Protrusive Dental Podcast

A fun little comparison episode discussing the differences between Dentistry in the States and in the UK – in this episode I am joined by the host of Dentistry Rising podcast, Dr Bette Robin! https://youtu.be/N_u8LkD8EnY Dr. Bette Robin, who desired to make a massive change in her life and left clinical Dentistry some years ago and went in to Law and practice sales – she never looked back!  Join us in this light hearted discussion where we chat about: Cultural differences in USA vs UK Dentistry – dental school, earnings, biggest barriers, treatment plans How the national health systems compare Finding different paths out of Dentistry How to become a better communicator SplintCourse update: Enrolment ends on Monday 21st June! Enroll now by clicking here to join a community of Dentists around the world who want to End Splint Confusion!  If you enjoyed this episode, then do check out Dr. Bette Robin on her Dental Rising Podcast You might also enjoy The American Dental Dream – PDP002 with Dr. Kristina Gauchan!

How to do Deep Margin Elevation? What are the most important factors in achieving high bond strengths for our restorations? I sometimes look at modern onlay preps and think, ‘God MUST exist’, because I think it’s a miracle how these flat, table-top onlays stay on! I am joined by a world-famous educator in Biomimetic and Adhesive Dentistry: Dr David Gerdolle David Gerdolle, based in Switzerland, introduced me to contemporary ceramic onlays 8 years ago. It took me 3 years to convince myself the techniques would work in my hands! In this episode I want to fast-forward your progress so you can gain more perspective on adhesive restorations and DME (Deep Margin Elevation). https://youtu.be/cOkEAaawgdI Super pragmatic and scientific bonding principles! Protrusive Dental Pearl: How can you show patients what shorter anterior teeth might look like to them discing them down? Use a black Sharpie marker, colour in the part of the edge (maybe 0.5-1mm) that you’re considering removing. Take photograph and show it to them! It helps if their mouth is open for the photo so we see the dark backdrop of the oral cavity. With the knowledge of Dr. David Gerdolle and biomimetic dentistry, we discussed how it is possible to bond a material to the tooth structure in those ‘table-top’ style, flat onlays.  It doesn’t happen magically. It’s about the nitty gritty detail, the micro steps and respecting certain criterias. “If you don’t remember anything of your bonding protocol, just remember that, it has to be clean and rough” – Dr. David Gerdolle Clean and Rough, that’s it right there! In this episode, we also talked about: Failures in using biomimetic dentistry and what we can learn from that How these restorations have resistance form Bonding protocol step-by-step for adhesive dentistry Deep Margin Elevation – how to do it As promised, DM me on Instagram @protrusivedental for the PDF copy of the steps of deep margin elevation.  If you enjoyed this episode, then do check out Dr. David Gerdolle for more courses. You might also enjoy Ceramic Onlays from Preps, Temporisation and Bonding Protocols by Nik Sethi!

‘The Riches are in the Niches’, apparently. In the last episode we already touched on the topic of finding your niche but this time we were able to dive deep in to this. Will your career sky rocket when you find your niche? Or are you better off being the jack of all trades?  What are the benefits of finding a niche, how to go about it? And what does it ACTUALLY mean? https://youtu.be/aGniihvrNpg Protrusive Dental Pearl: a Challenge for you – grab a pen and paper and write down ALL the clinical procedures that you LIKE to do, and then also what procedures you would like to do MORE OF. Figure out where your niche could lie. And don’t forget, it’s not a race! It helps helps to make a list of procedures that don’t excite you (for me, I have no affinity to facial aesthetics!) My guest, Dr Pav Khaira is a MASSIVE geek and I loved that he quite openly admitted to failure in the past and helped us learn some lessons. I also enjoyed hearing that it is TOTALLY FINE to change your niche as you mature as a clinician. In this episode, we talked about: Being a super GDP vs niching down? Young dentists rushing to find their niche Is it okay to niche too soon or is too late to find your niche? The opportunities of learning Becoming a ‘go to dentist’ The downside of niching  If you enjoyed this episode, then do check out the Dental Implant Podcast by Dr. Pav Khaira. You might also enjoy 6 Signs You are a Comprehensive Dentist!

When I see an already beautiful smile plastered with Composite Veneers, it makes me a little bit anxious. I think that maybe the patient just ‘needs’ minor edge bonding and teeth whitening. In our latest podcast, we are very lucky to have such an amazing, high caliber dentist and we get to hear his take on composite veneers. It’s none other than George Cheetham aka George The Dentist. You’ll also get to know a powerful communication/consent tip that I will implement in my workflow straightaway. https://youtu.be/k–Wjqjg2S4 Protrusive Dental Pearl: I love the Eve Twist Composite Polished by DiaComp (Not sponsored by the way). It’s my favourite polishers in the whole world. If you are looking for a new polishing system for your composites, you should definitely try the Eve Twist. It gives a high lustre relatively quickly. Check them out. In this episode we discussed: Establishing a practice as a young dentist George’s take on composite veneers Finding your dental niche Tips and tricks in managing your case documentation (and social media) Dealing with and treating fellow dentists Breaking down biomimetic dentistry George’s rapid quick fire about anything and everything dental If you like this episode, you’ll also like Alan Burgin’s Journey with a Young Dentist!

‘An average Dentist working with an excellent Technician can go very far’, was the message my old training program director gave me. Technicians are often the unsung heroes whilst the Dentists collect all the praise and accolades. Who do we blame when things go wrong? Our technician, of course! Not fair at all – this is why I welcomed RDT Graham Entwhistle of Trueform Dental Laboratory to air his frustrations at Dentists – you will pick up some great tips here to improve your working relationship with your dental technician! https://youtu.be/NRDdRCg-9QI How to work better with your dental technician Protrusive Dental Pearl: Use websites like Loom or even Whatsapp to communicate with video and voice with your technician. Great, clear communication will ensure expectations are met for both parties. SPOILER – the 5 things that Technicians wished we Dentists knew: Dentists need to improve their communication! Back to basics – if you want better work, you have to fill a better prescription form. Even just the lack of basic info drives technicians mad! We also discussed about Ivoclar Ingots for your ceramic Make sure your tooth preparation is appropriate for your material selection! Decide the material BEFORE you prep the tooth! Your impressions need to be clearer please! Do you always check for distortions, drags or voids? Could you consider trying Impregum? Shade guides – they can vary and can discolour over time. It’s important to ensure the shade guide matches your technician’s and the materials they use. Acrylic shade guides will discolour over time! We share some shade taking advice for Dentists Do you etch your own ceramic? If not, why not? Take control of your bonding, consider etching yourself to prevent ceramic over-etching. You can’t hold your technician accountable for your bond strength! Check our Graham’s work on Instagram! If you liked this episode, you will also enjoy the classic with Jason Smithson on eMax Onlays and Vertical preps!

Lower Complete Dentures are the bane of Removable Prosthodontics. I know many Dentists who ‘hate making lower full Dentures’, likely because they are difficult to master. So difficult that I got Dr Rupert Monkhouse to give the Protruserati a podcast masterclass on how to improve in this frustrating area of Dentistry! https://youtu.be/cW41CHiLgGI Why won’t you stop floating, damn you! Protrusive Dental Pearl: The power of silence! When you present your patients a solution or treatment plan, or tell them the fee, there may be a silence. Embrace it. Expect it. Don’t panic. This is normal! DO NOT but in with a ‘why don’t you just think about it…’ In this episode we discussed: How can you predict if a suction lower denture is anatomically possible? What materials Rupert likes to use What and how to adjust at the Try in stages of complete dentures How to get the wax try-in to stay in the mouth! Communication pearls surrounding lower complete Dentures If you enjoyed this topic, why not also check out the Master himself, Dr Finlay Sutton on Troubleshooting Chrome Dentures! For details on Rupert’s Denture course, DM him on Instagram! https://www.instagram.com/dentistrupert/

Dentistry is busy. How can we make sure that we live a balanced and fulfilled life in our hectic profession? As an associate, I am already struggling with time, I often wonder how practice principals and specialists play this game?! I am joined by my dear friend, Dr. Ricky Bhopal Specialist Prosthodontist to discuss how we work smarter and not harder. https://youtu.be/KpsHgDR2q6M Work Smarter Protrusive Dental Pearl: Do you carry out virtual consultations with your patients to discuss Orthodontics (Invisalign) or Smile Makeovers? How do you make notes for this? I am enjoying using Otter.ai to transcribe our Zoom virtual consultation In this episode we discuss: Ricky’s top tips to be productive and overcome procrastination How to make time for our loved ones and hobbies What is green space and why is it so important? How can we live a more fulfilling life as a Dentist? If you enjoyed this episode, you will enjoy How to Win at Life and Succeed in Dentistry!

We wrap up STRAIGHTPRIL with a HUGE one – what makes aligners predictable? How can we make aligner treatment protocols efficient starting right from the planning stages and the Clincheck. I am joined by a fellow podcaster and specialist Orthodontist Dr Farooq Ahmed who is a wizard with Aligners! https://youtu.be/FL1nDqYX7Ls Make Aligners Predictable Again – Donald Trump Protrusive Dental Pearl: Use floss to create loops and use a chain retainer, like Ortho-Flextech which has made it much easier in my hands! In this episode we discussed: How to pick the winning cases Which movements are tricky and how we can overcome them (including deep bite!!) Should we overcorrect expansion? What is Farooq’s take on elastics and aligners? Clincheck golden nuggets! Do check out Farooq on Ortho in Summary Podcast! If you liked this episode, you should check out IPR for Dummies with Dr Devaki!

As you get more experienced with clear aligner therapy you learn a universal truth about those pesky lateral incisors that will refuse to extrude! I am joined by Dr Robin Bethell from Aligner Nation to help us learn more about the use of Elastics as auxiliaries for Clear Aligner protocols. https://youtu.be/mOADKbT1uyo Dr Robin Bethell might surprise you! Protrusive Dental Pearl: The Bethell IPR Technique! Click Here for the Video of how Dr Bethell uses the bur for IPR Interestingly, Dr Robin Bethell has not used intermaxillary elastics for over 3 years. He primarily uses them for vertical movements. I personally have used them extruding lateral incisors, which works very well. Here is the video to share how to extrude lateral incisors with elastics: https://youtu.be/eAsbJBvYA2I 1/8 inch and 3.5 Oz would be ideal We also discussed: Common causes of Posterior Open Bites during aligner treatment How to manage Posterior Open Bites (the key is diagnosis) The role elastics play in clear aligner treatment Dr Bethell’s views on GDP Orthodontics Here is the link to the evidence base Dr Bethell referred to Be sure to follow Robin Bethell on Insta and check out @protrusivedental for more if you enjoyed this, you will also like Comprehensive vs Compromised Orthodontics as part of the Straightpril series!

Is it possible to be a Comprehensive Dentist on the NHS? How did Dr Devang Patel rise within NHS Dentistry to provide high level, complex care to his patients? https://youtu.be/Wy3NiZVa-3U Only on Protrusive Website Protrusive Dental Pearl Free Communication course by Dr Devang Patel >>>click here<<<< Free for Protruserati! Sponsored: If you want to provide your patients with written treatment plans that looks amazing and are easy to understand, do a 21-day free trial of MakeMeClear and see for yourself why I love it so much. Use code ‘protrusive’ for 25% off MakeMeClear (it works after you submit payment credentials) In this episode we hear Dr Devang Patel’s journey from working in a 99% NHS clinic to now carrying out complex general Dentistry at a very high level. I quizzed him on how it’s possible in a public funded system? If you enjoyed this episode, you will like the Case Acceptance in Smile Design episode with Gurs Sehmi!

Our views on Retention have changed over the decades – it is now regarded as a lifetime commitment and Dentist are getting good at letting patients know this from the start. In this episode, I ask Dr Angela Auluck questions from the Protrusive Dental Community as well as talking clinical steps of fiddly fixed retainers. https://youtu.be/BoZyHo9RGjY Dr Angela on Orthodontic Retention Protocols Protrusive Pearl: The Harridine paper helping to explain that wisdom teeth likely do not cause lower incisor crowding. In this episode we discussed: Fixed retention vs Removable Retention Why retention is individual to every patient Tips on placing Fixed retainers correctly What is the best retention on expansion cases? When should you consider a Hawley Retainer? I hope you are enjoying the Straightpril series of episodes! If you liked this episode, you will also enjoy Dahl Technique Part 2 with Tif Qureshi!

When it comes to direct composite restorations, shape is more important than shade. Mastering primary anatomy with well defined line angles is the difference between mimicking nature or ending up with flat white blobs with no definition. In this Group Function I’m joined by Dr Matt Parsons who answers the following question from the Protruserati: Once you have drawn on the desired line angles, how would you suggest to really define them? When using bur or disc I tend to find I get a result which is rather flat and lacks line angle definition. Dr Devin Firstly, if you don’t already follow Dr Matt Parsons on Instagram….you will now, and therefore you’re welcome. It’s dental porn. https://youtu.be/CFvmFm5FhQk Dr Matt Parsons on Nailing Line Angles If you have any other questions that would make a good group function, please do message me on @protrusivedental Instagram page or the Facebook Page If you enjoyed this, you will like my 3 reflections on a Composite Veneer case.

How does Orthodontist Mandeep Gosal feel about GDP ‘Alignment Only Orthodontics’ – in this hilarious episode (where I compared Orthodontists to builders) Mandeep ‘Gos’ shares his thought provoking views on how Orthodontics should be carried out (and how it shouldn’t!) https://youtu.be/eH_gfNc0IqY This episode will be ‘unlisted’ on YouTube so it cannot be searched. For lots of reasons. Protrusive Dental Pearl: For better portrait photos (Extra-oral) – point the ring flash to the ceiling! I use F8.0, ISO 800 with my Canon 60D body, 100mm lens and Canon Ring flash. This is the difference in lighting compared to point the ring flash at the face: One of the best bits from this episode I thought was Gos’ description of the 3 types of consent being carried out for Orthodontics. Which one did you identify with? If you enjoyed Mandeep Gosal’s style of teaching, do check out his Orthodontic course for GDPs. If you enjoyed this episode, you will also like 5 Lessons from Lincoln Harris where we also discuss consent in Dentistry.

We don’t refer all our extractions, root canals and crowns – then surely there is a role of GDPs to carry out Orthodontics? In the last 10 years we have seen a boom in GDP Orthodontics and much of this is ‘Alignment Only Orthodontics’. Protruserati, welcome to Straightpril! https://youtu.be/EuHTN4CXCxs Dr Nick Simon shares his journey and advice with Jaz In this episode we discuss: How GDPs can get involved in Orthodontics Which, according to Dr Nick Simon, is the best Orthodontic system for GDPs? His views on all the Dentists jumping on the Invisalign bandwagon How significant is the loss of anterior guidance in ‘STO’ (Short Term Ortho) cases The 2 most common mistakes GDPs make while carrying out Orthodontics Sponsor: Did you check out the Mini Smile Makeover course? You can attend again in the future at no additional cost – THAT’s awesome! Protrusive Dental Pearl: I use the Beauty and the Beast Mirror to ask patients what they hate most about their smile. It injects personality and humour – but you also find out exactly what the patient does not like about their smile! If you enjoyed this episode, you should also check out Are Class I Molars Important? With Dr Mo Almuzian

Canine guidance is overrated. Read that again. Crazy, I know. In this episode, one of my mentors Dr Riaz Yar explains the rationale of a functional occlusion whereby the pillars are the central incisor and the first molar. https://youtu.be/aQRQ43R4Obg Dr Riaz Yar is SUCH a good Educator I found some similarities to the Posterior Guided Occlusion (click to listen to the episodes by Dr Andy Toy) in that we place too much emphasis on canine guidance. Protrusive Dental Pearl: There is no joy in mediocre Dentistry Dr John Kois I hope you find this episode stimulating – and if you are a true protruserati, you will be grateful for another point of view AND NOT be upset that we all can’t agree with each other, haha! Stay tuned for STRAIGHTPRIL! Did you miss out on SplintCourse enrollment? It will be relaunching in June – click here to register for the launch offer Check out Dr Riaz Yar’s courses here – his book will also be launching in Q4 2021 – watch this space! If you enjoyed this episode, check out Posterior Guided Occlusion with Andy Toy!

This is THE most common question I get – ‘Jaz, can you just tell me which camera to buy for dental photography, I am so confused!’ I’m no mug when it comes to Dental photography, but I wanted to get a real expert to help answer this important question. I present to you Alessandro Devigus from Switzerland who owns the @dentist.camera Instagram page (which I love). https://youtu.be/q3VkbMLhsn8 I was shocked that he recommended a Mirrorless set up – but I totally understand his rationale. Here are the links to the products he mentions: Budget Setup Nikon Z50 Mirrorless Camera Body – ensure the kit comes with a FTZ Nikon adaptor so it works with the lensNikon 85mm Macro Dx LensMieke Ring Flash for Nikon Budget setup for excellent Dental Photography The ‘Posh’ Setup A Canon or Nikon Full Frame camera, with a 100mm macro lens and 2 x flashes mounted on a bracket – pick your favourite brand eg Nikon or Canon. It’s all good! If you enjoyed this episode, you may also enjoy the IMPORTANCE of taking photos in your Dental Journey, check it out!

You place some veneers and your patient leaves in tears of joy. Imagine getting a letter a few weeks later to tell you that the patient now HATES her veneers and would like a full refund. That is soul destroying stuff, and it’s NOT about the money! https://youtu.be/LCAhjm9ymy8 Dr Rhode to the Rescue! Within the context of this specific scenario where 6 veneers were placed, we discuss: A. How this could have been prevented B. How to handle the veneers that are ‘bulky at the gumline’ C. How to handle this refund request…! I want to thank Dr Manrina Rhode for yet again adding so much value for the Protruserati You can check out her course on Designing Smiles website If you liked her episode and want a full hour of Veneers from preps to Temps, check out Everything Veneers with Manrina Rhode

I gave Manuela Rodrigues one task: to reduce the stress levels of Dentists and the Dental team who listen to this episode. https://youtu.be/cNY_2QLWTuI With Mindful.Dentistry Manuela I know what you’re thinking…the whole positive mental attitude thing goes straight out of the window when a file has separated or the palatal root of the upper molar has been swallowed by the sinus. This is why I wanted Manuela to make this a highly relevant to the daily stressful scenarios we face. How can we make our profession less stressful, Manuela?! I pitched to her 3 different scenarios: When things are just not going right at work – think of TOUGH treatments/patients Litigation. Having a case over your head is one of the most stressful, gut-wrenching, confidence-destroying experiences a Dentist can have. Running late. I am SOOOO guilty of this and is the number 1 daily cause of stress for me! As Manuela promised, you can get 25% off her Mindfulness in Dentistry training by using the code ‘protrusive’ Do follow Manuela @mindful.dentistry on Instagram If you enjoyed this episode, you will like 10 Habits of Highly Successful Dentists

‘What on earth is Clubhouse?’ I hear you ask. Well, it’s kind of like being in a Whatsapp room with Richard Branson…and instead of typing you’re all just leaving live voicenotes. It’s like a Live Podcast and you get to contribute (sometimes). It’s also like a cult – it’s super addictive and invitation-only (at the time of publishing this). https://www.youtube.com/watch?v=s9POp8N9-Os Kevin Rose – who helps Dentists ‘Think’ My favourite thing about Clubhouse is that sometimes you’re not in the right state or environment to be on video – this audio-only platform has gained a lot of popularity! I have seem some great Rooms (like a Whatsapp group) within Dentistry where a lot of knowledge bombs have been dropped. There is something beautiful about Live content that is difficult to get a replay for – the FOMO factor is real! In this Interference Cast I am joined by Kevin Rose who helps drive better conversations in Dentistry. TLDR: I think Dentistry has a home in Clubhouse – we can learn and share great content (live podcast, right?) – we can also use it to change public perceptions of Dentistry. It’s probably not going to land you many patients in your chair, if that’s why you’re on it. You need to see a bigger picture!

Two ‘TMJ Queens’ in Two Days – another tribute to International Women’s Day last week and what better than having Dr Priya Mistry from USA who has limited her practice to the treatment of Temporo-Mandibular Disorders. https://youtu.be/FGVSbFjFrlw Step by Step Examination Protocol I first discovered Dr Priya Mistry’s fantastic content on YouTube – I really enjoyed her style of content presentation. I quickly saw her grow on this platform and help so many of the public with their TMD concerns. I realised that a lot of what she has to share is not just helpful for patients, but is really useful and helpful for Dentists, especially as many of us find the TMJ to be a mystical joint! I probe Dr Mistry about her full examination protocol for a typical TMD patient so we can gain insight in to how Dentists limited to TMD get to a diagnosis – arguably the trickiest part! Some parts of her specialised exam is already familiar to us – the usual palpation and range of motion measuring. Other parts are very different, such as measuring leg-length and really analysing the postural chain. Also, there are a lot of pre-appointment questionnaires that patients need to fill in advance of the appointment. The main take-home from this episode is to figure out when to treat TMD patients yourself in practice, and when to refer to someone like Dr Mistry. I enjoyed her ‘4 levels of TMD’ which was very easy to follow. If you enjoyed this episode, do check out the episode with Dr Gurs Sehmi where I probe him for the full protocol examination for his Smile Makeover treatments! Enrollment for SplintCourse ends on Friday (thanks for all of you who joined from around the world!) I look forward to catching you on the Monthly Live Webinars:

When it comes to the management of Temporo-manidbular Joint Disorders, we often NEED to adopt a multidisciplinary approach. I am a strong advocate of Dentists involving TMJ Physiotherapists (yes, they exist!) to help their patients. In this episode I am joined by The TMJ Physio Krina Panchal! https://youtu.be/5KcMOfdoDhg TMJ Physios are invaluable in the multidisciplinary management of TMDs Interestingly enough, Physiotherapists in the UK do not cover the TMJ in their studies – it is a postgraduate niche that Krina has travelled the world to learn – which is why I respect her even more! Protrusive Dental Pearl – have you checked out the ‘Bruxchecker’ foil as a tool to help diagnosis of Bruxism and much more? I comprehensively reviewed this product and thought it was very clever! https://www.youtube.com/watch?v=eQLGFc82EM0 In this episode I ask Krina: Whats the evidence that Physiotherapists can help our TMD patients? What does she think is the biggest aetiological factor for TMD? What is the most common diagnosis she makes, and what is her management of that diagnosis What should a Dentist do if, after a long procedure, the patient gets acute disc displacement without reduction? What kind of cases should we be working with physios for? I will add the promised downloads on to the Protrusive Dental Community Facebook Group (are you part of the Protruserati?!) If you enjoyed this episode, check out Stay Away from TMD – why you should think carefully before niching down to TMD as a Dentist. If you want to learn about Occlusal appliance as a protective appliance, to help with pain or as part of pre-restorative management, do check out the SplintCourse which launched a few days ago with a big bang! https://www.youtube.com/watch?v=2-Yt5YmEyes Click here to download the full Course Outline Enrollment ends 19th March at 10pm UK time so I can focus on Monthly Coaching! Thanks for your support, Protruserati! Enroll now to SplintCoure Online to finally understand Occlusal appliances!

How do you obturate yours? When I have had the equipment (and training) I have used warm vertical compaction – no doubt that IS the gold standard. However, what is the humble GDP using all over the world? I would argue that not only are we using cold lateral compaction with sealer, but in many cases, we are sticking a big, fat, tapered GP cone in the canal with a splodge of sealer around it. Is that legit? https://www.youtube.com/watch?v=GkWR7XzTHCs The million dollar endodontic question that no one asks! Obviously the landscape is changing with the popularity of bioceramic sealers in Endodontics – I use this time to ask Dr Ammar Al-Hourani about this too. Is single point obturation cheating? Should GDPs start using bioceramic sealers? Does it even matter? I hope you enjoy this group function – you can follow Dr Al-Hourani on Instagram via @theendoguys If you enjoyed this, you might also like my episode with another talented Endodontist, Kreena Patel, on why we hate cracked teeth!

Sometimes associates moan that they can’t improve their Dentistry or provide better outcomes because their principal/corporate will not buy them that fancy composite/instrument/air abrasion unit/orange floss (okay maybe not the last one!). Here’s a tip: buy it yourself! https://www.youtube.com/watch?v=JQKiaZgHbk4 I’m not saying you should go crazy and buy ALL your materials – thats the role of the practice – but if after having a good conversation with your principal about investing in the new gear and it is not bought for you….there are some major advantages of buying it yourself. In this episode I am joined by Dr Rosh Panju who, as an associate, bought his own intra-oral scanner (iTero) – that speaks volumes about his mindset. In a nutshell, this episode is about making your own luck. For those asking about where to buy the ‘associate box’ to transport kit between practices, here it is: https://amzn.to/3v1li3S If you enjoyed this episode, you will like the episode on Emotional Intelligence with Richard Porter – check it out!

No Ferrule? No problem! Dr Peter Raftery, Endodontist, discusses the contemporary use of the ‘Surgical Extrusion Technique’ to make hopeless teeth restorable. Crazy, I know, so take a listen because the science makes sense! https://youtu.be/gXN-2tgxtbU All the way back in Episode 9 with Dr Aws Alani (Restorability with a Restorative Specialist) we briefly mentioned this technique in passing…which led to a cascade in events and Dr Raftery reached out to me with enthusiasm because I called out to the audience if they knew anyone using this technique! I love that! Essentially you are (gently!) extracting a tooth and then intentionally re-implanting the tooth, except this time you are going to be a little greedy and ‘grab’ some ferrule. Then, a customary Root Canal Treatment 2 weeks afterwards, and you have yourself a restorable tooth. As someone who loves saving teeth, this is just fantastic. We know the science works because we DO re-implant dirty, grotty avulsed incisors of 12 year olds with some decent success rates. Protrusive Dental Pearl: have you used Viscostat clear? It is my preferred astringent and will not interfere with bonding How to restore teeth which appear to be restoratively hopeless aka no Ferrule Compared to SCL or Ortho extrusion – could this be more cost effective and less invasive? Surgical Extrusion technique – either with humble luxator or a posh Benex device I will have to add the resources later – right now I am running late for work!

I recorded an Instagram Live with Dr Prateek Biyani of The Dental Notebook to answer a question sent in from the Protruserati: Hi Jaz, I hope you are well. I’m working as a NHS associate for nearly 3 years and I was thinking whether it’s worth doing DCT training or if it’s better to keep up with private courses to improve skills? Anonymous question from a fellow listener https://www.instagram.com/tv/CKRxwRGJv6H/?utm_source=ig_web_copy_link Full IGTV Video Listen to find out what me and Prateek recommended! Check out Prateek’s new book, Single Best Answer Questions for Dentistry! If you enjoyed this episode, you might also like Making your Dental Portfolio by Jaz

The ORE exam to practice Dentistry in the UK is not easy – listen to Yazan Duedari’s top tips to pass this gruelling 2-part exam and find out what the ORE Exam has in common with a Beyoncé concert! https://youtu.be/qCPUsqPmino Dr Yazan Douedari gives away all the secrets! Dr Yazan Douedari reached out to me as he was a student of the Resin Bonded Bridges Masterclass. I loved connecting with Yazan. He had so much in common (we are both Refugee’s who came to the UK and are grateful for the opportunities) and listening to his hardships and struggles with the ORE process and how he triumphantly overcame it was very inspirational. There is so much hardship and sacrifice associated with the ORE Parts 1 and 2 – imagine having no income, studying several hours per day and supporting a family at the same time. To top it all off, even once you PASS the ORE Part 2 – how will you find a job? https://youtu.be/sc6HnlsyccY Don’t stress – it will not help you! Yazan shares everything: Step by Step application process How to get your GDC paperwork in order How long to study for each part of the ORE Revision tips How much does the ORE UK process end up costing you? How he failed Part 2 How he overcame Part 2! How he found a job in Private Practice I am so grateful to Yazan who shared his successes and failures in such a humble fashion. He also shared some good ORE resources: ORE Part 1 Facebook Group ORE Part 2 Groups: https://www.facebook.com/groups/645587355509380/ https://www.facebook.com/groups/161356114038001/ https://www.facebook.com/groups/orepart2/ https://www.facebook.com/groups/498077606922801/ Companies to buy materials and equipment from: https://www.mrdental.co.uk/https://www.dentalzonetrade.com/store/ Some thoughts from Yazan on MFDS Exam – is it worth it?: Actually, I wanted to mention MFDS & MJDF during the episode saying it would be good for those doing ORE to do one of these exams DURING their ORE journey (not after) as there are a lot of similarities and require minimum extra preparation. I have done MJDF while I was doing my ORE, I prepared for 1 week for part 1 and 5 days for part 2 and was able to pass from the first time. The drawback is that you need to spend extra money on exam costs (around £1000), but the benefit that you get a diploma degree with a few extra days of preparation.  Now to answer your question, MFDS/MJDF do not add much (or anything!) to your information or skills if you’re doing ORE. The only benefit is to improve your CV generally and esp if you are considering applying for further education degrees in the future, it ould be an asset. Additionally, in my case, my dentistry CV was very weak, so I felt having this extra degree in my CV would help me get a job and would give me some advantage over others.  Yazan on MFDS Exam Some thoughts from Yazan on the LDS Exam vs ORE Exam: One last thing I just remembered and I think it would be useful to mention in the episode is LDS, which is another exam one can take to be able to work in the UK. It is almost identical to ORE, however, it is less frequent (part 1 once a year, part 2 twice a year) and considered slightly easier than ORE, esp part 2. Dr Yazan If you enjoyed this episode, why not check out the advice on Finding an Associate Dentist position!

Move over, traditional crowns! These ceramic onlays are way more conservative and just downright sexier. But let’s not go crazy – like with all aspects of Dentistry, case selection is key. https://youtu.be/Rl9BF-sIHqI This is going to number 1 for 2021 – it HAS to! This episode is one for true Dental Geeks. Nik Sethi will adhesively blow your mind (wait….what did I just say?) Imagine a 1 hour podcast episode after which you will improve your Onlays like never before – THIS is that episode. From the painful temporisation of onlays to the delicate bonding procedure, Nik leaves no stone unturned. Grab a pen and paper! Protrusive Dental Pearl – use air abrasion on your Tanner/Michigan splints to help to see articulating paper marks more easily. Also it can be used to test compliance of your patients, as they will polish/grind away the abraded surface. Thank you Dr Tilly Houston for sending that one in! In this episode we cover: When to place large composites vs opting for indirect ceramic restorations How to incorporate Immediate Dentine Sealing in to your workflow without feeling you have done anything different or additional How to become more efficient with your adhesive onlay preps When to start overlaying cusps, and when to leave them be (the answer may surprise you…) The full bonding protocol with heated composite (etch and all!) HOW TO TEMPORISE THE BLOODY THINGS When to shoulder….when to bevel? Nik was really great – my only contribution to the show was the term ‘Vonlay’. You’re welcome, everyone! If you loved Nik’s down-to-earth style of teaching, do check out their courses: Elevate 6 – Elevate Dentistry (elevate-dent.com) By very popular demand Riaz and Niks hands on 2 day course covering their FIPO protocol: Leeds 12th & 13th March 2021 London 9th & 10th April 2021 London 23rd & 24th April 2021 Leeds 7th 8th May 2021  Leeds venue- Optident, Valley Drive, Ilkley, LS29 8AL London venue- Blue room venue 220, Headstone Lane, HA2 6LY 2 Day – FIPO – Elevate Dentistry (elevate-dent.com) Finally their pride and joy: Advanced Aesthetic Diploma. Diploma – Elevate Dentistry (elevate-dent.com) If you enjoyed this episode, you will love Emax Onlays and Vertipreps with Jason Smithson!

I am joined by a Dentist fellow podcaster himself, Dr Payman Langroudi, to help you improve your teeth whitening results right away! https://www.youtube.com/watch?v=n-PSjGsICbw Yes – that’s a fluorosis case I treated in the thumbnail! Protrusive Dental Pearl: Using the patients’ aligners as a whitening tray – and better yet, the use of Vivera retainers and Enlighten whitening to Guarantee B1 shade! https://youtu.be/VSQp-etyhZI Are all whitening gels the same? In this energetic and conversational (yet educational!) episode, we discuss: Light based systems – surely it’s all BS? OTC products? Is there a dark horse? Why and HOW to do more whitening cases (simple but effective!) Predictors of poor whitening response (watch out for these patients) Why impressions are still better than scans Whitening tray seal The best way to improve sensitivity If you enjoyed this episode and want more free training with Dr Langroudi, check out his free online training for Dentists You will also like my episode with Manrina Rhode on the nitty gritty details of Porcelain Veneers

Is it time to ditch the analogue occlusion tools like facebows in favour of Digital Dentistry workflows? In this special feature episode with Ian Buckle, we will explore the world of Digital Occlusion. https://youtu.be/M0OR0XJdUvg I was tempted to make this a 2 part, but the flow is too good. Protruserati, get your onions ready for chopping (lots of them) – this is a behemoth episode! We tackled a lot of key themes, include Specialising vs Private courses route (a common question I get sent by Dentists). One of my fav quotes from this episode:‘If you don’t have a clear goal, don’t be surprised if you end up somewhere you didnt expect’ – what we can learn from this is to MAKE a best guess! I also mentioned how it was through Ian that I learned about the FACE Group (Roth) of Orthodontists. These are Orthodontists who are well versed in articulators, facebow, occlusion and ‘stable condylar position’ (or Centric Relation, to many!) There are a good few gems in here about face scanning apps, use of photography, inciso-facial mock-ups, but my favourite gem I want to share on this blog is this:If you record your bite registration AT the DESIRED vertical dimension, you will eliminate any errors in opening the bite on an articulator/digitally. You may need to read that again or listen to that part of the episode again. Once it sinks in, it can be a ‘ah-ha!’ moment. If you want to find out more about future courses by Ian, check out his website. The SplintCourse is just weeks away from the launch offer – have you signed up for the big update? If you liked this episode, you might enjoy the Posterior Guided Occlusion 2 parts with Dr Andy Toy!

Think of this episode as a love letter to the Protruserati. We share the same struggles, and this episode could easily have been called the 6 STRUGGLES of a Comprehensive Dentist. https://youtu.be/DCTgR93Tk3c The struggle is real Here they are: You take your work home with you Dentistry was either mis-sold to me, or I was just naive. When I was a Dental student I read a young dentist magazine. It had a segment dedicated to interviews with DF1 Dentists who had finished their first year in practice. ‘What do you love most about being a Dentist?,’ was one of the questions. One answer caught my eye: ‘I love that I do not take my work home with me.’ I loved that! But after almost 8 years out of dental school, I can tell you (and my wife can testify!) that I find it impossible to be a comprehensive Dentist and NOT bring my work home with me. Treatment planning, organising photos, letters to patients, clinchecks and the list is endless – it will be a longer list for practice owners! New patient examinations will drain you It takes a lot of emotional energy to see new patients. There is a difference between the 15 minute new patient exam and the 45 minutes or 1 hour new patient exam. The longer appointments to learn what the patients goals are and help find the right solutions can be extremely challenging and require intense focus, and dare I say, showmanship. As my principal (Hap Gill) once taught me, we are in show business. You have more to give and more to say The classic sign of this is that your Nurse is always nagging you that ‘you talk too much’. You just want to make the patient’s experience as valuable as possible! You dont earn enough money Controversial. I know. If I could double your income but simplify your Dentistry and limit you to single tooth dentistry – you would probably say no. THAT speaks volumes.You do it for the bigger picture and for passion.Yes the comprehensive Dentist MIGHT gross more, but the amount of money you spend on equipment and courses can be eye-watering. That, and your hourly rate from all the work you do it home is ever-diminishing. Patients always say ‘you are the first person who told me this’ or, the more sinister cousin, ‘why has no dentist ever told me this before?!’ I never know what is the right way to handle this. I just smile and say ‘I love my job so much, that sometimes I care more about a patient’s mouth than they do!’ To clarify, I am suggesting I care more than the patient (not more than any previous Dentist – we should never throw our colleagues under the bus). 6. If someone ever stole your laptop, they would be so dissapointed Admit it. Your phone and laptop is full of forum screenshots, lecture photos, teeth, abscesses, shade matching photos (heaven forbid) and the odd bitewing for good measure! If you enjoyed this episode, you will also like 12 Rules for Dentistry with David Bretton!

Finlay Sutton has made Dentures sexy again. His teaching style is world-famous and it was an absolute thrill to chat to him. Protruserati – this one is going to be clinically IMPACTFUL. https://youtu.be/6Hz208Zv6yU The KING of Removal Prosthodontics We started by discussing the benefits of using Loom for video communication with patients and lab – it adds a personal touch. Genius! What do you do when the framework does not fit?!Finlay will firstly trial the denture on the model. If in doubt, rehearse the path of insertion several times and you can ask your lab.You can use occlude spray on the denture fit surface Regarding Immediate Dentures: Leave your patients in immediate denture (plus relines) for 9-12 months to get maximum shrinkage before upgrading to Chrome. Sometimes you move quicker but need to reline (use ZOE) and then alginate pick up 12 months later. Should you use high impact acrylic? It seems a sensible idea!How about metal mesh? What if your partial denture wearer is a bruxist? We talked about how your partial denture can BECOME a splint. Precision Attachments and Milled Crowns Why Finlay has moved away from precision attachments and true ‘milled’ crowns as they are maintenance heavy. It is simpler to have crowns that are shaped appropriately with guide surfaces that will improve the denture. He does use Stud Attachments, which he uses just twice a year, to resurrect a root-filled retained root to negate the need for a clasp in a high smile line patient. Tell the patient the root may split, AND the tooth in front will need a clasp in the future. Metal backings are amazing for bracing – ‘My dentures are like removable resin bonded bridges’. Hidden away but provide great resistance to rotation and adds rigidity and bracing. Another gem was the use of dimples in to the crowns palatally and distal guide surfaces – with metal backings. The metal backing would have small balls that would slot in to the dimples. ‘What I hate is patients coming back with problems after they spent lots of money. If it all fell apart in a few years time, which these do, we’re in dickie’s meadow’ – there we are, keep it simple! You can use Zirconia crowns with rest seats and dimples but ensure, smooth, round, organic shapes. Be careful about making upper palatal too bulky as affects speech – hence why preferences to make these dimples substractive. If you want to learn more from Finlay, do check out his website for denture courses and learning resources. If you enjoyed this, you may also like the episode about Complete Dentures with Mark Bishop!

In this long overdue (sorry, Protruserati!) episode I will go deeper in to Anterior Midpoint Stop Appliances as an occlusal splint for bruxism, myofascial pain and headaches. If you have not already, you must absolutely check out Understanding AMPSA Part 1 as this is the sequel! https://youtu.be/_dSkQFZa55w Protrusive Dental Pearl 55: Remember at Dental School where they taught us that 3 fingers worth of mouth opening is considered ‘good’ or normal? Well, make sure you remember it’s the patient’s fingers, not your fingers! I showed how to use a range of motion scale and the benefits of checking mouth opening objectively: https://youtu.be/LAlKNwedd6w I am so excited to announce pre-registration for SplintCourse – Splints Simplified for GDPs. Sign up for the launch offer which is just weeks away! You dig my logo, right?! I teach what I know, and I know Resin Bonded Bridges and Splints for GDPs as I have devoted my career to their study! “No amount of canine guidance or posterior disclusion or level of osseointegration of your implants will save you from the destructive forces of Bruxism” Jaz Gulati, PDP055 So here is a recap from AMPSA Part 1: Anterior appliances are not as evil as you were taught We myth busted the Dahl-concept-type occlusal changes with normal wear of such appliances I gave the analogy of the ‘locked-in’ patient, and how when you allow them freedom of movement (reduce the resistance in grinding motions) it is like weight lifting and the weights have been removed We looked at some of the contraindications – intra-capsular issues which are rarer – but also those who are just higher risk of anterior open bites Remember, sometimes you WANT patients to get an AOB! In this Episode I summarise: What is the difference between these various anterior appliances and is one better than the other? Deciding upper arch or lower arch, or sometimes both arches? How many of my patients have developed Anterior open bites, which splints caused them, and how to manage such a scenario? Why even an AMPSA can be an overkill and which patients may actually benefit from a soft bite guard, for example! These appliances can bring HUGE solution to a MASSIVE problem for our patients. Many of my patients are pain-free and no longe require painkillers for headaches and jaw pain. My strongest bruxists (whose teeth I have restored) are religious at wearing the appliance (despite a favourable occlusal scheme) and they love it and KNOW that their Dentistry is protected. This is not a cheap piece of plastic. It is a custom made Orthotic Appliance – I charge anywhere from £450 – £1,300 for appliances (simple AMPSAs, complex AMPSAs, Michigan/Tanner appliances – every case is different). One of my previous delegates from The Splint Course (when it was delivered live) called in to the show and asked ‘I am concerned about charging a high fee for this appliance? What is the appliance does not work?’ – towards the end of this episode we discuss this in full depth! If you enjoyed this episode, you will like why Michigan Splints are overrated! Don’t forget to sign up to The Splint Course for an exclusive launch offer.

**UPDATE** Discount codes for RipeGlobal valid until 31st January 2021 – thank you RipeGlobal for sharing these for the Protruserati! 20% off standard monthly membership Code: RipeLearn 30% off standard annual membership Code: RipeAnnual 30% off premium annual membership Code: RipeJaz https://youtu.be/-iSs8v3pz7Y This man has taught me so much! I would like to share with you 5 Key Lessons that Lincoln Harris has taught me (out of hundreds!). It was a tough list to whittle down to just Five. I have learned so much from this incredible Dentist, Mentor and Leader in Dentistry. [convertkit] When I first asked Linc to come on the podcast, I thought to myself, ‘This guy is ridiculously gifted in every aspect of Dentistry. What should the theme be for this episode?!’ https://youtu.be/QjM3YYM2o84 A great way to think about Written Consent: Setting Realistic Expectations I then settled on timeless, non-clinical lessons that I have picked up from him over time: Lesson 1 – The Stages of Grief I sometimes noticed that as I was explaining a treatment plan to a patient, their body language started to shift. They started to fold their arms. What was going on here? The penny dropped when Lincoln taught me how the stages of grief apply to Dentistry! Lesson 2 – When Dentistry get complex, slow down We all want to be efficient Dentists. However, Lincoln Harris taught me that the more complex Dentistry becomes, the more you need to slow down. This has been powerful. Lesson 3 – Photos – Every patient, every time!How that fits in to the workflow of a consultation Well, I was already taking a hell of a lot of photos before I met Lincoln. But now even the emergency patient that has been squeezed in at 4.50pm on Friday afternoon will get a few clinical intra-oral photos! Lesson 4 – There is no evidence for what is the best treatment for YOUR patient. How we give our patients too many options https://youtu.be/VhkTUOerLkw Evidence Based Dentistry, anyone? I have agonised and agonised over what is the best treatment plan for patients. You then end up sounding unsure of the plan yourself. Sometimes we have to go with our gut! Lesson 5 – How to overcome being uncomfortable discussing fees with patients We all have a number. Above this number, we get a funny feeling in your stomach. What’s your number? If you enjoyed this episode, then do check out eMax Onlays and Vertipreps with Jason Smithson!

TIME SENSITIVE – 50% off Maciek’s Online Contact Point Ambassador Course! Click here https://youtu.be/xVWlZbzSrKE It’s the big debate in General Restorative Dentistry: Which is the best Matrix band to rule them all? In the red corner we have the trusty circumferential Siqveland and Tofflemire bands that got us through dental school and have served billions of restorations…but surely they have no place in contemporary adhesive Dentistry anymore? In the blue corner, we have the sexier, younger sectional matrix systems that are the future (and hopefully the present for many of you!). But even within this category, there is a plethora of choice. Are bioclear celluloid matrices the King of Class II composites to create beautiful, voluptuous contact areas with an enviable seal and an Instagram worthy photograph? Or are the tougher, heavyweight metal sectional bands the one true matrix to rule them all? ‘But there are so many brands!’, I hear you cry. You’ve got Palodent, Garrison, Tor VM to name just a few. Surely one is champion? We haven’t even started talking about the plethora of Restorative Rings yet to get the ideal separation and adaptation of the matrix – even they differ from brand to brand. It’s no wonder that it’s sometimes easier just to pick the disposable circumferential matrix band and be done with this restorative debate… Oh but the wedges! Wooden? Plastic? Teflon floss? Wait, what? Yes you read that correctly. Maciek Czerwinski shares with us the Teflon Floss technique as a substitute for a wedge. It IS very likely the perfect Wedge! https://youtu.be/mEYpDtSNJUg Ladies and Gents: The Teflon Floss Technique! You’re welcome. Most importantly, what is the best matrix – ring – wedge combination! If you have ever struggled with an open contact, an imperfect cervical seal, a collapsed matrix band or a cheeky wedge entering your cavity (hopefully not all for the same restoration), then this episode will blow your mind. As promised, the Matrix Selection System: Matrix Selection System has really helped me with Decision making for Class II Composites https://www.youtube.com/watch?v=u16rST2H5sk Teflon Floss Technique Check out Maciek’s impressive Facebook page to stay up to date! Be sure to sign up to the newsletter for episode updates! If you are in the UK and Ireland and want to avoid fake Tor VM matrix bands from eBay, buy from a reputable source: Incidental Ltd If you enjoyed this episode, you might like Rubber Dam with Harmeet Grewal!

Learning Dental Implants can be confusing. There are so many layers of complexity, from space requirement, restorative components and surgical nuances. This 2nd part of the 2-part series on Implants with Dr Hassan Maghaireh looks to guide us through the fundamentals of assessing your patient for implants. https://youtu.be/VZfWZf1lpoU We cover A LOT of clinical Implantology for GDPs How do you assess the Implant space for the right mouth in the right patient? When patients ask how long Implants last for, what should we tell them? https://youtu.be/COtd1bpx0Jg How long will my Implant Last? How to respond to this? Can you place implants on Smokers? What is the protocol? Bisphosphonates – at what point are implants contraindicated? How can you tell if it’s going to be a complicated case? How about Perio Susceptible patients and placing implants? How will Parafunctional patients fare with implant restorations? Who should take the tooth out?! GDP or Implant placing Dentist I routinely section molars. Is that a good practice? What is ridge preservation and when to consider this? Protrusive Dental Pearl: How to use a pencil to draw line angles for anterior aesthetic composite restorations. I learned this from Dipesh Parmar on the Mini Smile Makeover course (next course in 2021) https://youtu.be/JDEibGUHA1w Please do not use your wife’s Eyeliner If you enjoyed Dr Hassan’s style of teaching, do check out the BAIRD Implant Course. If you liked this episode, you will love revisiting Complete Dentures with Mark Bishop!

When you present your patients with the ideal options, but they end up choosing ‘patch-up’ Dentistry…this is a real world problem, and we will tackle it in a comprehensive way in this Group Function! Thank you Anonymous Dentist on Instagram for sending in this BRILLIANT question: Hey jaz! I’ve been listening to your podcast and I’m a huge fan!I especially enjoyed the Chris Orr one and the communication one.I just wondered if I could have some advice please..I’m working across two practices at the moment, 1 fully private and 1 mixed practice.At the mixed practice, often patients with broken teeth don’t want to pay for crowns/onlays even though I spell out the benefits, often they will go for a replacement amalgam (which I hate doing) or a large private composite (again risk of debond due to the size)What would you recommend? If a patient doesn’t want to pay for a crown /onlay but you’ve spelt it all out then I’m not sure what else I can do?Thanks in advance! X Anonymous Dentist in the UK, Instagram https://youtu.be/Y9xGee14LMg Real world problem in Dentistry…what is the solution? Full episode above You all know what happens when you get Zak Kara to give a quick answer….there is not such thing! Dr Zak Kara goes way beyond the call of duty and delivers us solutions in his signature comprehensive fashion! We tried to steer away from the NHS vs Private Dentistry debate too much – but definitely your environment and the values of your patients plays a huge role. Thank you so much for sending this question in – if anyone has a question they want to submit, do contact me via the website or send your question via DM on Protrusive Dental Instagram. If you found this valuable, share it with your associates and principals. If you liked this, you will also like Zak’s gems on Communication in Episode 10! Here are some comprehensive notes/episode summary was written by fellow Protruserati, Taha Adamji – Thank you, Taha!: PDP GF002 – Communication with Zak Kara – patients always choosing the inferior option ROLE PLAY  Building rapport as you’re coming up/welcoming them in  E.g. How was your journey in today?/How’s your day going today? Feel free to put your things over there and take a seat – give them clear direction when they come in about what to do  What can I do for you? My molar broke – yes I heard, (Receptionist name) told me you’re having a bit of trouble with a tooth on the UL  I’ve had a look through your notes/X-rays/photos etc – from your previous visits – this shows you are well prepared to help them  Sorry to hear that/ that can happen sometimes (empathy) Is this the first time this has happened to you or has it happened before? (History)  Am I right that it doesn’t/does it hurt right now? Is it rough to your tongue/uncomfortable? Patient mentioned the clinic/gave praise Thank you/that’s kind of you to say, I’m reassured by that/what do you already know about us?/it’s your first time seeing me /you saw (x) dentist previously is that right? – all shows you have taken the time time to read their notes/are interested in them and their past experiences Patient apologised for not coming  That’s no problem/Don’t apologise/there’s no need to apologise. What we do here is always blame free/judgement free dentistry Let’s see how we can help you with this problem tooth today: Because this is a “get you of of trouble type of appointment”/urgent/emergency appt, the aim for today is to focus on that one tooth I’m not going to do a full health check/exam today if that’s okay, I’m going to focus on this main problem for you But let’s also check there’s nothing else urgent going on and then we’ll see if we can get this problem solved for you by the end of the visit  What did you hope or expect was going to happen today? (Check expectations) “I was hoping it could be patched up and then I would be on my way” that’s definitely something we could do for you to make it smoother/perhaps take away that sharp edge so that it’s more comfortable  Does that sound okay to you? “How long is that going to last me” Well why don’t we take a bit of a look at it/I’ll put my magnification on/mask up (emphasises you’re going to look at it carefully, in detail)  don’t over promise too early – investigate it first, don’t make any assumptions about treatment options yet  Often when a tooth breaks there’s a reason behind it / did you have an idea on why that might have happened in your tooth’s case? “ I shouldn’t have had that chocolate” Patient/dentist may tend to focus in on the tooth in isolation only – but we need to look at the mouth and the patients as a whole   what is the patients goal here?  any pain to resolve? Roughness/sharp edges – we are going to solve this today  Long term goal/expectations? Examinati

Dental Implant courses for Dentists are a significant pathway in terms of commitment. Have you ever attended a Dental course and not applied the knowledge…and then a few months or years later – you felt it was an absolute waste? For example, I did a laser course last year – I have hardly touched a laser since then – its my own fault and I take ownership of that…but what if the stakes were higher? https://youtu.be/rXYARG13AEQ Is it too soon to start Implants…? Implant courses are not a small investment and I know some Dentists who have invested heavily in implant training…but they never quite got going. Whatever the reason, it’s sad. This is why I recorded with Implant Dentist Dr Hassan Maghaireh who is going to help us over 2 episodes to cover this mammoth topic. In this episode we look at getting started with implants – is it for you? https://youtu.be/dSgGnoTyC1c Should you be placing Implants? Stay tuned for a very clinical Part 2 where we will discuss case selection, implant assessment and Ridge preservation for Dentists. This two-part series aims to help you even if you are not placing or restoring implants, we’re going to cover the fundamentals and scratch in itch we have all had since qualifying from Dental school with limited exposure to Implants! In this Episode, I asked Hassan: As you do not get to place or restore implants at Dental school, how can you know it is the right path for you? I know many young Dentists who dabbled with implants and then stopped placing implants – how can we ensure this does not happen to more dentists? There is a school of thought suggesting that with implants, you should either go all in, or do not touch them. How and where does the GDP fit in to this? Is there a place for ‘dabbling’ in implants? How can we start safely and positively? In this episode we promised you some downloads and resources: The ADI Whitepaper on Bisphosphonates The BAIRD Implant Course starting in October 2021 Wex for Refurbished Photography Equipment If you enjoyed this episode, you will also like Transition to Private Dentistry which changed my life.

This is the very first Group Function and we are tackinling RBBs! I will take questions from the fellow Protruserati – I will use your help to come up with some helpful solutions. TLDR: You can do Dahl RBBs, but it doesn’t always mean you should. A little prep of enamel will not be THAT detrimental for the tooth. https://youtu.be/VtRlzodts8c Thank you Aaron for helping this episode happen as our first question! It is about a technique dear to my heart – Resin Bonded Bridges! Firstly, if you know nothing about the Dahl technique, you totally need to listen to the episodes with Tif Qureshi on Dahl Part 1 and Part 2. It CAN be a good way to place Resin Bonded Bridges in a way to eliminate any preparation for the occlusal surface – in young patients it can be very successful. However, it just seems a shame to prop someone’s bite open on just ONE tooth and allow what naysayers refer to as ‘unpredictable orthodontics’ to work it’s sweet magic. I am totally fine with a little prep – staying in enamel (which is so key!) – every case is unique so treat on it’s merits. In a younger patient, I am more likely to consider that approach. I hope this helps! If you find this useful – send it to a colleague. I cover Dahl RBBs extensively in the Resin Bonded Bridges CPD Online Masterclass as well as Zirconia RBBs.

When Mike Gow first told me that he helped place dental implants on patients WITHOUT local anaesthetic, I thought he was lying. Then I found out they have also done a sinus lift without LA…what?! You read that correctly! Mike Gow has centred his practice around the management of nervous and anxious patients. Don’t you think we can learn so much about management of dental anxiety from someone who has achieved the above? This is exactly why I brought him on as my guest of honour for Episode 50 (50 not out!) and you will love this, gem-packed podcast with valuable ways to help us become better Dentists to anxious patients. https://youtu.be/dkMByGXwI1A Full episode with Dr Mike Gow only on Protrusive and Dentinal Tubules The Protrusive Dental Pearl is to check out Anydesk (it’s free!) to gain remote access to your work computer in a secure way, so you can access X-rays and treatment plans any time, from any where! This has helped me on so many occassions! Also check out the 1 hour free training on Teeth Whitening by Dr Payman Langroudi of Enlighten Smiles. https://youtu.be/jO0bIetHLtY We discuss: How and why he found himself in a situation to hypnotise patients and place implants without LA Mythbusting about Inhalation Sedation Top tips in making patient feels calm and cared for (gold) Gow Gates vs Akinosi – which ID Block alternative is better? How to have a thriving practice centered on anxious patients The powerful secrets of managing dental anxiety https://youtu.be/uqiXh6QUjXw Inhalation Sedation is massively underutilised https://youtu.be/LevjbyjOTIM Hypnosis is powerful! Mike’s resources as promised: ISDAM Website ISDAM Facebook page His practice, the Berkeley Clinic And of course, Mike on the news!: https://www.youtube.com/watch?v=D04uduXkYJ0 Dr Mike Gow also runs InterDental TV for the latest in Dentistry. If you enjoyed this episode, you may also like Dr Libi’s 2 episodes on Paediatric Dentistry!

As our level of Dentistry gets more comprehensive or complex, sometimes it is useful to write a treatment plan letter to your patient. In some practices, this is considered absolutely essential. https://www.youtube.com/watch?v=_sMt7QLaPCk Full episode with great gems from Dr Jorge Cardoso The problem with writing treatment plan letters to your patients is that….it’s not easy! It takes time. It takes thought. You need to come up with solutions to the unique and complex problems for our patients, and be able to present an estimate of fees at the same time. Not only that, but the letter should ideally be easy to understand, visual, detailed enough to be valuable but at the same time concise enough not to complicate it. Oh and by the way…after all that time and effort, the patient may not proceed with treatment. There goes that Saturday afternoon away from family, totally wasted, right? https://youtu.be/bo-fA-o4OC0 I found a solution. Kind of. It’s called MakeMeClear and it generates easy to understand, visual and beautiful treatment plan reports and letters. Once I got slick at using Make Me Clear, I still found it takes time. There is no shortcut/hack to good treatment planning. But there is a shortcut to creating wonderful letters that increase your case acceptance. Thank you, MakeMeClear! Protrusive Dental Pearl – Do the 21 Day Free Trial for MakeMeClear and do not make the same mistakes I did of not taking action! (It will be more clear when you listen to the episode). All of the Protruserati clan get 25% OFF the monthly or Annual plan with the code ‘protrusive‘! If your dental practice subscribes to MakeMeClear then all of the associates and Specialists can use the same membership. Let that sink in! Thank you to Jorge for this awesome deal. https://youtu.be/pfuG8Q08rck Click here to check out a sample report / example treatment plan letter produced using MakeMeClear. I am joined by Dr Jorge Cardoso, founder of MakeMeClear, to discuss: How and When to Write Letters to patients – is it always? What about when there is more than one option – how can you put that in a treatment plan letter without it being confusing? What is the role of digital smile simulation images? What is you give a ‘global fee’ or ‘ballpark figure’ but things turn out more complex than anticipated? So many great themes of challenges with comprehensive Dentistry discussed with Jorge. If you missed his eBook I gave out in the last episode, check out 16 Steps to get More Treatment Plans Accepted Today. If you enjoyed this episode, you will love Think Comprehensive with Zak Kara.

Do you make ‘shotgun’ treatment plans? A shotgun treatment plan is like a shotgun wedding. It is rushed, on-the-spot and poorly consented.. https://youtu.be/mAnXcTUdFuM Shotgun Treatment plan vs being Comprehensive I am back with a Fan favourite – Dr Zak Kara who absolutely bamboozled with his communication gems from episode 10 (must listen if you have not already!) In this mammoth 80 minute episode we dissect how to PRESENT treatment plans to patients. Should we use their chart? Should they get a quote for extensive work at Day 1? Should it be at a second visit or all at their first visit (after all…this what they expect from us, right?) Do we need a separate consultation room (LOL)? https://youtu.be/cFHE2nnCM5E FULL episodes only on the main website and on Dentinal Tubules for CPD/CE Protrusive Dental Pearl 1: ebook Download for 16 Steps to get more Treatment Plans Accepted Today Protrusive Dental Pearl 2: Thank you for Mini Smile Makeover Composite Course and Enlighten Smiles for sponsoring this episode! I talked about my favourite composite instrument I learnt about from attending Mini Smile Makeover – it is called the CASI 3C and it is the perfect non-stick instrument for anterior bonding. Those in the UK can get this from Enlighten Smiles, and those in the USA or Worldwide can get it from their Cosmedent supplier. https://youtu.be/Ob9srJZu3hM The CASI 3C We also discussing about getting comfortable talking finance with patients – what are our limiting beliefs about money and fees? Is that holding us back? It did haunt me for many years… Do we need to give exhaustive documentation afterwards? What is the point of all this? What is the patient and you do not share the same ethos and values? This is the App Dr Zak Kara mentioned he uses: DDS GP only on the App Store What I loved about the episode was learning why Zak DOES give an itemised plan for Phase 1 treatment, but not Phase 2 or 3: https://youtu.be/plIpA6AjtBg If you gained value from this episode, be sure to subscribe and share it with a friend! If you enjoyed this, you will of course love Zak’s first episode on Protrusive: Think Comprehensive!

Periodontology has some good studies and evidence base – but what is the current thinking in the role of occlusion/parafunction in the aetiology and progress of periodontal diseases? I am joined by Specialist Periodontist, London-based Dr Richard Horwitz to discuss exactly the correlation and link between occlusion and periodontitis. https://youtu.be/QhZfDxR4SoY Are those with Anterior Open Bites more likely get to get Perio? Full video episode out soon. This episode’s Protrusive Dental Pearl I picked up from Dr Dipesh Parmar on his fantastic Composite course Mini Smile Makeover – it is to use a sectional posterior matrix band (like the B100 from Garrison or Tor VM) in a vertical fashion to create perfect mesial and distal contours for your anterior composite restorations such as Class IVs. Maestro Dipesh Parmar teaching Composites I also revealed that the team at Doctify are offering all listeners to this podcast 50% off for the first 4 months – you just need to tell them you listen to Protrusive Dental Podcast. https://youtu.be/bpBSFyCFrN0 Full video episode with Richard’s cases – only on the website and on Dentinal Tubules I had a really fun chat with Richard which included so much: When and why would you consider occlusal adjustment/equilibration in a periodontally compromised patient, perhaps to reduce occlusal trauma? Can Periodontal splinting help in these parafunctional patients? How can you check for fremitus? What role can appliances have in the stabilised periodontal patient? Listen to how I ruined Richard’s canine guidance! If you enjoyed this episode, you will like my episode with Endodontist Kreena Patel on Cracked Teeth!

We think we know what a tooth looks like….but most of the restorations that we see on a daily basis…how many of them have truly natural or morphologically correct tooth anatomy? I am joined by Dr Jurgita Sybaite who is the undisputed Queen of Tooth Anatomy! (Full video on main website) She works with Dr Basil Mizrahi and is passionate about Restorative Dentistry. https://www.youtube.com/watch?v=70KQXO9CGkY Full Episode only on Protrusive.co.uk The Protrusive Dental Pearl for this episode is to use a Thermacut bur (by Dentsply) to remove the interdental papilla when managing very deep, subgingival caries – an example case was posted on Instagram and Facebook for you to see how this works. https://youtu.be/thz07JOrDts What does Brad Pitt have to do with Tooth Morphology?! The three steps to learning and mastering anatomy: learn, draw, sculpt! What if you cannot draw? What tips would you give to anyone to improve their morphology (anterior and / or posterior) I play devil’s advocate – is knowing anatomy THAT important now with digital wax ups and tooth libraries? Should we really invest our valuable time with Tooth Morphology? Which is the best way to learn, additive or reductive? Wax? Soap bar? Do we need to master tooth anatomy if we are not a ‘cosmetic dentist’? Do check out Jurgita’s Instagram profile to see clips of her producing stunning anatomy! She also is a prominent teacher in this field – check out her website! https://youtu.be/9sTqKOznXpA Do we need to learn Tooth Morphology that well? Now we have Digital Tooth Libraries…? See what Jurgita has to say If you enjoyed this episode, check out Composite vs Ceramic with Dr Chris Orr. As always, hit subscribe on your podcast platform and leave a review on Apple Podcasts!

Interproximal reduction (IPR) is a useful way to create space in Orthodontics, but it has to be performed carefully to make sure it looks good and is effective. If you are new to Orthodontics or have never performed IPR before – this episode is for you. I am joined by Dr Devaki Patel, specialist Orthodontist, to discuss IPR techniques and the nitty-gritty details and answer the questions you always wanted to ask about IPR…but never did! https://www.youtube.com/watch?v=v9dAcHtPiCU&ab GDP Orthodontics has boomed in the last 10 years. More and more of us are treating orthodontic cases and often this may be referred to as Short Term Orthodontics (STO), or Anterior Alignment Orthodontics (AAO). Protrusive Dental Pearl: If you view a ClinCheck or a similar 3D simulation, make sure that the initial bite/occlusion is set yup correctly. You will be surprised in how many cases this may be wrong and it has not been picked up! If you are starting out with Ortho cases, IPR may be something that worries you. You may have questions like: Which are the best strips? Are strips better than a bur? How should you hold/orientate your bur? How do you perform IPR when there is crowding? What are the secondary benefits of IPR? Should you place fluoride after, or is that overkill? A really great and helpful guide to IPR ipr-orthodontics-guide-dentistsDownload If you enjoyed this orthodontic episode, you may also enjoy my episode with Dr Almuzian on whether Class I molars are really that important? I appreciate you all listening – do subscribe on your preferred podcast platform so that you do not miss the latest episodes.

I am joined by a young Dentist, James Martin, who started a really cool Facebook group called Dentists Who Invest. Well, if there is a group dedicated to Dentists who own Air fryers, then James’ group definitely has a need! The advice we share on this podcast is aimed at Dentists who have no clue about Investing. Forget dental school, but even in our general education we are not taught personal finance and investments. https://www.youtube.com/watch?v=UHpkM-9Vg94 Protrusive Dental Pearl: have you been a victim to ‘lifestyle creep’? This is when your income increases, your lifestyle and expenditure also increases. This is all good and well, but it is so important to watch your savings rate (how much money you save). Here are the 5 topics we cover in this episode aiming to improve your financial literacy: 1) How to get started with Investing?We share our individual journeys. His involves cryptocurrency, and mine involves accidentally stumbling upon Tony Robbins’ book about financial freedom! 2) DIY vs Financial Advisor/Investment Broker. The Pros and Cons of doing it yourself vs picking a portfolio with an investments company 3) What is the best investment? Stocks? Real Estate? Cryptocurrency? Bank accounts? 4) WHEN should you start investing? 5) What other piece of advice do you give for Dentists looking to invest? If you enjoyed this episode, do check out Personal Branding for Dentists with Shaz Memon!

I want to talk about maximising your learning potential from all the courses that you attend, but particularly the online ones. I was inspired from listening to a book called Limitless by Jim Kwik (check it out if you’re in to maximising your potential and the human mind). It had so many gems in there which I thought would be so useful for Dentists to learn when we’re attending courses so they have more impact on us. https://www.youtube.com/watch?v=F6Qc0BwTGRU More importantly, now that with COVID-19, a lot of the education is going online. You now commonly hear the phrase “I’m webinared out” – we are attending too many webinars and are itching for in-person courses again. Over lockdown it was definitely the case, you could fill your whole day with webinars during lockdown. That just gave us digital fatigue. I want to refresh and recap on what are the ways that you can maximise your learning while you’re on dental courses, but particularly on the online courses, so you don’t feel “webinared out” or “digital fatigue”. We can apply this to any online education – in fact, as a Dentist you probably already subscribe to membership only platforms for dental education. However, like many of us in our busy lives, you may be guilty of not giving these platforms enough time to gain from them. It is so important to make time to actually watch that content and actually immerse yourself in that content. I like to call this ‘protected time’. Time is scarce. This is why when you do find time to watch these videos on the online platforms or actually attend these webinars, your time is so valuable. You really have to maximise what you gain for every single course that you do, and every single video that you watch, and every minute that you invest in them. This is why I want to share the FAST protocol to maximise your learning, inspired by Jim Kwik and Limitless. F = Forget A = Action S = State T = Teach F stands for forget, which sounds crazy. Let’s imagine you’re doing a course on veneers – maybe a webinar or an online course on veneers. The way to maximise how much you learn from that particular course is to forget everything you know about veneers. One of my favourite quotes is from someone called Malcolm Forbes, and it’s “the role of education is to replace an empty mind with an open one”. The A stands for action, and it can also be interpreted as active learning. For me, it’s definitely the case that I learn better when I’m taking notes. One thing that Jim Kwik teaches is that we do not learn from consuming. We learn from creating. When I’m creating notes, or when I’m creating mind maps, and some people like typing manually on their iPads or on their laptops, basically almost transcribing what the lecturer is saying… you gain so much more from that process! So note taking or whatever you need to do (whatever creative way that you learn), it’s so important to have that rather than just consuming blindly or consuming blankly, you need to be able to create and that way you will learn more. The other thing that comes with active learning is that multitasking is an absolute myth. We can’t multitask effectively. For example, have you ever been on a course and maybe you’re sat in the front row with all good intentions…but what happens is that you get a text message from your practice manager or patient emails you and now your attention is completely somewhere else. And now you’re dealing with a staffing issue or a patient issue. Of course then you leave the the course to make a phone call. You’re now dealing with the patient or the staffing issue. You’re absent from the course. It’s basically that you’re trying to juggle a few things at the same time, and it’s just not going to work. You’re not going to maximise your learning potential. You have to focus intensely on that course in front of you and forget everything else. Forget the distractions. As humans, we can’t process a negative. Because we can’t process a negative, if something pops up in your mind or you get an email. You can’t just be like “okay, I’m not gonna think about this..”. The best way to handle that situation is make a note of it somewhere or make a to do list, focusing on that task at hand, and then move on from it. The S is super important for all realms, but particularly online. And the S stands for state. That means your environment, your emotional state, and also physical state (what is your posture like as you read this?). Are you doing an online course or webinar, in your PJs, lying down in bed, sideways? It’s not going to make sense compared to working in a home-office, far away from the kids (as far as you can be!). Your posture is important. If you’re slouching on the laptop, your ph

Get ready for the best summary of bridges you ever heard, including diving deep in to this mystical design of bridgework called ‘fixed-movable’ bridge. You cannot search about Bridge Design on Google without landing on the great content that Prof Paul Tipton has released. https://youtu.be/h9mmRiFtHmU Protrusive Dental Pearl: where to place your grooves for crowns and bridges?Crowns: place grooves mesial or distal, or mesial AND distal. Ideally in tooth and not in core material (we elaborate in the episode). Why mesial and distal for crowns and bridges? The forces will be transmitted bucco-lingually on a crown – therefore grooves perpendicular to this force vector to resist it would be mesial/distal. How about for bridges then? For conventional bridges the grooves are placed buccal or lingual, or buccal AND lingual. This is because the forces are now acting antero-posteriorly on the bridge via forces on the pontic(s). The buccal/lingual grooves will resist antero-posterior forces. Prof Tipton and I discuss: The benefits of fixed-movable bridges (such as negating the need for parallel preps of abutments) The contraindications of Fixed-Moveable bridges (such mobility of abutments) Why fixed-moveable bridges should be the default design Myth-busting Ante’s law What is the maximum span of fixed-moveable bridgework? What are the rules that govern cantilever bridges? what about mesial cantilever vs distal cantilever? Why is Distal cantilever worse, and is there any evidence to back this up? The steps in planning for Bridges: 1. Design anterior bridgework first 2. Choose your abutment teeth 3. What Design? (F-F, F-M, Cantilever?) and 4. Type of retainers for the abutments (Adhesive retainer, conventional crown, onlay etc) We discuss an actual case and live planning for a Fixed-Movable bridge Where is the fixed-movable attachment housed? Anterior or posterior? Inside the abutment or outside of it? The one thing you must do when placing Fixed-moveable bridges or you would have wasted the time and effort:Remove a small portion of the male component – about 0.25mm on average If you enjoyed this episode, you will like the complete denture tips given by Dr Mark Bishop – check it out! To learn more about Tipton Training, check out their website for courses.

One night when Dr Rajiv Ruwala was up all night as his daughter would not sleep…he came up with a very inspired list… He was interviewing Dentists for associate positions and asked himself, ‘What are the habits of the most successful and valued Dentists?’ He came up with this awesome list which we discuss point-by-point in this episode of the podcast: https://www.youtube.com/watch?v=NJeMUF05T18 Here are the 10 habits below: They can listen to the patients story and find a treatment to become a solution for the patient. I asked Rajiv if he has any tips in encouraging patients to tell their story or their goal? They often do not offer this info up front. They are proactive in recommending treatment, not reactive. I asked Rajiv to give a tangible example of being proactive. I also asked how to handle the situation when a proactive Dentist inherits the list of a reactive Dentist. They don’t get validation from how much patients pay them, but from how much the patient values what they have to say. If the patients value what the dentist has to say, they naturally accept the treatment. How do we serve patients who do not value Dentistry? They work with their nurses to make sure everything is ready and set up before the patient enters the room. The value of a great nurse is monumental – are you a checklist kinda guy? You may be surprised by the answer he gives… They do not moan about their working environment, the “system” or their staff, they help find solutions to problems and improve the situation. I like this because I always like to approach people or managers with solutions not problems. Rajiv has lots of solutions to work effectively in the NHS. They are happy to refer out and develop a skill/niche that allows people to refer to them. I have my views on this but how do you think one should find their niche? Rajiv gives his ideas. They don’t ask for something for nothing. Instead they build value before investing/ asking for investment. This is massive. How can you build value in to the care you provide? They look to improve in three key areas; clinically, financially, and personal growth, and aren’t afraid to ask for help to do this. Tell us how you, Rajiv, have looked to improve in those 3 domains for inspiration? They are not adversaries, they want to associate/collaborate. I find most successful dentists are so willing to share and help! They take adequate time off to be fully charged/energised. How much time off do you recommend, or is it personal?How about 10,000 rule when you are newly qualified? Rajiv talked about courses for communication which also features making the NHS system work, rather than moaning about it! You can find out more about that here: Course for Associates – PYP course Course for Principals – KYN course If you would like to pre-register for the Splint Course (limited delegates to allow mentoring and support), please subscribe for updates and surprises if you are looking for a comprehensive, step-by-step, clinical splint course.

As Dentists we do not treat headaches – however, we can manage the parafunctional forces and you will be amazed at how many patients will reduce their use of analgesics after these appliances. This is the big one….we finally delve deeper in to Anterior appliances as part of Splintember! https://www.youtube.com/watch?v=0jX7mB_jDKc Lets talk about these really evil devices [/sarcasm] – the anterior only or segmental appliances, the ones dental school told me to stay away from… There are lots of names/derivatives/ and brands for these such as: B splint or Dawson B splint NTI /SCi/Mci Bitesoft FOS E-splint named after Jimmy Eubank DAASA or the umbrella term for this splint family which is called AMPSA I have decided the only way to make this work for those that listen to the podcast on your commutes and while you garden is that I will urge you to go on to the Protrusive Dental Community where I will post example photos and videos of the various appliances. If you have not listened to Episode 8 with one of my mentors Barry Glassman – I really urge you to, we talk about these appliances and whether or not they cause an anterior open bites. In a nutshell – many dentists condemn this appliance. They believe that by having a splint only on the front teeth, that the back teeth will over-erupt or dentoalveolar compensation will take place. Does that happen? – NO, they do not tend to cause a Dahl effect for the following reasons: AMPSAs are only worn during sleep Dahl effect you need bone deposition – its not going to happen from 8 hours a night! I was careful with my words, I specifically said they do not cause an AOBs due to the Dahl effect. Technically, ANY appliance can cause an AOB due to muscle deprogramming and condylar repositioning +/- postural changes depending on which camp you believe in. You can actually predict which are the patients this might happen to – once again, from any appliance, but because the anterior ones are more efficient at relaxing the lateral pterygoids, this is why they are implicated for it. How does it work and which records do you need? The way it works is similar to the concepts or rationale of anterior guidance which I discussed in the previous episode. By not involving the back teeth – you are furthest away from that powerful nutcracker AKA the TMJ, and also due to the proprioception from anteriors, you are able to switch off the anterior temporalis muscles. What does this mean? What records do you need? Why do I like leaf gauges? Find out all in this episode of the podcast – I will go even deeper with Part 2 – watch this space! If you would like to join us for Occlusion2020 Virtual 2 day intensive program on 27th and 28th November, there are a few tickets left! Join me in Part 2 where we will talk about: Deciding upper arch or lower arch, or sometimes both arches What is the difference between these various anterior appliances and is one better than the other? Why even an AMPSA can be an overkill and which patients may actually benefit from simpler devices How many of my patients have developed AOBs, which splints caused them, and how to manage such a scenario

Michigan Splints AKA Stabilization Splints are the ‘gold standard’ occlusal splint according to many occlusal camps. https://www.youtube.com/watch?v=DIfqn2Zkjp0 Check out the Youtube channel for video versions of the podcast. At 10 minute mark there is an error – I showed a Facebow being used whilst talking about Leaf Gauges. Dental School told me that this Splint is the only one I will need to know and it will cure all. If this does not work…maybe the patient has ‘atypical facial pain’ 😉 Now before you all attack me…. I have to confess. It is actually a great all-rounder splint – but there are some key reasons why Michigan appliances (or Tanner for the lower) is massively overrated! Listen to this episode as I cover: What is a Michigan splint? How does this splint work? What records do you need for a Michigan splint? Do you need a Facebow? What are the limitations of Michigan occlusal splints? Why might other splints be better for many scenarios? Why you should be careful prescribing Michigan splints to primary clenchers Protrusive Dental Pearls were sent in by fellow listeners regarding patient care and rubber dam hole spacing. Have you checked out the rest of the episodes from Splintember? Here is a rough transcript: Lets face it – Dental school barely scratched the surface in a lot of areas, including Occlusion and splints – so it should come as no surprise to you that Michigans splints are not as great as you were taught they were. Michigan splints are actually a really good all rounder splint for all the main diagnoses within ‘TMD’ – quite often when I find a tricky case and I am unsure if the issue is more muscle or joint, I will recommend a Michigan – but still, it is a massively overrated appliance and is totally overkill for most of our patients. Lets start the basics – what is a Michigan splint? It is classically a hard upper splint.The lower is called a Tanner. Aka Stabilisation splint. It’s a centric relation appliance. What does this mean? I explain in the podcast (so listen up!). I go in to this appliance in a lot more detail and all the shortcomings. Fellow geeks, to conclude: It’s a great all rounders splint. And if ever you’re unsure of joint vs muscle diagnosis and you can convince your patient to spend hours in the chair, spend that money and you think they’ll comply, then go for it. It’s a great splint. But if you’re more concerned that your diagnosis is muscular, or the asymptomatic patient, and perhaps as an appliance to deprogram your patient….there are definitely more efficient ways to deprogram your patient. And that’s exactly what we’ll talk about at the next episode….stay tuned for the rest of Splintember!