numbers are lower. In other areas, you’ve got high population density and low service output.

So you know, I have seen sleep departments that have got 60 week wait list just for the initial diagnostic tests. You already got the suspicion that they have obstructive sleep apnea. They’re already telling you that they’re struggling, and then they’re told to-

Sleep apnea is one of those things that a patient may need to report and they may need to report it in the case where they have moderate or severe obstructive sleep apnea with sleepiness.

And it’s really important that with sleepiness part is the main focus of the DVLA guidance. ’cause the sleepiness is the symptom that affects safety on the road. If the patient has sleep apnea, but they don’t wake up frequently from their breath holds, they don’t have the interruption to sleep, they don’t have the reduced cognitive function in the day. That sleepiness is what? This is all contingent on. 

Jaz’s Introduction:Protruserati, I think this is one of the most profound episodes we’ve done to date. You see, the problem is that everyone’s telling us that sleep apnea is this huge thing and that as dentists we ought to know about it. And there’s plenty of podcasts now out there. Plenty of content out there, plenty of courses out there that are kind of filling that gap of knowledge.

The issue is we’re still hungry. I’ll tell you what we’re hungry for. We’re hungry for the following. Okay, so now you know what sleep apnea is. Now you’ve asked your patient, you’ve done some screening questions to your patient, but then what?

What happens then? Because if you’re not already actively in this space and you kind of refer and you lose that patient forever, what if you as a dentist want to do the sleep test? That’s what I do. I’ve incorporated sleep testing into my clinic for about 15 months now and it’s amazing the results we come back.

Now, I just wanna start by saying that we as dentists, we cannot diagnose sleep disorder breathing. Okay, let me repeat. We as dentists cannot diagnose sleep disorder breathing, but we can screen and we play a pivotal role in its management. So what this episode will do is we’ll bridge that gap between actually knowing about sleep apnea and actually doing something about it as a dentist.

And that is only achieved by those who are testing in their clinic. And let me tell you, it’s not mega expensive. It can be very convenient for your patients. And hey, even if you don’t start testing yourself, you ought to find someone near you or a center near you that can get your patient tested for sleep disorder breathing, such as obstructive sleep apnea.

And correctly reported so that you can genuinely help your patients, help them live a healthier life with more energy, less dozing off during the day ’cause of sleepiness, better quality of sleep for them and their partners, and adding quality life to their years.

Hello Protruserati. I’m Jaz Gulati and welcome back to your favorite dental podcast. If you’...]]> 1:17:49 false https://podcast.show/protrusive/episode/148746273/ 148746273 https://protrusive.co.uk/?p=9190 Jaz Gulati Thu, 25 Sep 2025 04:09:34 -0400 Imagine your patient is choking on a rubber dam clamp…what’s the safest way to manage choking when the patient is lying flat?

Your patient’s hands are shaking and they’re drenched in sweat – is it low blood sugar, anxiety, or a cardiac event?

​​Do you know exactly what to do if your patient has a seizure in the chair?

This second part of the Medical Emergencies series with  Rachel King Harris dives even deeper into real-life scenarios that dental teams may face. From seizures and how (and when) to give buccal midazolam, to managing choking in a dental chair, this episode is packed with practical, clear guidance.

We also explore key steps in treating diabetic hypoglycaemia, understanding glucagon vs glucose, and how to confidently manage patients with angina or previous heart attacks—when to use GTN, when to give aspirin, and when to simply wait for the ambulance.

It’s all about staying calm, being prepared, and delivering safe, effective care when it matters most.

Protrusive Dental Pearl: Assign a clear lead to regularly check the expiry dates and supplies of emergency medications and equipment. This isn’t just about ticking regulatory boxes — it’s about saving lives. Little checks like this can make a big difference in a true emergency.

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

Highlights of this episode:

• 00:00 Teaser
• 00:44 Intro
• 03:09 Protrusive dental pearl
• 04:14 Recap from Part 1
• 06:58 Seizures: Personal Experiences and Practical Tips
• 13:45 Seizure Emergency Kit: Buccal Midazolam
• 21:29 Emergency Drug Kit Overview
• 22:10 Choking: Techniques and Guidelines
• 29:19 Midroll
• 32:40 Choking: Techniques and Guidelines
• 34:05 Handling Infant Choking Emergencies
• 36:11 Recognizing and Managing Hypoglycemia
• 41:11 Emergency Protocols for Hypoglycemia
• 47:35 Managing Cardiac Emergencies in Dental Practice
• 58:59 Final Thoughts and Training Recommendations
• 01:00:39 Outro

Stay up to date by reviewing the latest guidelines from the Resuscitation Council UK.

Grab your Anaphylaxis Summary + Medical Emergency Cheatsheets from https://protrusive.co.uk/me.

And make sure you’ve listened to Part 1 of Medical Emergencies so you don’t miss any crucial information.

#PDPMainEpisodes #CareerDevelopment #BeyondDentistry

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

This episode meets GDC Outcomes C and D.

AGD Subject Code: 142 Medical emergency training and CPR

Aim: To equip dental professionals with the knowledge, confidence, and practical skills to recognize and effectively manage common medical emergencies in the dental setting, ensuring patient safety and optimal outcomes.

Dentists will be able to:

1. Identify signs and symptoms of common medical emergencies in dental practice, including anaphylaxis, asthma attacks, seizures, angina, hypoglycemia, and stroke.
2. Describe the immediate management protocols for each emergency, including correct drug doses, routes, and timings.
3. Demonstrate appropriate use of emergency equipment and drugs available in the dental setting.

Teaser: And you're saying that you deal with one hole only and it's the mouth and not anywhere else.

Teaser:When you’re becoming a dentist and you have to choose between medical and dental school, you either look up one and you look down the other, and so I said, let me look down, not up. So here we are.

That made me realize, and the advice on that Facebook post was, anyone age five or under choke on grapes. And so you totally agree with that?

I do. I do. I just think it’s not worth it. Sweaty. Sweaty. Very, very clammy. You know, there’s pools of sweat that I mentioned with hypose. You can get exactly the same with an MI.

Yeah. Nausea, vomiting, sweaty, clammy, impending doom. So again, a bit like anaphylaxis, they say they feel like they’re gonna die. Blood pressure drops usually. Not always-

But here’s the thing where this is happening, right? I’m going back to-

Jaz’s Introduction:Welcome back to Part Two of Medical Emergencies to get you that big fat tick for your annual CPD requirement for medical emergencies, and hopefully in a way that you can leverage the time of commuting so it doesn’t feel like something extra you’re doing.

Also in a way that was conversational, something that was easy to listen to, and hopefully the retention will be really good. And to enhance that retention, don’t forget, we have got our premium notes, like a revision summary done for you notes for every episode for our premium subscribers. If you’re not on the already, head to www.protrusive.app.

In the last episode, we covered the most common medical emergencies that we see or could see vasovagal syncope, anaphylaxis, which is worrying and common nowadays, but with serious consequences. And we talk a lot about oxygen, like which medical emergencies should we be giving oxygen for and how do you actually give the oxygen?

The thing is right, we as dentists, we hardly ever administer oxygen. We only are told to do it when there’s a medical emergency, but I want to cover it because when push comes to shove and we need to deliver the auction, I’m hoping you found it useful to hear and to watch for those of you’re watching how to actually activate the damn thing.

And what it all looks like and works like. So that was all covered in part one. In this part two, we’re covering seizures, how to handle a patient that is having a seizure, including how you might actually deliver the buccal midazolam. What does it actually look like and feel like? And interestingly why in many scenarios you may not even need to give it.

Then we moved to choking. And we all know about back slaps and abdominal thrust, but we simulated choking and we discussed choking specifically for your patient that is like laying down the chair the exact steps you should do when your patient’s in your dental chair and why. Therefore, you may need to do a one handed abdominal thrust.

And so you get to hear about that and watch that again, if you’re watching on the app. The last two things we discussed were diabetics and how the whole glucose and glucagon works and how to administer each one, as well as our cardiac risk patients. These ones are very common patients that make me a little bit nervous.

These are patients with a history of angina, history of heart attacks in the past, and so therefore, should we be avoiding using adrenaline containing local anesthetics. And what should be doing if they’re having some sort of an episode in your chair. So once again, we’re joined by Rachel King Harris, or today’s part two, Deep Dive into Medical Emergencies.

Dental PearlHello, Protruserati. I’m Jaz Gulati and welcome back to your favorite Dental Podcast. Every PDP episode I give you a Protrusive Dental Pearl. In the last one it was to download for each condition the kind of like cheat sheet prompts that when you open up your medical emergencies drug box, like it’s so reassuring to see the step by step what you’re looking for, what to do next.

It was like a really helpful thing. I think every single medical emergency is boxing. Every dental practice should have this. So that was last episode’s Protrusive Pearl. This one is a bit more simple, but equally important is that are you checking the expiry date of your meds?

Who has been allocated as someone who takes a lead on this? Not only is this important to satisfy CQC or regulatory requirements to make sure your practice can run and stay in business. But this is life saving stuff. So who’s the person who’s checking monthly or quarterly to make sure that nothing is running out of date and that all the supply is there and it’s working and you haven’t run outta oxygen or your glucagon’s not outta date, and all those things.

So make sure you have a clear lead because that’s how you Protruserati, these little things are the big things. Hope you enjoy the episode. I’ll catch you at the end. I’ll give you more instructions of how to claim the CPD.

Main Episode:Rachel, welcome back again to the Protrusive Dental Podcast for part two. 

[Rachel]Thank you for having me again.

[Jaz]So in the last episode, we covered the common things. What I wanna do is make a really tangible piece of content with your help. So we covered the things that most likely common to happen. Okay. So, vasovagal syncope, ie the faint, super common, went deep into that. We went into anaphylaxis and I think we covered it really well.

We also talked about the oxygen, about what is the right dose of oxygen? Can you actually do harm by giving oxygen? And generally the consensus was, no, actually, it’s a good thing to have in practice. And I also took out the drug kit and it was really nicely how it was organized. And that might be inspiration for other practices.

So one thing I...]]> 1:00:28 false https://podcast.show/protrusive/episode/148579893/ 148579893 https://protrusive.co.uk/?p=9168 Jaz Gulati Thu, 18 Sep 2025 02:32:45 -0400 HIGHLY RECOMMENDED CPD for all Dental professionals – without getting bored!

Do you know exactly what to do if a patient faints in your chair?

Could you spot the early signs of anaphylaxis—before it’s too late?

How quickly could you find and deliver adrenaline if it really mattered?

After six years of podcasting and creating CPD, we’re finally tackling medical emergencies the Protrusive way. In this two-part series, Jaz is joined by lead nurse and medical emergencies educator Rachel King Harris, who breaks down the real-life scenarios every dental team needs to prepare for—without the fluff or generic lecture feel.

From vasovagal syncope to adrenaline protocols, you’ll learn how to stay calm, think clearly, and take action when it matters most. By the end of this episode (and the next), you’ll not only tick the box for your GDC-required CPD—you’ll actually feel ready.

Because when emergencies happen in the chair, panic isn’t a plan. Let’s get you prepared.

Protrusive Dental Pearl: Be emergency-ready! Download a free medical emergencies cheat sheet — a quick guide for symptoms, drugs, and actions during a crisis. You can download this ready-made cheat sheet for free at protrusive.co.uk/me. Print it, laminate it, and pop it into your medical kit. Your whole team will thank you!

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

Key Takeaways:

• Medical emergencies in dentistry are rare but high-stakes — being prepared is essential.
• Guidelines change often — regular refreshers are vital.
• You don’t need to memorise everything — use validated resources and calm judgment.
• Vasovagal Syncope is the most common emergency in dental settings.
• If unconsciousness persists → consider other causes: meds, blood sugar, cardiac issues.
• Anaphylaxis can occur even without rash — don’t wait for it.
• Key signs: stridor, lip/tongue swelling, wheeze, “impending doom,” difficulty breathing.
• Keep emergency drug guides visible and updated (e.g., BDA laminated sheets).
• Ampules = longer shelf life, more doses than EpiPens, and more cost-effective.
• Don’t wait for the rash — airway signs matter most in anaphylaxis.
• Always carry two adrenaline auto-injectors — even for mild allergy patients.

Highlights of this episode:

• 00:00 TEASER
• 00:53 INTRO
• 04:50  Protrusive Dental Pearl
• 06:01 Meet Rachel King Harris: Expert in Medical emergencies
• 09:42 Practical Tips for Emergencies
• 12:05 Understanding Vasavagal Syncope
• 17:01 GTN Spray
• 20:09 Recognizing and managing Anaphylaxis
• 30:05 Midroll
• 33:26 Recognizing and managing Anaphylaxis
• 34:41 Allergic Reaction to Chlorhexidine Gel
• 37:27 What’s Inside Emergency Bag?
• 41:51 Adrenaline Ampules vs Auto-Injectors
• 52:04 Oxygen Administration In Dental Practices
• 57:13 Oxygen and Emergency tools
• 59:05 Oxygen Contraindication
• 1:06:37 Outro

Stay up to date by reviewing the latest guidelines from the Resuscitation Council UK.

Check out this Anaphylaxis Summary Document

Enjoyed this one? Make sure to check out PDP159 – How to Manage Children in Dental Pain, where we dive into real-life paediatric emergencies in dentistry.

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

This episode meets GDC Outcomes C and D.

AGD Subject Code: 142 Medical emergency training and CPR

Aim:To improve the preparedness and confidence of dental professionals in recognising and managing common medical emergencies in the dental setting, with an emphasis on vasovagal syncope, anaphylaxis, and appropriate use of emergency medications and equipment.

Dentists will be able to –

1. Identify early signs and symptoms of vasovagal syncope and anaphylaxis in a dental setting.
2. Apply appropriate first-aid management protocols, including patient positioning, airway support, and oxygen delivery.
3. Understand the updated guidelines for prioritising adrenaline over antihistamines or steroids in anaphylaxis management.

#PDPMainEpisodes #BreadandButterDentistry

Teaser: When you faint, essentially your blood pressure drops. So that quick event that happens, what you need to do is actually try and I know, I don't know whether your dentistry bed's tilt, but tilting is actually the best.

Teaser:So you want their head down, if the bed’s not quick enough getting up or it’s not working or whatever, you actually can just manually lift the legs and hold them up or get their relative, if they’ve got a relative in with them or somebody that’s come in and then just keep them like that until they come round.

When histamine is released into the patient, they get widespread vasodilation and bronchoconstriction. So those two things combined is a bit of a car crash. Even 0.5 because really you’re going to get an ambulance within five minutes. 

It’s true, you’re not though. You need to be carrying two at all times and people don’t. And particularly if you’re teenagers, you know you’ve got a handbag that doesn’t fit it. It’s tricky I actually think that in a medical center am feels better- 

Jaz’s Introduction:When you are dealing with a medical emergency in your chair. That stuff can get really scary for dentists. It’s not pleasant to have to deal with it, but we need to be sharp, we need to know exactly what to do because our patient’s life actually depends on this. 

This is why it’s a legal requirement in the UK and probably around the world to do medical emergencies training every year, and I’m proud that after six years of podcasting and creating CPD, we can finally now cover this topic in the true protrusive way, and now give you core CPD or CE credits.

The GDC recommends 2 hours per year and in a five year cycle, that means 10 hours of medical emergencies training for the dental team, and this is mandatory. Now, most practices arrange some sort of group session where they’re doing simulation and hands-on CPR, which is amazing, but sometimes we’re left to our own devices and we’re watching these little bit slightly boring videos and lectures online. Always scrambling to buddy up with a neighboring practice to actually get this training done on time. 

Now, in this episode, I’ve got a Lead nurse, an educator in medical emergencies. Her name is Rachel King Harris, and one of her roles as well as working in acute medicine is to teach dental teams everything they need to know about their medical emergence training every year. So I’m proud to say that after listening to this Part 1 and the next episode, you’ll give a massive tick box for your annual requirement of CPD.

But the key thing is that you do it in a true protrusive way. We’re going to make it tangible. I’m hoping that Rachel and I, and mostly Rachel, we’ll present things in a way that it actually sticks. Sometimes when the patient is feeling unwell in your chair, we start to get a bit of panic and confusion. Is this just a Vasovagal Syncope or could there be something going on with the patient’s heart?

Is this an anaphylaxis? Should I be giving oxygen? All these questions can come at you a million miles an hour, and you have palpitations and you’re sweating, and medical emergencies are just no fun to deal with. 

But after today and the next episode, you’re going to smash your annual requirement of CPD and in a way that you’re going to retain this information because every episode we make some premium notes and we just deliver it in a way that’s a bit easier to listen to, it’s not someone lecturing at you. 

You are there by osmosis absorbing these things. And I really told Rachel, I told her I want to create a really compelling piece of content for the dental team. Which makes it tangible and relatable and real world.

What I mean by that is the topics we cover in this 2 hour training are actually medical emergencies that you are likely to actually see in your practice and talking about some details that are really important, but no one ever talks about some. 

I’m hoping through that, that should you be in that unfortunate scenario that you will face a medical emergency because of this training, you’ll be feeling much more confident, much better prepared, and of course you won’t be panicking in December trying to make sure you’ve done your medical emergencies mandatory CPD, because we got you covered.

Now to listen to this episode is free for all. Okay? The podcast is free for you, but to actually get the certification, you have to answer some questions and do some reflections, and that’s possible on the protrusive guidance app. 

You can listen via Spotify through the app, all Apple Podcasts, again through the app, or watch the video on the app, and the benefit of that is you just scroll down and answer the questions and our CPD Queen Mari will look after you.

And once you start doing more CPD with us, we actually send you quarterly certificates and an annual summary of all your certificates, how many hours yo...]]> 1:06:07 false https://podcast.show/protrusive/episode/148501657/ 148501657 https://protrusive.co.uk/?p=9153 Jaz Gulati Mon, 15 Sep 2025 14:13:15 -0400 How on earth can a neck injection eliminate teeth sensitivity?

Can a patient’s tooth sensitivity really be linked to their occlusion?

Is occlusal adjustment ever indicated for sensitivity?

And what’s the actual mechanism behind those cases where everything looks fine — no cracks, no significant wear, no exposed dentine — yet the patient still complains their teeth are sensitive?

In this episode, Dr. Nick Yiannios shares the concept of Sympathetic Dental Hypersensitivity (SDH), a groundbreaking way of understanding sensitivity that goes beyond the usual suspects like caries, erosion, or leakage.

We dive into how the sympathetic nervous system in the pulp can drive unexplained pain, why traditional approaches often fail, and how objective tools like T-Scan and EMG can reveal what articulating paper misses.

This could completely change the way you diagnose and manage those “mystery” sensitivity cases that just don’t add up.

Protrusive Dental Pearl: When fitting a resin-bonded bridge (RBB), if you’re unsure about the fit and cement gap, use light-bodied PVS on the intaglio surface of the wing. After setting and peeling it away, the thickness of the PVS shows you the expected cement layer. Ideally, it should be thin and even; a thicker area highlights where your gap is excessive.

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

Key Takeaways:

• The T-scan technology revolutionizes occlusal analysis.
• Sensitive teeth can be linked to occlusion and bite adjustments.
• Frictional dental hypersensitivity (FDH) is a key concept in understanding sensitivity.
• Sympathetic responses may contribute to dental hypersensitivity.
• Innovative treatments include laser therapy and ozone application.
• Addressing root causes is essential for long-term solutions.
• Dentists should explore literature for new insights and techniques.
• Critical thinking is vital in dental practice.
• Advanced technology can enhance patient care and outcomes. Objective data is essential for effective occlusal adjustments.
• Understanding joint function is crucial for dental health.
• Differentiating between types of dental hypersensitivity is important.
• The sympathetic nervous system plays a significant role in dental pain.
• Educating patients about their conditions fosters better outcomes.
• The beaker of pain concept helps in understanding patient symptoms.
• Continuous learning is vital for dental professionals.
• Objective metrics are necessary for accurate diagnosis and treatment.

Highlights of this episode:

• 00:00 Teaser
• 00:39 Intro
• 03:51 Protrusive Dental Pearl
• 05:42: Dr. Nick Yiannios’ Journey and Innovations
• 07:46 T-Scan and Digital Occlusal Analysis
• 08:29 FIRST INTERJECTION
• 13:46 T-Scan and Digital Occlusal Analysis
• 14:07 Discovery of Occlusion–Sensitivity Link
• 20:44 Second interjection
• 24:25 Student Case – Sensitivity from a Bridge
• 26:04  Dentine Hypersensitivity
• 28:39 Cervical Dentine Hypersensitivity
• 30:44 The Role of Lasers and Ozone in Dental Treatment
• 35:24 Alternatives for Dentists Without Lasers
• 43:12 Alternatives for Dentists Without Lasers
• 44:00 Frictional Dental Hypersensitivity Explained
• 47:15 The Importance of T-Scan in Dentistry
• 50:57 Neck Blocks and Sympathetic Responses.
• 58:24 Third interjection
• 01:00:01 Neck Block Mechanism
• 01:12:34 The Beaker of Pain Concept
• 01:14:38 Fourth interjection
• 01:16:23 The Beaker of Pain Concept
• 01:16:59 Community and Collaboration
• 1:20:57 Outro

Curious to dive deeper?You can explore more of Dr. Nick’s work and insights through these resources:

• Upcoming course: CNO6 – Sympathetics in Dentistry: The Missing Link in General & Specialty Practice
• AES (American Equilibration Society) – check out their upcoming conference for world-class learning in occlusion and TMD.
• CNO – Center for Neural Occlusion
• Facebook community: Neural Occlusion
• YouTube channel: Dr. Nick DDS – packed with case examples, lectures, and protocols.
• CNO YouTube playlist

Studies & Resources

• Sympathetic Dental Hypersensitivity – An Alternative Etiology for Dental Cold Hypersensitivity
• Greater Auricular Nerve Block Reduces Dental Hypersensitivity to Intraoral Cold Water Swish Challenge: A Retrospective Study
• Dr. Mark Piper Lecturing at the American Academy of Craniofacial Pain: Sympathetics & CRPS1 

If this episode helped you, check out PDP199: How to Eliminate Sensitivity During Teeth Whitening

#PDPMainEpisodes #OcclusionTMDandSplints #BreadandButterDentistry

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

This episode meets GDC Outcomes C.

AGD Subject Code: 180 OCCLUSION

Aim: To provide dentists with an updated understanding of tooth sensitivity, highlighting the role of sympathetic nervous system involvement, occlusion, and modern treatment approaches beyond traditional desensitizers.

Dentists will be able to –

1. Explain the concept of Sympathetic Dental Hypersensitivity (SDH) and its link to occlusion and cervical nerves.

2. Identify diagnostic tools (e.g., T-Scan, JVA, imaging) that provide objective data for managing sensitivity.

3. Evaluate treatment options, including laser-ozone therapy, occlusal adjustments, and neck block techniques.

Teaser: I want you to think the sideways incursive movements like speed bumps. The more speed bumps, the more likely the nervous system doesn't like all that extra bump, bump, bump, bump. So you want to kind of smooth out the ride when you're going left and right. Imagine you're in a car, you want it to be a little smoother.

Teaser:Remember misfolded proteins? If you as a human, which is rare die of prion disease, you are a complete biohazard. They don’t even know what to do with your body. Cremation is not enough, but guess what kills prions? Well, they’re not alive. Guess what destroys prions? Their misfolded proteins. Ozone, trigeminal, cervical,*** and this all ties into sensitive teeth because it’s not just trigeminal. It’s also***-

Jaz’s Introduction:Most of us have the same protocol for managing sensitive teeth. We check the patient’s oral hygiene, we check for acid erosion, be it intrinsic or extrinsic. We try and take care of the acid basically. Most of us are heavily recommending some sort of desensitizing toothpaste, like a Sensodine or an Oral B sensor version, or a pro relief from Colgate, whichever it may be.

Some of us are scrubbing desensitizing agent into tooth, perhaps even fluoride. And if the sensitivity is coming from like a Class five region, like abrasion a fraction, we might slap a composite in there hoping that the sensitivity will improve. Unfortunately, have those patients who no matter which brand of toothpaste they try, like it all helps, but they forever have sensitive teeth. I already have some patients in my mind that fall into this category. So what’s going on there? Why are these patients’ teeth sensitive?

Well, hello there, Protruserati, I’m Jaz Gulati, and welcome back to your favorite Dental podcast. For those of us dental geeks who like to spend a lot of time on YouTube, you probably already know today’s guest: It’s Dr. Nick Yiannios. I remember seeing his videos like, 10 years ago, 12 years ago. And I was like, what on earth is going on? This guy is using a computer to inform him about the bite, and he had all these like EMG leads on the patient and you are thinking, what on earth is going on? I’ve never seen anything like this before.

And then you hear about all these patients problems like they’ve got like clicking, popping, muscular pain, headaches, sensitive teeth, and by the end of the video it shows on the computer screen what the new bite is showing. But amazingly, the patience and their response was pretty spectacular.

When I look back in my journey into occlusion, and now how I’m diving deeper into digital occlusion, like using the T scan for ...]]> 1:19:32 false https://podcast.show/protrusive/episode/148409318/ 148409318 https://protrusive.co.uk/?p=9135 Jaz Gulati Thu, 11 Sep 2025 09:46:29 -0400 Is it time to say goodbye to your DSLR?

Are mirrorless cameras really the future of dental photography?

If your DSLR is still working perfectly, should you upgrade now or wait for the right time?

Jaz is joined by Dr. Ashish Soneji in this game-changing episode to discuss the death of the DSLR and why the shift to mirrorless cameras is inevitable.

They break down whether you should proactively switch or strategically hold off, plus what this means for your existing lenses.

You’ll also learn the rules of mix and match—can you use your current DSLR lens on a mirrorless body? And most importantly, which mirrorless lenses are worth buying and which ones to avoid (hint: if they don’t have markings, you might be in trouble!).

If you care about consistent, high-quality dental photography, this episode is a must-listen!

Protrusive Dental Pearl: Jaz introduces the 21-Day Photography Challenge for beginners, featuring 21 short videos to help dentists take clear, well-framed photos. In just three weeks, participants will master essential shots, including tricky occlusal views, at their own pace.

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

Key Takeaways:

• Investing in quality equipment pays off in the long run.
• Mirrorless cameras offer significant advantages over DSLRs.
• Lighting is crucial for capturing quality images.
• Standardized images require barrel markings on lenses.
• Second-hand DSLRs can be a cost-effective option for beginners.
• The evolution of camera technology impacts photography practices.
• Choosing the right lens is essential for dental photography.
• Flash consistency is vital for accurate representation in images.
• Upgrading to mirrorless is a smart move for future-proofing photography. Upgrading your camera setup should align with your clinical progression.
• Mirrorless cameras are lighter and offer better image quality.
• Consider the size and transportability of your camera kit.
• Timing for upgrades can be linked to job changes or equipment failures.
• Image quality is influenced by megapixels, especially for presentations and printing.
• Using the right tools, like smaller mirrors and retractors, can improve photography outcomes.
• Testing second-hand cameras before purchase is crucial to avoid issues.
• Mobile photography is improving, but may not match the quality of dedicated cameras.
• Investing in good photographic equipment is essential for quality results.

Highlights of this episode:

• 00:00 Teaser
• 00:47 Intro
• 01:41 Protrusive Dental Pearl
• 03:30 Ashish’s Journey into Photography
• 09:06 The Shift from DSLR to Mirrorless Cameras
• 13:33 Choosing the Right Camera Setup
• 15:32 Upgrading to Mirrorless Cameras
• 19:22 Camera Recommendations for Beginners
• 27:23 Investing in Reliable Flash Equipment
• 32:20 Investing in Reliable Flash Equipment
• 33:48 When to Upgrade Your Camera Setup
• 38:08 Getting HQ Images: Mirrorless vs DSLR
• 42:03 Avoiding Newer Lenses
• 43:23 Posterior Quadrant Photography
• 47:50 Tips for Buying Second-Hand Cameras
• 49:54 Mobile Dental Photography: Are We There Yet?
• 53:20 Getting Your First Mirrorless Camera
• 55:40 Course Information
• 57:53 Outro

????Catch Dr. Ashish Soneji’s upcoming course The Magic of Dental Photography this November 2025!

???? Friday 14th November 2025 – Exclusively for BUPA dental care professionals at Bupa Head Office in Staines???? Saturday 15th November 2025 – Open to all dental care professionals at the A-dec Showroom in Bracknell

You can head over to https://www.magicofdentistry.com/ and add yourself to the waitlist. Further details on how to book will be sent directly to your email.

Course overview:

• Understanding an SLR camera it’s features
• Understanding a mirrorless camera and its features
• Discussing the process of recording an image
• Overview of SLR equipment available and custom set-up for dental photographs
• Overview of mirrorless equipment available and custom set-up for dental photographs
• Understanding how to record a standardised set of clinical photographic views and posterior quadrant photographs
• Logistics of effective clinical photography workflow
• Introduction into more advanced techniques
• Introduction into recording portrait views
• Case presentations
• Hands-on implementation of the concepts discussed 

If you liked this episode, you will also love Basics of Dental Photography [B2B] – PDP087

#PDPMainEpisodes #PDPMainEpisodes 

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: 130 ELECTIVES (138 Dental photography)

Aim: To explore the transition from DSLR to mirrorless cameras in dental photography and highlight the advantages, optimal setups, and key considerations for upgrading.

Dentists will be able to:

1. Recognize the benefits of mirrorless cameras, including focus peaking, real-time adjustments, image stabilization, and high ISO performance.

2. Choose appropriate mirrorless cameras, lenses, and flash setups based on their clinical photography needs.

3. Assess whether transitioning from a DSLR to a mirrorless system is the right choice based on their current equipment and practice requirements.

Teaser:And also from the fact that technologies moving forward, but also from the fact that you’re not getting so much support from the suppliers. If you have problems or if your camera is going to break or issues like that, you’re not going to get so much support.

Yeah posterior shots exactly. The point that I sort of made at the beginning is it’s about the light, right? It’s about getting that powerful exposure of light, which you’re just not going to get with a camera and there’s so much more better quality images. And even the way that you’re holding your DSLR the mechanics of how you’re holding that, you’re going to a better frame shot, you’re going to create better angles. So if I’m on to invest in the good clip–

Jaz’s Introduction:I’m actually a little bit emotional, guys. It’s the death of the DSLR camera. You’ll find out in this episode why? The future, the now is mirrorless cameras. They are perfect for dentistry and they are the future. They’re not going to make any more DSLRs in the future. But the million dollar question is if like me, you already have a decent camera.

It’s a DSLR, the photos are fine, you have no issues with it, should you? Proactively or preemptively upgrade now to a mirrorless? Or is there perhaps a more strategic time to do that? What are the rules of mix and match? Can I use my existing lens on a mirrorless body?

And you’ll also find out which mirrorless lens to buy and which ones to avoid because they don’t have any markings, that they don’t have any markings. How are you going to keep your photographs in consistent reproducible framing? We cover all that with our guest, Dr. Ashish Soneji.

Dental Pearl:Every PDP episode, I give you a Protrusive Dental Pearl, and this one is pretty special. This one’s dedicated to anyone who’s new to dental photography. Like you’ll hear the importance of dental photography and you know why it’s important. That’s why you’re listening to this episode. You just cannot develop as a clinician without a camera.

So dedicated to the absolute new beginner to photography I’ve created. The 21 day photography challenge. Just give me three weeks and I’ll get you taking consistent, beautiful, nicely framed, nicely exposed photographs. It’s like an online challenge if you like, right? 21 videos. Now they are short little videos that you can consume day by day, and like I said, within three weeks you’ll be taking great photos, like you’ll be proud of them as a beginner, including the dreaded occlusal photo.

The 21-day Photography Challenge starts with which kit to buy and then develops into all the different shots and all the different settings and why you do each setting. You can choose to do one video a day, or you can actually binge the whole series in true Netflix fashion. The choice is yours at the time of publishing this episode, it is now available on the Protrusive Guidance app.

You’ll see it listed in the Jaz’s Masterclasses section. And it’s got all the cheat sheets you need as well. So if you’re brand new to gender photography and you love our content, then do check it out. Now do I think you need a hands-on course? Ideally, right? So what my 21 day challenge does, it gets you started, it gets you to pick up the kit and start taking photos and start practicing those dreaded shots, but to go to the next level I would recommend an in-person hands-on course, which really does elevate you. 0:57:54 false https://podcast.show/protrusive/episode/148236980/ 148236980 https://protrusive.co.uk/?p=9114 Jaz Gulati Thu, 04 Sep 2025 02:02:59 -0400 Should we be doing more to save questionable teeth?

What if you could buy more time — without compromising patient care?

Dr. Omar Ikram returns for a powerful episode diving into the real-world decision-making between endodontics and implants. Together with Jaz, they explore tough scenarios — like teeth with nasty cracks or minimal remaining structure — and ask the critical question: when is it truly time to extract?

They break down concepts like retained roots, root burial, amputation, and a new term Jaz introduces — palliative endodontics. Because sometimes the best outcome isn’t immediate replacement, but smart, strategic delay.

Protrusive Dental Pearl: When discussing treatment longevity with older patients, tailor your language to be more relatable. Instead of saying, “I plan my dentistry to age 100,” say, “I want this to last well into your eighties or nineties.” This makes the conversation more personal and realistic, helping patients better connect with the concept of long-term outcomes.

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

Key Takeaways

• Understanding the limitations of implants compared to natural teeth is vital.
• Medical history significantly impacts dental treatment decisions.
• Managing patient expectations is crucial for satisfaction.
• Palliative endodontics can provide temporary relief and management.
• Reading and interpreting CBCT scans requires skill and experience. If it’s not that five millimeter defect, it’s up to you.
• The second molar is a good one because often second molars can’t be replaced with an implant.
• Retaining roots is definitely a good way to go.
• You need to risk assess the patient before extraction.
• Palliative endo is technically always an option.
• Success in endo can be often difficult to achieve.
• Asymptomatic and functional is a good criteria.
• If endo is on the table, it’s feasible.

Highlights of this episode:

• 00:00 Teaser
• 00:35 Introduction
• 01:48 Protrusive Dental Pearl
• 04:15 Interview with Dr. Omar Ikram: Philosophy and Growth
• 10:17 Endodontics vs. Implants: Treatment Planning
• 16:35 Antidepressants and Dental Implant Failure
• 19:37 Managing External Cervical Resorption (ECR)
• 22:30 Patient Communication
• 24:16 Cracks and Complications in Endodontics
• 29:12 Endodontic Protocol
• 30:50 Challenges with CBCT and Cracks
• 32:07 Second Molars: Retain or Extract?
• 35:05 Retaining Roots for Future Implants
• 36:21 Root Burial and Special Cases
• 40:08 Root Amputation: A Niche Solution
• 40:57 Key Signs to Rethink Root Canal Treatment
• 43:17 Cracked Teeth: Poor Prognosis
• 47:08 Stained Crack Tooth
• 50:19 Success vs. Survival in Endodontics
• 56:02 Final Thoughts and Upcoming Events

Want to sharpen your endo game even further? Watch Stop Being Slow at Root Canals! Efficient RCTs with Dr Omar Ikram – PDP163

Check out Specialist Endo Crows Nest — led by Dr. Omar Ikram, offering expert care, hands-on courses, and practical tips for real-world endodontics.

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

This episode meets GDC Outcomes A and C.

AGD Subject Code: 070 ENDODONTICS (Endodontic diagnosis)

Aim: To help clinicians develop a deeper understanding of when to preserve a tooth through endodontic treatment versus when to consider extraction and implant placement.

Dentists will be able to –

1. Identify key red flags that may contraindicate definitive root canal treatment.
2. Understand the concept of palliative endodontics and how it can be used to delay or defer implant placement responsibly.
3. Recognize the value of retained roots in maintaining alveolar bone, particularly in medically compromised or high-risk patients.

#PDPMainEpisodes #EndoRestorative #BreadandButterDentistry

Teaser:They look at you like, really? I thought implant would last till I was a hundred. How long anyone’s gonna last on this planet? But in my planning, I plan to age 100. So I see everyone as living to age 100. And so my planning, I don’t think this will make it, therefore–

Your health is within your own control. Also, it might be only 50%, 25%, but some of it’s within your own control. I want the patient to go on holiday and not be sitting there worrying about whether their tooth might be bothering and they have to go to a dentist and take antibiotics–

Jaz’s Introduction:Endodontics versus Implants: is this even a worthy battle? Let’s be honest, right. Any implant dentist worth their salt would agree that for themselves or their family member where an Endo is feasible and you have a good prognosis, that that is the obvious choice first before having an implant, because an implant will still be an option for the future. And that’s pretty much easy and unanimous in dentistry. Unless of course your patient suffers from titanium deficiency disease.

Now where this becomes more pertinent is those dubious scenarios, lack of tooth structure, those nasty cracks we’ve particularly discussed these two scenarios. Whereby perhaps we should be considering implants. But wait, Dr. Omar Ikram may have a few things to say about that and why we should be considering perhaps root filling, retained roots, root burials, amputation, and a term I introduced called Palliative Endodontics. Why that might have a growing role so that we can defer implants because we know implants do not last forever, Endo doesn’t last forever, nothing lasts forever. So important about seeing the bigger picture when it comes to longevity.

Dental PearlHello, Protruserati I’m Jaz Gulati. Welcome back to your favorite Dental podcast. Every PDP episode, I’ll give you a Protrusive Dental Pearl. Now, there is a theme in this podcast where we discuss about the age of the patient. We all know it’s better to have an implant when you are 60 or 70, than when you’re 40. And one thing I always did is when I communicate to patients, I was inspired by a consultant in Restorative Dentistry Dr Chander used a line to a patient. 

He said, “Look, I don’t know how long anyone’s going to live for, but I always plan my dentistry to age 100.” And I’ve been using this line to my patients, and yeah, it’s okay it works well, they get to see the bigger picture. But a lot of patients can’t relate to that. A lot of my patients, their 60’s, 70’s, and 80’s they just can’t relate to that.

They immediately start thinking off topic and thinking, oh, I probably won’t make it. So one of the changes I’ve made in communication based on what Omar discussed with me today, and really the pearl I want to pass on to you is instead of saying to age 100 for everyone, look at your patient. Let’s say they’re in their 70’s and then you wanted to say, “Look, I want this to last well into your 80’s maybe into your 90’s. 

Now, they may still think, “Oh, I probably won’t make it.” But it’s just a bit more relatable than putting a number age 100, because chances are most people don’t know a 100-year-old, but they might have friends in their 80’s and 90’s. Do you see what I mean? Obviously, it’s a very niche scenario. But me personally, I have a very age population that I look after my patients on average are 60.

And so this change in terminology in the way I communicate to patients in terms of longevity of treatment. I think’s gonna really help me to get the point across well into your 70’s well into your 80’s. And you’ll hear this again in this episode being a big part of today in this episode with specialist ended on Dr. Omar Ikram. 

Before we join the main episode, have you downloaded the app yet? The best way to do it, if you haven’t already, is visit the website www.protrusive.app. Once you’re there, make your account. Then once you’ve made your account, you could download the iOS or Android app and log in to find the nicest and geekiest community of dentists in the world.

What I’ve found is that dentists join the app for the content. The premium notes, the transcripts, the Protrusive Vault, our Mini Master Classes and Courses, just a better overall listening and watching experience. But what they stay for is the community. What they find is that they fall in love with dentistry all over again because dentistry can feel so lonely and isolated. 

And on some of these social media groups, you get shot down when you ask for opinions. But really, we’ve brewed a culture very hard to brew, a culture of kindness, being considerate and selflessly sharing information. So remember, the website is protrusive.app. The app is ca...]]> 1:01:39 false https://podcast.show/protrusive/episode/148062826/ 148062826 https://protrusive.co.uk/?p=9093 Jaz Gulati Thu, 28 Aug 2025 03:09:00 -0400 Is Practice Ownership worth the stress?

 What’s the most difficult thing you have to do as a practice owner? 

Thinking about starting your own squat practice?

How long does it really take before you see profit, and what sacrifices do you need to make along the way?

In this episode, Jaz is joined by Dr. Shabnam Zai to unpack the real highs and lows of running a dental practice. From the loss of control as an associate, to the resilience needed during COVID, to the challenges of leadership and managing a team—nothing is sugar-coated here.

They also tackle the big money question: when does a squat practice finally become profitable, and is it worth the grind in those first few years?

If you’ve ever wondered whether practice ownership is for you—or why it might not be—this episode will give you the clarity (and reality check) you need.

Protrusive Dental Pearl: “DO NOT COMPARE YOUR WORK TO WHAT YOU SEE ON SOCIAL MEDIA”

Most cases shown online are the very best results, done under perfect conditions by clinicians with thousands of hours of experience. 

Instead of letting that trigger self-doubt or imposter syndrome, use it as inspiration: respect it, aspire toward it, and occasionally achieve it — but remember that real-world dentistry is different.

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

Key Takeaways

• Engagement in work is crucial for job satisfaction.
• Time management is essential for balancing work and family.
• Marketing and patient relationships are vital for practice growth.
• Quality time with family is more important than quantity.
• Coaching can help surface potential and provide accountability. Delegation is essential for effective practice management.
• Vulnerability can arise unexpectedly in practice ownership.
• Managing people requires empathy and clear communication.
• Being an associate can be fulfilling and offers flexibility.
• It’s important to have projects outside of dentistry.
• Balancing family life with practice ownership is challenging but possible.
• Financial planning is crucial before starting a practice.
• Understanding your priorities helps in making career decisions.
• Documenting staff performance is key to effective management.
• Continuous learning and self-improvement are vital for success.

Highlights of this episode:

• 0000 Teaser
• 00:25 Intro
• 06:10: Guest Introduction – Dr. Shabnam Zai
• 08:38 Journey into Dentistry and Practice Ownership
• 15:08 Practice Philosophy and Security
• 16:33 Decision Making and Growth
• 19:10 Hardest Part of Being a Practice Owner
• 24:30 Balancing Parenthood and Dentistry
• 26:10 Coaching and Supporting Others
• 30:44 Compliance and Personality Types
• 34:15 Compliance and Personality Types
• 35:55 Navigating Career Vulnerability During COVID-19
• 37:06 The Importance of Self-Awareness and Managing People
• 40:07 The Forever Associate Trend
• 43:01 Projects vs Goals
• 48:33 Balancing Parenthood and Professional Growth
• 50:47 Financial Considerations for Starting a Practice
• 59:05 Final Thoughts and Mentorship Opportunities
• 59:42 Outro

Enjoyed this episode? You might also like Treatment Co-Ordinators – Are They Right For Your Practice? – IC043

#PDPMainEpisodes #CareerDevelopment #BeyondDentistry

Connect with Dr. Shabnam:Website → shabnamzai.comInstagram → @drshabnamzai

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

This episode meets GDC Outcomes:

B: Effective management of self and working with others in the dental team.

AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS

Aim: To provide dentists with an honest, practical insight into practice ownership—particularly squat practices—covering the challenges, rewards, financial realities, and mindset shifts needed for success.

Dentists will be able to –

1. Explain the main motivations for becoming a practice owner versus remaining an associate.

2. Describe the key challenges of practice ownership, including compliance, leadership, and financial planning.

3. Outline the realistic financial commitments involved in setting up a squat practice.

Teaser:The reason I say that is, is because how much your practice is gonna cost depends on, but I did it by reducing clinical day, but I cut down from five to four. What was interesting, my income didn’t change. You know, you have to be honest. Sometimes practices don’t work out. You know, and that’s okay, but–

Jaz’s Introduction:Practice ownership, it makes a lot of sense. In fact, in a lot of countries that is the culture. You qualify, you buy a practice, you do your own brand of dentistry. You are never truly fulfilled until you are a practice owner. In fact, in some countries, the associates are rare. Now, here in the UK, US, Australia, there is a big associate culture, if you like. There are many associates out there.

And you know what? As an associate, myself, there are so many good things, but there are also some bad things, the lack of control. What if tomorrow a corporate takes over the practice completely changes the culture? It’s what happened to me. And then you have to jump ship and start your patient base all over again. You lose that security, you lose that control and security control are too major reasons we explore today and why one may consider to become a practice owner.

And particularly we’re talking about a squat practice. A squat practice is when you buy a building and you turn it into a dental practice. So whilst the themes we cover in today’s episode with Dr. Shabnam Zai, it does apply to buying an existing dental practice because we talk about leadership, we talk about being the boss, being the principal.

A lot of our advice, especially when we talk about money towards the end, is about when you are doing a startup or a squat. Hello, Protruserati I’m Jaz Gulati, and welcome back to your favorite Dental Podcast. You’ll find out why I don’t think owning a practice is right for me at this stage of life. And maybe never, maybe you’ll never be right for for me, there are a few really good and really important reasons why I hate the idea of running my own practice. So you’ll get to hear about that later, but then you get to hear about so many benefits and good things and why it might be the best thing that ever happened to you, as explained by Shabnam.

The kind of themes that we cover are: Is it right for you to be a practice owner? What are the sacrifices you have to make? What’s the most difficult thing you have to do as a practice owner? How long would it take for you to make a profit? Does it mean that you may have to give up your clinical dentistry? What’s the most challenging thing about being the boss?

Dental PearlAnd so many other themes explored in this one hour podcast. Now this episode is eligible for CE credits as Protrusive Education is a PACE approved education provider, and so when you answer the quiz at the end on the app, you’ll get your CE and CPD. Talking of the app, the app has inspired today’s Protrusive Dental Pearl.

I’d like to give you a quick win at the start of every PDP episode. So, as you know, we built this community of 4,000 of the nicest and geekiest dentists in the world. It’s absolutely magic. Waking up and seeing all these notifications and all these cases being posted, and all the advice that’s being given and all the, just camaraderie and kindness.

Now, I’m very careful about promoting the app outside of the podcast. We have a very niche audience here of either the most engaged and caring dentists in the world, or dentists who want to be more engaged with what they do, and they’ve all found a home in Protrusive guidance. So if you’re not part of it, check out Protrusive.app that’s the website, www.protrusive.app. Make your account at the time of publishing, it is free to make an account. There are paid plans available if you want amazing value that we offer, but you can just join the community and meet your tribe. You can then download the app on iOS and Android.

But recently Hannah Cooper for a dentist student in Slovakia posted a case and she said deep breath this is my first anterior case, and she felt really beat up by it. Okay. And I thought she’s being very critical of herself bless her. Okay. So she did some good work. And what I love is that Hannah, she made herself vulnerable. She really put it out there as like, guys, can you help me? And the advice that was given, the reflections by the Protruserati, shout out to the usual suspects.

Okay, Mohammad Mozaffari, an absolute legend on the ap...]]> 1:00:21 false https://podcast.show/protrusive/episode/147921892/ 147921892 https://protrusive.co.uk/?p=9072 Jaz Gulati Thu, 21 Aug 2025 04:34:06 -0400 Are you living your career by design—or just letting it happen to you?

Do you know what your ideal day as a dentist looks like?

What about your ideal week?

In this episode, Jaz is joined by Dr. Andrea Ogden to explore how you can design a career—and a life—in dentistry that feels purposeful and fulfilling.

They dive into why many of us get stuck on autopilot, chasing goals we’ve never truly chosen, and how to break free by aligning work with your values. 

Andrea also shares practical techniques to help you fall back in love with dentistry, so you can build a career that energises you—inside and outside the surgery.

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

Highlights of this episode:

• 00:00 Teaser
• 00:21 Introduction
• 04:49 Guest Introduction – Dr. Andrea Ogden
• 06:05  Andrea’s Journey in Dentistry
• 08:51 Pivotal Moments in Dentistry
• 14:51 Trial and Error in Career Development
• 15:51 Current Role
• 16:59 Identifying Strengths vs. Enjoyment in Dentistry
• 18:18 Challenges for Young Dentists
• 21:51 The Importance of Career Awareness
• 24:05 Impact of Social Media
• 26:57 Understanding the Decline in Dentist Morale
• 31:51 External Factors Contributing to Stress
• 35:09 Internal Factors and Cognitive Dissonance
• 41:17 Practical Steps to Reignite Passion for Dentistry
• 47:32 Resilience Through Adaptation
• 48:59 Community and Support Networks
• 51:46 Enjoying the Journey
• 56:30 Outro

Key Takeaways: 

Dentistry is more than fillings and crown preps—it’s a career you can shape to truly excite you.

• Choose Variety & Joy – Build a mix of roles that energise you, not just ones you’re good at.
• Ditch the Comparison Game – Your journey is unique; stop measuring it against 15-year veterans on Instagram.
• Guard Your Values – Burnout often comes from a mismatch between what you believe in and where you work. Align the two.
• Create Space to Reflect – Slow down, think, and use SMART goals to plan your next step.
•  Find Your Tribe – Mentors, colleagues, and community will keep you inspired and resilient.
• Celebrate the Wins – Small or big, they’re proof you’re moving forward.

Loved this conversation? You’ll also enjoy Passion and Values in Dentistry – PDP014

#CareerDevelopment #InterferenceCast #BreadandButterDentistry

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

This episode meets GDC Outcomes 

B: Effective management of self and working with others in the dental team.

C: Maintenance and development of knowledge and skills within your field of practice.

D: Maintenance of skills, behaviours and attitudes which maintain patient confidence in you and the dental profession, and put patients’ interests first. 

AGD Subject Code: 770 – Practice Management and Human Relations

Aim: To provide dentists with strategies, insights, and practical steps to rekindle passion for dentistry, align their work with personal values, and develop sustainable career satisfaction.

Dentists will be able to –

1. Identify personal values and career drivers that contribute to long-term job satisfaction.

2. Recognise common stressors affecting dental morale and their underlying causes.

3. Apply structured decision-making frameworks (e.g., SMART goals) to career planning.

Jaz’s Introduction:Hello Protruserati. I’m Jaz Gulati and welcome back to your favorite Dental podcast. This is the interference cast, like the nonclinical arm, but a very important arm of the podcast.

One of the things that Andrea mentioned, is that when she was studying in dental school, that’s what it was all about. It was just about studying and becoming a dentist and passing your exams, and I resonated with that so much because our date was 6th of June. I knew that on 6th of June 2013, we were gonna get our results. 

And I could not imagine life beyond the 6th of June. Like it was all about am I gonna become a dentist? This is what I’ve been building up my last sort of eight to nine years to do. Like I wanted to be a dentist since I was 14, but I couldn’t even think about the future and what it will actually be like to be a real dentist in the real world.

Now, fast forward so many years, I have a lot of real world insight and I’d love to share it with you today along with Andrea. I love people like Andrea because they are all about helping us feel fulfilled in dentistry. 

There are plenty of people out there who perhaps dentistry didn’t go the way they planned. They leave and now they want to coach you on your exit plan, which I understand, but what I don’t believe in is making permanent decisions based on temporary feelings and actually attempting to figure out exactly how to make dentistry work for you.

Now, some things I didn’t discuss in the conversation with Andrea, because she was on a roll and I want to give her the space and time to talk about all the wonderful things, including the latter part, the end of the podcast, whereby she actually gives real techniques, is about five techniques she shares to help you feel more fulfilled from dentistry.

But one thing I wanna just talk about while I have this opportunity in the intro is the following. Have you actually put pen to paper to write down what your ideal day actually looks like? Like you are actually allowed to have an ideal day. Have you thought about it? 

I didn’t do this until a few years ago, and it made a big difference to my clarity of thinking and where I want to take my career. And the other one, of course is what does your ideal week look like? Once you’ve decided what your ideal day and ideal week looks like, then make that your goal, that’s your aim. 

Why wouldn’t you make some decisions right now to make your ideal day and your ideal week become a reality. For example because I think examples really help. I’m someone who if I don’t exercise at least three or four times a week, I don’t feel like I’m living to my truest value. I become grumpy I don’t feel like I’m enjoying my life as much as I could be. And so I know in my ideal week I need that. 

Now, I’ve had a few years in my career where that wasn’t happening, especially when we are building OBAB that was such a huge project. I had to wrongly sacrifice some health for that. But now I’m back on track.

And so slotting that into the ideal week for me is really important, and you make it work and you make some key life decisions. And something that you do with your significant other, you decide that you design your perfect life how do you actually want it to look like, where you’re gonna live? What gym membership will I will have to make sure this all happens.

And so it’s about living a life of purpose, allowing you to live to your truest values. And that was just one example of me making sure that I designed my ideal day and my ideal life to make sure I get to go to the gym 3-4 times a week.

Another thing that was important to me is like I’m someone, I’m not good at multitasking. I think most, most of us aren’t, and we shouldn’t be multitasking. It’s better to focus on one thing, and I’m particularly bad and like sometimes I get distracted and I feel like really overwhelmed easily. And so when I’m in clinical mode, I’m in clinical mode. And because I love my clinical dentistry, it’s not a big deal for me to do a 12 hour shift.

I know it’s not for everyone, but I’m more than happy to do an 8:00 AM till 8:00 PM if it means I can work less days. So for me that made perfect sense that I have a really long Monday and now I don’t have to work a Thursday anymore, for example. And this has only just come to fruition. It’s something that we agreed on about a year ago, and then we had to wait for my Thursday patients to diminish, if you’d like.

And now I really consolidated my clinical days. This allows me to be in the zone on Monday. And whilst I don’t get to see my kids much on a Monday, I get to make up for it on the other days. because now three days a week, I get to do either school drop off or a pickup, or both. And the main point of sharing this detail with you, my friend, is that everything I’m trying to do is with great intention, it’s on purpose and it’s by design.

And it doesn’t happen overnight. It actually took a discovery process first, and then you put your action plan, and you relentlessly chase that. And that ideal week may look different for everyone. But if you don’t decide what your ideal day or ideal week looks like, then you’ll never get it. If you don’t know where you’re going, how do you know when you’ll g...]]> 0:56:31 false https://podcast.show/protrusive/episode/147843329/ 147843329 https://protrusive.co.uk/?p=9047 Jaz Gulati Mon, 18 Aug 2025 15:24:16 -0400 Is gold really dead or making a comeback 2025?

Are zirconia and biomimetic dentistry sounding the final bell for precious metal restorations?

Is there still a place for gold in modern practice—and when is it actually the best option?

Dr. Lane Ochi joins Jaz for a rare live podcast episode to unpack the current and future role of gold restorations. From skyrocketing costs and lost lab skills, to emerging alternatives like milled cobalt chrome, this episode covers everything you wish dental school taught about gold.

They even dive into clever tricks for temporizing gold and discuss the surprising lab workaround that may save your patient money—without compromising function.

Protrusive Dental Pearl: You can achieve profound anesthesia for lower molars—including cracked, heavily worn ones—using Articaine buccal infiltrations instead of an ID block, even in dense bone cases.

???? Key nuance: Ensure blanching of the attached gingiva and infiltrate through the papillae for better effectiveness.

Watch the detailed technique breakdown (including patient feedback):

Articaine works—master the nuances! 

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

Key Takeaways

• Use gold in tight spaces, short preps, or when longevity matters.
• Simpler preps = better milling, easier seating.
• Burnish when needed—but focus on great impressions.
• Talk to your lab. Explain your margins, internal spacing, and cement plans.
• Treat the patient, not just the prep: comfort, cost, and communication matter.

Highlights of this episode:

• 0:00 Introduction
• 2:06 Protrusive Dental Pearl
• 06:19 Welcoming Dr. Lane Ochi
• 09:40 The Resurgence of Gold in Dentistry
• 14:11 The Importance of Preparation and Cementation
• 18:17 Cost-Effective Alternatives to Gold
• 21:39 Burnishing Gold Margins
• 26:53 Partial Coverage Margin Designs
• 29:04 Retention vs. Resistance in Tooth Preparation
• 43:14 Vertical Preps with Gold
• 45:05 Immediate vs. Delayed Dentin Sealing
• 47:23 Challenges with Temp Bonding and Solutions
• 49:13 Recap
• 50:02 Lab Considerations for Gold Crowns
• 54:53 Perforated Gold Crowns
• 57:24 Temp Bond Troubles and Fixes
• 59:59 Gold vs. Ceramic Longevity
• 1:06:25 Gold Crowns on Implants
• 1:08:44 Wrapping Up and Final Thoughts 

Unlock webinars like this one by joining the Protrusive App.

Studies Mentioned in the Episode:

1. Marginal Gap of Milled versus Cast Gold Restorations
2. Marginal Fit of Gold Inlay Castings
3. Longevity of the Tooth Restoration Complex : A Review

Catch another episode from Dr. Lane Ochi: Cracked Teeth and Dentistry’s Tough Questions with Dr Lane Ochi – PDP175

#PDPMainEpisodes  #BreadandButterDentistry #OrthoRestorative

???? Join the world’s leading organization dedicated to occlusion, temporomandibular disorders (TMD), and restorative excellence — the American Equilibration Society (AES).

????️ AES Annual Meeting 2026 – “The Evolution of the Oral Physician” ???? February 18–19, 2026 · Chicago, Illinois Don’t miss Dr. Jaz Gulati and Dr. Mahmoud Ibrahim as featured speakers, presenting on “Occlusion Basics and Beyond”

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: 250 OPERATIVE (RESTORATIVE)DENTISTRY – Preparation technology

Aim: To provide clinicians with a comprehensive understanding of the rationale, techniques, and clinical considerations for using gold restorations in modern restorative dentistry, including when and how to use them, cost-effective alternatives, and how to communicate value to patients.

Dentists will be able to –

1. Justify the use of gold restorations based on their mechanical properties, clinical longevity, and adaptability under occlusal forces.

2. Compare gold with alternative materials (e.g., zirconia, cobalt chrome) in terms of fit, performance, and cost-effectiveness.

3. Explain the principles of traditional and modern gold preparation designs, including vertical margins, bevels, and resistance features.

Teaser:Well, Mrs. Smith. What is your desire, longevity, or pretty? The beauty is that when they looked at the occlusal margins, the ones they could finish, the state acceptability was- 

Jaz’s Introduction:In this world of lithium disilicate, and zirconia, is there a place for gold? Many years ago, it was agreed that nothing beats gold. Gold is the best because it gives you absolutely brilliant longevity. It’s kind to opposing tooth structure and you can burnish the margins. What does that actually mean? We’re actually going to cover it in this episode. What does it mean? Is there a place for Gold in 2025 and beyond?

I’ll tell you, the last time I did a gold restoration about three years ago, I had to sell my left kidney to pay the technician. Gold is expensive. Are the benefits of gold worth that expense? Or perhaps, just perhaps, there’s a viable alternative to gold, what you’ll find out today.

Hello, Protruserati. I’m Jaz Gulati and welcome back to your favorite dental podcast. This is a slightly different one. We did this live. This was a rare live podcast with one of my heroes and mentors, Dr. Lane Ochi, one of the geekiest and kindest dentists I know. And to see him communicate with us on Protrusive Guidance, our network.

And every time we all get stuck and we’re like, oh, what do we do with this query? Or something like really obscure and geeky about material science or how things were done back in the day and we’d always tag Lane. Dr. Ochi is an absolute pleasure to have you as part of the community, and thanks for doing this live with us.

So for those who are now listening on Spotify, Apple, or watching on YouTube, just bear in mind that I do lots of shout out when I do a live on Protrusive Guidance. It’s very much responding to the chat, engaging, serving. So you’re gonna hear lots of names being shouted out.

Dental PearlNow, every Protrusive episode we give you a Protrusive Dental Pearl. This one is already spilling the beans. It’s giving the secret away of this podcast. It’s gonna blow your mind, right? Many, many years ago, this is probably the first meeting I ever went to, like maybe 13 years ago, it was the British Society of Restorative Dentistry Meeting. Maybe I’ve told this story before to you guys.

I’ve been speaking to you guys for six years now. I can’t even keep track anymore of what I’ve told you and what I haven’t told you. Anyway, back then, we are moaning about the price of gold. Now I had a check, and actually since that meeting, the price of gold has doubled. So here we are in 2013, moulding about how expensive gold is, and now the price has doubled 12 years later.

So we asked the restorative specialist, what should we be using? And so what this specialist said back then, which always stuck with me, is to consider the use of a milled cobalt chrome. That’s right. A milled cobalt chrome for your indirect restoration such as crowns and onlays. So since then when I’ve got second molars and I’m tight for space, I’ve been doing non precious metal crowns and onlays and I’ve been pretty happy with how they fit and especially with how much they cost.

And did you know that something like cobalt chrome is so kind to enamel. So any opposing enamel, it is so kind to it, but is this like a forbidden cheat code and there’s a good reason why we perhaps shouldn’t be using this? Well, stay tuned my friends, because I asked this question to Dr. Lane Ochi and let’s see later in this episode, what he had to say.

But as far as the Pearl is concerned, that specialist believe in it. I believe in it. In fact, recently if you’re on Protrusive Guidance, you would’ve seen me do a live, I treated a crack tooth case and I walked you through exactly why and how I prepared this for a cobalt chrome restoration. I show you the entire prep, the cementation, and this is available with CPD CE quiz. We are a PACE approved education provider, as you know.

So if you’re curious about metal restorations for compromised second molars, when you’re lacking that space, check it out in the Premium Clinical Video section of the app. And speaking of the app, I just wanna do a shout out to Dr. Jamie Adamson.

Jamie said on the app, thank you, Jaz, for the availability of your VertiPrep course. Fitted my first anterior VertiPrep crown today and just plunked it on loving the soft tissues especially. Appreciate your commitment to helping the Protrusive community. Well, Jamie, to you and everyone who’s started to do Ver...]]> 1:12:07 false https://podcast.show/protrusive/episode/147708105/ 147708105 https://protrusive.co.uk/?p=9023 Jaz Gulati Tue, 12 Aug 2025 08:19:00 -0400 Can you apply the Dahl technique to localised POSTERIOR wear?

Spoiler alert: hell yeah!

How can the Dahl Technique help when there is posterior wear and NO space to restore?

How predictable is building up posterior teeth (rather than the usual worn anteriors)?

In this episode, Jaz dives into the ‘Reverse Dahl Technique’, a twist on the classic method typically used for localized anterior wear. Dr. Hans Kristian Ognedal from Norway shares his insights, explaining how building up posterior teeth with composite can lead to occlusion magic! 

If you’re curious about this technique and want to see a real-life case study, this episode breaks it all down, with a special visual breakdown for those watching on YouTube or Protrusive Guidance.

Protrusive Dental Pearl: Jaz shares insights from Hold On to Your Kids by Dr. Gordon Neufeld & Dr. Gabor Maté, emphasizing how modern children lose parental attachment too soon, turning to peers for guidance. This shift can lead to anxiety and emotional disconnection. 

Takeaway: Kids thrive when their primary attachment remains with parents, not peers. Strengthening this bond is crucial for healthy development. 

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

Key Takeaways

• The traditional Dahl principle focuses on creating occlusal space for anterior crowns.
• The reverse Dahl technique is a direct method for treating worn POSTERIOR teeth.
• Diet plays a significant role in tooth wear and dental health.
• Taking photographs of patients’ teeth can help track wear over time.
• Understanding the etiology of tooth wear is crucial for effective treatment.
• Building up dental anatomy is essential for successful restorations.
• Occlusion should be viewed as a dynamic system rather than a static one. 
• Patients can adapt well to this treatment modality
• “Patients that wear their teeth, they don’t usually have TMJ problems.”

Highlights of this episode:

• 02:22  Protrusive Dental Pearl
• 04:50 Guest Introduction: Dr. Hans Kristian Ognedal
• 07:06 Understanding the Original Dahl Concept
• 09:31 Exploring Reverse Dahl Technique
• 13:30 Etiology and Patterns of Tooth Wear
• 23:46 Facial Patterns and Occlusal Traits Linked to Wear
• 24:44 Clinical Approach to Posterior Wear
• 30:26 Patient Comfort and Staging Treatments
• 32:11 Cuspal Planes and Guidance
• 34:21 Review Schedule and Observations
• 38:44 Longevity of Treatments
• 44:04 Contraindications and Patient Selection 
• 45:24 Case Studies and Practical Tips
• 49:30 Night Guard Use
• 53:06 Final Thoughts and Education Opportunities

If you want to learn more about Dahl Technique, be sure to listen/watch:

• Why do some Dentists find Dahl Distasteful? – PDP016
• Dahl Part 2 (The Spicy Bit) – PDP017
• Dahl Technique and ‘Maryland Bridges’ – GF001

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)

Aim: To explore and understand the Reverse Dahl Technique, focusing on its application for patients with localized posterior tooth wear. This technique provides a solution when posterior teeth are worn, and there is insufficient space for proper restoration.

Dentists will be able to –

1. Understand the principles behind the Reverse Dahl Technique and how it differs from the traditional Dahl Technique.

2. Identify the clinical scenarios where the Reverse Dahl Technique can be applied.

3. Comprehend the role of composite build-up in restoring posterior wear and its impact on occlusal reestablishment.

Teaser:I don’t wear my back teeth. I think I am not able to generate a type of forces that wears my teeth. But I think most patients who wear their teeth, they’re usually in full occlusion. I think having posterior where it’s more a function of consequence of how they function, how they chew, how they eat, how they swallow, how they process food when they take food into the mouth.

Jaz’s Introduction:So whether you use it or not, I’m sure we’ve all heard about the DAHL technique, right? This is when you have localized anterior tooth wear, and what you’re doing in this case is you are building up the anterior teeth even though you don’t have space. And so because you’re building these teeth up, when the patient bites together, now they’re prematurely hitting their front teeth, the back teeth all open.

There are like bilateral posterior open bites, and what happens over time is intrusion of the anteriors and you know, over eruption or Dento alveolar compensation of the posterior and the occlusion. Like magic reestablishes. So if you wanna go deep dive into that, check out our previous episodes on the  DAHL technique.

Like these are some of the ones we did five years ago with Tiff Qureshi, and they are literally like Protrusive Wall of Fame. So do check out those and I’ll link them at the bottom. But today’s episode, my friends is on something quite different. It is same, same but different as they say in Asia, right?

It is the reverse  DAHL technique. Now instead of having localized anterior tooth wear, we have localized. Posterior tooth wear. Think of that patient who when they bite together, their posterior teeth are just shot, right? There is exposed dentine, there is lots of erosion, and so you’ve got plenty of localized posterior wear.

And then the premolars, canines and anteriors are maybe a little bit worn, but not that worn. And the problem we have is that yes, the posteriors are worn, but when the patient bites together, the back teeth are all contacting, meaning you don’t have space.

So with the reverse  DAHL technique or modified  DAHL technique, what you do then is you build up the posteriors in composite, you leave the anteriors out of the bite, and then like magic, the posteriors will intrude and everything else over ups, if you like, and the context will reestablish.

Now, our guest today, Dr. Hans Kristian Ognedal from Norway, does a wonderful job of discussing this technique and his experiences, and at the end, he shares a case. So for those of you who are listening, while you’re jogging on a train, while you’re driving, don’t worry, I describe the caseand the exact scenario.

For those of you who are watching on Protrusive Guidance or on YouTube, you’ll actually get to see the images as well if you listen all the way to the end. I was quite excited to record this episode because it’s a, a new one, right? It’s a, it’s a new thing for me. I haven’t seen much published on the interweb about this technique, so hopefully you’ll learn something new.

Dental PearlTalking of learning something new, every PDP episode I give you a Protrusive Dental Pearl. Now, as you know, I’m a family man, and for those of you on our community Protrusive Guidance, I’m always talking about the books that I’m reading, or actually I’m listening to on Audible. The current one, I just feel compelled to talk about it.

It’s called Hold on to your Kids. Like I’ve got two boys, a 6-year-old and almost 2-year-old, and I think a lot about being a dad and being hopefully a good dad. I actually always wanted to be a parent. I actually love my role as a dad it’s my favorite title in the whole wide world. Quite often I’ll pick like, you know, parenthood books or relationship books because just like I’m interested in dentistry and I read their dental literature.

I’m interested in parenting and being the best parent I can be. So I kind of am attracted to these kind of titles. Now, the book, again is called Hold Onto Your Kid, it’s by Dr. Gordon Neufeld and Dr. Gabor Matè. And it essentially talks about how in modern society, children lose the attachment to their parents too soon.

And so what it talks about is that what children of modern society do is when they lose that attachment to their parent, they then gain the attachment from their peers. And then it’s like, you know, the blind following the blind and there’s a major cause of anxiety and disconnection from family. I’m actually now just getting into the really good parts of the book where it’s actually telling me solutions, right.

You know, the whole several first few hours are talking about the problem, right? The problem of losing attachment to a children and how you cannot serve two masters so they can’t be attached to their peers. And attached to you as their parent. At the same time, they have to pick one. And the way that we have the schooling system, the way that we have social media and phones, that they’re constantly now messaging each other and they’re gaining their attachment from their peers no longer from their parents.

Now we need that parent attachme...]]> 0:59:44 false https://podcast.show/protrusive/episode/147568744/ 147568744 https://protrusive.co.uk/?p=8996 Jaz Gulati Thu, 07 Aug 2025 01:49:20 -0400 Do you feel confident managing patients with TMD or oro-facial pain?

Are you clear on when to treat conservatively—and when to escalate?

What’s the best SEQUENCE of care for TMD patients?

Emma returns to Protrusive Students fresh from her finals, joining Jaz for an insightful episode on the basics of TMD management. Together, they explore the foundational steps of TMD care, from proper diagnosis to the logic behind a structured treatment hierarchy.

They break down conservative versus aggressive approaches, share clinical tips for muscle and joint assessment, and highlight common mistakes to avoid—especially during palpation and history taking.

Whether you’re a student, a dentist returning to practice, or just want a refresher on TMD, this episode will help solidify your approach and boost your clinical confidence.

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

Key Takeaways

• TMD is a complex topic with various treatment approaches.
• Patient education is crucial in managing TMD effectively.
• Physiotherapy can significantly aid in TMD treatment.
• Different splints serve different purposes in TMD management.
• Bruxism can be a silent issue that affects many patients.
• Identifying the source of pain is essential for effective treatment.
• Stress can exacerbate TMD symptoms in patient cohorts
• Continuous learning and resources are vital for dental professionals.

Highlights of this episode:

• 02:35 Emma’s Finals Experience and Advice
• 05:16 Deep Dive into TMD: Clinical Insights
• 09:59 Common TMD Disorders and Their Presentation
• 18:31 TMD Treatment Options
• 28:00 Medications and Appliance Therapy
• 34:25 Practical Tips for Managing TMD
• 37:19 Addressing Bruxism and Patient Communication
• 41:00 Protrusive Pathways and Future Plans
• 43:46 Protrusive Students S2

???? Protrusive Resources

• OPPERA Study
• Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†
• TMD Therapy Hierarchy of Management
• Effects of occlusal splint therapy in addition to physical therapy on pain in patients affected by myogenous temporomandibular disorders: A pilot randomized controlled trial
• Splints Decision-Making Flowchart 

???? Protrusive Pathways Structured playlists grouped by topic (e.g., TMD, bridges, onlays): TMD Content Playlist

???? Crush Your Exam Student NotesDownloadable summaries by Emma, covering TMJ anatomy and function, are available inside the Protrusive Guidance App (request student access via Mari)

If you loved this episode, be sure to watch TMD New Guidelines! Evidence-Based Care – PDP213

#OcclusionTMDandSplints #BreadandButterDentistry #Communication

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

This episode meets GDC Outcomes 

C – Maintenance and development of knowledge and skill within your field of practice.

AGD Subject Code: 200 – Orofacial Pain / TMD

Aim: To provide a practical, evidence-informed framework for the conservative diagnosis and management of Temporomandibular Disorders (TMD).

Dentists will be able to –

1. Describe the three major categories of TMD and their clinical features.

2. Differentiate muscular from joint-related symptoms using simple chairside tests.

3. Explain the rationale for a conservative, staged approach to TMD management.

Teaser:Taking these broader categories, like how do these typically present in practice to during an exam, or does it chop and change for every patient?

I tell ’em, I’m not a guru. I don’t know what’s gonna work. But can we at least try things that are conservative and then we can always escalate to more aggressive things? 

Jaz’s Introduction:Welcome back to another Protrusive Student episode. Emma is back after finishing her finals exam. So, in Glasgow where she studies you do the finals exams in your fourth year. And so she’ll be soon heading into her final year, which is fifth year.

So it’s strange that they do their final like academic exams in their penultimate year, but I guess that’s how it works there. And I’m pleased to say she passed. She passed, and she’s back again for this series called Protrusive Students. Now it’s not just for students, it can be provision for someone returning back into dentistry or validation for many clinicians.

Or maybe you are feeling that TMD is not your hot point, and so this is a great basics episode to lift up your foundational understanding. Now, it’s very tough to cover TMD in this short episode, but the main takeaway I can tell you now is the hierarchy of treatment or management is probably a better word than treatment.

We do talk about a few clinical gems and a few pertinent points in someone’s history. Or the common mistakes we make when we’re palpating the joints and the muscles. But if there’s one thing that you’re to take away from this foundational episode on TMD management is the hierarchy of treatment and why it exists.

What are the modalities included in conservative care and what are the modalities that are deemed more aggressive? And why we should have a bit more logic and sequence to how we treat our patient. You’d be able to download my hierarchy underneath the link if you’re on the app. And of course, for the students out there who have exams coming up or want some really good revision notes, Emma regularly updates the Crush Your Exam section.

So in this section on the Protrusive Guidance app, you can access it on your phone or on your browser, anywhere you like, and you can download revision notes. For example, PS006 was indirect restorations, a really good overview for young practitioners and students. And for this episode, you can get everything about TMJ anatomy, which is so important.

How can you understand what pathology is if you don’t understand what normal anatomy is? So to access that, just head over to protrusive app. Make your free account and join the ‘Are you a student?’ section. If you can verify you’re a student, you just need to DM Mari on the app. Her name is Mari Benitez. She’s like our CPD Queen, also student lead.

She’ll just need some proof that you’re a student and she’ll let you access the Protrusive vault, which has got like all our infographics and papers. It’s our way of like supporting and nurturing you students. But like I said, this episode’s also useful for those who have a bit more experience, who are qualified, and you can even get CPD or CE credits for this episode.

We are a PACE approved education provider. For that, you need one of our paid plans, and you scroll down, you answer the quiz. And Mari, our CPD Queen will arrange your certificate. Let’s now join Emma the Protrusive Student and welcome her back for this episode.

Main Episode:Emma, welcome back, the Protrusive Student. Congratulations for passing your finals like in Glasgow. You do it in the fourth year. Tell us how was it? 

[Emma]It was intense, but I made it through. I think anyone that’s done final exams before. You’ve just gotta keep your head down for a bit and get through it, really. But I survived. So here I am. 

[Jaz]Never in doubt, Emma. Never in doubt. I remember we were chatting before you getting results and it’s sometimes difficult to gauge how you’ve done, like I was convinced, I failed. Like it was that one of the OSCEs went that bad. But actually I did end up doing very well and so it was a bit of a family joke now about how I catastrophize.

That kinda stuff. But yeah, it was all good. And now that you’ve been through it, what’s the number one advice you can pass on someone who’s gonna be maybe doing finals next year, for example, or coming up imminently? 

[Emma]I would say don’t underestimate anything ’cause they will just ask you anything question by- 

[Jaz]You’re supposed to make it, like you’re supposed to make them calm and reassured that, that’s gonna overwhelm them like to the nth degree. But it is what it’s. 

[Emma]I think you can either be one of two people. You’re either gonna be someone that knows a little bit about everything or a lot about certain subjects. So for me, I’m one of those peopl...]]> 0:46:32 false https://podcast.show/protrusive/episode/147399348/ 147399348 https://protrusive.co.uk/?p=8973 Jaz Gulati Thu, 31 Jul 2025 02:13:01 -0400 Have you heard of Photobiomodulation (PBM)? Or are you thinking… ‘photo-what?!’

Is red light therapy just voodoo science—or is it already part of mainstream healthcare?

Can PBM really help with wound healing, pain relief, and even reduce the risk of dementia?

In this episode, Professor Praveen Arany joins Jaz Gulati to break down the science and clinical relevance of PBM in dentistry. They explore how this light-based therapy works, its applications in managing oral lesions, and why it’s already standard care for cancer patients undergoing chemotherapy.

They also discuss real-world cases, practical protocols, and how PBM could shape the future of dental care. Whether you’re a skeptic or just curious, this episode will open your eyes to an emerging and evidence-based treatment modality.

Protrusive Dental Pearl: SHEEP Scoring as a practical tool to assess the prognosis and restorability of compromised teeth.

???? SHEEP stands for:

• S – Structure: Amount of remaining tooth structure
• H – History: Patient’s dental and medical history (e.g. caries risk, trauma)
• E – Endodontics: Endodontic prognosis (ease/difficulty of root canal treatment)
• E – Expertise: Your personal skill and experience with managing such cases
• P – Periodontal: Periodontal condition and bone support

Each category is scored out of 10, and the total is doubled to give a percentage-based prognosis. This structured approach supports clinical decision-making, encourages honest reflection on the clinician’s own skills, and enhances patient communication during consent. The method is backed by literature, including a paper co-authored by Martin Kelleher.

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

Key Takeaways

• Photobiomodulation can significantly improve patient comfort and healing.
• The treatment is standard for cancer patients undergoing chemotherapy.
• There are no known adverse effects of PBM when used correctly.
• PBM can be used effectively in various dental procedures.
• The future of PBM includes personalized treatment protocols.
• Research is ongoing to optimize PBM applications in dentistry.
• PBM is distinct from other laser treatments and has unique benefits.
• The technology is becoming more accessible to practitioners.
• Awareness of PBM’s benefits is growing in the wellness industry.

???? ResourcesProf. Praveen Arany shares papers on:

• Light buckets and laser beams: mechanisms and applications of photobiomodulation (PBM) therapy
• Photobiomodulation therapy: Ushering in a new era in personalized supportive cancer care
• Photobiomodulation Therapy by Prof. Praveen R. Arany
• Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022

For full PDFs, you can check out Protrusive Guidance.

???? You can find more of Prof. Praveen Arany’s scientific papers on Google Scholar

???? Two Upcoming PBM Courses!

ADA PBM Course – A dental-focused program by the American Dental Association.???? Contact: Sherie Tynes – tyness@ada.org

PBM in Supportive Cancer Care – Held at Gustav Roussy Hospital, Paris.???? Contact: Dr. Camelia Billard – camelia.billard@gustaveroussy.fr

If you liked this episode, check out Medication Related Osteonecrosis for GDPs – What You Need to Know (MRONJ) – PDP215

#PDPMainEpisodes #OralSurgeryandOralMedicine #BreadandButterDentistry #CareerDevelopment

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

This episode meets GDC Outcomes B & C.

AGD Subject Code: 135 – Laser Therapy/Electrosurgery

Aim

To introduce dental professionals to the fundamental science, clinical applications, and emerging potential of Photobiomodulation (PBM) therapy in dentistry.

Dentists will be able to –

• Define photobiomodulation (PBM) and explain how it differs from surgical laser applications.
• Describe three key mechanisms of PBM at the molecular level.
• Identify clinical situations where PBM can enhance patient outcomes (e.g., mucositis, ulcers, TMD).

Teaser:People used to use a point and shoot approach. They just switch on the light pointed at the patient and hope that they get better. And hope is not a scientific strategy. So-

In a 30-second soundbite, are you able to just describe the actual molecular mechanism or the physiology of how it actually gets the results it does? So our current understanding of photo biomodulation mechanisms is- 

Jaz’s Introduction:Did you know there’s something called PBM, which stands for photo biomodulation and I know what most of you’re thinking. Photo what? Listen, I was as confused as you are and I thought, what is this mumbo-jumbo voodoo science? But then I found out that photo biomodulation or light therapy is already the standard of care when it comes to cancer patients undergoing chemotherapy. And then it reminded me of my physio who uses red light therapy for pain.

And today’s guest, professor Praveen Arany, who does a wonderful job on educating us on this treatment modality explains about the mechanisms in wound healing. So, dear Protruserati, I’m Jaz Gulati and welcome back to your favorite dental podcast. I’m so excited to share this episode with you today for so many reasons.

Number one, a lot of the guests I have on, we talk about restorative dentistry or occlusion, things that I really have an interest in and I know a fair amount about. But then this episode, I came in with nothing. I purposely didn’t do any research ’cause I wanted that magic and the aha moments to be alive.

And I enjoyed this. I enjoyed learning about PBM very much, and I know you will too. Number two is our guest has no financial interest at all. He is a pure academic for the love of it, for the love of research. I even asked him to recommend specific PBM units ’cause trust me, by the end of this episode, you want to know.

And he directed me to like guidelines. And scientific websites, which I absolutely love. So I think you really enjoy this, what I feel is really unbiased and it focused on an emerging technology, which I’m so excited to unpack today with you.

So on Protrusive guidance, our community group. I asked a question a few weeks ago, do you know anything about or actively use photo biomodulation in practice? Okay. And 74% of us were like, what? What is that? We have no idea. 7%, just 7% use PBM. And only 18% have actually heard about PBM and its use in wound healing and in dentistry. And you know, interestingly, one of our members, Lindsay, she said there’s a lot of research being done on PBM at the moment, which you’ll see today.

And then she wrote something fascinating, which is also something that was DMed to me on Instagram when I talked about this on the story, is how it can help you in pain. So for example, with Lindsay’s case, it cured her ruptured vertebral disc symptoms we’re using her laser, and she managed to avoid spinal surgery.

And there’s also some great insight from our resident implant geek Doctor Pav Khaira, like research on PBM to reduce the risk of Alzheimer’s and Dementia. But why I can promise you in today’s episode is that we’re gonna make it very relevant for dentistry. You’ll learn about how PBM works and what indication should it be considered, and what are the protocols and what does the future hold.

Dental Pearl:Now, before we unpack this topic, I’m gonna give you a Protrusive Dental Pearl. If you’re new to the podcast, welcome, it’s a good one to join. And every PDP episode I give you a tip, a pearl, a hack. Something you can use, you use straightaway. A lot of times’ clinical. Sometimes it’s mindset and nonclinical.

Today’s is very clinical. So Dr. Jack, as he likes to be known on Instagram, DM me this pearl. He noticed that sometimes I mentioned on these episodes that, ah, I’m struggling to find a pearl for today. And so he rescued me. He said, listen, SHEEP, he said, SHEEP, remember the acronym SHEEP? When you want to find out the prognosis of a tooth, you can use SHEEP.

And so let’s talk about this for a few minutes. From his DM, I was a little bit confused about its application. Then I saw Googled...]]> 1:04:36 false https://podcast.show/protrusive/episode/147235936/ 147235936 https://protrusive.co.uk/?p=8956 Jaz Gulati Thu, 24 Jul 2025 02:42:11 -0400 Should you be re-treating that root canal—or referring it out?

What are the red flags that scream “specialist only”?

How do you confidently remove GP without compromising disinfection?

Dr. Ayman Al-Sibassi joins Jaz in this endo-packed episode to help you navigate the tricky world of root canal re-treatments. From solvent selection and GP removal techniques to assessing case difficulty, they break down everything a GDP needs to know to make smart, confident decisions.

You’ll learn how to spot the cases you should be tackling, which ones to send to your endodontist, and what tools and techniques will make the re-treatment process smoother and safer. Because not all re-treatments are created equal—and some are surprisingly simple once you know what to look for.

Protrusive Dental Pearl: A crack in a bonded ceramic restoration isn’t necessarily a failure!

Just like we accept cracks in natural enamel, we can also accept cracks in ceramics—as long as it’s been properly bonded.

Shoutout to Dr. Pascal Magne for this powerful mindset shift!

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

Key Takeaways

• Specialist training in endodontics includes a variety of surgical skills.
• The complexity of root canal retreatments varies significantly.
• General dentists can perform some retreatments, but should assess complexity carefully.
• Patient consent is essential, especially regarding potential unrestorability.
• Communication about fees should be clear and upfront with patients.
• Red flags for retreatment include poor coronal seal and previous treatment quality.
• CBCT imaging is becoming increasingly important in endodontic practice.
• Collaboration between general dentists and specialists enhances patient outcomes. Many referrals stem from straightforward cases that are poorly managed.
• Using solvents can aid in GP removal but should be approached cautiously.
• Single visit treatments are often preferred for patient convenience.
• Adequate disinfection is crucial, sometimes necessitating a second visit.
• The survival rate of root canal-treated teeth is comparable to implants.
• Patient age and overall health should guide treatment decisions.
• Understanding the difference between success and survival in endodontics is essential.

Highlights of this episode:

• 00:00 Introduction
• 05:02 — Protrusive Dental Pearl: Cracks in enamel vs. dentine 
• 06:34 — Guest Introduction: Dr. Ayman Al-Sibassi and his journey into Endo 
• 11:03 Assessing the complexity of re-treatments and when to refer
• 15:21 The role of CBCT in diagnosis and treatment planning
• 17:47 Ethical and financial dilemmas: charging for unrestorable teeth
• 22:05 Red flags in root canal re-treatments
• 34:55 Techniques for GP removal and file selection
• 47:07 Cost vs. predictability: re-treatment vs. implants and long-term outcomes

Take a look at this Endodontic Complexity Assessment Tool to help you evaluate how challenging a root canal case really is.

If you enjoyed this episode, you’ll definitely want to check out: Stop Being Slow at Root Canals! Efficient RCTs with Dr. Omar Ikram – PDP163

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: 070 ENDODONTICS (Non-surgical treatment)

 #PDPMainEpisodes #EndoRestorative

Aim:

To provide clinicians with a structured approach to diagnosing, planning, and executing simple Re-Root Canal Treatments (Re-RCTs), while recognizing case limitations and improving treatment outcomes.

Dentists will be able to:

1. Identify clinical situations where Re-RCT is appropriate and distinguish them from cases requiring referral or alternative treatment.
2. Describe the potential challenges such as canal blockages, separated instruments, or apical complications, and know when to refer.
3. Communicate effectively with patients regarding prognosis, risks, and treatment expectations, including the need for possible referral.

Teaser: Fractures somewhere in the root essentially. If we come back to what I said about why most these more straightforward cases, why they fail a lot of the time. As I said, it’s because the gps already not that well condensed to begin with. So in terms of removing the gp, my first go-to in those kind of cases would always kind of be- so the reason I say that is ’cause they’re handfull, so they’re probably a lot safer than using sort of rotary files. You can control it a bit better as well. 

Jaz’s Introduction:I used to think that root canal re-treatments were only for specialists and that GDPs should not touch them. Well. How wrong was I? When I entered my training post in Sheffield, it was a a dental core trainee post. Now the rest of the world is kind like a residency.

It was like one year attachment with the restorative department, and this was in a dental hostel. I remember seeing a case, it was a central incisor and it already had a root filling, so it was up to me to do the root canal re-treatment. Now, I was scared. I was, oh my God, I’ve never done a re-treatment before.

I’ve never had to remove gp. And also I was learning how to use the scope of the first time. So for me, I was nervous. I was thinking, this is very much specialist treatment. Will I be able to carry it out? Now, when the case actually came in front of me and I saw the radiograph, it literally was like a GP cone floating in this big wide canal.

Just that one sultry master cone. Plenty of air and fluid if you like around it. No wonder it failed and I accessed the tooth. I literally, with my tweezers, could see so clearly that GP cone, I picked it out and I carried out the root canal treatment and that was the easiest root canal re-treatment ever.

And it just made me realize that had this limiting belief that not all re-treatments are the same. So I guess the point of this episode and what we’ll learn with my guest Dr. Ayman Al-Sibassi, is how to know which re-treatments GDPs should totally get involved with and how to know where perhaps this is one to refer to our specialist colleagues.

You’ll find out the best ways to remove the gutta percha. Is it gutta percha or is it gutta Perker? Honestly, endo is not my thing so much anymore, so I don’t even know how to say it anymore, but you know what I mean. The GP. Which is the best instrument, which is the best solvent? And interestingly, how much solvent should he actually be using?

Like should you be flooding your canal with solvent or should you be just using tiny drops on your instrument? And related to what I just said earlier, I want you to understand more about risk and predictability of re-treatments. What are the red flags that you should not pass go? We cover all this and so much more in this episode.

Now, if you’re new to the podcast, welcome. My name is Jaz Gulati, and therefore you are called affectionately the Protruserati. We are the community of the nicest and geekiest dentist in the world. So if you wanna join that community, head over to www.protrusive.app. The idea is that we don’t want anyone to feel isolated, that they can’t ask for advice.

If anyone’s feeling nervous or unsure about certain treatments, well check the whole backlog of all the episodes we’ve done. But also having peers, like-minded Protruserati to support you is exactly what you’ve created on our app. Now those of you who are returning viewers and listeners, please do hit that subscribe button.

Dental PearlAnd as you know, every PDP episode, I give you a Protrusive Dental Pearl. Now by the time episodes come out to publish, it’s actually probably been a few months sometimes what I’m kind of doing now is like early spring now, and I’m kind of getting ahead so that I can enjoy my summer with my family.

But you guys all get an episode once a week. That is the dream. And one thing that you guys ask me all the time is Jaz, how do you do it? How do you stay motivated with your podcast? How do you get it done? How do you balance family, children, clinical dentistry, and of course watching cricket, which I love doing.

How do I make it all happen? Well, I’ll tell you something guys. Something just from the heart. I have a big team now and they help me so much. It is a real team effort to get every episode out. Every episode that has CPD or CE especially, has probably been through about four different people and about three of those are dentists before it actually reaches publication.

That’s so that we can actually quality control the CPD questions, the learning outcomes, and produ...]]> 0:55:53 false https://podcast.show/protrusive/episode/147077877/ 147077877 https://protrusive.co.uk/?p=8942 Jaz Gulati Thu, 17 Jul 2025 00:49:46 -0400 Are you confident when increasing the vertical dimension?

How do you plan, stage, and sequence a full-mouth case safely?

What’s the right deprogramming method—leaf gauge, Kois appliance, or something else?

Dr. David Bloom joins Jaz in this powerhouse episode to demystify the real-world process of increasing vertical dimension. With decades of experience in comprehensive dentistry, David shares how he approaches diagnosis, bite records, temporization, and final restorations—with predictability and confidence.

Protrusive Dental Pearl: Pick one occlusal philosophy and stick with it until you understand it well through real cases. Once you’re confident, stay open to other approaches—hearing different views will make you smarter, more flexible, and a better dentist.

If you are looking to get started with the foundations of Occlusion, check out our comprehensive Online Occlusion Course.

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

Highlights of this episode:

• 00:00 Trailer
• 00:55 Introduction
• 04:43 Guest Introduction: Dr. David Bloom
• 10:25 Equilibration Techniques Explained
• 11:18  Interjection #1
• 15:50  Opening Vertical Dimension vs. Orthodontics
• 18:06 Interjection #2
• 23:05 Whitening and Restorative Solutions
• 25:27 Guidelines for Raising Vertical Dimension
• 25:52 Interjection #3
• 29:28 Midroll
• 32:49 Guidelines for Raising Vertical Dimension
• 36:06 Visual Try-In and Adapting Vertical Dimension
• 40:16 Case Planning and Execution
• 41:16 Interjection #4
• 43:42 Case Planning and Execution
• 50:23 Material Preference for Provisionals
• 52:00 Bite Registration and Final Adjustments
• 55:06 Do’s and Don’ts for Clinicians
• 57:15 Conclusion and Resources
• 58:59 Outro

Key Takeaways

• Vertical Dimension and Adaptation: Opening the vertical dimension in dentistry can be challenging, especially for edentulous patients who lack proprioception. However, with proper planning and understanding of occlusion, the human body can adapt remarkably well.
• Occlusal Philosophy: It’s important to learn one occlusal philosophy well, whether it’s Kois, Dawson, or another. Understanding different approaches can make you a more rounded clinician, as different patients may benefit from different methods.
• Equilibration and Deprogramming: Equilibration is crucial for idealizing occlusion by eliminating interferences. Deprogramming helps in achieving centric relation, a stable and repeatable position for the condyles, which is essential for successful equilibration.
• Orthodontics vs. Vertical Dimension: Deciding between orthodontics and opening the vertical dimension depends on the specific case. For example, pre-aligning patients with orthodontics might be necessary to address a restricted envelope of function.
• Testing and Adaptation: Testing the vertical dimension with transitional materials like composite can help patients adapt before moving to definitive restorations. Experienced clinicians may sometimes proceed directly to final restorations based on their judgment and diagnostic steps.

Get CE/CPD for this episode only on the Protrusive Guidance App.

????️ A new website is launching soon by Dr. David Bloom — ppcontinuum.com

Also, Dr. David Bloom’s hands-on courses on veneers and minimally invasive dentistry

If you found this episode valuable, you’ll definitely want to watch PDP197: Vertical Dimension – Don’t Be Scared!, part of Occlusion Month.

#PDPMainEpisodes #OcclusionTMDandSplints #BreadandButterDentistry

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

This episode meets GDC Outcomes B and C.

AGD Subject Code: 180 OCCLUSION (Occlusal therapy)

Aim:

To provide clinicians with a comprehensive understanding of how to safely and predictably increase the vertical dimension of occlusion (VDO) for restorative cases, using a diagnostic-driven, conservative, and patient-centred approach.

Dentists will be able to: 

1. Describe the indications and contraindications for increasing VDO.
2. Differentiate between conformative and reorganized approaches to occlusal rehabilitation.
3. Identify the steps involved in diagnostic planning, including CR bite records, wax-ups, and visual try-ins.

Teaser: We’re probably not gonna be prepping the teeth at all, but patients need to be aware that whilst there’s gonna be less cost, I’d consider it as a long-term provisional. Because-

Transitional, almost.

Transitional. Yeah, absolutely. I mean, ideally, if I’m doing restorative, I’d rather not whiten first, because if we have our super thin restorations and our whitening result, over time will fade. It’s much harder to top that up. If you have a restoration.

The first step in a collaboration is to be able to manipulate someone into centric relation. And 90% of the population have a slide from CR Central relation to CO centric occlusion habit by whatever your terminology and the first step in a equilibration is-

Jaz’s Introduction:So we’ve talked about this big topic before, vertical dimension and restorative dentistry. Me and Mahmoud did an episode basically reassuring you that you can safely raise the vertical dimension and that we shouldn’t be so scared of it. What I do in this episode with Dr. David Bloom is really lean on his decades of experience.

Comprehensive dentistry to delve deeper into the intricacies of opening the vertical dimension, the staging, the phasing, the planning, and a full walkthrough of how Dr. David Bloom does it. And you know what? There’s many different ways to go about it. In fact, for those of you who can see me who are watching this, I’m a bit more formally dressed.

I’m not wearing my hoodie. I was actually at an occlusion symposium today, and you had these great speakers and inclusion like Paul Tipton and Koray Feran, Tif Qureshi. And these guys were talking about the importance of canine guidance. And then you had Ken Harris, also a legend in occlusion. And one, the mentors on Kois.

He did not care for canine guidance. It was irrelevant, it was not important. And if you go back into the Archives of Protrusive podcast, you remember two episodes we did with Dr. Andy Toy. About the posterior guided occlusion where actually we don’t want canine guidance. So it goes to show my friends that in the world of occlusion, there’s many ways to do it.

Learn one way, learn it well, it will serve you well. And then the benefit of learning the other ways is that sometimes you’ll find a patient that really fits into that box a little bit better. For example, for many years I didn’t use a Kois appliance. I had my ways of deprogramming that I was very happy with, and just a couple of years ago, I did my first Kois, and I’ve done a few more since then.

And there are certain patients and characteristics that just are very amenable to that way of doing it. But then for most of my patients, I use a leaf gauge. There’s two types of patients. There’s loosey goose and tighty whitey. The tighty whitey patient, we all know this patient, right? It’s the one where you’re trying to do some manipulation, you’re trying to seat the joints and their mandible is just so stiff.

Whereas you have, they’re much nicer loosey goosey patients where you don’t have to work very hard to deprogram them or get everything nice and relaxed and hinging. And these two patients will need a different type of deprogramming. So I say learn one school, one occlusal religion well, and then start looking at the others.

And I think there’s so much to learn from all the occlusion camps. Just like I said, two polarizing views I was listening to today on canine rises and whether canine guidance is even important at all. And you know what? I subscribe to them both. And you are thinking Jaz. That’s not possible. How can you serve two masters?

Well, you can because our patients are so variable. They’re so unique. That’s what actually makes our dentistry fun. If every patient was the same, it would be boring. But our patients come with these unique challenges, these unique presentations, and we have to sometimes be very creative in how we treat someone, how we arrive at treatment decisions.

And lemme tell you, learning about the different occlusal religions has made me a better, more rounded clinician. But for many of you listening early in your career. Honestly, just pick one religion, whether that’s the ...]]> 0:58:00 false https://podcast.show/protrusive/episode/146908716/ 146908716 https://protrusive.co.uk/?p=8930 Jaz Gulati Thu, 10 Jul 2025 02:55:43 -0400 How do you manage patients that have ultra high expectations?

What’s the best way to communicate cosmetic outcomes before the final result?

How do you balance your aesthetic vision with what they see?

Dr. Brandon Mack joins Jaz for a deep dive into the realities of cosmetic dentistry—from subjective perceptions of beauty to practical tips that make or break a case.

They discuss how to navigate aesthetic stress, manage patient expectations, and even go into Brandon’s favorite veneer cement and occlusal philosophy. Plus, Brandon shares key failures that shaped his journey—and how you can avoid the same pitfalls.

Protrusive Dental Pearl: When discussing smile design with patients, especially in high-end cosmetic cases, set the right expectations early by using this memorable “Eyebrow Analogy”:

• Central incisors = Twins (they should be as symmetrical as possible)
• Lateral incisors = Sisters (not identical, but related)
• Canines = Cousins (more individual)

This helps patients understand that perfect symmetry isn’t always natural or necessary — especially for lateral incisors!

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

Key Takeaways

• Cosmetic dentistry as a lens through which all treatment should be approached—balancing patient autonomy with ethical care.
• Managing expectations begins before the patient sits in the chair. It continues through structured checkpoints: from initial consultation to provisional feedback and final delivery.
• Temps aren’t just placeholders—they are test drives. They align expectations between the dentist, patient, and lab, reducing surprises and improving satisfaction.
• Some dentists may under-diagnose due to fear of rejection—not out of true minimalism. Thoughtful planning can make “more treatment” actually less invasive.
• Patients often want teeth that are both ultra-white and natural-looking. Brandon developed the concept of believability—a visual balance that delivers a wow-factor while still appearing real.
• Creating a mathematically perfect smile can make natural facial asymmetries more obvious. Dentists must weigh beauty against harmony.
• Social media and filters have distorted patient self-perception. Dentists must learn to identify signs of body or tooth dysmorphia and respond ethically—not just clinically.
• Building relationships with ceramists over time—expecting 15–20 cases before finding synergy. Each technician has unique strengths and should be matched accordingly.
• Composite veneers are accessible and beautiful—but extremely technique-sensitive. You become the ceramist. Brandon admires them but uses them selectively due to long-term maintenance concerns.
• Panavia Veneer Cement – Translucent for its predictable handling, strength, and minimal risk to thin ceramic restorations.

Highlights of this episode:

• 01:35  Protrusive Dental Pearl
• 03:11 Dr. Brandon Mack’s Journey and Philosophy
• 09:19 Managing Patient Expectations in Cosmetic Dentistry
• 14:23 Choosing the Right Technician
• 21:13 “Undersell and Overdeliver” Philosophy
• 25:12 Conservatism in Cosmetic Dentistry
• 26:48 Overcoming Failures
• 33:15 Body Dysmorphia in Dentistry
• 37:28 Occlusal Philosophy and Techniques
• 38:30 Fake It Till You Make It?
• 40:38 Veneer Cement 
• 42:07 Composite Veneers
• 44:17 Upcoming London Event and Final Thoughts

???? Coming Soon: Occlusion in Dubai ????A luxury course experience at Atlantis, The Palm — yes, the one with the famous waterpark!

???? Learn practical occlusion during the day????‍????‍????‍???? Bring your family for a fun, relaxing getaway???? World-class location, world-class content

Two-day immersive aesthetic experience aka ReturnofTheMack

Rewire how you think about cosmetics with Dr Brandon Mack

Participants will learn how to create personalized smile transformations that harmonize with each patient’s unique facial features, moving beyond generic smile designs to achieve truly customized results that enhance overall facial aesthetics.

• Bigger picture and smaller details in 2 days: transition zones, light interaction, surface modulation
• For new grads and seasoned dentists alike→ “It’s like re-reading a great book. The content didn’t change — but you did.”
• Discount Code: PROTRUSIVE for £100 off (case sensitive)

If you enjoyed this episode, don’t miss PDP129: 4 Rules of Planning Aesthetic Dentistry (Ortho-Resto)

#PDPMainEpisodes #AdhesiveDentistry #CareerDevelopment

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

This episode meets GDC Outcomes A, B, C, and D

AGD Subject Code: 780 ESTHETICS/COSMETIC DENTISTRY (Tooth colored restorations)

Aim: 

To enhance the clinician’s ability to manage patient expectations, communicate effectively with labs, and deliver predictable, high-level aesthetic outcomes in cosmetic dentistry through philosophy-driven protocols and reflective case-based learning.

Dentists will be able to –

• Understand the importance of managing patient expectations in elective cosmetic procedures.
• Recognize the role of provisional restorations as communication tools between dentist, patient, and lab.
• Reflect on how personal failures can lead to clinical growth and stronger aesthetic outcomes.

Teaser:Number one, why people don’t want to take more creative risk. It boils down to fear. And this idea as dentists we’re so type A that we feel like everything is a Super Bowl. We have to get it right on the first attempt. When you are in the process of doing this, you have to understand the level of anxiety that comes with it on the patient’s part, because everything that we’re doing is semi-permanent, right? Nothing lasts forever, but this isn’t a hair dyeing or a haircut.

When a patient says, I want really white teeth, but I want it to look natural. That is a horse with stripes. It’s not a zebra. It is a horse with stripes. I think that for the young dentists embracing every failure, no matter how big or how small, and understanding that every one of those lessons are an opportunity to put you in a better position to treat the next person better, it’s going to make the next person’s case better, every single failure.

So there’s always five checkpoints for patient expectation. Patients are demanding certain things, and so how much do we balance patient expectation and autonomy, what a person wants for themselves? I think it all boils down to one thing. 

Jaz’s Introduction:Cosmetic dentistry is tough. Think about it when you’re removing caries, is there a way to make that objective? Like some of caries removal is obviously subjective because how much I would remove is different to how much you might remove. But with something like caries detector dye, we know that we can turn this procedure and add a degree of objectivity to it, and we have some guidelines that we all work to.

Now, in the world of cosmetic dentistry, there is the lens that the dentist wears, and then there’s a perception of the patient. And as they say, beauty is in the eye of the beholder. Now, add to that the ultra high expectations that patients can carry today and the very nature of cosmetics and beauty being subjective. This is tough. This is what makes cosmetic dentistry tough. So I’m absolutely honored toast today, Dr. Brandon Mack from Florida.

He is one of the biggest names in cosmetic dentistry and we have a really geeky session today. I asked him how he manages those ultra high expectations patients, so big level stuff. And I also ask him little details like what’s his favorite veneer cement? What is Brandon’s occlusal philosophy? And one thing I really love is I ask him to tell us about his failures. And I always appreciate colleagues that share their failures and what they’ve learned along the way.

Hello, Protruserati. I’m Jaz Gulati and welcome back to your favorite dental podcast. If you’re returning to the podcast, maybe you’re watching this on the Protrusive Guidance app. Thank you so much for coming back.

If you are new to the podcast, you picked a really awesome one to join us. I said on the podcast, I actually really enjoyed Brandon’s flamboyant vocabulary. He’s full of energy, and these are the kind of episodes th...]]> 0:51:53 false https://podcast.show/protrusive/episode/146750797/ 146750797 https://protrusive.co.uk/?p=8913 Jaz Gulati Thu, 03 Jul 2025 02:08:24 -0400 We use articulators to help ‘mimic’ our patient’s jaw movements, to ultimately do less adjustments/revisions in the future.

But are digital articulators there yet? Or is analog king?

Or is digital dentistry just flashy tech with no real-world benefits?

Can a virtual articulator truly match the movements of your patient’s jaw?

Is a CBCT really better than a facebow—and WHEN should you use which?

In this cutting-edge episode with Dr. Seth Atkins, we dive into the world of digital articulation—exploring how tools like virtual articulators, CBCT alignment, and 3D-printed provisionals are transforming clinical workflows.

You’ll learn how to combine analog wisdom with digital precision, improve lab communication, and make full-mouth rehabs more predictable and efficient than ever.

From mounting accuracy to motion capture, this episode is your ultimate guide to articulating smarter in the digital age.

Protrusive Dental Pearl: Always send your lab the color version of your digital scan — the PLY file — not just the STL. STL shows shape, but PLY shows color — like markings and tissue detail. Ask your lab: “Are you seeing color, or do you need the PLY?”

Better scans = better results

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

Key Takeaways:

• Digital methods can enhance accuracy and patient outcomes → but only when used intentionally.
• Understanding both analog and digital techniques is crucial → they complement each other, not compete.
• Mentorship plays a significant role in advancing dental education → experience accelerates clinical confidence.
• Digital workflows can significantly reduce chair time → and improve patient comfort in the process.
• The integration of CBCT with digital workflows enhances diagnostics → giving clearer insight into static and functional relationships.
• Digital provisionals offer a cost-effective and efficient solution → saving time, money, and frustration for both dentist and patient.
• Axiography is essential for capturing patient motion accurately → because real movement matters more than assumptions.

Highlights of the Episode:

• 00:00 Introduction
• 04:00  Protrusive Dental Pearl
• 05:32 Interview with Dr. Seth Atkins and his Journey into Digital Dentistry
• 08:06 The Evolution of Digital Articulation
• 13:38 Digital Workflow and Mentorship
• 20:01 Accuracy and Efficiency in Digital Dentistry
• 22:32 Static and Dynamic Relations in Digital Dentistry
• 31:01 Interjection 1
• 36:05 Practical Guidelines on Integrating CBCT
• 37:15 Interjection 2 
• 40:59 Clinical Observations in Dental Rehabilitation
• 42:29 Interjection 3 
• 45:21 Introduction to Axiography
• 46:40 Advancements in Digital Dentistry
• 49:33 3D Printing in Dental Practice
• 53:31 Motion Tracking on Digital Articulators
• 57:30 Cost Efficiency of Digital Tools
• 01:01:10 Alternatives to CBCT
• 01:05:52 Involvement with AES and Future Plans

Check out the study mentioned: “Comparison of the accuracy of a cone beam computed tomography-based virtual mounting technique with that of the conventional mounting technique using facebow”

???? Join the world’s leading organization dedicated to occlusion, temporomandibular disorders (TMD), and restorative excellence — the American Equilibration Society (AES).

????️ AES Annual Meeting 2026 – “The Evolution of the Oral Physician” 

???? February 18–19, 2026 · Chicago, Illinois Don’t miss Dr. Jaz Gulati and Dr. Mahmoud Ibrahim as featured speakers, presenting on “Occlusion Basics and Beyond.”

If you loved this episode, be sure to watch Basics of 3D Printing, Milling and Digital Dentistry – PDP224

#PDPMainEpisodes #OcclusionTMDandSplints

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

This episode meets GDC Outcome C – Maintenance and development of knowledge and skill within clinical practice.

AGD Subject Code: 610 – Fixed Prosthodontics – Emerging techniques and technology

Aim: To provide a comprehensive understanding of how digital articulators can enhance clinical workflows, improve occlusal precision, and minimize restorative complications through accurate static and dynamic articulation.

Dentists will be able to:

1. Differentiate between analog and digital articulation methods, including their benefits and limitations.
2. Apply digital workflows to provisional restorations, improving efficiency, patient experience, and predictability.
3. Recognize cost-saving and diagnostic advantages of digital design in restorative and full-arch treatment planning.

Teaser:Do you think the new grad, the new generation coming through, all they’ll ever know is digital, is that a bad thing or is that a good thing?

Yes, and the reason I say that is I think it’s the correct answer for both. Yes, bad and good.

Are you at any point picking up your analog facebow and then working on analog articulators to wax up, or have you got to a point now whereby the trust and the faith you have in your digital workflow means that you can do it fully digitally?

The biggest thing that a lot of people don’t understand is- 

Jaz’s Introduction:Analog versus Digital. Are we there yet? How on earth does a digital articulator work and what’s the point? And are there any real advantages to the digital workflow other than it looking cool and pretty on the screen? Can it help you be more efficient, more accurate, more predictable?

We’re gonna cover all those things with our guest today, Dr. Seth Atkins. I tell you, this guy is a wiz. He’s part of the organizing committee of the AES, that’s American Equilibration Society, and this is part of the AES takeover. We are promoting the AES 2026 conference, which has got some of the biggest names in occlusion, comprehensive dentistry and TMD over two days in Chicago.

The date is 18th and 19th of February, 2026, and it’s called the Evolution of the Oral Physician. The lineup, I tell you, is absolutely phenomenal, and also it’s a privilege to be one of the speakers alongside Mahmoud Ibrahim. We have the 8:00 AM slot on Thursday 19th of February, so it’d be great to see as many of you there as possible.

Hello, Protruserati. I’m Jaz Gulati, and welcome back to your favorite dental podcast. Let’s talk about digital articulators. Now, let’s go back to basics for our students and younger colleagues. The whole point of an articulator is that we can mimic the patient on the table because we can’t take the patient home with us and design the restoration in the mouth.

And then fit it the next day. We have always needed a way to mimic the patient, mimic their head, mimic their movements, mimic their bite so that we can work on the benchtop. So the analog way was to use a face bow and then feed that face bow into something like a semi adjustable articulator. Now what you see on the articulator, this analog articulate in front of you, we’re hoping is somewhat representative of your actual real patient, so that when you design the cuspal inclines of the molar, let’s say that you are restoring that when you put it in the mouth.

And the patient then moves left and right, it happens, so in the same way as it did on the articulator. The ultimate benefit of that is less adjustments, more accuracy, and ensuring that the design that you intended actually works in the patient’s mouth. Now, when you talk about comprehensive dentistry and doing more units, doing full mouth cases, you can appreciate how important it is to replicate the patient.

And let me tell you, this episode is all about digital. We are moving away from analog facebow and analog articulators. Now you’ll see how Seth explains why we can never probably be fully a hundred percent digital in these big cases because the final stages still need to be analog because our patient, when we fit the crown in the mouth. That’s an analog process, so we still need some analog knowledge, but how can we harness the power of digital articulators?

It’s a very exciting, very geeky episode, and I put a few interjections in there to help make it as tangible as possible so that our younger colleagues, our students, can also follow along. That’s always the mission of this podcast.

I asked Seth how we are now transferring the patient to the digital articulator. So like I said, in the analog world, we use a face bow and we talk about the role of face bow, but then how do we actually now use a digital face bow, if you like, and then how do we ensure that the movements are as close as possible on the digital articulator?

Dental PearlT...]]> 1:09:50 false https://podcast.show/protrusive/episode/146575285/ 146575285 https://protrusive.co.uk/?p=8699 Jaz Gulati Thu, 26 Jun 2025 03:35:39 -0400 Are you considering the airway in your treatment planning?

Could centric relation (CR) be compromising your patient’s breathing?

When you open the vertical dimension, are you making the airway better—or worse?

Welcome to another AES 2026 series episode, this time with LEGEND Dr. Jeff Rouse as he joins Jaz in this eye-opening episode to explore how airway, aesthetics, and function are deeply interconnected—especially in prosthodontics.

They discuss key clinical scenarios like vertical dimension changes, examining how your choices may impact the airway—sometimes in ways you didn’t expect. With practical insights and examples, this episode will help you make smarter, airway-conscious decisions that elevate both your functional and aesthetic outcomes.

Protrusive Dental Pearl: Plan your breaks 12 months in advance to avoid burnout and ensure quality time with your loved ones. Prioritize rest and connection before reaching exhaustion—your body, mind, and heart will thank you.

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

Key Takeaways

• Airway health is crucial in dentistry, impacting aesthetics and function.
• Understanding airway issues can lead to better treatment outcomes for patients.
• Breastfeeding plays a significant role in childhood development and airway health.
• Interdisciplinary approaches are essential for effective adult treatment.
• Aesthetics and function are key factors in airway prosthodontics.
• Most patients are unaware of their airway issues until they are addressed.
• Early intervention in childhood can prevent future airway problems.
• Combining orthodontics and prosthodontics can enhance patient care.
• Airway management is crucial for overall patient health.
• A great bite is not just about teeth alignment.
• Pathway wear can indicate deeper dental issues.
• Vertical dimension changes can negatively impact airway.
• Understanding joint positions is essential in treatment planning.
• Continuous education is vital for modern dental practices.

Highlights of this patient:

• 02:22  Protrusive Dental Pearl
• 04:34 Interview with Dr. Jeff Rouse Begins
• 09:05 Understanding Airway Prosthodontics
• 15:58 The Role of Cone Beam CT Scans
• 17:58 Treating Children and Early Interventions
• 24:50 Addressing Adult Airway Issues
• 29:43 Multidisciplinary Approach in Dentistry
• 31:46 Patient Transformations and Airway Focus
• 34:42 Understanding Pathway Wear
• 41:32 Impact of Vertical Dimension on Airway
• 48:55 Exploring Different Occlusion Philosophies
• 51:34 A Sneak Peek at AES 2026: Dental Wear Patterns Of The Airway Patient
• 55:25 Upcoming Events and Resources

Explore the world of sleep disordered breathing with Prof. Ama Johal in PDP033: “Airway – Dentistry’s Elephant in the Room.”

???? Join the world’s leading organization dedicated to occlusion, temporomandibular disorders (TMD), and restorative excellence — the American Equilibration Society (AES).

????️ AES Annual Meeting 2026 – “The Evolution of the Oral Physician”???? February 18–19, 2026 · Chicago, IllinoisDon’t miss Dr. Jeff Rouse as featured speaker, presenting on “Dental Wear Patterns Of The Airway Patient”

???? Learn more with Dr. Jeff Rouse on The Spear Education Online

#PDPMainEpisodes #CareerDevelopment #BreadandButterDentistry

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

This episode meets GDC Outcomes A, B and C.

AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Sleep medicine)

Aim: To deepen clinicians’ understanding of airway prosthodontics and empower them to recognize airway-related dental issues across all age groups.

Dentists will be able to –

1. Differentiate between anatomical airway dysfunction and sleep-disordered breathing, and understand the unique role of dentistry in addressing each.

2. Explain the principles of Airway Prosthodontics, including the significance of tooth position in facial space and its impact on breathing.

3. Recognize signs of airway compromise in both pediatric and adult patients, including atypical wear patterns, bruxism, reflux, and chronic fatigue.

Teaser:A woman I was visiting with earlier today had had orthognathic surgery and she said, I didn’t really realize that I never was able to breathe and I never slept until I had the surgery done. People that are constricted in their bites like this, their maxillas are constricted.

And if their maxillas are constricted and their nasal cavities constricted, they can’t breathe well through their nose. And so if you go from giving a small piece of cheese or beef jerky or a peanut to chew, they can manage their airway, have ’em bite into a sandwich with a bunch of bread and a bunch of stuff in it. They can’t, so their chewing cycle will move forward and they’ll hit their front.

For me, airway is just established the aesthetic position of the teeth first and the functional position of the teeth. If you get those things normalized, then we help the patient normalize what they do, which is close the mouth and breathe through their nose.

That’s dentistry and the success of that treatment is does the patient have a beautiful smile and a great bite? That’s success. Not did I reduce the apnea level? We’re treating 26 month old as the youngest I’ve ever heard, done Invisalign first to expand, start expansion early, but at four you can start to see if you’re leaving them in a constricted pediatric arch that the permanent teeth are gonna erupt outside of the housing of the bone. So the orthodontist never moved the teeth outta the bone. They were never in the bone to begin with. 

Jaz’s Introduction:How does the airway relate to aesthetics and function? Interesting concept ’cause we think about aesthetics, we think about function, but are we necessarily thinking about the airway when it comes to our treatment planning?

Related to this is a scenario like, let’s think of complete dentures. When we deliver complete dentures, the joint position that we usually select is centric relation or seated condyle position. Now the question is, is this position adversely affecting their airway? i.e. by moving their condyles in into centric relation, which usually means they’re moving their jaw a little bit further back. Is that necessarily worsening their airway?

Well, we answered that in this episode. And how about when we’re opening someone’s bite? Well, in prosthodontics, when we open someone’s bite, there are some scenarios where you are at risk of making the airway worse and other scenarios where you’re probably not gonna make the airway worse.

And you’ll learn this episode exactly what those two distinctions are. I’m joined today by the Dr. Jeff Rouse absolute giant in our profession. What a lovely guy he is. Author of one of the best dentistry textbooks there are Global Diagnosis. He’s also a very prominent educator with spear education and the impact this man has made in airway and dentistry and prosthodontics is just absolutely amazing.

So it’s real privilege to host him today as part of our AES takeover. See, Jeff Rouse is one of the speakers at the AES Conference, 2026 in February, and that will be held in Chicago. And we’re trying to shine a light on this conference because it’s based on occlusion, right? It’s related to occlusion, but it’s so much more than occlusion.

In fact, the theme of the AES conference next year is the Evolution of the Oral Physician. Let me say that again. The Evolution of the Oral Physician. So it really looks more than just the occlusion. When I attended a few years back, they really are a comprehensive, holistic group that brings together all the occlusion camps and me and Mahmoud Ibrahim, have the privilege of being able to speak there.

But we are a small piece of it. You know, some of these giants, like Dania Tamimi that we had on previously, Lukasz Lassman, Jeff Rouse, who you’ll hear from today, is gonna make a really great conference. We’re shining a light, so check out aes-tmj.org, that’s aes-tmj.org to learn more about this conference in Feb 2026.

Hello, Protruserati. I’m Jaz Gulati and welcome back to your favorite dental podcast. Every PDP episode, I give you a Protrusive Dental Pearl, and quite often the pearl I give depends on my mood and my context and what I’ve been doing that day or the ...]]> 1:04:44 false https://podcast.show/protrusive/episode/146431297/ 146431297 https://protrusive.co.uk/?p=8688 Jaz Gulati Thu, 19 Jun 2025 16:01:58 -0400 Have you actually looked back at your long-term cases to see how layering compares to injection moulding?

Is traditional freehand layering still your go-to for anterior composite aesthetics?

Are you using it because it gives the best result — or just because that’s how you were trained?

In this episode, Dr. Marco Maiolino joins Jaz Gulati for a meaty discussion about injection moulding—a technique that’s changing the game in anterior composites (and posterior!)

This isn’t about trends. It’s about clinical outcomes.

We’ve all admired the beauty of layered composites—translucency, halo, the “natural” look. But after 5, 7, or even 10 years… do they hold up?

Dr. Maiolino brings over a decade of follow-up data—and the results might surprise you.

• When in doubt between two shades (e.g., A1 vs. A2), always choose the lighter shade. Higher-value shades blend better and result in higher patient satisfaction.
• Techniques: Use the composite button method and black-and-white photography to objectively evaluate shade blending.
• Outcome: Lighter shades minimize the risk of patient dissatisfaction and rework.

???? Download the full Premium Notes for this episode—including clinical comparison of injection moulding and layering technique, long-term before/after documentation, and Marco’s complete injection moulding protocol: ???? protrusive.co.uk/im

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

• Injected composites often outperform layered ones in long-term follow-up.
• Color stability is as much about technique as it is about material selection.
• Edge bonding requires careful occlusal planning and respect for functional dynamics.
• The biologic cost of veneers is frequently underestimated—additive approaches can be more conservative.
• Composite thickness and occlusal harmony are critical for restoration longevity.
• Rigorous documentation and honest case review matter more than dramatic presentations.
• Failures are not setbacks—they are opportunities for professional growth and better patient care.

Episode Highlights:

• 0:00 Introduction
• 02:45 Protrusive Dental Pearl: Practical shade selection hacks
• 08:54 Dr. Marco’s journey into injection moulding
• 15:44 Why Marco transitioned away from layering
• 18:00 Edge Bonding and Occlusion Considerations
• 25:20 Layering vs. Injection Moulding
• 29:15 Variations of Injection Moulding Techniques
• 32:32 Injection Moulding for Edge Bonding
• 39:29 Edge Bonding Protocol and Materials
• 49:18 Understanding Failures and Diagnostics
• 53:23 Managing Tooth Wear with Injection Moulding
• 55:47 DAHL Approach Complexity and Cost
• 56:41 Swallowing Patterns Affecting Treatment Success
• 01:00:07 Importance of Case Selection
• 01:01:08 Rubber Dam Use
• 01:03:17 Flexible Use of Techniques
• 01:17:24 Outro

????Upcoming Talks & Courses

Dr. Marco Maiolino will be one of the notable speakers at the Injectable Restorations European Summit 2025, taking place on November 7–8, 2025. This highly anticipated event gathers leading experts in the field and will be held in Europe. For more information and registration details, visit the official website: injectionsummit.eu.

If you loved this episode, be sure to watch Stop Being a Perfectionist – it’s OK to Fail – PDP184

#PDPMainEpisodes #OrthoRestorative

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

This episode meets GDC Outcomes C and D

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

As clinicians, we’re constantly challenged to balance esthetics, function, and longevity in our restorative work. In this episode, Dr. Marco Maiolino joins Jaz Gulati for a candid, evidence-driven exploration of injection moulding—a technique that’s rapidly shifting the paradigm in anterior composite restorations. This isn’t about chasing trends; it’s about critically evaluating what truly works for our patients over the long haul.

1. Understand the indications, benefits, and limitations of edge bonding and injection moulding.

2. Recognize how minimally invasive dentistry can provide reversible, conservative treatment options.  3. Appreciate the importance of proper planning and case selection when using techniques like injection moulding.

Teaser:I’m glad you mentioned it, that you are so convinced and dedicated to the injection moulding way to deliver a restoration that you’ve pretty much now found ways. As long as you can make your scaffold. 

On the mesial distal, you have some composite with just one shade. Now this brown area is much more evident than before. So the patient completed the appointment. Saying, I am very happy. I have no more black triangles. I am very happy. But when you’re doing a study patient with the worn dentition because of occlusal problem, if you are going to do, for example, an important canine guidance, an important incisal guidance, they’re going to break everything after a while.

But honestly, when I see with air drying the restorations with magnification, and I see the interproximal surfaces in comparison to the surface that I have with injection moulding with matrices. This surface- 

Is there a composite that you found to have superior longevity in terms of color stability, polishability? Is it a 3M Filtek? Is it Estelite? I dunno, what are you preferring nowadays? 

Okay. What I use every single day in my life is I use- 

Jaz’s Introduction:Protruserati, there’s been a big shift over the years towards injection molding. Now, some of this has been driven by the industry, of course, right? So we always have to be careful about biases.

Biases are everywhere. Now, use this technique, use that technique because there’s a lot of money involved for these companies. But what I look for is clinicians that change, that pivot from a technique that’s perhaps established and we know of, and they pivot and change to a different technique. And if they can justify why they’ve made that change and share the science or the rationale, I like when something is justified.

There is a clear science behind a decision that’s made by a clinician that’s fantastic. Rather than, oh, this company’s paying me. So I’m talking more about this product. This is why I really respect today’s guest, Dr. Marco Maiolino. We’ve had him on as a guest before on the imperfect dentist. He is such an authentic character.

He talks about his failures very openly, and it’s his failures in layering over time, right? He shares the long-term data of seeing his composites and he is a very good practitioner. High quality isolation, high quality materials microscope, everything. But what he noticed at the eight, 10 year mark is that his layered composites were not looking very aesthetic despite using the best materials and best techniques.

They certainly did not look as lovely as they did at day one. So many years ago. He moved, I believe he said 2014, he moved towards injection molding. Now when I say injection molding, you guys probably think, oh, exaclear or memosil stent, and then you inject the genial injectable composite or any other composite that may be available.

But actually, injection molding is just the name of the technique, the act of injecting into a space. So this could be bioclear or these transparent matrices. It could be just a humble mylar strip behind a tooth, and then you inject the composite into that space once you’ve made your scaffolding. 

So really, this episode is about the process of injecting that material and why the injection of composite is superior according to Marco than layering bit by bit and some of the issues that you can face with that, and why in the long run, whilst your layered composite may look a little bit more beautiful, a little bit nicer on day one compared to your injected composite, when you look at them at eight, 10 years, the injected composite looks more consistent, more stable, both types of color. Luster, shape, all those things. So there is a science behind it. And to discuss that science we have Dr. Marco. 

Dental PearlHello Protruserati. I’m Jaz Gulati, and welcome back to your favorite dental podcast. Every PDP episode I give you a Protrusive Dental pearl. Today’s pearl is something I shared a few weeks ago on our community Protrusive Guidance, the home of the nicest and geekiest dentist in the world.

And it’s about my thoughts on shade selection on composite. Now, in previous pearls, I have discussed the button technique. Getting a small button of composite, curing it, and then having a look. Hmm, does it match the adjacent tooth? Is this gonna be the right shade to use for my patient? And in another episode we did with Dr. Jason Smithson, he ...]]> 1:18:43 false https://podcast.show/protrusive/episode/146221292/ 146221292 https://protrusive.co.uk/?p=8670 Jaz Gulati Thu, 12 Jun 2025 08:17:58 -0400 Should we really restore primary molars without local anaesthetic or injections?

When should we start taking radiographs for child patients?

Is it time to say goodbye to traditional anterior strip crowns and embrace preformed zirconia crowns?

And seriously – how do you get a wiggly, fidgety child to sit still long enough for a solid restoration?! The secret lies in choosing a technique that’s both quick and effective!

In this episode, Dr. Tim Keys unpacks the real challenges of restoring primary teeth, breaking down the pros and cons of popular approaches like the Hall Crown technique, Pediatric Zirconia crowns, and conventional stainless steel crowns (SSCs).

Tune in for practical insights to make pediatric crown work less stressful and more successful – helping you find the best fit for your little patients.

Dr. Keys is also involved in dental education and offers courses through his platform, Kids Dental Tips. One of his upcoming courses is titled “Restorative Paediatric Dentistry,” a two-day event scheduled to be held in Brisbane.

Protrusive Dental Pearl: One of our best ever Protrusive Infographics! This week’s Pearl is a handy downloadable PDF infographic summarising the key points from this episode on Children’s Crowns Techniques. Grab your copy here!

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

Key Takeaways:

• The Hall crown technique is a non-invasive approach to treating pediatric teeth.
• Radiographs are essential for accurate diagnosis and treatment planning in children.
• Case selection is crucial for the success of pediatric dental treatments.
• Zirconia crowns have superior aesthetics over stainless steel crowns.
• The success rate of intra-coronal fillings in primary molars is lower compared to crowns.
• Zirconia crowns rarely fracture compared to strip crowns.
• Mild supra-occlusion is acceptable in pediatric dentistry.
• Hands-on experience is crucial for mastering crown techniques.

Highlights of this episode:

• 00:00 Introduction
• 01:32 The Protrusive Dental Pearl
• 04:19 Dr. Tim Keys
• 06:26 Work-life balance & parenting
• 12:05 Hall crowns Vs Zirconia crowns
• 13:12 Pediatric crowns and caries management
• 15:40 Failure rates and clinical implications
• 17:51 Stainless steel crowns: conventional vs Hall technique
• 21:03 Case selection and radiographs
• 25:31 Radiographic criteria
• 27:04 The Hall Technique
• 29:59 Technique tips
• 38:00 Zirconia crowns vs strip crowns
• 46:55 Education, resources, and further learning
• 51:02 Outro

Key Article mentioned in this episode: Effectiveness, Costs and Patient Acceptance of a Conventional and a Biological Treatment Approach for Carious Primary Teeth in Children | Caries Research | Karger Publishers

#PDPMainEpisodes #BreadandButterDentistry

If you enjoyed this episode, you should check out PDP159 – How to Manage Children in Dental Pain.

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

This episode meets GDC Outcomes A and C.

AGD Subject Code: 430 Pediatric Dentistry.

In this episode, Jaz and Dr. Tim Keys explore practical approaches to restoring pediatric teeth, focusing on the selection, preparation, and placement of direct restorations. They discuss material choices, clinical tips, and how to tailor techniques to improve outcomes and cooperation in young patients.

Dentists will be able to:

1. Understand the clinical indications and benefits of various crown techniques used in the restoration of pediatric teeth
2. Recognise the importance of selecting appropriate cementation materials and techniques for different types of direct restorations in children
3. Appreciate the key clinical considerations involved in the preparation and placement of a range of direct restorative techniques in pediatric dentistry

Teaser: The success rate at 10 years sits between 97% and 99%.

Teaser:This is the traditional conventional approach. Yeah. 

Conventional crowd. Yeah. And I would argue that is more successful than what you would be doing in an adult tooth. A name of restorative material in adult tooth that you know is got a 97% to 99% success rate at 10 years.

It’s incredible. So there’s nothing like this. So if you’ve got a patient who’s got a clinical issue, I would encourage all your listeners, please do not do anything without x-rays. And if you can’t get x-rays on that patient because of compliance issues, you really need to reconsider your ability.

The strongest way to get that crown to sit down as the kid ’cause their jaws a lot stronger than my thumb. And so I put a cotton roll in it. I get the kid to bite down really hard and you get a floss with a knot in it, and then you put it on and then you get your DA to put dental assist to put their thumb over the top of the crown. You floss down and then pull it out and then go to the other side. Floss down, pull it out.

I haven’t done a strip crown on a primary interior tooth in five years. And I’m so bloody happy I don’t do them anymore. Keep in mind, each x-ray is the equivalent of around six bananas. Six bananas got radiation in right? So the radiation test is insignificant, really. And I think I need your listeners to really understand that we don’t treat children differently because they’re children.

You know, we wouldn’t treat an adult and extract a tooth on an adult without an x-ray. You wouldn’t do a filling on an adult without an x-ray. You wouldn’t do a nerve based treatment on an adult without an x-ray. So please stop doing it on children because there is no defense for it. It’s completely wrong.

Jaz’s Introduction:This episode is such a wonderful resource and refresher on the whole crown technique. If you listen to the end of this episode with the wonderful Tim Keys. He’s like the Aussie, you know, Aussie man reviews those hilarious videos with a funny Australian accent comedy like Tim has that voice where he should just do dental videos and a funny commentary.

He’d be like, Aussie man dental reviews. And Tim spoke so well, so passionately and so clearly about this topic so that by the end of this episode, you will know the difference between the conventional stainless steel crown technique versus the more contemporary hall crown technique.

When should you use? Which one and all about this newcomer, the zirconia children’s crowns, and how the technique actually is really different and how to prepare the tooth accordingly for a zirconia crown, which is relevant both for anterior and posterior teeth, from knowing which cements to use and whether or not you should use local anesthetic on a child.

And something that Tim’s very passionate about. Should we be taking radiographs on children and at what age? What are the clinical and radiographic science look for, to make sure that a tooth is suitable for this type of treatment, i.e. the whole crown treatment.

Hello, Protruserati. I’m Jaz Gulati and welcome back to your favorite dental podcast. Like I said, Tim, honestly just absolutely smashed this episode, and I’m so excited for you to learn from him. As you know Protrusive, we have guests from all around the world, but I have to say there’s something. I have a soft spot for my Aussie guests. I dunno what it is. They just come on and they put on a show every time. So sending love to all the Aussie Protruserati. You guys have been supporting me for over the years, but we’re gonna win the ashes. I just had to put that in there.

Dental PearlEvery PDP episode I give you a Protrusive Dental Pearl, and today’s pearl is just the most wonderful summary of this entire episode. It is one of our famous Protrusive Infographics. There are two ways to get this for free. One is if you’re viewing this episode on the Protrusive Guidance app, then thank you for being a member of the nicest and geekiest community of dentists in the world. Just scroll down and you’ll see the PDF there, and please comment if you’d like it. Number two is, if you’re not on our community, then head over to protrusive.co.uk/kidsteeth. That’s kids teeth.

And when you enter your first name and your email address, I’ll email it to you personally with the PDF in your inbox. Our infographics are pretty famous, the ones that we have on deep margin elevation to which ceramic to use, which type of zirconia to use. We work really hard, especially the oral medicines one.

Again, that was actually another Aussie guest we had on as well. So once again, hat tip to all the Aussie guests I’ve had on the show. But yeah, you’re gonna love this infographic, so please do download it. And if you’re not on the Protrusive Guidance community, what are you waiting for? Honestly, it’s so, so nice to learn from everyone and to share my special snippets.

And actually, there’s a part of this episode that is gonna be only on Protrusive Guidance, and this might actually sway me in a different direction, but. You know at...]]> 0:54:20 false https://podcast.show/protrusive/episode/146036249/ 146036249 https://protrusive.co.uk/?p=8653 Jaz Gulati Thu, 05 Jun 2025 13:15:50 -0400 How can dentists help kids breathe, sleep, and grow better—even if the problem isn’t the teeth?

When should you refer, and what tools can you use right now in your practice?

In this AES special episode, Jaz Gulati is joined by Dr. Liz Turner and Dr. Meggie Graham—general dentists who have evolved their practice with a deep passion for airway and whole-child health.

They walk us through five real patients, including Jaz’s own son, to show what airway dentistry looks like in the real world. From growth appliances and myofunctional therapy to inflammation control and ENT collaboration, this episode connects the dots between breathing and behavior, development, and even dental crowding.

Protrusive Dental Pearl: “Don’t stay stagnant—keep learning, keep growing, and reinvent yourself every 5–10 years.” Think of your dental career in seasons—explore new areas, refine your interests, and let go of what no longer brings you joy. This keeps your passion for dentistry alive and evolving.

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

Key Takeaways

• Airway dentistry is a growing field that emphasizes prevention.
• Understanding airway issues can lead to better health outcomes.
• Dentists can play a crucial role in optimizing health through airway management.
• Health optimization is a key focus in modern dentistry.
• Interdisciplinary collaboration is essential for effective patient care.
• Functional dentistry addresses the root causes of dental issues.
• Children’s airway health can significantly impact their development.
• Dentists should feel empowered to make positive changes in their patients’ lives. Facial aesthetics can significantly impact self-esteem and health.
• Nasal breathing is crucial for overall health and well-being.
• Quality of life can be improved through better patient care.
• Breastfeeding plays a vital role in a child’s development.
• Addressing sleep issues in children is essential for their growth.
• Understanding the connection between breathing and systemic health is vital.

Highlights of this episode:

• 02:04  Protrusive Dental Pearl
• 04:08 Interview with Dr. Liz Turner
• 06:18 Interview with Dr. Meggie Graham
• 07:43 Personal Journeys into Airway Dentistry
• 16:26 ENT Referrals
• 21:55 Understanding Airway Symptoms and Treatment
• 26:10 Patient Case Studies and Treatment Approaches
• 36:46 The Importance of Nasal Breathing
• 45:30 Pediatric Airway Concerns and Solutions
• 55:09 Educational Resources and Final Thoughts

???? Join the world’s leading organization dedicated to occlusion, temporomandibular disorders (TMD), and restorative excellence — the American Equilibration Society (AES).

????️ AES Annual Meeting 2026 – “The Evolution of the Oral Physician” ???? February 18–19, 2026 · Chicago, Illinois Don’t miss Dr. Jaz Gulati and Dr. Mahmoud Ibrahim as featured speakers, presenting on “Occlusion Basics and Beyond.”

???? Learn more about airway and breathing issues with Dr. Liz and Dr. Meggie on The Untethered Airway — and stay tuned for their first course, launching soon! – Waitlist for course and email list

Enjoyed this episode? You will also enjoy exploring the world of OSA with Prof. Ama Johal in PDP033: “Airway – Dentistry’s Elephant in the Room.”

#PDPMainEpisodes #CareerDevelopment #BreadandButterDentistry

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

This episode meets GDC Outcomes A, B and C.

AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Sleep medicine)

Aim: To enhance the general dentist’s ability to recognize, evaluate, and initiate management of patients with airway-related dysfunctions across all age groups.

Dentists will be able to –

1. Identify common dental signs of airway-related disorders in infants, children, and adults.

2. Understand the systemic impact of airway dysfunction, including its behavioral, developmental, and physiological consequences.

3. Describe the role of early intervention, including tongue-tie releases and palatal expansion.

Teaser: Have you ever been on an airplane and you hit turbulence and the whole plane goes like, nobody can say no to that. It's the same thing with breathing. We need our breathing to be passive and not turbulent.

Teaser: We as dentists shouldn’t be feeling like we’re putting out fires all the time. We should be patting ourselves on the back for being quarterbacks of not just the oral cavity, but of full body health as well. If you’re looking at things with an airway positive spin.

This is an ENT issue. This is a dental issue, but the body has no idea what you’ve studied. It has no idea what your specialty is. It’s just functioning or dysfunctioning the way it is. 

Jaz’s Introduction:In this episode, I’m joined by two dentists, Dr. Liz Turner and Dr. Meggie Graham, who started as general dentists, but then they have later niched or pivoted more into airway and health. They still do dentistry, but they’re very much an airway focused passion. I think passion, is the best word, and let me tell you guys, you’re gonna absolutely love the different themes and facets we explore.

The thing I love the most about this episode, which I know you will too, is how it made airway tangible. For example, when I ask my patients, what do you do? They will say something like, oh, I’m in logistics, or I am a project manager, or I am a business consultant. Honestly, I could not even shut my eyes and imagine what they actually do.

Like I wanna know what people do day in, day out. I dunno if it’s just me, but I genuinely cannot imagine what a typical day in their life looks like and how they actually operate. So similarly, when someone says, oh, I’m a dentist, but I have an airway focused practice. I actually didn’t know what that actually looks like day to day.

So one of the questions I asked them is, okay, what does a typical day look like? What interventions do you use? What different tools do you have in your toolbox to help your patient? And I think they both did a wonderful job to explain that. And you’ll see these five patients discussed like five typical patients that they see that we see day in, day out.

These are five real patients, the fifth one being my second son, Sihaan, that we actually discussed who we can help as dentists. But their primary issue is an airway issue, so I love how we made it tangible. Now, this episode is part of the AES takeover. We are shining a big light on the AES conference in Chicago.

That’s in February 2026. The website will all be below, and this is where the creme de la creme come together in occlusion, TMD and Airway. Me and Mahmoud will be speaking at the conference, but honestly, the lineup is insane. I definitely want every single person to click on that link to AES. I’ve got my show notes and have a look.

Does this tickle your fancy? Have you never been to Chicago before? Lemme tell you. It’s an amazing place, great culture, great food, but just comfort the education alone is gonna be mind blowing.

Dental PearlHello, Protruserati. I’m Jaz Gulati, and welcome back to your favorite Dental Podcast. Every PDP episode I give you a Protrusive Dental Pearl, and this one was inspired by my conversation with Liz and Meggie.

Before we actually hit the record button, I was talking about one of the missions. This podcast has is to help dentists fall in love with dentistry again, and we need to remember that the kind of themes we’re talking about, the discipline of dentistry, which is airway that we talk about is growing and is growing for good reason and reminded me of how not only our life, but our career also comes in seasons.

And we need to appreciate that dentistry is a wonderful profession in the sense that we can redefine ourselves or be reborn like every 10 years. Think of it like that, like every 10 years, there could be like a season of your career. For example, for the first 10 years, you could be focused on general dentistry.

The next 10 years you could be general dentistry and facial aesthetics. And maybe in the 10 years into that, it could be just facial aesthetics, for example, should you wish for that. I’m giving quite extreme examples on purpose. For someone else it might be single tooth dense for the first 10 years, then it could be for the next 10 years, full mouth dentistry.

And for the last 10 years it could be periodontally focused alongside full-mouth dentistry. And of course, you can think of every possible combination. You can bring in implants at 10 years, or you can start doing...]]> 1:01:53 false https://podcast.show/protrusive/episode/145860246/ 145860246 https://protrusive.co.uk/?p=8635 Jaz Gulati Thu, 29 May 2025 06:52:06 -0400 Are you still using long-term provisionals just to test OVD?

Is an occlusal splint really the best way to assess vertical dimension?

Could raising the OVD actually harm your patient?

Dr. Lukasz Lassmann joins Jaz and Mahmoud Ibrahim  this AES special episode to challenge conventional thinking around occlusion, vertical dimension, and full mouth rehab. Lukasz shares his unique perspective as a clinician, educator, and researcher, bringing clarity to a topic that often feels murky and divided.

They explore real-world questions like managing asymptomatic clicks before ortho, why occlusion alone won’t “cure” bruxism, and the number one reason not to raise the vertical without proper understanding.

Plus, Lukasz drops an incredible airway assessment tip at the end of the episode!

Protrusive Dental Pearl: Use a comprehensive TMD history-taking form to effectively triage patients into urgent (red), moderate (amber), or low-risk (green) categories—this allows you to prioritize care appropriately and build rapport by focusing on examination rather than data collection during the appointment.

Download the form: protrusive.co.uk/tmdhistory

Download the Patient History Evaluation Form

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

Takeaways

• Understanding red flags in TMD patients is essential.
• Patient history is vital for effective treatment.
• Phonetics can be unpredictable in dental rehabilitation.
• Diet and sleep significantly affect TMD management.
• Gut health is linked to chronic pain conditions.
• Communication with patients is key to successful outcomes. Bruxism may not be solely caused by occlusion issues.
• Palpating the lateral pterygoid is often ineffective and painful.
• Equilibration and centric relation are controversial topics in dentistry.
• Increasing vertical dimension can exacerbate sleep apnea.
• Holistic approaches are essential in diagnosing and treating TMD.
• Not all patients with TMD have malocclusion or attrition.
• Sleep apnea is increasingly common in younger, slimmer patients.
• Polygraphy is a useful diagnostic tool for sleep apnea.
• DISE (drug-induced sleep endoscopy) is a valuable diagnostic procedure.

Highlights of this episode:

• 02:48  Protrusive Dental Pearl
• 04:37 Lukasz Lassman’s Journey and Philosophy
• 08:11 Debunking Myths About Vertical Dimension
• 12:10 Patients in the Red Zone
• 23:15 The Role of Diet and Lifestyle in Facial Pain
• 31:38 Adapting to New Restorative Methods
• 34:41 Phonetic Challenges in Dentistry
• 39:02 The Role of Occlusion in Bruxism
• 41:18 Palpating Lateral Pterygoid Muscle
• 43:27 Centric Relation vs. Equilibration Debate
• 50:07 OVD Red Flag: Airway
• 01:03:27 Conclusion and Future Events

Studies Mentioned:Gut Bless Your Pain—Roles of the Gut Microbiota, Sleep, and Melatonin in Chronic Orofacial Pain and Depression

Randomised controlled trial on testing an increased vertical dimension of occlusion prior to restorative treatment of tooth wear

???? Upcoming Talks & Courses

• AES Annual Meeting 2026: The Evolution of Oral Physician – February 18-19, 2026
• Lassmann Education: SummerCamp 2025

If you loved this episode, be sure to watch Myth Busting Occlusion and TMJ – PDP022

#PDPMainEpisodes #OcclusionTMDandSplints

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 therapy)

Aim: To enhance clinical understanding of occlusal principles, vertical dimension management, and red flag indicators that impact prosthodontic and TMD treatment, based on current best evidence and insights from Dr. Lukasz Lassmann. 

Dentists will be able to –

1. Identify common myths and misconceptions about vertical dimension increase and temporization.

2. Recognize red flag patient presentations that are not suitable for prosthodontic treatment.

3. Understand the airway implications of increasing vertical dimension and how mandibular rotation impacts it.

Teaser: This is insane. You know, I was always asking, what do you mean progressively you want to increase first like two millimeters and then you want to check if it's all right. If there is no joint pain or- I never start doing prostho or ortho when my patient has pain. I first want to turn my patient to be asymptomatic and then we go ahead.

Teaser:On the first appointment, you are explaining on the second one you are justifying. We don’t want to tell our patients that this is because of the systemic disorders or some psychiatric disorders because we, ourself, we consider it is like showing the white flag that we just confessed that we don’t know the answer we do. If your patient has a problem with the bladder, you as a dentist, you’re not treating the bladder, but you just refer the patient to the proper doctor. Right? 

Jaz’s Introduction:Stop placing your patients on long-term provisionals, or even worse, giving them an occlusal appliance. If the sole reason you’re doing it is to test the OVD.

Hello, Protruserati. I’m Jaz Gulati. Welcome back to your favorite dental podcast with an absolute superstar, Lukasz Lassmann. I remember meeting him in 2019 in Dubai on a course, and he just blew my mind. His cases are spectacular, and honestly, I have no idea how this guy does it. You guys say Jaz, how do you do it?

I look at Lukasz and think, how do you juggle everything, PhD, three kids, everything he’s doing in progressing education and occlusion. Absolutely inspiring guy. And yes, of course, we asked him how does he do it? This episode is one of the AES special episodes to shine a light on the AES 2026 conference where Lukasz Lassmann himself will be doing the closing act.

Me and Mahmoud, we got the paracetamol on day 2, AM but don’t worry, me and Mahmoud will try and keep you awake. But Lukasz is the main act and deservedly so. And this episode will give you an insight into his thinking, the work he does, the kind of patient he sees, including at the very end, he will just blow your mind.

It’s a way of checking your patient’s actual airway while they’re laying down in your dental chair, this video at the end, he shares it’s absolutely golden. For those audio listeners, that part lasts for 10 minutes, is on video only because I didn’t want you guys to feel alienated. But for those video watches you are in for a treat at the end.

So my friends, me and Mahmoud on this episode, we asked Lukasz so many questions. It was quite a broad overview and some were quite basic things and some were quite advanced things. And I’ll kind of like chime in now and again just to make a few things tangible because when we talk about occlusion, things can get a little bit saucy, a little bit too excited sometimes.

So we’ll just bring it back down a few pegs now and again with a little interject, which I hope will be helpful. And if it is, please comment below and let us know if it is we discuss real world things like if your patient has a click, does that mean we need to intervene before they have orthodontics, or is it okay for them to have a asymptomatic click?

You’ll also find out how many patients bruxism, me, Mahmoud, and Lukasz have cured from doing a full mouth rehab or an equillibration. Okay, tell you what. I’ll give you the answer. It’s zero. So find out why we believe that in our experience so far, that perfecting someone’s occlusion will not necessarily stop their bruxing.

And I know some of my dear friends and mentors are, are probably about to throw a brick at the screen here or smash their headphones. Let’s try and stay friends, everyone. I know everyone’s got different mixed views when it comes to occlusion, but everyone just take a breath. woosah-woosah. Take a breath. It’s gonna be okay.

Just hear us out. And of course, we’re gonna give you the number one reason not to raise a patient’s vertical dimension. Why by raising their vertical dimension, you might actually be killing your patient a slow and miserable death. All that, and much more to come in this episode.

Dental PearlNow every PDP ep...]]> 1:14:54 false https://podcast.show/protrusive/episode/145669879/ 145669879 https://protrusive.co.uk/?p=8619 Jaz Gulati Thu, 22 May 2025 05:57:35 -0400 Should You Invest in Chairside Milling or 3D Printing?

How do milling and printing compare in durability and cost?

Which option provides the best long-term ROI for your workflow?

In this deep dive, Dr. Rustom Moopen shares his experience with CEREC, ExoCAD, and in-house fabrication, breaking down the real benefits and limitations of both technologies.

From restoration strength to efficiency and investment costs, this episode unpacks what every dentist needs to know before taking the leap into milling, printing, and CAD/CAM workflows.

Protrusive Dental Pearl: Achieving the same effect (of the ‘Soft Clamp’ by Kerr) with a metal clamp without requiring a potentially painful palatal injection – Dr. Jo Cape (Protruserati) suggests using a cotton bud to apply topical anesthetic to the gingiva where the clamp will be placed, leaving it for a minute, improving patient comfort!

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

Key TakeAway:

• Investing in technology like milling can lead to a measurable ROI.
• Time management is crucial in dental procedures for efficiency.
• Milling is a subtractive process, while printing is additive.
• Mentorship is often more valuable than formal courses.
• The dental industry is evolving with new technologies.
• Understanding the nuances of dental procedures can enhance practice.
• Early adoption of technology can set a practice apart.
• Milling and printing serve different purposes in dental work.
• Mock-ups can save time and improve patient satisfaction.
• Milling offers more reliability than printing for dental applications.
• The choice between milling and printing depends on personal preference and practice needs.
• Milled composites have a proven track record of durability.
• Printed splints may not hold up under heavy use.
• Investing in milling technology can enhance practice efficiency.
• Design software plays a crucial role in modern dentistry.
• Understanding the strengths and weaknesses of each method is essential for success. Investing in dental software can be costly but worthwhile.
• Learning design software is crucial for modern dentistry.
• Milling is generally superior to printing for final restorations.
• Regulatory considerations are important for in-house lab work.
• Choosing the right milling equipment depends on practice needs.
• Training and mentorship are essential for mastering dental technology.

Highlights of this episode:

• 03:29 Protrusive Dental Pearl
• 04:59 Meet Dr. Rustom Moopen: Journey of Learning and Mentorship
• 09:21 Early Adoption of CAD/CAM Technology
• 11:54 The Practicalities of Chairside Milling
• 19:01 Emax Chairside Workflow
• 23:10 Printing vs. Milling: Understanding the Basics
• 26:48 Printed Mock-Ups and Workflow Integration
• 29:43 Comparing Milled and Printed Composites
• 32:07 The Future of Splints: Milling vs. Printing
• 35:50 Choices After Scanning a Tooth
• 37:16 Milling vs. Printing: Pros and Cons
• 41:11 Design Software and Training
• 49:28 Practical Applications of 3D Printing
• 53:42 Investing in Digital Dentistry
• 55:35 Printed Restorations vs Direct Composite
• 56:45 Regulatory Concerns
• 58:31 Investing in Milling Units
• 01:00:53 Ideal Candidates for Milling
• 01:03:49 Training and Resources 

If you enjoyed this episode, don’t miss PDP137 – Q&A with a Dental Technician!

#PDPMainEpisodes #BreadandButterDentistry

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: 130 ELECTIVES (Product/technology training)

This episode aimed to provide an in-depth understanding of the fundamentals of 3D printing, milling, and digital dentistry, enabling clinicians to integrate these technologies efficiently into their workflow for improved precision, cost-effectiveness, and patient outcomes.

Dentists will be able to –

1. Differentiate between 3D printing and milling, understanding their respective strengths, limitations, and applications in dentistry.

2. Recognize the financial implications, including initial costs, long-term savings, and return on investment when incorporating digital fabrication.

3. Understand the workflow of chairside milling, including preparation, scanning, design, fabrication, and finishing of restorations.

Teaser: It makes you better because you're making your own work. Okay. So your preps get better straight away 'cause you are designing everything, you understand things better and you also gotta think that immeasurably because you are faster at everything, 'cause you're doing things the same way. Then you're getting paid more to do the same thing.

Teaser:You are saving on time. Again, time comes back to time. That’s important, how you want approach it. What’s the best way for you for your personal preference as a dentist? So like, cost doesn’t, so they do a lot of IM sort of stuff. And I’m part of that group and I see people just pumping out like beautiful stuff for me.

For me, I like it, but it is very hard for me as though I just don’t see the benefit for me personally, because I would rather just mill it or print it and it makes my life easier. It’s just that the problem with all these really fast growing industries is that you don’t have long-term studies.

You don’t know for sure how long things are gonna last. You could spend 12 grand than pay like thousand pounds for each bottle of resin and then you’re like, okay, I’m gonna replace all these things in two years. Then what’s the point of that? Like, you’ve lost that money and then you’ve lost more money and you’ve lost time as well.

Jaz’s Introduction:Protruserati, I don’t know about you guys, but I am a noob when it comes to 3D printing, milling, and my limit of digital dentistry at the moment is my scanner. Right? My intraoral scanner is great. I’ve been using it for several years. Absolutely hate taking impressions now, obviously, but when it comes to this whole other world of actually production, right?

Printing stuff, milling stuff, man, I have no idea. And so I am so, so pleased to share this episode with you today. I have Dr. Rustom Moopen, who not only is one of the biggest geeks you’ll ever meet, but he’s a geek in a way that he’s not gonna lose you, right? He’s not gonna talk about like, molecule size of resin and different chips that you need for different printers and processing speeds and that kind of stuff.

In this episode, he will legit tell you why he thinks milling is better than 3D printing. But of course, what is the limit of 3D printing? What can be done with milling and how’s actual software and design part work as part of the workflow. Of course, you’d be wondering how much does this all cost? ‘Cause it doesn’t sound cheap and it isn’t, but it may work out more cost effective for your clinic.

There’s a few things I love about our guest, Rustom and I mentioned it right at the beginning of our chat. You know how I’ve shattered him in the past and saw the CEREC in action, how he really inspired me. I never really then got into the CEREC, but you could see him absolutely flying and he just gets a huge kick of having all these toys.

And importantly, with all these toys and different brands of toys he has, he’s not sleeping with anyone. He’s very unbiased. He’s very real talk and he’s just genuinely helpful. A really good argument Rustom makes in this podcast episode is that when it comes to his sphere of digital dentistry, printing, milling, a lot of people are very secretive about their knowledge.

They put up barriers so that then you have to do these curriculums and courses to be able to gain what he thinks is very basic knowledge. So I’m really hoping that this is the episode that finally brings it all together, and you’ll be amazed with everything that Rustom shares. It just makes so much sense, and he just gives it all away. And that’s just the kind of guy he is. He’s not only a phenomenal clinician, but he’s really, really caring and giving, and that shines through this episode.

Dental PearlOf course, I give you a Protrusive Dental Pearl, and I’m proud today to give you one from our community. Our community is called protrusive Guidance. There’s over 3000 of the nicest and geekiest dentists in the world, and what I like to do is I like to keep it as a little family, right? I don’t try and invite every single dentist I have ever met onto the community.

I actually want you guys to self-select yourselves. If you identify yourself as nice and geeky, and you crave this forum and this chat group in this lovely app that we have on iOS and Android, and of course on the laptop, you go to wwww.protrusive.app, you can access our entire web app, which is very powerful.

Then it’s like a treasure trove of all the content we made over the years. Our special webinars that we have, our paid masterclasses, everything is on there, but the magic of people and t...]]> 1:13:51 false https://podcast.show/protrusive/episode/145521589/ 145521589 https://protrusive.co.uk/?p=8605 Jaz Gulati Sat, 17 May 2025 01:33:08 -0400 “Jaz, I don’t know which course to take?”

“Should I do Aspire Academy, Kois, Chris Orr or Paul Tipton?” (all great courses and legends by the way!)

Of course its confusing – there are now more ‘Level 7 Diplomas’ than Dentists!

There are also lots of biased testimonials – surely they can’t ALL be the ‘best course I ever did?’, right?

So just HOW do you choose the right postgraduate program to elevate your skills? 

What mindset helps new grads thrive, especially when they’re feeling stuck?

This episode shares Lakshmi’s decision making as she opted for the RipeGlobal Fellowship.

Lakshmi’s journey is a perfect example of how the right mindset and a strategic approach to education can transform your dental career. Jaz and Lakshmi discuss her experience of choosing the right course, enrolling in the Ripe Global Restorative Fellowship, and the challenges she faced along the way.  

They also talk through the importance of ongoing learning, the impact of mentorship, and how Lakshmi’s mindset shift helped her grow as a dentist. Whether you’re a new grad or seasoned dentist looking to upskill, Lakshmi’s story will inspire you to take control of your career growth and make the most of every opportunity.

Book a free video consultation with the RipeGlobal Team to see if this course is right for you: protrusive.co.uk/RGdiscount

This is an affiliate link that gets you 20% OFF if you enrol – but you first need to discover if it’s the right course for you (it involves treating a manikin in your own clinic!)

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

Key Takeaways:

• Hands-on experience is crucial for building confidence in clinical skills.
• Finding the right practice is important for professional growth.
• Investing in continuing education is vital for skill enhancement.
• Mentorship plays a vital role in navigating early career challenges.
• A supportive team can significantly impact a dentist’s experience.
• Understanding one’s learning style is key to effective training.
• Practical learning enhances engagement and application in real scenarios.
• Balancing time commitments is essential for managing a demanding course load.
• Choosing a course that aligns with one’s career goals is vital for success.
• Maintaining a passion for one’s work contributes to success.
• It’s important to reflect on personal growth and set achievable goals.
• The journey in dentistry is not linear; expect ups and downs.

Highlights for this episode:

• 02:29 Lakshmi’s Journey and Dental School Experience
• 06:45 First Year as a Dentist
• 12:01 Finding the Right Practice
• 19:49 Considering Advanced Courses
• 25:36 Choosing RIPE Global Fellowship
• 29:21 Lakshmi’s Hands-On Experience with Ripe Global
• 37:40 Challenges and Growth in the Fellowship
• 42:37 Balancing Life and Professional Growth
• 52:57 Mentorship and Personal Development
• 54:41  Future Aspirations and Final Reflections

This is a non-clinical episode without CPD. For CPD or CE credits, visit the Protrusive Guidance app—hundreds of hours and mini-courses await!

Stay up-to-date with Dr. Lakshmi’s valuable content and expert advice! Follow her on Instagram!

If you loved this episode, be sure to check out another epic episode – Non-Clinical Growth for the Busy Dentist (Your Health, Relationships, and Business) – IC023

#InterferenceCast #CareerDevelopment #BreadandButterDentistry

Jaz's Introduction: Hello, Protruserati. I'm Jaz Gulati, and welcome to the introduction of the Introduction, I guess. I think this episode deserved an extra bit right at the beginning to let you know what's in store for you by listening to this episode. Look, the number one question I've been asked for years and years and years is, which course should I do?

Jaz’s Introduction:What’s the best course you went on? What’s the number one course I should be doing right now in my stage of my career and literally daily basis? And it’s a tough one ’cause I need to do some like discovering about you. I cannot answer what’s the best course for you until I learn more about you. So anyway, back to this episode.

A similar interaction happened between me and our guest Lakshmi. And at that time, some years ago, I recommended that she did the Ripe Global fellowship. And so this episode is all about how it went, was my recommendation. Good. And that recommendation was given to her purely based on some of the things that she requested.

Now I’m gonna tell you now that for every single person, that course would look different based on what’s important to you and what kind of learner you are. Some people absolutely smash through online learning, whereas other people really struggle to get the time and to make online learning a priority.

Some people absolutely hate traveling and therefore the online world is well worth it. And believe it or not, there are some colleagues who don’t really need the hands-on so much ’cause their philosophy is, once I understand what I’m doing, once I know what I’m doing, the one or two times you get to do it on hands-on isn’t gonna make a big difference.

‘Cause really practice makes perfect and it’s important I get stuck in with patients and develop that over the next few years, whereas others absolutely need must have loads of hands on. Otherwise they don’t truly grasp the concept of what they’re learning. So everyone’s different and we’re very fortunate that we’ve never had more courses on the planet than today, honestly.

And that number is probably going up and up and up. There are courses everywhere, which actually makes it a bit of a challenge. It confuses us even more about which one to do. Now, I dunno exactly about those in Australia, USA, India or wherever you are in the world, but in the UK we have some brilliant educators.

Like I never did Aspire by Richard Porter and Raheel. I never did Chris Orr’s Continuum, but these are some huge courses that I always hear great things about. Also, Monica Vasan Continuum. So, so much great choice in the UK. Also, shout out to the ACE Academy in London. Look, the list is endless.

There are some great courses out there, but what I want to think about is to decide what’s the best course for you. Figure out what kind of a learner you are. Speak to as many people as you can who’ve done the course. See if it works out with your family life and your logistics and your geography. Try and find out how many people are at the course and what’s like the ratio between educators and learners.

For me, when it gets to more than 12 learners per educator, on some course I’ve been on, like in hotels where there’s been like, 30, 35 delegates and one educator, I haven’t been the biggest fan of that. I also wanna know what is the educator doing? Like how much do they care about your success?

It’s a difference between you being on a course and every opportunity, the educators like somewhere else. Their minds elsewhere, they’re on their phone versus the educator being in your face and really wanting you to grasp every single concept and what are the values and what’s the person like, what is that educator like?

Are they your cup of tea? Can you relate to them? Do they inspire you? Some of the best courses and where I learned the most is when I actually really admired the person. This person inspired me in their personal life and their philosophy and their values, and I often gain more because of that. So please don’t think that just ’cause we’re talking about the Ripe Global Fellowship, that this may be the right one for you.

I want you to do your own research and find out what kind of learner you are. You should know that I have been an educator in Ripe Global before. I’m a shareholder of Ripe Global and I bloody love Lincoln Harris, Michael Frazis, Michael Melker, all these guys behind Ripe Global. And I think it’s an important duty for me to tell you that before we dive into the episode.

And one last thing, just yesterday, I was at my wife’s graduation, right? She got awarded her masters in pediatric dentistry at the Eastman Dental Institute. Very, very proud of my wife. It was no easy feat. It was very tough, with two kids. She was exclusively breastfeeding my second born during her final year, and she came out with a distinction.

So ever so proud of her. And for her, the MSC was a great choice. She liked having that contact time. She was able to do her like online lessons when there wasn’t any contact time. But was there much hands-on? No, it was a lot of reading and research and that kind of stuff. You have to relook at these programs.

Do you actually get to treat patients or not? So there are really pros and cons, but now some of the opportunities she’s getting ...]]> 1:08:47 false https://podcast.show/protrusive/episode/145397341/ 145397341 https://protrusive.co.uk/?p=8594 Jaz Gulati Tue, 13 May 2025 08:51:10 -0400 Which imaging techniques should you prioritize for TMD patients? Does a panoramic radiograph hold any value? 

When should you consider taking a CBCT of the joints instead? How about an MRI scan for the TMJ?

Dr. Dania Tamimi joins Jaz for the first AES 2026 Takeover episode, diving deep into the complexities of TMD diagnosis and TMJ Imaging. They break down the key imaging techniques, how to use them effectively, and the importance of accurate reports in patient care.

They also discuss key strategies for making sense of MRIs and CBCTs, highlighting how the quality of reports can significantly impact patient care and diagnosis. Understanding these concepts early can make all the difference in effectively managing TMD cases.

Protrusive Dental Pearl: Don’t lose touch with the magic of in-person learning — balance online education with attending live conferences to connect with peers, meet mentors, and experience the true essence of dentistry!

Join us in Chicago AES 2026 where Jaz and Mahmoud will also be speaking among superstars such as Jeff Rouse and Lukasz Lassmann!

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

Key Takeaways:

• Imaging should follow clinical diagnosis → not replace it.
• Every imaging modality answers different questions; choose wisely.
• TMJ disorders affect more than the jaw → they influence face, airway, growth, posture.
• Think beyond replacing teeth → treatment should serve function, not just fill space.
• Avoid “satisfaction of search error” → finding one problem shouldn’t stop broader evaluation.

Highlights of this episode:

• 02:52  Protrusive Dental Pearl
• 06:01 Meet Dr. Dania Tamimi
• 09:04 Understanding TMJ Imaging
• 16:00 TMJ Soft Tissue Anatomy 
• 21:04 The Miracle Joint: TMJ Self-Repair
• 24:26 The Role of Imaging in TMJ Diagnosis
• 28:15 Acquiring Panoramic Images
• 39:35 Guidelines for Using Different Imaging Techniques
• 41:26 Case Study: Misdiagnosis and Its Consequences
• 45:46 Balancing Clinical Diagnosis and Imaging
• 50:17 Role of Imaging in Orthodontics
• 53:18 The Importance of Accurate MRI Reporting
• 58:27 Final Thoughts on Imaging and Diagnosis
• 01:00:54 Upcoming Events and Learning Opportunities

???? AES 2026 Conference (Chicago):

• Topic: “Telling the Story of Your Patient Through Imaging”
• Focus: Understanding patterns in imaging and how they reveal the patient’s full clinical picture

???? “How to Read a Cone Beam CT” Virtual Course (Concord Seminars)

If you enjoyed this episode, don’t miss out on [Spear Education] Piper Classification and TMJ Imaging with Dr. McKee – PDP080.

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

This episode meets GDC Outcomes A, B, and C.

AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Imaging techniques)

Aim: To enhance clinicians’ understanding of TMJ imaging modalities, improve diagnostic reasoning, and empower dental professionals to make evidence-based imaging decisions for temporomandibular joint disorders.

Dentists will be able to –

1. Differentiate between panoramic radiography, cone beam CT (CBCT), and MRI for TMJ evaluation.

2. Identify the appropriate imaging modality based on specific TMJ diagnoses (e.g., soft tissue vs. hard tissue pathology).

3. Recognize the risks of under- and over-imaging and apply a diagnostic question-driven approach to imaging selection.

#PDPMainEpisodes #OcclusionTMDandSplints #OralSurgeryandOralMedicine

Teaser: We do need to make sure that our teeth are in an orthopedically stable situation. And you should never trust what you see in the mouth 'cause the teeth may fit beautifully. But if the condyles aren't seated properly in the fossa, then it's like basically having a house built on quicksand. And this is a big thing that I see a lot in orthodontic treatment and others, they're just thinking about, alright, let's fix these.

Teaser:And they’re not paying attention to the foundation of the house. The teeth are the window dressing. You are not a carpenter, even a carpenter diagnosis. You need to diagnose your patient prior to doing anything to them, to figure out what really is going on.

Medicine, including dentistry is seven parts, diagnosis, two parts treatment planning, and one part execution. So if you get all that, those first nine parts wrong, you’re not treating the patient. You may be treating a symptom, putting a bandaid on something, but you’re not getting the full picture. But we’re really storytellers, we’re detectives and we are looking at the imaging to try to find the stories and the history that the patient can’t verbalize themselves.

Jaz’s Introduction:In our day-to-day dentistry, we take bite wings, we take periapical, and if you’re lucky enough to have a panoramic or a CBCT machine, we may take some of those. But what do we do when we have that TMD patient, TMD, obviously being an umbrella term. Listen to a lot of the other episodes on this podcast.

Learn more about TMD and how we can help as general dentists. But the question we’re really going to explore in today’s episode with an absolute sensational guest, the author of this book right here for the audio listeners is Temporomandibular Joint and Sleep Disorder Breathing by Dr. Dania Tamimi. And let me tell you guys, you are in for an absolute treat in today’s episode.

Some of the analogies she uses and the ways to explain certain elements of TMD, like for example, the clicking joint or the posh way of saying it is disc displacement with reduction. And so many colleagues get confused with that part with reduction. They still have no idea what it means. I’ve spoken to board certified prosthodontists on the phone and even they have been confused about what this actually means.

And so what Dr. Tamimi does in this episode is gives you one word to substitute in a way that suddenly all of this makes so much more sense. All her analogies are brilliant and we will explore, does a panoramic radiograph have value? When should we be considering taking a CBCT of the joints instead?

And are there any special instructions when doing so? And when do we need to take an MRI scan for the TMJ? And a little bit of the spoiler alert. My experiences with the MRIs have been just crazy in the sense that the person who reports it, will make a huge difference to the diagnosis. Let me say that again.

If you send your patient for MRI of the TMJs, well done. You might have helped it. And for the certain patient, we may be getting closer to the truth or to diagnosis, but the report can be so shockingly poor in my experience that, that MRI report ends up being a waste of money. I’ve seen this a few times down in my short career so far, and we discussed that.

I confronted the radiologist, Dr. Tamimi, on why this is happening and she had a really good answer actually. So get those onions ready, Protruserati, lots of chopping to do as you listen to these gems. 

Hello, Protruserati. I’m Jaz Gulati and welcome back to your favorite dental podcast. This is the first AES takeover every year the AES put on a show in Chicago around about the second, third week of Feb, and Dr. Tamimi is one of the guests. And so what we’re doing basically is we’re getting on these absolute superstars in the world of occlusion comprehensive dentistry to create these awesome and engaging podcasts, but also shine a light on the good work done by the AES. Our guest today, Dr. Dania Tamimi, is one of the speakers, and guess what?

Yours truly me and Mahmoud will also be speaking at the AES 2026 in February. Our topic is Occlusion Basics and Beyond. Basically, we wanna put something together for the younger colleagues and cover the foundations of occlusion that you can apply on Monday morning. But the AES has a reputation of actually being leading and at the cutting edge of comprehensive dentistry.

Let me just talk you through the lineup, right? So this is the Protrusive Dental Pearl, by the way, get yourself to AES 2026. Okay, well, I’m kind of kidding, but I’m kind of not. Okay. The real Protrusive Pearl behind this is don’t lose touch with the magic of in-person learning and the magic of conferences where you get to meet your peers. Online is great.

I’ve been a fan of online since I graduated, but I also mixed it with in-person events. Obviously, minus covid. If all you’re doing is going to in-person events, then you’re missing out a lot online. And if all you’re doing is sat in front of a laptop watching videos and webinars, you are really missing the true essence of dentistry, which is the people around you, the new and old friends that you get to see, and the connect...]]> 1:06:27 false https://podcast.show/protrusive/episode/145201090/ 145201090 https://protrusive.co.uk/?p=8574 Jaz Gulati Wed, 07 May 2025 01:11:51 -0400 Why do some patients struggle with anesthesia, requiring multiple cartridges just to get numb?

Could your TMD patients have an underlying systemic condition that’s been missed?

Are you overlooking the signs of a connective tissue disorder?

”When you can’t connect the issue, think connective tissue!”

Dr. Audrey Kershaw joins Jaz for a fascinating deep dive into the world of connective tissue disorders and their hidden impact on dentistry. Together, they explore how hypermobility, unexplained joint issues, and even a history of spontaneous injuries could be key indicators of an underlying disorder.

They also break down why dentists play a crucial role in screening and identifying these conditions, ensuring better patient outcomes and a more holistic approach to care. Because sometimes, when things don’t seem connected… they actually are.

Protrusive Dental Pearl: Don’t just take a “relevant” medical history—take a comprehensive one! Encourage patients to share all health issues, even those they don’t think relate to dentistry. You might uncover important clues about conditions like connective tissue disorders or sleep-disordered breathing, leading to better care and stronger patient trust.

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

Key Take-aways

• Ehlers-Danlos Syndrome is often misunderstood and underdiagnosed.
• Patients with connective tissue disorders often face skepticism from healthcare providers.
• POTS is a common condition associated with EDS that affects blood pressure regulation.
• Many TMD patients may have undiagnosed connective tissue disorders.
• Awareness and education about EDS are crucial for better patient outcomes.
• The healthcare system can be challenging for patients seeking diagnoses.
• Research on local anesthetic effectiveness in EDS patients is lacking.
• Personal experiences can help in understanding and diagnosing connective tissue disorders.
• Collaboration between healthcare professionals is essential for patient care. Genetic testing is crucial for diagnosing rare types of Ehlers-Danlos.
• Dental professionals should be aware of the signs of connective tissue disorders.
• Diagnosis can empower patients to understand their health better.
• Holistic care is vital in managing symptoms associated with EDS and TMD.
• Medical histories should be seen as relevant in dental practice.

Highlights of this episode:

• 02:17 Protrusive Dental Pearl
• 04:21  Dr. Audrey Kershaw’s Journey and Insights
• 09:45 Personal Experiences and Professional Observations
• 11:55 Diagnosis and Management of Connective Tissue Disorders
• 13:31 POTS (Postural Orthostatic Tachycardia Syndrome)
• 15:30 Understanding Ehlers-Danlos Syndrome (EDS)
• 24:55 Hypermobile EDS and the Need for Awareness
• 27:53 International Consortium of EDS GP Checklist
• 28:34 Genetic Testing and Red Flags
• 31:44 The Role of Dentists in Identifying EDS
• 40:32 Journey to Diagnosis
• 43:47 The Value of a Diagnosis
• 48:43 Dental Implications of EDS
• 55:00 Final Thoughts and Resources

“If you know one case of EDS, you only know one. Every case is different. Many are severely debilitated, unable to work or carry out daily tasks, often denying their struggles after years of being dismissed.” – Dr. Audrey Kershaw

Promised Resources

Podcast Recommendation:

• Linda Blustein’s Podcast (about POTS and connective tissue disorders)

Specialists & Research:

• Dr. Alan Hakim – A specialist in Ehlers-Danlos Syndrome (EDS) research based in London.
• Norris Lab (U.S.) – Researching genetic markers for hEDS
• Local Anesthesia Information

Resources for Screening & Diagnosis: 

Educational Conferences & Talks:

• Scottish Dental Show – Audrey is involved in raising awareness at this event.
• Podcast with Periodontist Reena – Discussing HbA1c meters for diabetes screening in dental practice.
• “If you can’t connect the issues, think connective tissues”. An EDS talk for professionals.

Advocacy & Support:

• Learn more about EDS and Dr. Audrey Kershaw
• Ehlers-Danlos Support UK Scotland – Audrey collaborates with them for better patient care pathways.
• EDS PATIENT EMAIL Template April 2025
• GMP EDS EMAIL TEMPLATE  April 2025
• Connect with specialists like Dr. Audrey Kershaw

Pack to aid identification of possible HCTD/EDS cases in the dental setting 

1. Watch YouTube video made for Prof Tara Renton, by Drs Kershaw and Bluestein 

2. Read this – https://gptoolkit.ehlers-danlos.org/ 

3. Fill out Oral Surgery Scotland Advanced Medical History Form 

4. Fill out this – International Consortium of EDS GP Checklist 

OR use this link – https://apps.apple.com/app/id6642710534 

5. If appropriate, give patient EDS information email EDS PATIENT EMAIL Template April 2025

6. Send email to GMP GMP EDS EMAIL TEMPLATE  April 2025 

7. For any issues, or feedback, please contact Dr. Audrey Kershaw

If you loved this episode, make sure to watch Periodontal and Systemic Link – Correlation or Causation?

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: 150 Health medicine and nutrition

Aim: To enhance dentists’ awareness and understanding of connective tissue disorders (CTDs), particularly Ehlers-Danlos Syndrome (EDS), and their impact on dental treatment, local anesthesia effectiveness, TMD, and overall patient care.

Dentists will be able to –

1. Identify key dental manifestations of EDS, including local anesthesia failure, TMD, and periodontal considerations.

2. Apply a multidisciplinary approach to managing complex TMD cases with suspected connective tissue involvement.

3. Appreciate the dentist’s role in identifying and supporting patients with suspected connective tissue disorders.

#PDPMainEpisodes #BestofProtrusive #BreadandButterDentistry

Do you know when to choose an inlay over an onlay?

What makes occlusal veneers so effective — even at just 0.6 mm thickness?

After years of anticipation, Dr. Pascal Magne finally joins Jaz Gulati on the podcast for an episode packed with adhesive dentistry gold. They dive deep into occlusal veneers, material selection, and why indirect composite may be the best-kept secret for worn, root-filled molars.

They also unpack the full bonding protocol step-by-step—from air abrasion and IDS to silane application and cementation with preheated composite. Whether you’re doing full rehabs or composite repairs, this episode is your go-to guide for smarter biomimetic dentistry.

Protrusive Dental Pearl: After applying silane, don’t just let it evaporate—let it react for 30 seconds, then air dry, and crucially, use a heat source (like a hairdryer) for 60 seconds to activate it properly and achieve optimal bond strength. This enhances the effectiveness of silane and significantly improves the bond strength of indirect restorations like composite or lithium disilicate.

Key Takeaways:

• Occlusal veneers can be as thin as 0.6 mm.
• Indirect composite is often a superior choice for restorations.
• Proper bonding protocols are crucial for successful restorations.
• Focusing on strengths rather than weaknesses is key in dentistry.
• Conservative approaches in dentistry can preserve tooth structure.
• The vital tooth is always preferable to a non-vital tooth.
• Composite resin has wear properties similar to enamel.
• Occlusal veneers provide excellent protection for compromised teeth.
• Porcelain veneers have long-term durability compared to composites. The evolution of composite materials has led to better options for restorations.
• Zirconia is strong but difficult to adjust and bond effectively.
• Immediate dentin sealing is crucial for successful bonding and patient comfort.
• The Dahl principle allows for minimal preparation in certain cases.
• Composites can be as effective as ceramics when used correctly.
• Understanding the properties of materials is essential for successful restorations.
• Thin occlusal veneers can be successfully bonded with proper techniques.

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

Highlights of this episode:

• 0:00 Introduction
• 02:52 Protrusive Dental Pearl
• 04:42 Dr. Pascal Magne on His Current Focus
• 10:16 Understanding Cusp Coverage and Material Choices
• 15:48 Conservative Approaches in Dentistry
• 23:16 Unsupported Enamel: Can it Still be Reinforced?
• 28:05 Occlusal Veneers Indications
• 37:00 Material Selection: Composite vs Ceramic
• 01:24:42 Outro

Referenced Studies – all below are available to download on Protrusive Vault in Protrusive Guidance

• Effect of immediate dentine sealing on the aging and fracture strength of lithium disilicate inlays and overlays 
• Short-fiber Reinforced MOD Restorations of Molars with Severely Undermined Cusps 
• Ultrathin CAD-CAM glass ceramic and composite resin occlusal veneers for the treatment of severe dental erosion 
• Strains in the marginal ridge during occlusal loading 
• Antagonist Enamel Wears More Than Ceramic Inlays 
• Outcomes of resin-bonded attachments for removable dental prostheses
• Performance of ceramic laminate veneers with immediate dentine sealing 

Keep the learning going with Magne Education

If you enjoyed this episode, don’t miss A Geeky Discussion on Adhesive Onlays – that’s PDP161!

This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance. 

This episode meets GDC Outcomes B and C.

AGD Subject Code: 250 OPERATIVE (RESTORATIVE)DENTISTRY (Indirect restorations)

Aim: To provide clinicians with evidence-based guidance on occlusal veneer indications, material selection, and conservative restorative protocols—emphasizing the role of adhesive techniques and biomimetic principles in long-term success.

Dentists will be able to –

1. Differentiate between inlays, onlays, and occlusal veneers, and select the most conservative option suitable for each clinical scenario

2. Make informed decisions on material selection based on occlusal anatomy, antagonist material, and long-term clinical performance.

3. Assess the biomechanical behavior of composite vs ceramic materials, including their effect on stress distribution and enamel wear

Teaser: An onlay is always going to make the tooth stronger than an inlay. However, the chances of catastrophic fractures with an onlay are bigger than with an inlay. And I know it's not unanimous, some of my colleagues, they don't like the fact the composite has a lower elastic modulus. But again, you have to understand a non-vital tooth is a handicapped tooth.

Teaser: So the damping affect the damping behavior of this occlusal volume of composite in our studies actually proved to protect the remaining tooth structure at the level of the root. With the occlusal veneer, there’s no need- Element of biomimetic dentistry is to say that the restoration should be allowed to fail in order to protect the tooth. Zirconia is the opposite. 

Jaz’s Introduction:It finally happened. Finally got Dr. Pascal Magne on the podcast. If you remember episode 100, I was in Edinburgh at the BACD in the queue to get my book signed by Dr. Magne. And I said to him, please, will you come on the podcast one day? And that day finally came a few years later than I wanted, but we finally made it guys.

And let me tell you guys, you are in for a treat. We’re talking about occlusal veneers. How thin can you go? Like think of a lower molar that is worn and is spawn into dentine possibly because erosion and attrition and you don’t have much space and you don’t really wanna prep so much, we can go as thin as, let’s say 0.6 millimeters.

And what if I told you, you can do it in indirect composite? And that’s probably in many cases, the preferred choice. At the end of the podcast, we discuss the exact protocol of bonding and indirect composite which actually is also gonna help you if ever you’re doing a composite repair, how to bond new composite to old composite.

Now we covered so many geeky adhesive and restorative themes, like why not use zirconia? Why is indirect composite a superior choice, especially for your root filled molars that need cuspal coverage? Which is interesting because I have been doing lithium disilicate for many years thinking that composite was like a cheaper option, was like a second rate option.

Actually, Dr. Pascal Magne says that if it was his tooth, he’d want indirect composite. Well, you are in the right place to find out why he said that, and also why we should not be so aggressive in capping cusps. 

Hello, Protruserati. I’m Jaz Gulati and welcome back to your Favorite Dental Podcast. If you’re returning again, thank you so much for being a Protruserati. If you are new to the podcast, you picked a really good one. I’ll tell you what all our podcasts are awesome, thanks to the wonderful guests we have on, so please don’t forget to hit that subscribe button if you like what you hear or see today. 

Dental PearlEvery PDP episode, I give you a Protrusive Dental Pearl, and today’s one is of course inspired by Pascal Magne and an adhesive protocol tip. The tip is when it comes to the silane step, that step is so critical in whether you’re bonding an indirect composite or an indirect ceramic such as lithium disilicate. Once you’ve done the correct surface preparation of your indirect restoration, so that’s different for composite, which you’ll hear at the end, and that’s different for ceramic.

And once you get into the silane stage, here’s what you don’t do. You don’t just apply silane and leave it on the side to let it evaporate. No, you want to let it react for 30 seconds, then you want to air dry it. But then you want to use something like a hair dryer. You need to use some hot air to achieve the perfect layer and the perfect chemistry of your silane.

And this surface preparation with silane, such a critical step that it makes a huge difference in the bond strengths you can achieve. So makes your guys that you are air thinning your silane, and then you’re using some sort of a heat source to achieve that optimal layer. And you’ll hear about the the geeky justifications and the steps for this towards the end of this podcast.

Do not go anywhere, guys. You’re gonna enjoy this a lot. And remember, our episodes are eligible for CE. This episode is worth 1.25 CE credits, and we are a PACE approved education provider on our platform, which is called Protrusive Guidance. The website for that is protrusive.App. That’s www.protrusive.App. You’ll have access to over 350 hours of CE.

This includes the podcast episodes, but also our mini courses and on demand webinars, which are thoroughly enjoyed by ou...]]> 1:26:44 false https://podcast.show/protrusive/episode/144846695/ 144846695 https://protrusive.co.uk/?p=8538 Jaz Gulati Wed, 23 Apr 2025 10:00:54 -0400 What is the number 1 communication advice for Dentists?

Are you confident in discussing treatment fees with your patients?

Do you struggle with communicating your worth without feeling awkward?

How do you shift your mindset to charge what you’re truly worth without feeling guilty (a money mindset issue)?

In this enlightening conversation, Jaz opens up about his own struggles with money mindset and how he overcame them to confidently charge for his dental services.

Joined by dental student Naveed Bhatti, they explore the challenges of pricing treatments, offering empathetic solutions to patients, and using the power of visualization to boost confidence in fee discussions.

They also dive into the importance of being transparent with fees, managing discounts, and recognizing your true value as a dental professional. Whether you’re new to the field or have years of experience, these strategies will help you navigate the financial side of dentistry with ease and confidence.

Key Takeaways

• Communication is crucial in dentistry, often more than clinical skills.
• Active listening is essential; avoid interrupting patients.
• Nervous patients may talk excessively; guide the conversation gently.
• Patients may withhold information due to fear or anxiety.
• It’s important to make treatment recommendations based on patient needs.
• Asking open-ended questions can help gather more information.
• Experience builds confidence in patient interactions.
• Being authentic while adapting to patients is key.
• Patients can sense when a dentist is confident or insincere.
• Building rapport leads to better patient relationships. Kindness is essential in patient interactions.
• Patients often reflect the values of their dentists.
• Effective communication can bridge the gap between jargon and patient understanding.
• Long-term relationships with patients enhance trust and satisfaction.
• Discussing fees requires confidence and transparency.
• Visualization techniques can improve communication skills.
• Empathy is important, but it should not compromise business integrity.

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

Highlights of this episode:

• 01:46 Introducing Naveed Bhatti and His Journey
• 02:53 The Importance of Communication in Dentistry (Do’s and Don’ts)
• 08:13 Handling Nervous and Quiet Patients
• 10:51 Dealing with Patients Who Don’t Tell the Whole Truth
• 14:35 Making Treatment Recommendations
• 17:56 Asking the Right Questions
• 21:36 Balancing Professionalism and Personal Connection
• 25:49 Handling Difficult Patients 
• 31:38 Effective Communication with Patients
• 35:05 Discussing Treatment Fees with Confidence
• 40:25 The Power of Visualization in Dentistry
• 48:56 Concluding Thoughts and Future Plans

Support Nav’s YouTube channel, The StuDent

If you enjoyed this episode, don’t miss out on Think Comprehensive – Communication Gems with Zak Kara – PDP010!

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

This episode meets GDC Outcome B.

AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS

Aim:

To enhance dental professionals’ communication skills by exploring effective strategies for patient interaction, treatment planning, and fee discussions—ultimately building trust, improving patient outcomes, and boosting confidence in everyday clinical practice.

Dentists will be able to –

1. Recognize the importance of active listening and body language in patient communication.

2. Explain treatment options using patient-centered language and analogies that promote understanding and buy-in.

3. Discuss treatment fees with clarity and conviction, addressing money mindset barriers and building perceived value.

Teaser: If you ask seven dentists, you'll get 12 opinions. You see what I mean? Right. So firstly, okay, you must appreciate that there are so many opinions out there. Every dentist will give a different opinion, which is absolutely mad to just remember. But then remember that when a patient comes to you, they're coming to you, they're seeking your opinion.

Teaser: They’ve selected you either by a geographical convenience or recommendation or whatever. They now ended up in your chair, right? So, all you are ever giving them is an opinion. That’s it. Okay. Here’s the stupid thing, Nav, right? You say to a patient 120, and they’re still gonna be like, oh, 120. That’s too much, right?

And they didn’t even know that was one 50. You just counted it. The worst you could do is you give a discount, but the patient ever knows that you got a discount. That’s the worst thing, that’s the stupidest thing ever. 

[Nav]Well, I’m with you. 

Jaz’s Introduction:Patient communication is one of those things that you just don’t get taught at dental school, like a few other things. Again, not their fault. We always talk about it never being the fault of dental school. They just need to make you a safe beginner. But the kind of things we worry about once we qualify is how do we actually make a connection with the patient? How can we communicate fees with the patient? And just how do you communicate the patient’s options without coercing them into a particular treatment or trying to be salesy to a patient.

These are all things I cover with Nav Bhatti. Now, Emma is doing her finals at the moment, so we wish her all the best. You got this, Emma. But I tell you this episode really packs a punch. We talk about body language, we talk about building rapport. We talk about patients that you just won’t get along with and how you should manage those, and how over time your patients become a reflection of you. And interestingly, we also discuss your money mindset. It’s actually important when you’re communicating with key paying patients. 

Hello, Protruserati. I’m Jaz Gulati and welcome back to your favorite dental podcast. This is the student arm, but I tell you, these episodes are not just for students, especially this one. Anyone who’s struggling with communicating fees to patients or anything around being a more effective communicator, I really think you’ll gain a lot from this episode. So make sure you listen all the way to the end. 

This one is eligible for CPD or CE credits. There’s only one place you can get that, and that’s on Protrusive Guidance. Please do download the app on. iOS or Android store, but to actually make an account, the best way to do that is on the website. That’s protrusive.app. You can try one of our paid plans, and I’m convinced you’ll love being part of the nicest and geekiest community of dentists in the world. Let’s now join Nav, who’s a dental student in Slovakia. As he asks some truly wonderful questions around patient communication, catch you in the outro. 

Main Episode:Nav Bhatti. Today’s filling in for Protrusive Student. Emma is doing her finals as we speak right now. We’re excited to grow this with you as well, my friend. Just remind everyone about yourself, my friend. 

[Nav]No worries. I’m trying to fill in for Emma for now, which is huge boots to fill by myself and a fourth year dental student in Slovakia of all places, which is a six year course. So I’m not quite at my penultimate year. But, we are almost there, so, it is going quite well. 

[Jaz]And if anyone hasn’t listened yet, we know we talked about your journey right, in a previous episode, and that was really cool. You inspired a lot of people, so please do listen to his backstory, how you went from country to country. And finally, you are still a little bit, few years away still, but your enthusiasm, your passion, your drive is amazing. 

[Nav]Thank you. A lot of it I must thank sort of Protrusive as a whole community. Your podcast. It kind of keeps myself and my colleagues sort of kicking, inspires us on a daily basis. I’m not just saying that for the sake of it, it genuinely does to see so many people out there supporting us on our journey is just amazing. 

[Jaz]And it’s been nice to also see your contributions on the Protrusive app. Like you took out some teeth recently, you saw some surgery recently, and you’re posting about that. So it’s great to have your student viewpoint. And of course today, probably in the title, this may not even be a Protrusive student episode because communication is communication.

This is like the biggest thing in dentistry is far more important than your clinical skills. I’ll just say that right off the bat. Far more important than your clinical skills. So I’m excited to record this episode with you today and just any questions that you have in this sphere and to take it. So Nav, take it away, my friend. How can we help? 

[Nav]For sure. I think communication obviously is huge, as you quite rightly said, but for some weird reason, it’s just never taught. At university, you get all this theory, you get all this clinical kind of workload and they teach you how to do fillings and extractions and whatnot, but they never really get you to communicate with the patient effectively.

So this whole re...]]> 0:51:26 false https://podcast.show/protrusive/episode/144475121/ 144475121 https://protrusive.co.uk/?p=8477 Jaz Gulati Sat, 12 Apr 2025 09:25:37 -0400 Are ergonomic loupes and fancy chairs really worth the investment?

Is back pain an inevitable part of being a dentist—or can it be prevented?

Are you setting yourself up for a long, pain-free career in dentistry?

What’s the number one thing you should be doing right now to protect your body for the long haul?

Dr. Sam Cope is back, and he’s not just any dentist—he started as a physiotherapist before training in dentistry. That means when it comes to musculoskeletal health, posture, and career longevity, Sam knows his stuff. In this episode, Jaz and Sam revisit the crucial topic of back pain in dentistry and dive even deeper into what actually works to keep you practicing pain-free.

So, if you clicked on this because you’re worried about back pain, take this as your sign—your future self will thank you.

Protrusive Dental Pearl:  Motion is lotion. Staying active prevents back pain and keeps your career strong. If you’re not making time for exercise, it’s time to rethink your habits. Knowing isn’t enough—action is what matters. Prioritize your health now.

Key Take-Away:

• Posture and back pain have no direct correlation.
• Apprenticeships provide invaluable experience and learning opportunities.
• Investing time in learning and shadowing can accelerate career growth.
• Ergonomic tools can enhance comfort but should be tailored to individual needs.
• Mental health is crucial for dentists, and seeking help is a sign of strength.
• The human body can adapt to various postures with training.
• Choosing a specialization should align with personal interests and strengths.
• Preventative measures in ergonomics can improve career longevity.
• Continuous learning and adaptation are essential in the dental field. Choosing the right dental chair is crucial for comfort.
• Preventative strategies for back pain include regular exercise.

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

Highlights of this episode:

• 02:05  Protrusive Dental Pearl
• 04:26 Sam’s Journey from Physio to Dentist
• 10:33 The Value of Apprenticeships and Mentorship
• 16:24 Niching in Dentistry
• 22:30 Ergonomics in Dentistry: Loupes and Chairs
• 27:03 Choosing the Right Chair for Your Comfort
• 29:54 Top Tips for Dentists to Prevent Back Pain 

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

This episode meets GDC Outcomes A and C.

AGD Subject Code: 130 ELECTIVES (149 Multi-disciplinary topics)

Aim:

To highlight the importance of ergonomics and physical well-being in dentistry. To share strategies for preventing occupational strain and burnout.

Dentists will be able to –

1. Assess the role of ergonomic loupes, chairs, and posture in reducing strain and improving long-term musculoskeletal health.

2. Understand the significance of muscle conditioning over posture correction.

3. Incorporate exercise routines to manage physical strain during long procedures.

If you enjoyed this episode, you won’t want to miss Got Your Back – Physios and Dentists – PDP025!

#PDPMainEpisodes #BeyondDentistry #CareerDevelopment

Jaz's Introduction: Over 270 episodes ago, I had on Dr. Sam Cope when he was a a baby dentist, and he's unique because he's a physio who trained to then become a dentist. Back then, we discussed about back pain and dentistry and how to prevent it, and we talk a bit more about those themes today. Are ergo loops worth it?

Jaz’s Introduction:Are those posh Bambach kind of chairs. Are they worth it? What’s the number one advice to have a career with longevity and good health from a back pain perspective and as a physio come dentist, what does Sam do? What are the things that he practices? Because he’s a bit like when Christiano Ronaldo rejoined Manchester United.

He was like a, he was a big deal, right? He is the goat. He’s the greatest of all time. I’m a Ronaldo fan. Anyway, when he was in the canteen of Manchester United, he was like eating with all other players. Everyone just looked at Ronaldo, what was on his plate. They wanted to model Ronaldo. So why do I mention that?

Because I’m looking at Sam, whatever Sam’s doing with his posture, with his back, et cetera, I wanna be doing that because he has the most knowledge. He’s musculoskeletal with his physio background. He’s a really good dentist. So let’s see what advice Sam has for us today. Now, after this episode, if you wanna go deeper into back pain, chronic back pain.

We’ve got Ben Physio and Sam Physio come dentist, that was PDP 025, like I said, over 280 episodes ago. In fact, it’ll be good for you to revisit some of the old episodes to see my journey and the journey of Protrusive now that we have team members and whole production line to bring you all this content.

And a special thanks for all of you that member listening to that episode on Spotify all those years ago. There is some new information, applicable information, and Sam’s no longer a baby dentist. He’s really accelerated a fast rate. So I made a big deal over at the beginning of this podcast to talk about his journey.

Because his journey really exemplifies the advice I give to every single young dentist. I get the question all the time, how do I structure my career? How do I grow at the fastest rate possible? How can I find the right clinic? How can I be doing the more of the higher end dentistry? Well, Sam’s playbook is there, and he shares it with us in this episode. So you’ll get some career advice as always, plus how to get more longevity from your career. 

Dental PearlThe Protrusive Dental Pearl is a nonclinical one, and it’s taken from this episode and it’s just something that you already know, but it’s just important to hear again, and that is motion is lotion. Too many of my dentist friends are talking to me and saying that, oh, I just don’t have time to excise, and oh, I really let myself go.

I’m not prioritizing it, and that is the wrong way to go. Your physical health and mental health is super important, but just focusing a little bit on the physical aspect, spoiler alert, that is the number one way to prevent back pain and to give you a career with longevity. And you’ll hear later in this episode whether deadlifts are recommended or not or what’s the best type of exercise.

But as long as exercise is part of your life, and for many of you, you guys are running or jogging when you’re listening to the episode and you guys are already living and breathing that and more power to you. But so many of you in the car on the train, and maybe the most exercise you get is when you are going upstairs and downstairs of your surgery and you need to really reevaluate life and your life decisions and how you may be neglecting your physical health. 

Again, it’s stuff we already know, but one of the first dental pearls I ever shared with you may actually have been number one and number two was to know something and not actually do it is as good as not knowing it in the first place.

So Protruserati, I’m trying to look out for you here. Are you making time for physical exercise? Are you practicing motion is lotion? I hope you are, and if you’re not hoping, this is gonna give you to kick up the backside to make some sort of regime, some sort of promise to change that by yourself. Because the reason you clicked on this episode is ’cause something piqued your interest about back pain and having a career with longevity. And if you’re not even doing that, then losing out on so many benefits. Anyway. Hope you enjoyed the rest of this episode. I’ll catch you in the outro. 

Main Episode:Dr. Sam Cope, welcome back again to the Protrusive Dental Podcast. So nice to see you and your growth and your journey and to see you live at the Protrusive events on the app and doing wonderful things on social media, my friend. Welcome. How are you? 

[Sam]Thanks very much and thanks for having me back on the podcast as well. It’s a real honor I’ve seen, ’cause it was in the early stages that I was on last time and it’s really grown and kind of kicked off. 

[Jaz]You were about 270 episodes ago, mate. 

[Sam]Wow. Yeah. Crazy a dinosaur. 

[Jaz]Well, honestly, you did so well then. But there’s some unfinished business, right? The unfinished business is a little bit of a stir that we created and we talked about being no correlation between bad posture. Back pain. Okay. So we wanna just talk a little bit about that, little finer points about that, and also just revisit your journey from physio to dentistry.

But now that you’ve been in the game for a bit longer, right? How do you feel? Do you have any regrets and that kind of stuff. And I hope you like the title of this podcast, My Neck, My Back Fix your posture while removing plaque. I just wanted to go into some sort of a funny theme, but Sam, for those who didn’t listen to that episode, looking at back pain, it was two guests I had at the same time. And so for those who haven’t listened to that, please do check it out, but just remind us about your journey and where you practice today? 

[Sam]Yeah, so I started off, I did physiotherapy at King’s from 2011 to 2014, and I actually met some, I was on a course this weekend and met somebody that was there at the same time who was doing dentistry at the same time.

And ...]]> 0:44:27 false https://podcast.show/protrusive/episode/144399196/ 144399196 https://protrusive.co.uk/?p=8466 Jaz Gulati Thu, 10 Apr 2025 02:46:35 -0400 Are “contact lens veneers” just fake news?

Why is the traditional 0.7mm prep approach outdated?

Are you truly preserving enamel in your veneer preparations?

Should you ever bond veneers to root dentin or cementum after crown lengthening?

Why is the Galip Gürel technique the gold standard for minimal prep veneers?

Dr. David Bloom joins Jaz for an insightful episode, sharing his 36 years of experience in cosmetic and restorative dentistry. With over two decades in the same practice, he’s seen what works—and what leads to failure—when it comes to veneers.

We also cover the key steps in mock-ups, planning, and veneer preparation.

Protrusive Dental Pearl:  Always Wax Up for 10: When planning veneers, start with a 10-unit wax-up (even if the patient initially wants 4 or 6). This allows them to visualize their full smile with a mock-up, compare different options, and make an informed decision. It’s not about upselling – most patients will appreciate the fuller look.

Key Take-aways:

• Health and diagnosis are foundational in cosmetic dentistry.
• Visual try-ins are crucial for patient engagement and satisfaction.
• Minimally invasive techniques are preferred for cosmetic procedures.
• Communication with patients about their options is essential.
• Bonding to enamel is more reliable than bonding to dentin.
• Permission statements help in guiding patient expectations.
• The transition from veneers to crowns should be carefully considered.
• Staining is not the primary concern when bonding to dentin.
• A change in surface texture is key in modern dental preparations. Visual aids are crucial in helping patients understand their treatment options.
• The Gurel technique emphasizes minimal preparation for veneers.
• Effective communication with patients can enhance their treatment experience.
• Understanding occlusion is fundamental in aesthetic dentistry.
• Veneer thickness should be as minimal as possible for aesthetic results.
• Patient involvement in the design process is essential.
• Cementation techniques can vary based on gingival health.
• Maintaining a facial path of insertion is important for aesthetic outcomes.
• Building a good relationship with lab technicians is key to successful restorations.

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

Highlights of this episode:

• 02:56  Protrusive Dental Pearl
• 04:15 Interview with Dr. David Bloom: Journey and Expertise
• 11:54 The Importance of Enamel in Veneer Longevity
• 13:46 Prepless Cases and Visual Try-Ins
• 18:54  Permission Statement
• 22:24 Visual Try-Ins Protocol
• 25:13 Decision-Making: Veneers vs. Crowns
• 28:35 Bonding to Root Dentine and Long-Term Outcomes
• 33:34 Opening Embrasures: Techniques and Tips
• 35:19 Visual Try-Ins and Patient Communication
• 38:50 Wax-up in Occlusion
• 41:25 The Gurel Technique Explained
• 47:09 Black Triangles 
• 49:40 Guidelines for First Veneer Case
• 54:10 Contact Lens Veneers
• 56:18 Cementation Preferences and Techniques
• 01:00:15 Final Thoughts and Educational Resources

Need expert guidance on veneers and smile design?

Join Intaglio Mentoring and connect with top mentors for real-time case support and level up your Dentistry. Dr David Bloom is also a mentor on Intaglio.

Watch this space for David’s new educational website coming soon – he teaches Veneers hands-on too.

If you loved this episode, make sure to watch How to Temporise Veneers Step by Step FULL GUIDE – PDP214

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/COSMETICDENTISTRY (Tooth colored restorations)

#PDPMainEpisodes #AdhesiveDentistry

Aim:

To provide an in-depth understanding of minimal preparation veneers, focusing on enamel preservation, diagnostic workflows, patient communication, and clinical techniques to enhance the longevity, function, and esthetics of veneer restorations.

Dentists will be able to –

1. Identify when a prepless approach is feasible and when minimal preparation is necessary.

2. Use visual try-ins effectively to enhance patient understanding and involvement in treatment decisions.

3. Understand long-term maintenance, including managing black triangles, embrasure shaping, and repairs.

Teaser: We were used to heavily prepping and it was fine, but what I found was after seven or eight years, these units were popping off. And I mean, I'm a fourth generation bonding guy. I'm OptiBond FL was using the same bond then. I don't think it's about bond strength, it's about the enamel and longevity is enamel.

Teaser:So I found after typically seven or eight years, the units were popping off and I wasn’t sure why. It’s gonna feel artificial, it’s gonna feel strange, but I don’t care what it feels like or I get what it looks like because within five or 10 minutes they’ll have adjusted it. It’s how it looks. I mean, originally when we had Feldspathic, you might say, oh, well just use a completely clear feldspathic portion in there.

And that’s where that it sucks in the color from the underlying tooth. Some people are using Feldspathic and have for many years and it’s a great material. But any veneer is gonna, generally, unless it’s a high opacity, is gonna pick up color as long as it’s thin. 

Jaz’s Introduction:It’s another veneers episode. But with someone who’s got so much experience, 36 years and counting, and a wonderful man. Great dentist, a true GDP, who is pivoted into cosmetic and restorative. The key theme of today’s episode when it comes to veneer is not just the full workflow. I’ve done episodes on that before. And yes, we do go deep into the workflow. It’s a lovely perspective to have, but really the main focus is minimal preparation, the importance of preservation of enamel.

But what about those scenarios where, let’s say you have some aesthetic crown lengthening. You have a gum lift. Am I naughty if I’m now partially bonding this veneer on root dentine or cementum? Are those cases more like to stain in the long run? Well, you see from speaking to Dr. David Bloom, he’s been in one practice for 24 years, so he knows what works and what doesn’t.

And he mentions he’s seen some cases that come back as failures. And what was the reason for that failure? We essentially dissect the Galip Gürel technique. This is a really contemporary and essential way of prepping for veneers. Like when I qualified, I was taught that, okay, for veneers you’ve gotta do like, 0.7 millimeter of prep.

And so in my mind, whatever tooth you have in front of you, you put a 0.7 millimeter margin on all these teeth that is totally wrong. And you’ll see for many reasons why that is wrong and why the Gürel technique is really the way to go. It helps us to give the patient the smile they want, but in the most minimal way.

We don’t go too deep into temporization ’cause we did that in a recent episode with Aidan. So to check out that episode, if you haven’t ready, if you wanna go deep into temporaries, but in this one we talk about the mockup, the planning, and the prep itself. Find out in the end why contact lens veneers are fake news and why you should never do a depth groove at the cervical region.

Hello Protruserati, I’m Jaz Gulati and welcome back to Your Favorite Dental podcast. This episode is totally eligible for CPD or CE credits. You’ll just have to answer the quiz at the end. 

Dental PearlThe Protrusive Dental Pearl, which I give you in every PDP episode. Gosh, we’ve got hundreds of those. Now I struggle to keep up. Sometimes I get anxiety that I’m repeating a pearl, but it is what it is. And for those of you now listening, I’m examining my hoodie, my Protrusive Hoodie for stains. I went to my mom’s for a curry today. I had some butter chicken, not butter chicken, butter chicken. And I look to have got some on my hoodie.

So, thankfully it’s hidden in the camera, but I can tell you now, the aroma in my office is fantastic. By the way, butter chicken, like is one of my pet peeves. Like Indian people, when they go to Indian restaurants, they always seem to order a butter chicken. It has become, for me, the most like boring vanilla thing that you can get an Indian restaurant.

So my recommendation if you wanna be a bit different like me, is next time you go to a good Indian restaurant. Order the Lamb saag. So this is like a spinach and lamb dish. Much tastier, much richer, much more adventurous, and way less boring than the butter chicken. Anyway, that was a massive digress. I was just coming on to the Protrusive Dental Pearl.

So your patient comes in and they want, let’s say four veneers, upper lateral to lateral, or maybe they want six and there’s a reason why you should never do six, and maybe they want eight, maybe they want 10, you don’t know. But in your wax up, go for 10. Okay? In your wax up, go for 10. Because ac...]]> 1:09:25 false https://podcast.show/protrusive/episode/144067851/ 144067851 https://protrusive.co.uk/?p=8427 Jaz Gulati Wed, 02 Apr 2025 05:10:56 -0400 CORE CPD ALERT! ????

How dare I veer away from our beloved clinical topics to talk about… decontamination!?! ????

Have you ever wondered how you should be disinfecting occlusal mirrors without getting them scratched?

Should we be using PTFE inside the pulp chamber if it’s not been autoclaved?

What are the most common decontamination mistakes that we make day in and day out that are so easy to fix?

In this episode, Jaz sits down with Decon Pete, the go-to expert for all things dental decontamination, to drive into the nitty-gritty of keeping your practice squeaky clean (and compliant!). He shares practical tips to make your decontamination process safer, smoother, and stress-free.

Common decon mistakes, PPE slip-ups, distilled vs. RO water, HTM guidelines vs. manufacturer guidelines – this episode will help you feel more confident in decontamination and up your infection control game.

How to reach Decon Pete:

1. Facebook group: IPC Support by Decon Pete – a private space for dental teams to ask decontamination-related questions.
2. Website for practice support and consulting: www.deconpete.co.uk

The Protrusive Dental Pearl: Pete’s Expert Recommendation on Cleaning your Loupes

• Ideally, loupes should be disinfected between every patient, but at the very least, at the end of each clinical session
• Avoid submerging loupes in any liquid – instead, use distilled water and a microfiber cloth or cotton buds for frames and nose pads
• For lenses, use 70% isopropyl alcohol wipes – no acetone or bleach!
• If you’re using a visor with your loupes, you won’t need to clean them as often

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

Key takeaways:

• Decontamination is essential for patient safety in dental practices.
• Using proper protective equipment is crucial for staff safety.
• Transporting instruments safely is a key aspect of decontamination.
• Manufacturer guidance should always take precedence over general guidelines.
• Policies must be relevant to the specific practice.
• Manufacturer’s guidance should always be followed.
• Disinfecting instruments is crucial for patient safety.
• Water quality impacts the effectiveness of dental procedures.
• Distilled water should be used quickly after opening.
• Reverse osmosis water is more sustainable for practices.
• Proper storage of instruments prevents contamination.

Highlights for this episode:00:00 – Intro03:52 – Protrusive Dental Pearl: Pete’s top tips for cleaning your loupes06:02 – Introducing Decon Pete: Pete’s background in dental decontamination12:40 – Manual cleaning and PPE errors17:51 – Washer Disinfector27:06 – Instrument Transportation30:08 – Guidance vs. Manufacturer Instruction36:05 – PTFE Tape: Sterilization and best practices41:06 – Occlusal Mirror Care48:18 – Distilled vs. RO Water56:37 – Water for Ceramics57:22 – Outro

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

This episode meets GDC outcomes B and C. This is a GDC Recommended CPD Topic – 5 Hours of Disinfection and Decontamination every 5 year Cycle.

AGD Subject Code: 550 Practice Management and Human Relations.

Dentists will be able to:

1. Identify common decontamination errors and implement strategies to enhance infection control standards
2. Appreciate the appropriate methods for cleaning and maintaining dental equipment
3. Apply best practices for instrument handling, including proper PPE use, safe transportation, and effective sterilisation protocols

If you loved this episode, be sure to check out this one: PDP018 (Don’t Get Sued)

Teaser: Manual cleaning instruments just with surgical gloves on. And I see so many practices doing that and it offers them no protection whatsoever. You don't need to use sterile gauze.

Teaser:If you’ve got sterile gauze in, great. But yeah, the cheaper way of doing it, just get non-sterile gauze, or you can use lint-free cloth. The two fundamental waters that we have to use within dentistry for everything is distilled or RO. And the only reasons why we are using those two types of water is because both of them are deemed good quality water. They’ve got no magnesium, nothing like that. And thirdly, they have no endotoxins in them.

Jaz’s Introduction:Protruserati, I’d never thought I’d see the day that I’d be publishing an episode on decontamination. How dare I veer away from those beloved clinical topics to talk about decon? Well, in the UK as you know, it’s a required topic. It’s a recommended topic by the GDC. The problem is a topic like decon is violently boring until now.

I’m so pleased and proud to announce that Protrusive is going to reduce your CPD burden by recording and publishing episodes that are relevant to the recommended fields, but with a twist. Instead of those incredibly boring lectures that are used to in the field of decon, medical emergencies, and radiation protection, I’m actually gonna try my best to make it fun, to make it tangible in true Protrusive nature.

So now you can not only learn something, enjoy the conversation, I hope, but do a massive, big fat tick to the end of year CPD declaration so that by the end of your cycle, you complete your five hours of decon and your recommended hours for medical emergencies and radiation. So, all the good stuff will come soon.

This is core CPD, but not as you know it. It’s gonna be different. It’s gonna be hopefully enjoyable. The reason I think we’ve made it enjoyable is three reasons. Number one, I’m an inquisitive idiot. There are certain fields of dentistry, like implants, like decontamination that I literally know nothing about, and I am learning so much, and I’d love for you to be a fly on the wall and learn, because at the end of the day, sometimes when you are tuning into a conversation, like a podcast type conversation, you soak up and you learn so much more than just being talked at like in a webinar or in a lecture that you may be used to.

Number two, we don’t just cover the usual how many degrees in autoclave we actually cover real world scenarios. For example, how to properly disinfect your mirrors without scratching them, or should we be using PTFE inside the pulp chamber if it’s not been autoclaved. And what are the two most common mistakes that we are making day in, day out that are so easy to fix? Our guest Decon Pete is gonna answer all those questions. 

And number three, Decon Pete, our guest today, he’s super knowledgeable, but he’s relatable. He’s a human, he shows us human side, and he’s just so knowledgeable and it was absolutely brilliant to chat with him. I’m so excited for you to listen to this episode and again, put that big fat tick next to CPD.

Now, hundreds of you are used to getting CPD from Protrusive, but understandably, many of you, this will be your first time. I welcome you. I’d love for you to join the Protrusive family. The way to get involved is www.protrusive.app. It’s best to make your account on the web browser so you’re not paying all your money to Apple.

And we Protrusive don’t get anything. I’m just saying the truth. If you wanna actually support Protrusive, you go on the web browser www.protrusive.app, and you choose one of our paid plans, either Podcast CE only, so you get podcast CPD hours and CE credits, or you get access all areas through the Ultimate Education plan.

It is tax deductible, and I think it’s the best value CPD going in the universe. Of course, I’m a little biased. But if you love these episodes, why not answer the quiz at the end of the episode and get your CPD. Also, once you make an account, you can download our native app on Android or iOS and join the nicest and geekiest dentist in the world.

I guarantee you, you’ll sign up for the CPD, but you’ll stay for the people and the friends that you’ll meet on the Protrusive Guidance app. So if you are sick and tired of paying for CPD memberships that you never actually log into. Pick Protrusive ’cause this is the one that you use every single day.

Even one of our dentists, Megan recently said that she checks the app every day as though it’s Instagram. So like I said, if you’re paying for a subscription and not using it, what’s the point? There is so much to learn on the Protrusive community and I’d love for you to join us. If you wanna get the Access All Areas plan, go to protrusive.co.uk/ultimate. That’s protrusive.co.uk/ultimate. And we, the Protruserati, are excited to see you on the app. 

Dental PearlThe Protrusive Dental Pearl I have for you is something from the community. You guys asked, what’s the best way to clean your loops? Now, unfortunately, I ran out of time to ask him this question, but I called him up later and I said, Pete, we need to know the answer from you ’cause you are the expert.

And so this is how it goes. Firstly, how often should we be cleaning and disinfecting our loops? Well, technically, if you wanna aim for the highest level, you should be doing it between every single patient. That’s right, every single time you use them. And every time you change a patient before, then you need to disinfect them, because very often there’s aerosol that could be droplets. 1:01:03 false https://podcast.show/protrusive/episode/143779564/ 143779564 https://protrusive.co.uk/?p=8393 Jaz Gulati Wed, 26 Mar 2025 05:24:49 -0400 Is Work-Life Balance a Myth?

How do you find the right balance between your professional responsibilities and personal life?

Can you truly have it all…without sacrificing your health or family time?

In this episode, Jaz and Emma Hutchison, ‘the Protrusive Student’, dive into the real challenges of balancing parenthood, clinical dentistry, and LIFE! Jaz shares his strategies for managing these demands, revealing that while perfect balance might not exist, navigating life’s seasons with intention can make all the difference.

If you’ve ever struggled with finding your own balance, this episode is packed with key takeaways for dentists at every stage of their careers.

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

Highlights of this episode:

• 03:34 Emma’s New Year Reflections and Study Habits
• 12:20 Balancing Family, Work, and Personal Time
• 19:50 The Importance of Planning and Support Systems
• 23:16 Recognizing Opportunities and Setting Boundaries
• 28:15 Understanding Circle of Concern and Influence
• 30:24 Eat That Frog: Tackling Difficult Tasks First
• 31:02 Burnout in Dentistry: Real Experiences
• 39:51 The Importance of Mentorship
• 41:07 Just in Time Learning
• 44:03 Decision Making and Confidence
• 49:15 Effective Time Management Strategies
• 51:16 Final Thoughts and Takeaways

Key Takeaways:

• Preparation and good mental health are crucial for success during exam periods.
• Internalizing knowledge helps in better understanding and retention.
• Finding time for hobbies and self-care is essential for well-being.
• Planning and prioritizing tasks can lead to more effective study habits.
• Support systems play a vital role in managing stress.
• You can achieve a lot by focusing on your big priorities.
• Eat That Frog: tackle difficult tasks first.
• Burnout is a real risk for dentists.
• Finding a mentor is extremely beneficial for career growth.
• Just-in-time learning is more effective than just-in-case learning.

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.

If you enjoyed this episode, be sure to watch Stress in Dentistry 2024 – Life Changing Decisions – IC048

Jaz's Introduction: Guys, there is no such thing as work life balance. It's a myth. 'cause sometimes when I'm with my family and we're on vacation, it's all about my family. Nothing else matters, and that's really the way it should be. But there are other times where things get really busy at work and I'm not able to give my children the quality time that they deserve.

Jaz’s Introduction:And sometimes that happens. Or sometimes you are sacrificing sleep or your health, which really we shouldn’t be doing. But sometimes this happens. ’cause of other events and other priorities at that time. So to find this daily balance and work-life balance that slots into everyone’s magic week, it just doesn’t exist because there’s a season of life for everyone.

And so a lot of what we talk about today with Emma Hutchison, who’s the Protrusive Student. So welcome to this Protrusive Student episode. About 20 or 30% of what we talk about in this episode is related to students, and about 70% is all to do with dentists in the real world. Because Emma asked me, how do I do it? How do I balance everything? How do I balance fatherhood, clinical dentistry, Protrusive? And so a lot of my tactics or the strategies that I use are revealed in this episode. 

Hello Protruserati. I’m Jaz Gulati. Welcome back to your favorite Dental Podcast. It’s the student series that we do, but as we’ve seen in the comments on YouTube, mostly dentists tune in because they find it’s nice to reconnect with the basics and with a topic like work-life balance and priorities in life. This is applicable and universal to everyone. So if you like the title and you clicked on, thank you so much and I hope you enjoy this listen. 

As part of this Protrusive Student episode, Emma has released her orthodontics for students notes. So in the Crush Your Exam section of the Protrusive Guidance app, there’s a section just for students.

Basically there’s little student forum there. It’s like an up and coming area. So if you’re a dental student, you want free access, please do join the app and email student@protrusive.co.uk proof that you’re a student. And then get, also, get access to the Protrusive Vault. That’s where all our infographics and everything live.

That’s how all community service to students. Emma’s just has done a wonderful job of sharing all her notes, so it’s about, I think 14 or 15 sets of notes on there from dental materials to indirect restoration to now orthodontics for students, and if you’re just a geeky dentist that just wants to download them and read them, then you can totally do that as well. Head over to www.protrusive.app to get started with Protrusive Guidance. Those sections I mentioned are absolutely free. 

In this episode, Emma and I discuss so many themes, and what’s striking is that Emma’s time as a locum nurse, so she’d go to different clinics when she was called and she’d nurse for like a new clinic every time, for example, and I asked her, did you ever come across any miserable dentists?

Any dentists that just looked really burnt out or unfulfilled in their profession? Which I think is a really sad thing, right? Everything we do in this podcast is about making dentistry tangible. But also reigniting your passion for dentistry. Reconnecting with that feeling you used to get in your belly when you wanted to get into dental school.

I think it’s really important to just remember that feeling. ‘Cause that sometimes helps us to drive us through a difficult patch. But when I ask Emma about this, and she noticed certain trends, certain qualities about the dentist or the practice that she knew within 10 minutes that, okay, this practitioner is burnt out or this practice lacks a culture, and that’s very relevant to work-life balance and priorities and setting boundaries and all those things. So a big higher level discussion today, and it’s laced with themes like burnout, goal setting and setting. Really importantly, what are your non-negotiables in life? It’s really important to do that, but of course you’ll see that all in the main episode, which will check out now, and I’ll catch you in the outro. 

Main Episode:Emma, happy New Year 2025. Welcome back to the show. You are the Protrusive Student, so tell me what student thinks have been up to over this Christmas and New Year period.

[Emma]Over my Christmas and New Year, I’ve been trying to enjoy it, obviously, and I have enjoyed it, but I just know that my big exams are around the corner, so I have been doing work every now and again, just keeping on top of making lecture notes and flashcards and all those sorts of things, but I’ve just not been overwhelming myself. So, that’s what I’ve been. 

[Jaz]You need to share these flashcards with the students if you’re comfortable to do something. 

[Emma]Yeah, yeah. I use Quizlet for my flashcards. I know a lot of students use Anki as well. I think that’s quite a popular one. 

[Jaz]But think these are all digital things, right? 

[Emma]Yeah, all digital. 

[Jaz]A flashcard on old school still means like in a paper and pen like I used to back in the day. 

[Emma]So, no, it’s all there on there. So. 

[Jaz]Good. And so it should be so great, if you’re happy to do so, ’cause you’ve been sharing your notes so generously, whenever is the best time for you to share those to the students who will help someone in the world to help pass their dental exams, which would be good. Today we’re talking about a different topic as you requested. Basically the story is, guys, Emma wanted an episode on like the student perspective of orthodontics, and I thought that’s gonna be so difficult to do.

Right? Like, I was extractions, one was a real success and extractions went really well. But you asked me about ortho, like I think, I won’t be able to help you as a student. When you come to your first ClinCheck and your first, it’s all conundrums.

Is this possible with liners or should I refer? I’ll be able to help you then. But actually at the student level, it was always a blur what they wanted and yeah, orthodontics was very, very confusing as a student, I have to admit. 

[Emma]That is fine. That’s fine. For this episode anyway, we’ve made like orthodontics student notes for this episode, so. We’ve still got our format. 

[Jaz]They can download him in the Crush Your exam section of the Protrusive Guidance app. But the topic chosen by Emma was an interesting one, actually. Work life balance. So what spurred that one? 

[Emma]Probably inspired from my Christmas period and my mom’s like, oh, come watch a movie. Come watch a movie. And I’m like, oh, give me an hour. I’m sitting down doing work, blah, blah, blah. And it’s just, I’ve had on my minds that I do have exams coming up. I th...]]> 0:54:45 false https://podcast.show/protrusive/episode/143482035/ 143482035 https://protrusive.co.uk/?p=8354 Jaz Gulati Wed, 19 Mar 2025 03:10:08 -0400 Your apex locator isn’t giving you a zero reading. Your file is stuck. You’re wondering—have you ledged? Or could something else be at play?

In this must-listen follow-up episode, Dr. Samuel Johnson returns to tackle the biggest endodontic dilemmas left unanswered from part one. If you haven’t checked that out yet, go back and listen—it’s packed with insights on working lengths, apex locators, and even the role of consent in endodontics.

Now, in part two, we go deeper. We’re talking blockages, ledges, portals of exit, and the mysterious phenomenon of file gripping. Plus, Dr. Johnson takes on your burning questions from the Protrusive community—like how he responds to biological dentists claiming root canals should be avoided entirely. (Yep, we’re addressing that controversy head-on!)

Protrusive Dental Pearl: For a more visual learning experience, dive into the Pre-Endo Build-Up on Protrusive Guidance and see Jaz and Samuel’s insights in action.

Sonic Pro Ultrasonic Bath – 10% OFF with coupon code ‘protrusive10’

Improve your Bond Strengths – purchase while stocks last: Sonic Pro Discount

Key Takeaway:

• General dentists often overlook the importance of taper.
• Removing too much dentin can weaken the tooth.
• GP cones can be unstable and affect the procedure.
• Reshaping GP cones can often resolve length issues.
• Pre-bending GP cones can help navigate tight curves.
• Biological dentists have controversial views on root canals.
• It’s essential to prioritize the patient’s best interest.
• Using endo frost can aid in manipulating GP cones.
• Consent should be informed and comprehensive.
• Communication between referring dentists and specialists is vital.
• Continuous learning is essential for dental professionals.
• Ultrasonic activation improves endodontic outcomes.
• Pulpotomy and root canal treatments have distinct indications.
• Building a supportive community can alleviate feelings of isolation in dentistry.
• Dentists should charge for their time and expertise.

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

Highlight of this Episode:

• 01:03 Protrusive Dental Pearl
• 01:49 Common Scenarios and Tips for Young Dentists
• 05:30 File Gripping and Canal Anatomy
• 08:30 Master Apical File: The Common Dilemma
• 11:18 GP Cone Issues and Solutions
• 17:03 Addressing Root Canal Myths 
• 23:35 Cracks in Teeth: Prognosis and Treatment
• 25:44 Ninja Access Cavities: Pros and Cons
• 28:21 Common Mistakes in Emergency Endodontic Treatments
• 33:51 Obturation: Overextended vs Short
• 34:41 UltraSonic vs Sonic Irrigants
• 36:15 Pulpotomy and General Dentistry
• 39:25 Building a Dental Community

As promised, here are the ESE Guidelines on managing cracked teeth.

Watch and learn from Dr. Samuel Johnson on Instagram and YouTube!

Don’t miss the first part of this series: PDP216 – Working Lengths and Troubleshooting Apex Locators

#PDPMainEpisodes #EndoRestorative #BreadandButterDentistry

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

This episode meets GDC Outcomes B and C.

AGD Subject Code: 070 ENDODONTICS (Emerging concepts, techniques, therapies and technology)

This episode aimed to provide deeper insights into troubleshooting endodontic challenges, particularly when files fail to reach working length. It explores common pitfalls, advanced techniques, and expert strategies to improve clinical outcomes in root canal treatments.

Dentists will be able to –

1. Recognize common endodontic challenges and strategies to navigate them effectively.

2. Evaluate the role of master apical files and resolve common dilemmas in achieving optimal shaping.

3. Identify frequent errors in urgent cases and improve treatment approaches.

Teaser: So your size 10 file is stuck. It's not going to length and you're not getting a zero recording on your apex locator. What do you do? Have you ledged? Or could there be another reason for this? This is where we answer that question leftover from part one.

[Jaz]So if you haven’t watched or listened to part one yet, check it out. It was a great introductory episode. We talked all things, working lengths, apex locators, career and consent in Endo. So do check out part one. 

In this part two with Dr. Samuel Johnson, gosh, he loves Endo, doesn’t he? And it’s infectious, right? You can totally feel that. We’re going to talk about blockages, ledges, different portals of exit and a phenomenon called file gripping. Then Samuel answers all the questions from you guys, the Protrusive Community.

You guys asked some fantastic questions and it was a great pleasure to ask him all those. One of which what does Samuel think about those biological dentists who are suggesting that root canals are bad and that no one should have a root canal? I know, it’s crazy, but how does Samuel handle those kind of patients? We go deep in all the little facets and details of all things endo. Thanks again for all your questions, guys. 

Dental PearlThe Protrusive Dental Pearl for this episode is you need to see, if you haven’t already, you need to watch my pre endo build up video. It’s so relevant to everything that me and Samuel are discussing.

And that video was published just a few weeks ago as part of my POV clinical walkthrough series. You see my full video walkthrough of a couple of cases where I do a pre endo build up and do like a screen recording and interjection and running commentary of everything I’m doing. Very similar to wonderful videos that Samuel makes.

So I’ll put the link to that in the show notes if you haven’t already seen that. If you happen to be listening on Spotify or Apple, then do check out the video on the Protrusive Guidance app or just type in on YouTube, Pre Endo Build Up Protrusive. You will find it. Let’s not delay getting to the main part of the episode. I know you’re going to love this just as much as you loved part one. Let’s go with Samuel Johnson. 

Main Episode:Just talk about the common scenario that you want a young dentist to appreciate that when they feel encountered scenario. A great tip there is don’t force it. Slow down, retract because you don’t want to make it worse. And that’s a top tip already. 

[Samuel]So I would say, have you reached zero or not? Cause you can get a canal. I’ve had one yesterday. I did distal buccal, which was 17 millimeters and in length. So if you have already reached zero and then at 18, you’re getting this hard stop. You have probably likely ledged it, but don’t panic. 

I think we might move on later on to talk about managing ledges, but if you haven’t already reached zero with your apex locator, I think the best thing to do first is just estimate where you are actually within the tooth. So, you can estimate the working length in many ways.

You can use a radiograph, although, sometimes if you can learn how to draw how long it is on your radiographic software. It’s not perfect, but it kind of gets you in that kind. It’s a useful estimate, isn’t it? Another thing as well is, if you’ve got a multi rooted tooth, you say you’ve got a lower six and you’ve got a mesial buccal and you’ve got a mesial lingual.

If the mesial lingual is 19 millimeters or say the mesial lingual is 22 millimeters and you’re getting stuck at 18, you’re probably short. And also take a working length radiograph. I did say I don’t take them, but I do, do take them. Cause sometimes my apex locator is all over the place. And I don’t know why. And sometimes it’s good. 

[Jaz]This is the one that you said is not routinely advocated by FGDP, but sometimes when you’re getting erratic measurements and just to verify. That’s when you would take it with and you are doing it with a size 10 because obviously you’re stuck there. Is that right? 

[Samuel]Yes. Yeah, absolutely. So say you are near to the end. Okay, this could be a ledge. It could also be complicated anatomy that the x ray is not going to show these many portals of exit. And I would say a really really common sign that it is complicated anatomy, not a ledge is that you get that kind of sticky feeling.

So it’s a hard concept to kind of...]]> 0:44:11 false https://podcast.show/protrusive/episode/143143288/ 143143288 https://protrusive.co.uk/?p=8304 Jaz Gulati Tue, 11 Mar 2025 03:17:00 -0400 What makes apex locators reliable—or completely misleading?

How do you determine the true working length of a root canal?

Why is relying solely on radiographs for endo success a risky move?

Dr. Samuel Johnson joins Jaz for a game-changing episode that will make you rethink everything you know about endodontics. In this first part of a two-part special, they dive into the nuances of apex locators, the difference between the radiographic apex and apical constriction, and why our radiographs might be lying to us.

They also explore the power of glide path files, how to improve your endodontics workflow, and an incredible way to consent patients—something that extends beyond just root canals. Because mastering endodontics isn’t just about technique—it’s about communication, precision, and making the right calls for long-term success.

Stay tuned for Part 2, where we go even deeper into endo essentials!

Protrusive Dental Pearl:  Buy a small whiteboard and marker for patient communication. Draw details, highlight the treatment plans, and list pros, cons, and fees. This builds trust, improves consent, and makes treatment clearer. Snap a photo and upload it to the patient’s records.

https://amzn.to/3DzUJfn

Key Takeaway:

• Understanding the difference between radiographic and anatomical apex is crucial.
• Apex locators are essential tools for accurate working length measurements.
• The anatomy of the root canal system is complex and requires careful navigation.
• A well-informed patient is more likely to have realistic expectations about treatment.
• Glide path files can significantly reduce treatment time.
• Avoid forcing files into hard stops to prevent damage.
• Complicated anatomy can lead to unexpected challenges during treatment.
• Taking radiographs can help clarify uncertain situations.