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Just qualified — so why does it feel like the learning is only just beginning?

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...

Your patient is nine years old. One first permanent molar is crumbling — the others look fine. Does it stay, or does it go?

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...

Patient has patchy white spots after braces — do you really whiten, or will that just make the spots stand out more?

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.

Is rotary really better than reciprocating?

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.

 https://www.youtube.com/watch?v=onZMR-872HQ 

Watch PDP271 on YouTube

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.

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

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

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

Which episodes gave you that “aha” moment?

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

Protrusive Dental Pearls: 

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

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

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

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

Highlights of this episode:

• 01:08  Protrusive Dental Pearl
• 06:25 Value Your Skills
• 11:54 Importance of Photography and App Launch
• 14:42 Audio Notes in Dentistry
• 16:41 Rubber Dam Mastery
• 18:07 Composite Techniques and Innovations
• 21:07 Onlays vs Full Crowns
• 25:54 Best Bonding Agents
• 28:55 Digital Dentures Revolution
• 31:24 Mastering Vertical Dimension
• 32:29 Perfecting Posterior Composites
• 34:58 Creating Awesome Dentures
• 36:27 Extraction Techniques and Avocado Analogy
• 37:47 Looking Forward to 2025

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

• Value Your Skills – How to Stop Underselling Yourself – AJ006
• Your Occlusion Questions Answered by Dr Michael Melkers – PDP015
• Cracked Teeth and Dentistry’s Tough Questions with Dr Lane Ochi – PDP175
• NEVER Write Notes Again! How I Use AI for Awesome and Efficient Dental Records – PDP181
• Canine Guidance vs Group Function – Does it Matter?! – PDP182
• Class II Composites WITHOUT a Wedge + Contact Opening Technique – PDP188
• Onlays Vs Full Crowns – Decision Making 2024 – PDP189
• Quick and Slick Rubber Dam
• Vertipreps for Plonkers 
• Premium Clinical Videos 
• My Productivity Secrets Revealed Webinar REPLAY
• Deep and Dark Class III Restorations
• Which Generation Bonding Agent is the Best? 2024 Adhesive Systems – PDP192
• Digital Dentures for Every Dentist – The Death of Impressions? – PDP195
• [OCCLUSION MONTH] Vertical Dimension – Don’t Be Scared! – PDP197
• How to Place Posterior Composites without Destroying Your Anatomy – PDP200
• Making Awesome Dentures – Border Moulding and Beyond – PDP205
• Exodontia for Beginners – Extractions via Avocados! – PS012

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

Are you focusing enough on pink aesthetics in smile design?

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

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

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

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

Protrusive Dental Pearl: Shade Matching

1. Composite button technique – a small blob of composite is applied to a dry tooth without etching or bonding to assess shade match and translucency, avoid excess thickness, which can affect opacity and aesthetics (Jason Smithson’s Tip: take a black-and-white photo to evaluate the composite’s value and ensure it matches the natural teeth)
2. Using a custom composite shade guide like Smile Line by Style Italiano for more precise shade matching.

Key Takeaways

• Gingival architecture plays a vital role in aesthetics.
• Dentists should focus on patient-centered care.
• Understanding tooth position is key to treatment planning.
• Orthodontics can sometimes resolve gingival issues without surgery.
• Communication with patients is essential for effective treatment.
• Aesthetic dentistry requires a comprehensive approach.
• The dental field is evolving, and practitioners must adapt. Root coverage procedures can be effective with proper techniques.
• Understanding prognosis is crucial for successful treatment outcomes.
• Aesthetic considerations are a primary reason for root coverage.
• Restorative dentistry should consider the position of the gingiva.
• Crown lengthening should not expose root surfaces unnecessarily.
• Mucogingival surgery plays a vital role in implant aesthetics.
• Education and training are essential for dental professionals.

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

Highlights for this episode:

• 4:29 Protrusive Dental Pearl
• 6:16 Dr. Tidu Mankoo’s Journey and Inspirations
• 11:48 Reflections on Comprehensive Dentistryand Lifelong Learning
• 15:59 Balancing Work and Family in Dentistry
• 17:52 Understanding Gingival Architecture
• 19:49 Creating a Harmonious Smile
• 21:52 Addressing Gingival Aesthetics & Limitations
• 26:56 Orthodontics and Surgical Interventions
• 29:40 Root Coverage Procedures
• 33:49 The Value of Early Diagnosis and Referral
• 35:01 Indications for Root Coverage
• 36:03 Root Coverage vs. Class V Restorations
• 39:50 Managing Gingival Zenith Irregularities
• 41:23 Role of Mucogingival Surgery inImplant Success
• 47:47 Course on Mucogingival Surgery with IAS

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

This episode meets GDC Outcomes B and C.

AGD Subject Code: 780 ESTHETICS/COSMETIC DENTISTRY

(Esthetic diagnosis and treatment of intraoral soft tissues) 

Dentists will be able to –

1. Discuss when and how to manage gingival recession, including the role of root coverage procedures.
2. Explore the anatomy and function of the dento-gingival complex and its influence on smile aesthetics.
3. Promote the value of early diagnosis and timely referrals to specialists for successful treatment.

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

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

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

✅ Implant soft tissue management

✅ Root coverage and crown lengthening

✅ Complex case planning and aesthetics

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

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

Key Takeaways:

• There is a strong link between gum health and systemic health.
• Diabetes and cardiovascular disease are key conditions linked to gum health.
• Understanding correlation vs. causation is crucial in dental practice.
• Effective communication with patients can improve treatment outcomes.
• Treating pregnant patients for periodontal health is safe and beneficial.
• Proper diagnosis is essential for effective dental treatment.
• Patients are often unaware of the links between gum health and overall wellness.
• Motivating patients with health benefits can enhance compliance.
• Evidence-based dentistry is vital for accurate patient information. Add the word diagnosis to templates for clarity.
• Team collaboration (dental and medical practices) enhances patient care effectiveness.
• Screening for conditions like diabetes can save lives.
• Holistic care in dentistry is becoming increasingly important.
• A periodontal protocol is crucial for consistent care.

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

Highlights of this episode: 

• 3:50 Introduction to Dr Reena Wadia
• 7:14 Systemic Link
• 12:24 Under Investigation
• 13:54 Using this with our Patients
• 17:04 Birthweight-related Studies and Pregnancy
• 20:14 Make a Periodontal Diagnosis
• 23:34 Medicine and Dentistry Collaboration
• 26:29 Understanding the Patient
• 29:14 HbA1c Machine
• 32:19 The Perio Handbook

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

This episode meets GDC Outcome A, B and D.

AGD Code: 490 PERIODONTICS (Pathophysiology of periodontal disease) 

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

Learning Outcomes:

1. Knowledge and Application: Dentists will gain a thorough understanding of the bi-directional relationship between periodontal disease and systemic conditions such as diabetes and cardiovascular disease, and learn how to apply this knowledge in clinical practice to improve patient outcomes.
2. Patient Education: Dentists will acquire practical strategies for effectively educating patients about the systemic implications of periodontal health, using analogies, visual aids, and evidence-based communication methods.
3. Holistic Treatment Planning: Dentists will learn how to incorporate systemic health considerations, such as screening for diabetes or collaborating with medical professionals, into their periodontal treatment plans to deliver comprehensive care.

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

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

What are the steps involved in Functional Crown Lengthening?

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

What is biologic width and why should we care?

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

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

Protrusive Dental Pearl – Bone Sounding

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

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

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

Highlights of this Episode:
03:19 Protrusive Dental Pearl
06:10 Introduction – Dr Hiten Halai
12:56 Functional Crown Lengthening
15:41 Understanding Crown Lengthening Types
18:42 University of Dental Instagram
22:38 Biologic Width aka Supra-crestal Tissue Attachment
25:51 Functional Crown Lengthening: Practical Considerations
31:09 Assessments & Keratinised Tissue
35:47 Understanding Tissue Phenotypes
39:16 Case Study: Premolar Treatment
43:17 Bone Sounding and Biologic Width
46:58 Shape of Gingivectomy
50:31 Flap Designs
52:37 Burs for Crown Lengthening
56:13 Healing and Restoration Timelines
58:31 Learning and Training Opportunities

Key Takeaways:

• Hiten’s journey began with a passion for periodontics during dental school.
• Managing time effectively is crucial for specialists with busy schedules.
• Functional crown lengthening is often underutilized in practice.
• Aesthetic crown lengthening can lead to complications if not done correctly.
• Understanding biologic width is essential for successful crown lengthening procedures.
• Preoperative assessments are critical for determining candidacy for crown lengthening.
• The type of gingival tissue affects surgical outcomes and healing.
• Proper surgical techniques can prevent complications and ensure better healing.
• Postoperative care is vital for achieving desired aesthetic results.
• Continuous education and mentorship are important for dental professionals.

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

This episode meets GDC Outcome C.

ADG Code: 490 PERIODONTICS (Mucogingival management) 

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

Learning Outcomes:

1. Identify the key differences between aesthetic and functional crown lengthening and the clinical scenarios in which each is most appropriate.
2. Demonstrate an understanding of biologic width and its significance in the success of crown lengthening procedures, including the impact on long-term periodontal health.
3. Apply the principles of bone sounding to accurately assess the need for crown lengthening and ensure optimal restoration outcomes, minimising risks such as gingival recession and bone loss.

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

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

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

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

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

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

Key Takeaways

Tactile feedback is crucial during tooth extractions.

• Understanding application points can improve extraction techniques.
• Using the right amount of pressure is essential to avoid breaking teeth during extraction.
• Luxators are typically used to sever the PDL before extraction.
• Atraumatic extraction techniques are important for preserving bone for future implants.
• Luxators should not be used as elevators.
• Understanding the mechanics of elevators is crucial for effective extractions.
• The ‘six second rule’ helps in assessing extraction progress.
• Having a plan for extractions can prevent complications.
• Communicating with patients about the extraction process is essential.
• Avoid tunnel vision; consider the surrounding teeth during extractions.
• Breaking interproximal contacts can simplify extractions.
• Always check the patient’s medical history before procedures.
• An audible checklist can prevent mistakes during extractions.

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

Highlight of this episode:

• 00:00 Introduction
• 02:07 Catching Up with Emma
• 05:58 Teeth are like avocados!
• 11:13 Understanding Application Points in Extractions
• 17:01 Luxators vs. Elevators: Techniques and Safety
• 24:10 Extraction Technique
• 25:08 The Six-Second Rule
• 28:04 Having a plan
• 29:58 Common Mistakes and  How to Avoid Them
• 38:17 Conclusion and CE Certification

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

This episode meets GDC Outcomes B and C.

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

Dentists will be able to –

1. Recognise essential steps to establish secure application points

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

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

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

Are you confident in diagnosing white patches?

Which white patches need an URGENT referral?

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

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

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

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

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

Key Takeaways

• White patches in the oral cavity can be classified into normal variants, non-pathological patches, and potentially malignant disorders.
• It is important to identify the cause of the white patch and differentiate between different types.
• Referrals should be made based on the characteristics of the white patch and the urgency of the situation.
• Clinical photographs are valuable in referrals and can aid in triaging patients.
• Ongoing monitoring is important for potentially malignant disorders. Lichen planus can have different types and presentations, and a biopsy may be necessary for certain cases.
• Enlarged taste buds, particularly in the foliate papillae, are usually bilateral and not a cause for concern.
• Oral lichenoid lesions can be triggered by dental restorative materials or medications, and a change in dental material may sometimes improve the condition.
• Smoker’s mouth can present with white patches and inflammation in areas where smoke gathers, and counseling patients to reduce smoking is important.
• Oral submucous fibrosis, often caused by areca nut chewing, requires regular review and counseling patients to stop chewing the nut. 

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

Highlights for this episode:

• 01:22 Protrusive Dental Pearl
• 05:13 Dr. Amanda Phoon Nguyen Introduction
• 07:39 White Patches Introduction
• 09:16 Understanding Geographic Tongue
• 12:44 Keratosis vs. Leukoplakia
• 19:02 Proliferative Verrucous Leukoplakia
• 22:18 Referral Tips for General Dentists
• 29:56 Understanding Leukoplakia
• 33:17 Urgent and Non-Urgent Referrals
• 34:37 Patient Communication
• 39:17  Discussing Erythroplakia 
• 41:03 Oral Lichen Planus: Diagnosis and Management
• 47:50 Enlarged Taste Buds
• 49:47 Oral Lichenoid Lesions vs Oral Lichen Planus
• 53:43 Smoker’s Mouth
• 55:14 Oral Submucous Fibrosis
• 57:23 Learning more from Dr. Amanda Phoon Nguyen 

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

This episode meets GDC Outcomes B and C.

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

Dentists will be able to –

1. Identify the cause of a white patch and differentiate between different types.
2. Understand when and how to make referrals based on the characteristics of the white patch and the urgency of the situation.
3. Appreciate the importance of ongoing monitoring for potentially malignant disorders, including when to consider a biopsy.

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

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

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

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

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

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

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

Highlights of this Episode:

• 02:07 Protrusive Dental Pearl
• 03:31 Mike Gregory’s Journey into Dental Technology
• 10:09 Understanding Border Moulding
• 13:19 Technician’s Role in Denture Creation
• 15:45 Improving Communication with Technicians
• 18:34 Special Trays and Custom Trays
• 25:58 The Role of Green Stick
• 29:04 Denture Impressions
• 31:35 Boxing and Beading Techniques
• 35:08 Additive vs. Reductive Rest Seats
• 40:46 Guide Planes
• 42:43  Creating Undercuts for Dentures
• 45:10 Final Tips and Best Practices
• 48:54 Learn More with Mike Gregory

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

This episode meets GDC Outcomes B and C.

AGD Subject code: 670 REMOVABLE PROSTHODONTICS   

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

Dentists will be able to: 

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

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

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

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

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

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

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

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

And how often would this need to be repeated?

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

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

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

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

Key Takeaways

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

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

Highlights of this Episode:

• 01:34 Protrusive Dental Pearl
• 02:47  Introducing Professor Riaz Yar
• 05:07 Understanding Implant Failure Causes
• 08:04 Analyzing Implant Occlusion and Peri-Implantitis
• 10:27 The Chewing Gum Test
• 13:20 Guidelines and Challenges with Implant Occlusion and Lab Protocols
• 17:33 Bone Regeneration and Functional Guidance
• 19:22 Dynamic Movements and Occlusion Analysis
• 23:48 Practical Tips for Implant Bridges
• 28:19 Patient Guidelines for Implant Care

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

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

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

This episode meets GDC Outcomes B and C.

AGD Subject code: 690 IMPLANTS

Dentists will be able to: 

1. Recognize key factors that contribute to implant failure and how occlusion plays a role.
2. Utilize practical approaches, such as the Chewing Gum Test, to assess and manage implant occlusion (function) effectively.
3. Discuss guidelines for implant occlusion and understand the challenges involved in lab protocols.

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

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

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

Protrusive Dental Pearl:

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

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

Use discount code ‘protrusive’ (No financial interest)

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

Highlights of this Episode:
02:18 Protrusive Dental Pearl
04:30 Introduction – Dr Sarika Shah
10:10 Transition to Private Dentistry
13:40 Practice Ownership
17:20 Managing the Practice
24:55 Internal Leadership
29:40 Principals vs Associates Friction
41:56 Women in Dentistry
47:15 Supportive Partners
55:25 Top Advice from Sarika
58:28 Flourish

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

This episode meets GDC LEARNING OUTCOMES A and B

AGD Subject Code 550 Practice Management and Human Relations

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

Dentists will be able to: 

1. Identify key principles of self-leadership and apply them to improve personal and professional development within their practice.
2. Understand the impact of effective communication and aligned values on maintaining strong, respectful relationships between associates and principals in a dental setting.
3. Develop strategies to enhance emotional intelligence, ensuring improved patient care and better collaborative relationships in their practice environment.

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

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

How can we improve the efficacy of our endodontic irrigation?

What % of NaOCl should we be using?

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

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

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

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

Highlights of this Episode:

• 02:09 Protrusive Dental Pearl
• 04:23 Is Sodium Hypochlorite Still The Gold Standard?
• 06:54 The Role of Surfactants in Irrigation
• 07:58 Concentration of Sodium Hypochlorite
• 09:47 Chlorhexidine: Is There Still a Place?
• 11:32 Advanced Disinfection Technologies
• 21:31 Evidence-Based Techniques in Endodontics
• 25:22 GP Pumping

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

This episode meets GDC Outcomes B and C.

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

Dentists will be able to: 

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

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

Rotary or reciprocating files — which should you actually be using?

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.

 https://youtu.be/HfWDBbNgjsA 

Watch PDP270 on YouTube

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 C
AGD 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

What’s the difference between radiolucency and burnout? 

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

When should we pick up the bur for interproximal caries?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Highlights of this Episode:

• 3:01 Protrusive Dental Pearl
• 03:55 Dr. Brett Gilbert’s Journey and Philosophy
• 07:17 Elective or Pre-emptive Endodontics
• 11:06 Radiographic Measurement
• 11:40 Real-Life Encounters 
• 15:29 Discussing Treatment Options and Patient Communication
• 20:28 Can Biodentine Prevent Root Canal?
• 22:45 Materials and Techniques in Endodontics
• 26:16 Death of Gutta-percha?

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

This episode meets GDC Outcomes B and C.

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

Dentists will be able to: 

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

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

Are single-use diamond burs more efficient at cutting?

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

Are expensive brands a con?

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

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

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

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

HIGHLIGHTS of this Episode:

01:24 Protrusive Dental Pearl

02:03 Introduction to Team Intensiv

05:40 Understanding Bur Codes

10:49 Bur Colours

15:10 When to Use Different Grit Diamonds

18:40 Single Use Burs vs Reusable Burs

24:59 Sourcing Diamonds

29:18 Fixing the Diamonds to the Metal Shank

32:40 Is my bur fit for purpose?

37:30 Drilling Zirconia

39:30 Final Tips

41:20 Contact Intensiv

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

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

GDC Learning Outcome:  C

Learning Outcomes

1. Identify the appropriate dental burs for different procedures, considering grit size and material composition, to ensure efficient and safe treatment.
2. Evaluate the impact of bur selection on patient comfort and procedural outcomes, minimising trauma and maximising efficiency during dental treatments.
3. Implement best practices for the maintenance and replacement of burs to ensure optimal performance and longevity, thereby improving clinical results and patient satisfaction.

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

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

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

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

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

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

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

Enter this podcast to save your career! 😉

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

Key Takeaways:

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

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

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

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

Use thinner articulating paper for more precise occlusal markings.

Communicate effectively with your dental nurse about new protocols.

Involve your senses to assess the quality of your restorations.

Document occlusal marks pre and post-restoration for reference.

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

Educate patients about their occlusion to manage expectations.

Highlights of this Episode:
05:24 Introduction – Dr Mahmoud Ibrahim
08:42 Posterior Composite
14:15 Shim Stock Foil
16:35 Effects of Numbing on Occlusion
18:23 Lower First Molar Example
22:06 Shim Stock revisited
26:22 Lateral Excursions
30:32 Fissure Staining?
31:56 Old Restoration as a Guide
35:33 Restoration Techniques and Adjustments
38:03 Tips and Tricks
43:28 Event Discussion
45:09 The Importance of Marginal Ridges
46:25 Anatomy or aNOTomy?
48:17 Post-Op Checklist: Final Adjustmentsand Polishing Tips
54:19 Wrapping Up: Using Your Senses in Dentistry
56:43 Outro

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

This episode meets GDC Outcomes A and C.

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

Dentists will be able to:

1. Evaluate and manage occlusion during posterior composite restorations, ensuring that patient bite and interdigitation are maintained post-procedure.
2. Effectively use shim stock foil and articulating paper to achieve precise contact points and occlusal balance, minimizing the need for post-restoration adjustments.
3. Apply practical techniques, such as using occlusal stamps and soft flex discs, to streamline posterior composite restorations while improving the durability and aesthetics of the final result.

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

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

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

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

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

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

Highlights of the episode:

• 03:06 Dr. Linda Greenwald’s Background and Experience
• 07:09 Teeth Whitening: A Global Perspective
• 08:31 Diagnosing Teeth Sensitivity
• 14:28 Managing Non-Carious Cervical Lesions (NCCLs)
• 22:30 Using Sensodyne for Sensitivity Management
• 24:36 Exploring Different Sensodyne Products
• 26:26 Bruxism and Occlusal Forces: Mechanisms of Sensitivity
• 29:39 Role of Hydration and Tray Design
• 32:57 Whitening Limitations: Cervical Whitening and Medication Impact
• 36:41 Dehydration and Discoloration
• 42:03 Therapeutic Uses of Whitening Trays
• 48:53 Upcoming Events and Final Thoughts

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

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

This episode meets GDC Outcomes A and C.

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

Dentists will be able to:

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

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

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

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

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

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

How about the ‘GABS occlusal philosophy?’

Is ‘centric relation’ full of unicorns and rainbows?

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

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

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

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

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

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

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

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

Does Dentistry have a social media problem?

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

2 Events to Attend:

DentoRama 18th October

Treatment Planning Symposium (Hybrid Event) 16th Nov

Highlights of this Episode:
02:05 Introduction – Dr Mehy Lo-Presti
06:42 Mehy Early On
12:04 Dento-Rama
15:30 Social Media in Dentistry
20:35 Life Before Social Media
21:25 Social Media is a Business 
23:40 What Causes Anxiety for Dentists?
29:45 Overcoming the Fear Factor
34:45 Fast Tracking to Success
41:20 Wrapping Up
47:14 Booking the Event and Getting in Touch

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

GDC LEARNING OUTCOMES: A

AGD Code 770 (Self Improvement)

Dentists will be able to:

1. Gain insights into how social media affects clinical practice, patient perceptions, and professional image, learning how to use these platforms responsibly.
2. Manage the pressures of online validation, minimising the impact on their mental health and maintaining a healthy work-life balance.
3. Develop stronger communication methods both online and offline, ensuring clearer patient education, reducing complaints, and fostering better relationships within the dental team.

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

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

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

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

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

So how do we decide between bridges and dentures?

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

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

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

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

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

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

Follow Dr Michael Frazis on Instagram

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

This episode meets GDC LEARNING OUTCOMES: A and C

AGD Subject Code: 610 Fixed Prosthodontics

Dentists will be able to:

1. Demonstrate improved decision-making skills in treatment planning, particularly regarding non-implant tooth replacement options.
2. Apply communication strategies to better explain treatment options, manage patient expectations, and gain informed consent, especially in high-risk cases involving implants, bridges, or challenging restorations.
3. Recognize red flags and understanding the risks involved in specific dental procedures (such as implant failure or the use of root-filled teeth as abutments) and how to mitigate these risks through careful case selection and patient education.

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

Highlights of this Episode:
00:01:37:00 Protrusive Dental Pearl
00:03:51:05 Introduction – Dr Michael Frazis
00:10:43:10 Growth in Dentistry
00:14:10:10 Non Implant Tooth Replacement Options
00:18:15:10 Treatment Planning Bridges and Dentures
00:24:35:10 Ideal Treatment vs Budget
00:30:15:10 Single Tooth Dentures
00:36:58:10 Thin Implants vs Bridges
00:39:25:10 Bridge Spans
00:49:20:10 Root Filled Teeth as Bridge Abutments
00:55:35:10 Failures
01:05:35:10 Wrapping Up – Contact Michael

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

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

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

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

What is a safe limit of increasing the vertical dimension?

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

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

Highlights of this episode: 

• 02:05 Protrusive Dental Pearl  Acyrlic Copings for Guide Planes
• 03:57 Dr. Mahmoud Ibrahim’s Introduction
• 06:05 Personal Experiences with Vertical Dimension
• 08:45 Challenges and Techniques in Vertical Dimension
• 14:17 Clinical Considerations (Restorative Dentistry) and Research
• 21:15 How to Assess OVD Loss?
• 24:35 Factors to Consider in Increasing the Vertical Dimension
• 28:41 Treatment Planning: Orthodontics vs. Restorative Management
• 32:21 Assessing Cases for Vertical Dimension
• 34:39 Joint Position and Vertical Dimension
• 39:47 Occlusal Appliances Prior to Increasing Vertical Dimension 
• 45:26 Joint Relationship
• 50:49 Reproducibility and Stability in Occlusal Planning
• 53:00 Summary and Final Thoughts on Vertical Dimension

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

AGD code: 180 Occlusion  (Occlusal therapy)

This episode meets GDC Outcomes A and C.

Dentists will be able to:

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

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

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

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

Plant it low and watch it grow? Is that serving our patients?

Should we keep our crowns flat to avoid ‘interferences’?

How about guiding teeth – how can we recreate and build in guidance and the correct cuspal inclination in our indirect work?

As part of Occlusion month I am joined by my dental technician Graham Entwistle and Occlusion geek Dr Mahmoud Ibrahim. We discuss foundational occlusal concepts relevant to our daily indirect restorations.

Protrusive Dental Pearl: Bleeding papilla? Use the HOW technique to QUICKLY stop bleeding – insert a Wedge obliquely (Haemostasis with Oblique Wedge technique) as taught by Dr Sunny Sadana from Drecomposite.com

Treatment Planning Symposium 16th November HYBRID EVENT

Basics of Occlusion Live 2 Day Hands-On Course with Jaz and Mahmoud

Highlights of this Episode:
0:00 Introduction
03:31 Protrusive Dental Pearl
05:16 Introduction – Graham Entwistle + Mahmoud Ibrahim
08:25 Guiding Teeth
11:40 Why is Guidance important?
16:35 What information should we provide our technicians?
20:00 Excursions and Patient Case
28:00 Complex crown creation
33:33 To Facebow or not to Facebow?
34:40 A Technician’s POV
49:50 What is the Technician aiming for?
51:06 Perfect Contacts – technician perspective
53:23 Final Thoughts

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

This episode meets GDC Outcomes B and C.

AGD Subject code: 180 Occlusion (Occlusal functional concepts)

Dentists will be able to:

1. Understand the importance of guidance and occlusion in crown design, ensuring restorations contribute positively to occlusal function and patient well-being.
2. Improve communication strategies with dental technicians, including providing crucial details such as shim holds and occlusal plane guidance, to ensure optimal restorations.
3. Make informed decisions about the distribution of occlusal forces to prevent damage and maintain functional integrity in prosthetic designs.

If you liked this episode, you’ll love PDP137 – Q&A with a Dental Technician

Should we still be drilling early caries lesions?

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.

 https://youtu.be/dGt7FW7C4N0 

Watch PDP269 on YouTube

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 Pack
Head 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 ...

There is something very satisfying about a well fitting denture.

I am joined by our resident Dental Student, Emma Hutchison, to demystify removable prosthetics.

Which joint position should we use for dentures? Is this important?

How do you calculate the freeway space?

What are we actually recording during a Wax Jaw Registration for complete dentures?

Don’t miss the special exam revision notes on Removable Pros available exclusively in the Protrusive Guidance app! (Join the free Students Section)

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

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

If you love this episode, check out PDP162 – Occlusion for Complete Dentures

The first EVER ‘Prospective’ episode of Protrusive – I interviewed new-grad Dr Triman Ahluwalia in 2023, then again 7 months later in 2024 to see how he gets on with his first year as a *real* Dentist 😉

We uncover what it feels to be a freshly qualified Dentist, the pressures and fears that come with procedures such as endo and surgical extractions, but what we can do as growing clinicians to overcome these hurdles.

This episode is packed with lots of top tips to help you in your journey from the ground up, or as a reminder for those that have been there and done that, that we are forever learning on our journey and there’s always something out there to help us become better Dentists.

Highlights of this Episode:
02:02 Introduction to Dr Triman (2023)
03:32 Experiences at Dental School
07:15 Procedures You Fear + Sectioning Teeth
11:25 Thoughts on Social Media in Dentistry
15:26 Documenting Work
16:30 Future Career Plans
18:00 Additional Comments from Triman
19:03 Back to the Future: 2024 Triman Update
21:50 Dental Photography Progress
23:08 Tricky Dental Procedures Update
27:46 The Good and the Bad of DFT
32:26 Career Path in Dentistry
34:49 Triman’s Top Tips
37:06 Wrapping Up

Don’t forget to check out the Protrusive App where you can find more awesome tutorials on becoming a more efficient and effective practitioner.

If you liked this episode, you will also like IC029 – Young Dentist Thrival Guide 

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

Is this the death of impressions for Dentures?

Are digital dentures predictable? Time saving? Cost saving?

Are all types of dentures suitable for the digital workflow?

Even if you don’t use an intra-oral scanner, your lab may be utilising a digital workflow, so it’s a great time to dive deep into this area.

Impression Club’s Dr Rupert Monkhouse joins us for another removable prosthetics themed episode where we discuss how digital dentistry is changing the way we make partial dentures and complete dentures.

Check out Impression Club courses

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

This episode meets GDC Outcomes A and C.

Dentists will be able to:

1. Understand the key differences between traditional impression techniques and digital workflows in denture creation, including the benefits and limitations of both methods.

2. Evaluate the accuracy and efficiency of digital dentures compared to traditional methods and implement best practices for integrating digital workflows into their clinical practice.

3. Effectively collaborate with dental technicians using digital tools, fostering better communication and teamwork to achieve optimal patient outcomes in denture fabrication.

AGD code 670 Removable Prosthodontics (Emerging technology or techniques)

Highlights of this Episode:
03:18 Protrusive Dental Pearl – Understand the Why
05:38 Introduction to Dr Rupert Monkhouse
8:11 What kind of Dentures can we do Digitally?
13:33 What work still requires Impressions?
17:05 Which Scanners?
19:55 How Accurate?
28:24 Should Digital be the Gold Standard?
30:55 Immediate Dentures
38:55 Cobalt Chromes
47:55 Finding great technicians
58:08 Impression Club

If you liked this, you will also like GF018 Intra-Oral Scanner

How are periodontal diseases managed in general practice?

Join us for an engaging conversation with Emma Hutchison, our Protrusive student, as we explore Periodontology (Perio) in the real world.

This conversation delves deep into the practical protocols, patient communication strategies, and real-life scenarios every dental student and practicing dentist should be aware of.

Highlights of this Episode:

• 0:37 Emma’s Dental School Experience: Special Care Dentistry
• 03:02 Emma’s Denture Adjustment Case 
• 06:11 Periodontics Month 
• 06:54 Communicating with Patients about Gum Disease
• 10:15 Managing Non-Engaging Patients
• 15:04 The Psychology of Habits
• 17:13 Referral Protocols in Dental Practice
• 20:00 Risk Factors in Periodontal Treatment
• 25:03 Genetic Factors in Periodontal Disease

Don’t miss the special notes on An Introduction to Periodontal Diseases available exclusively in the Protrusive Guidance app!

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

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

If you love this episode, be sure to recap PS007 – Basics of Indirection Restorations Part 2 – The Crown Fit

It’s your first night on-call and you are bleeped at 3am – there’s a nasty facial laceration waiting for your urgent attention. You have never sutured the face before…”who you gonna call?” – well sometimes even the Ghostbusters will be more helpful than the on-call trainee!

Our good friend Dr Ameer Allybocus joins us again for another episode where he gives us a lowdown of his experience when he was a DCT trainee many years ago. There is a lot to learn in this podcast from Ameer as he dives into the Trials and Tribulations of being an Oral and MaxilloFacial Surgery DCT during the early years of his career. 

There are laughs and tears in this one, so hold on to your seats for an emotional podcast that will leave you wanting more.

Highlights of this Episode:  
00:00 Introduction
01:37 Protrusive Dental Pearl
03:26 Introduction to Dr Ameer Allybocus
19:40 The MaxFax Beginnings
24:00 MaxFax at UCL
29:37 MaxFax isn’t all bad
36:05 DCT Oral Surgery 
42:16 On Call 
48:26 Book Recommendations
49:15 Working at the Queen Elizabeth Hospital
54:13 A Life Changing Experience
59:57 MaxFax: Benefits, Tips & Tricks
65:26 Tips from Ameer
66:25 Trauma and Accidents
70:56 MaxFax Puts Dentistry Into Perspective
74:33 Closing Words

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

If you liked this episode, you will also like: Getting Ahead after Dental School 2023 – IC042 – Protrusive Dental Podcast

What makes us reject crowns and send them back to the technician? What are the standards/guidelines to consider before accepting and luting indirect restorations?

Join us as we explore the key factors that determine the quality of a crown. From the initial lab communication to the final occlusal checks, we cover it all. This episode is packed with essential tips that are perfect for dental students and professionals alike. 

Highlights of the episode:

• 1:33 Emma Hutchison: Student Life and OSCEs
• 06:44 Handling Lab Work and Fitting Crowns
• 14:15 Crown Rejections
• 18:12 Understanding Occlusal Tolerance
• 20:09 The Importance of Occlusal Precision
• 22:24 Building a Strong Dentist-Lab Technician Relationship
• 24:17 Tips for Dental Students
• 27:46 Microbiology in Dentistry

Don’t miss the special notes on Microbial Ecology and Infection Transmission available exclusively in the Protrusive Guidance app! (Join the free Students Section)

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

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

If you love this episode, be sure to recap PS006 – Basics of Indirect Restorations Part 1 – Decision Making

Clinician Development Tool: https://protrusive.co.uk/cdt

Did you know, there’s a cheaper, quicker and more natural treatment option than using Dental Implants, WITHOUT compromising on longevity? Sounds too good to be true right? 

You already know about it. You most likely studied it already at Dental School and just haven’t given it much thought in a clinical scenario.

Meet Dr Lukas Huber who will remind us of the power of Autotransplantation for such cases, which in turn can massively help our patients who have missing or hopeless teeth, all while keeping laboratory costs down and success rates up.

Highlights of this Episode:
02:10 Clinician Development Tool
03:34 Introduction – Dr Lukas Huber
07:40 Autotransplantation Procedure
12:45 Example Autotransplantation
18:40 Step by Step Autotransplantation
26:35 Placing the Donor Tooth
30:15 Transplant Restorative Augmentation
35:00 Learn more from Lukas

I thought that Dr Lukas is an inspiration to all the general Dentists and am so grateful he is part of our Protrusive Community – thanks for sharing your entire protocol!

Don’t forget to claim CE Credits on Protrusive Guidance by completing the quiz.

Check out Dr Lukas Huber’s Instagram!

If you liked this episode, you will also like Atraumatic Extractions

What is the best bonding agent to use?

Does it actually matter? Spoiler: it does!

How do you get the best bond to dentine and enamel with the adhesive system you are using?

Dr Sam Sherif joins us in this episode, where he discusses bond strength in detail as well as sharing his top tips in achieving long lasting adhesion for our daily adhesive Dentistry. There’s a lot to learn in this one so get ready those onions ready!

​Protrusive Dental Pearl: Always read the directions for use – ESPECIALLY for your adhesive systems!

Did you know? Paid members on Protrusive Guidance can access the PDF summary notes as part of the Protrusive Vault. Oh and be sure to answer the quiz for 1 CE credit!

If you liked this episode, you will also like Immediate Dentine Sealing Part 2

Is Shillingburg’s textbook irrelevant?

What materials are used in the real world?

Is it right that dental students are primarily taught PFM crown preps?

When to Onlay and when to go full crown?

The Direct vs Indirect debate continues, too!

In this two-part journey, we’ll dive into the world of crowns, bridges, and ceramics, exploring their applications, benefits, and the science behind these crucial dental materials.

Join Emma and Jaz as they guide you through the fascinating world of indirect restorations.

Highlights of this Episode:

• 01:46 Welcoming Emma back
• 02:07 Emma’s Learning Progress
• 05:57 Crowns: Material Choices and Real-World Applications
• 09:41 Onlays and Overlays
• 11:33  Direct vs Indirect Restorations
• 18:40 Onlays vs Crowns: Decision-Making
• 22:18 Conclusion and Next Steps

Don’t miss the special notes on Indirect Restorations available exclusively in the Protrusive Guidance app in the ‘Crush Your Exams’ space!

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

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

If you love this episode, be sure to recap PS005 – Should our Restorations Follow Textbook Anatomy? Tooth Morphology 

The secret to success with non-vital bleaching is knowing when it’s not going to work.

Dr Jason Smithson shares his decision making in discoloured incisors AND the protocols he uses in their management.

When is a purely restorative approach more appropriate than bleaching?

When is ceramic preferred to composite?

What is the best way to mask a metal post?

Listen/Watch this episode which reveals all! This episode is eligible for 1 CE credit via the Protrusive Guidance platform.

Protrusive Dental Pearl:

To help achieve great shade selection, take pictures sequentially during your assessment and throughout the procedure, then edit the pictures to show as black and white. By analysing the shade match through a black and white process and in steps throughout the treatment, the shade selection will be far more accurate than just attempting this once at the beginning, especially without using the black and white technique, as this will emphasise the value of the shade

Highlights of this Episode: 
01:56 Protrusive Dental Pearl
03:15 Introduction – Dr Jason Smithson
05:30 Biomimetic Dentistry
14:50 Non Vital Bleaching
24:55 Calcific Metamorphosis
28:30 Ceramic or Composite Resin
31:17 Deeper Dive into Ceramic Use
32:55 Composite veneers
40:35 Perfecting Shade
43:40 Jason’s Courses

Access the CPD quiz either on your browser or by downloading our mobile app. For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content.

If you liked this episode, you will also like The ‘Anti-Biomimetic Dentist’ – Restorative Lessons from Pasquale Venuti Part 1 – PDP152 – Protrusive Dental Podcast

If you showed the same bitewing to 10 dentists, would they all agree on whether to pick up the drill?

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.

 https://youtu.be/YriLo8_hXNw 

Watch PDP268 on YouTube

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 ...

When restoring molars, should we ALWAYS try to recreate textbook anatomy? (spoiler: NO WAY!)

What preventive measures can we use for toothwear?

Tooth Morphology in the Real world!

In this episode, Emma Hutchison and I explored the nuances of practical tooth morphology. Textbooks provide us with idealized versions of dental structures, but how do these perfect images translate into real-life practice? Can and should we aim to replicate these diagrams exactly in our dental work?

Highlights of this episode:

• 1:38 Introducing Emma Hutchison
• 01:53 First Denture Experience – What is an Overdenture?
• 03:13 The Importance of Complete Dentures in Aesthetic Dentistry
• 8:26 Understanding Tooth Morphology in Practice
• 11:25 Changing the Morphology of the Tooth
• 15:56 Difference Between Morphology of Premolars
• 20:31 Preserving Natural Tooth Morphology
• 27:26 Real-World Application of Tooth Anatomy

Don’t miss the special notes on tooth morphology available exclusively in the Protrusive Guidance app!

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

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

If you love this episode, be sure to recap PS004 – Learning Can Be Stressful!

Air Particle Abrasion!

Images of Sandblasted teeth look cool but does it ACTUALLY improve clinical outcomes?

What are the indications? When is it genuinely critical to use?

More pragmatically, are there any decent alternatives eg. roughening with a bur?

Air particle abrasion, a technique used to prepare tooth surfaces for bonding, has sparked considerable debate among professionals. This episode discussed its effectiveness, implications, and best practices with  Dr. Veronica Pereira de Lima. 

Protrusive Dental Pearl: 

Two advantages of slicing off a corner of the rubber dam are:

1. Anterior Dam Stabilization: By flossing the cut piece through the front teeth, it acts as a makeshift wedge, securely fastening the dam in place without the need for traditional wedjet.
2. Simplified Orientation: This technique aids in aligning the rubber dam properly, streamlining the entire setup process for more efficient dental work.

Check out ‘Quick and Slick Rubber Dam’ online course (on-demand) only available via the Ultimate Education Plan on Protrusive Guidance

Highlights of this episode:

• 00:44 Protrusive Dental Pearl
• 04:16  Dr. Verônica Pereira de Lima Introduction
• 07:07 Journey of Dentistry in Brazil
• 08:34 Academia vs Clinical Practice
• 09:20 Journey about PhD and Work Surrounding Air Particle Abrasion
• 11:12 Importance of Air Particle Abrasion to Clinical Dentistry
• 15:57 Health Concerns Regarding Air Abrasion Particles
• 18:10 Air Abrasion Contraindication
• 20:13 Size of the Microns –  Clinical Guidelines
• 22:25 Pragmatic Approaches in Clinical Practice
• 24:28 Cojet as an Air Abrasion Particle
• 27:37 Improper Use of Air Abrasion
• 30:07 Air Abrasion Guidelines Regarding Different Ceramics
• 31:40 Alternatives to Air Abrasion
• 33:29 Dr. Veronica’s Personal Guidelines – Air Abrasion Protocol and Unit
• 40:27 Learning with Dr. Veronica 

Access the CPD quiz either on your browser or by downloading our mobile app. For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content.

If you love this episode, be sure to watch Immediate Dentine Sealing Tutorial Part 1 – PDP173

Paying through the nose for your indemnity? You may get better protection with insurance AND it has saved Dentists £1000s – get a quote today from PDI / AllMedPro and get an additional £100 off (this is a promotional link that will save you money)

Associate contracts are actually a HUGE deal that we do not give enough attention to…

How long can your principal keep your retention for?

Is it really true you cannot work within a certain radius?

How principals and associates may be getting screwed over by the poor contract!

Finding the right principal/associate is very exciting, so much so that we sometimes forget how important it is to read through the small print of our contract. 

This can prove very costly in the future in our industry where mistakes do happen, so it is extremely important to be aware of what we are signing up for.

Join us today with Neel Jaiswal and Sarah Buxton for a breakdown of how to negotiate the right contract for you, the power of being an Associate in this day and age, and the importance of Insurance. There’s a lot more in this episode so don’t miss out…’Court is in session!’

Highlights of this Episode:
02:08 Sarah Buxton and Dr Neel Jaiswal 
08:40 Associate Contracts
11:15 Who Checks the Contract?
13:50 Contract Bias towards Principals?
18:50 Getting Contracts Checked
21:28 Retention of Fees
30:48 Annual Leave
35:00 Exclusion Zones
43:04 Vicarious Liability
52:18 How to get in touch

For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. This includes Vertipreps for Plonkers and clinical videos demonstrating Onlay Preps.

If you liked this episode, you will also like GF019 – Indemnity vs Insurance

Have you ever considered Dental Aid Work?

Imagine giving up your morning starbucks and your air conditioned dental surgery to work in a developing country that has just 7 dentists.

Fellow Protruserati, Dr James Hunter and his young family will be doing just this – they are preparing for a four-year mission to Liberia, Africa, to dedicate themselves to dental aid work.

Follow along as we delve into their story of skill, passion, and humanitarianism.

Highlights of this Episode:
00:00 Introduction
2:52 From Theology to Dentistry
5:35 Dr. James on Dentistry
06:44 The Decision to Move to Liberia for Aid Work
09:52 Understanding Liberia’s History and Needs
15:28 The Future Plans for Dental Aid in Liberia
18:37 Motivations Behind the Mission
20:04 The Challenge of Committing to Charity Work
20:57 Financial Planning, Schooling and Adaptation for Children Abroad
26:40 Sharing Experiences and Encouraging Aid Work
28:13 Raising Awareness and Support for the Mission
32:09 Closing Thoughts and Encouragement

Be sure to visit https://www.thehuntersinliberia.co.uk/ for details on supporting charity work in Liberia. Additionally, explore other charity websites in your country for more ways to make a difference locally.

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

For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. This includes Vertipreps for Plonkers and clinical videos demonstrating Onlay Preps.

If you enjoyed this episode, don’t miss out on watching “The International Dental Student – From Ukraine to Egypt to Slovakia – IC047”

Have we fully shifted towards lithium disilicate overlays and onlays?

Are full crowns considered a sin in 2024? (Maybe just on Instagram then!)

Spoiler: Crowns TOTALLY have a place, and so do large direct composite restorations!

Dr Alan Burgin and I share our decision making trees for indirect restorations as part of ‘Crowns and Onlays Month’ on Protrusive Dental Podcast.

Find out which clinical factors sway us more towards a Overlay vs a Vertiprep – and the rationale for each type of restoration.

Protrusive Dental Pearl: Use Vaseline on the gingivae when carrying out a ‘smile trial’ or bis-acryl mock-up – will result in an easier clean up!

Highlights of this Episode:
01:54 Protrusive Dental Pearl
02:44 Introduction – Dr Alan Burgin
18:20 Types of Indirect Restorations
31:16 From Onlay to Crown
44:40 Crowns – Traditional vs Verti-Preps
54:00 Reflection
57:48 Alan’s Prep Course

For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. This includes Vertipreps for Plonkers and clinical videos demonstrating Onlay Preps.

Join us on Protrusive Guidance, our own platform for dental professionals. No need for Facebook anymore! 😉

If you liked this episode, you will also like PDP089 – Vertiprep Revision

Clinical Dentistry is a steep learning curve – it can be frustrating, frightening and quite frankly exhilarating.

This episode (better late than never! My wife finished her MSc so now I’m back on track!) picks up the theme of Stress Awareness and I discuss with Emma Hutchinson, our Protrusive Student, how students can manage stress effectively, prioritize their studies, and identify their unique learning styles. 

We also address imposter syndrome and the various difficulties encountered while learning something as complex as dentistry.

Highlights of this episode:
00:00 Introduction
03:25 Welcoming Emma Back
04:16 Protrusive Students
06:30 Dentistry Students vs Other Courses
08:24 Hobbies and Activities Outside of Dental School
12:50 Communication Style
14:48 Student-Life Balance
19:01 Past Papers during Exam Time
21:00 Networking in Dentistry
28:51 Burnout and Mental Health Perspective
33:45 Next Month – Orthodontics

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

For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. Join us on Protrusive Guidance, our own platform for dental professionals. No need for Facebook anymore! 😉

If you love this episode, be sure to watch Adhesive Dentistry for Beginners – PS002

Implants can fail – we all know that…but what are the medico-legal implications when they fail at 6 months after restoring them…

Is it all the restoring Dentists’ problem? ‘He who touched it last’? Or does the implant placing surgeon also need to be involved in the ‘post-mortem’?

How can we handle the upset patient (and prevent this in the first place!)

In the latest podcast episode, we introduced Dr. Joe Bhat and Neel Jeiswal, both prominent figures in Dentistry. Neel, representing PDI, has a rich background in clinical dentistry and medico-legal matters, while Dr Joe Bhat is a dual specialist in Oral Surgery and Prosthodontics. Joe established a pioneering multi-disciplinary clinic 20 years ago, which continues to thrive with numerous referrals.

Both guests provided deep insights into implant failures, patient management, and the importance of effective communication and collaboration in dental practices.

Check out Dr Joe Bhat’s place of practice – Moor Park Specialists

Due a renewal for your indemnity/insurance? Get a quote and special discount from PDI

If you liked this episode, you will also like 4 Ways to Boost Osseointegration of Your Implants – PDP155 – Protrusive Dental Podcast

More brilliant questions from dental students as Jaz is joined by Dhruti Mysore from Plymouth University.

We covered themes of student-life balance and professional development. Jaz shared the powerful technique of ‘Just-in-Time’ learning to gain structure and purpose to post-graduate development.

Jaz gave his top tips for preventing burnout and the power of a supportive network. 

And of course, we discussed Occlusion and Facebows!

For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. Join us on Protrusive Guidance, our own platform for dental professionals. No need for Facebook anymore! 😉

If you liked this episode, you will also like Occlusion Questions from Students – AJ005

Hear how Aidan went from anxious about exodontia to now feeling confident and enjoying his oral surgery list.

We cover the themes of career progression, overcoming procedural fears and decision making early in our careers.

At the end, Aidan shares a clever way to deliver saline when washing out sockets!

Highlights of this Episode:
00:00  Intro 
01:47 Imposter Syndrome
02:45 Aiden’s Story
05:16 Daunting Experiences with Stubborn Canine
06:48 How Aiden would approach things now
07:33 Dental Pearl – 6 second rule
09:56 What happened during COVID?
18:08 After the Ipswich post, what happened?
25:04 Aiden’s advice for young dentists 
29:53 Lesson about photography
35:13 Whole tooth extraction vs. sectioning?
36:26 Sectioning School
39:31 Outro

Sterile Saline Pods

Check out Sectioning School and the entire collection of masterclasses for just $450

Check out the First Video of Sectioning School for Free:

Occlusion Online Summer Sale – £100 OFF Expires 3rd June

Class II’s are only easy when they are small (but not too small), supragingival, easily accessible with straight-forward anatomy.

In other words, about 1% of the Class IIs we encounter – because the vast majority I see are subgingival, wide, with awkward root concavities and tricky access.

I went from using sectional matrices 97% of the time to now just using them 30% of the time – this is thanks to a circumferential matrix I started to use last year which is a game changer.

I now do not need to use a wedge in most scenarios (something I used to think was a crime!) and have been using the ‘contact opening technique’.

Meet Dr Sunny Sadana, who has brought the Greater Curve system to the UK and taught me a lot about efficiency with direct restorations.

We also discuss fee-setting and patient communication – this part of the video is only available for those on our Protrusive Guidance network.

Protrusive Dental Pearl 

Pre-wedging; use this technique before beginning any restorative work on the tooth you are working on, this will allow a greater field of view to work in. It also helps suppress the papilla to get better access to the caries. This can all be achieved by numbing the area first and wedging with adequate enough pressure for there to be separation. It also reduced iatrogenic damage and is also worthwhile considering using a wedge-guard/fender wedge.

Check out the DRE Composite Course

Access the CPD quiz through our app on https://www.protrusive.app, either on your browser or by downloading our mobile app.

For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. Join us on Protrusive Guidance, our own platform for dental professionals. No need for Facebook anymore! 😉

If you liked this episode, you will also like PDP104 Back to Back Class II Secrets (Sectional Matrix Troubleshooting)

Why does dentistry on social media look so perfect?

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.

 https://youtu.be/uTKaeewgrgE 

Watch IC074 on YouTube

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.

Check out the ‘semi-indirect’ technique to restore toothwear cases – including palatal backings made chairside and bonded at the same time.

Join Jaz as he geeks out with Dr Zohaib Khwaja to extract the nuances of this clever technique.

We also deep dive into the Dahl technique.

Protrusive Guidance members with access to the Protrusive Vault can check our Semi-Indirect Composite infographic with a step by step visual protocol for semi-indirect palatal backings.

Protrusive Dental Pearl: Practice finding centric relation on your general patients, even if they are just attending for a routine examination. It is a great way to get practice!

Check out Dr Khwaja’s Instagram page

Highlights of this Episode:
02:48 – Protrusive Dental Pearl – Finding CR
05:15 – Dr. Zohaib Khwaja Introduction
11:14 – What is the Dahl Technique? 
17:41 – Restoring Worn Posterior Teeth 
28:37 – Restoring Anterior Teeth
39:23 – Dr. Zohaib – The Teacher

Access the CPD quiz through our app on https://www.protrusive.app, either on your browser or by downloading our mobile app.

For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. Join us on Protrusive Guidance, our own platform for dental professionals. No need for Facebook anymore! 😉

If you liked this episode, you will also like Why do some Dentists find Dahl Distasteful? – PDP016

From softwares to enhance communication with prospective patients, and clever ones that utilise AI for radiographs and note taking, Prav Solanki and I deep dive into some products we currently like to use or have heard good things about.

In this episode, we discuss the many ways that AI is now streamlining things in our workplace and ensuring that we are able to protect ourselves from a medico-legal perspective, as well as providing the patient with confidence in their treatment plans. Get ready to get techy!

Softwares mentioned in this episode:

LeadFlo – CRM System for Dentists

DigitalTCO – AI and Voice Assisted Dental Notes [Affiliate Link]

Dental Audio Notes – Secure Audio Recording

CareStack – Cloud Based Dental Software

Software of Excellence Exact – Practice Management

Loom – Async Video Messages

SmileCloud Smile Design

Chairsyde – Consultation Platform

Pearl AI – Radiographs in Colour

MakeMeClear – Treatment Plans that Explain Themselves (25% off using ‘protrusive’ – Affiliate Program]

Highlights of this Episode:
00:00 – Intro
03:22 – Protrusive Dental Pearl
04:53 – Introducing Dr. Prav Solanki
05:35 – Skillset Enhancement
07:45 – CRM Introduction
09:02 – LeadFlo
12:52 – Follow-up Strategy
18:20 – Building Trust
20:33 – Lifetime Value Focus
23:45 – Simplify Plans
30:40 – Communication Tools
42:27 – Best Patient Management Systems
58:10 – Visual Communication
59:40 – Video Disclaimers
64:54 – More Software Options
80:10 – Final Words

Access the CPD quiz through our app on https://www.protrusive.app, either on your browser or by downloading our mobile app.

For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. Join us on Protrusive Guidance, our own platform for dental professionals. No need for Facebook anymore! 😉

If you liked this episode, you will also like NEVER Write Notes Again! How I Use AI for Awesome and Efficient Dental Records – PDP181 – Protrusive Dental Podcast