Sleepless Nights, Failures, and Bouncing Back (Part 2) - PDP290
Wednesday, October 28, 2026 • Duration 40:22
Do you ever take your patients home with you — replaying the day, the difficult conversation, the distal margin you wish you’d sealed a little better?
Have you ever lost a night’s sleep over a case that went wrong?
Which parts of dentistry fill you with energy — and which quietly drain you?
And are you cutting corners you know about — and paying for it in job satisfaction?
This is Part 2 of my conversation with Dr Ronit Patel — a general dentist with more than 20 years in practice, who built a referral book in endodontics and restorative dentistry and then, by design, flipped back to mostly general dentistry. Part 1 was about taking control of your diary. This part goes further: fuel versus friction, why general practice is the toughest and most fun job in dentistry, what to do when your diary has white space, and the conversation we don’t have enough — failures, complaints and sleepless nights, and how to bounce back. It stands on its own, but Part 1 is a great companion.
Protrusive Dental Pearls: Clean It, Hand It, Check It
This episode has three pearls instead of one — one clinical, one for your team, one for your systems.
1. Clean the teeth. Endodontics is chemo-mechanical: we accept that bacteria and biofilm are there, so we debride mechanically and disinfect chemically. Restorative dentistry deserves the same respect. Before placing a composite or fitting a crown, clean the tooth — pumice is the most accessible option, with ultrasonic scaling or air abrasion as alternatives. Disclose first so you can see what’s there, then clean until it’s gone. Everyone knows they should; it’s the step most often skipped, and it shows up later as staining around the margins.
2. Hand instruments with intention. In Japan, even a receipt is handed over with care and intention. Bring that to four-handed dentistry: the right instrument, the right way round, arriving with the weight and timing your hand expects. A seamless transfer is efficiency the patient can feel.
3. Give yourself checklists. Most missed steps aren’t a knowledge problem — you know what to do, and a step still gets skipped. Give yourself and your nurse checklists and pro formas. A new step that relies on you asking every time disappears the first day you forget. Write it into the checklist, and it becomes the system.
What You’ll Take From This Episode
Fuel vs friction — how to audit your whole working week and find the niche that energises you instead of draining you.
Keep sharpening the knife — why stagnation, not hard work, is the real burnout risk, and how to take on new skills mid-career.
Your day list is your revenue — the three-way test for where to niche, and why you shouldn’t panic-book the white space.
Bouncing back from failure — a real full-arch case that went wrong at the fit, and what actually helped.
The cognitive dissonance trap — the hidden reason so many dentists feel miserable, and the mentor lesson that changed how one endodontist practises.
Highlights of This Episode 00:00 TEASER 00:56 Sleepless Nights in Dentistry: Do You Take Patients Home? 03:39 How to Find Your Niche in Dentistry 06:06 Fuel vs Friction: Which Dentistry Drains You? 08:32 Referral Work vs General Practice: Why Continuity of Care Matters 10:15 Why General Dentistry Is the Toughest — and Most Fun — Job 12:04 Learning Surgical Dentistry Mid-Career 13:32 Avoiding Burnout: Keep Sharpening the Knife 15:27 Cherry-Picking Cases and Practising Authentically 18:52 Your Day List Is Your Revenue 21:35 Empty Diary Time: Why Not to Panic-Book 24:10 How to Cope With Clinical Failures and Sleepless Nights 29:27 Mentor Advice: Make the Parts Nobody Sees Beautiful 30:32 Cognitive Dissonance: Why Cutting Corners Makes Dentists Miserable 32:50 Why a Non-Judgemental Dental Community Matters 34:31 Three Dental Pearls: Clean Teeth, Four-Handed Dentistry, Checklists 38:12 OUTRO
From the Guest
Dr Ronit Patel is a general dental practitioner and associate at the White House Dental Clinic in Kew. His work spans endodontics, microscope-based restorative dentistry and, more recently, surgical dentistry, alongside general care for whole families. Inside Protrusive Guidance he records short video explanations answering members’ clinical cases.
Gawande A. The Checklist Manifesto: How to Get Things Right. Metropolitan Books, 2009. The distinction between errors of ignorance and errors of ineptitude behind the third pearl.
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 B.
AGD Subject Code: 770 Self-Improvement.
Aim & Learning Outcomes
Aim: To help dental practitioners build a sustainable, fulfilling career by recognising what energises and drains them, managing their diary and development deliberately, and recovering constructively from clinical setbacks.
Learning Outcomes — by the end of this episode, dentists will be able to:
Identify the clinical and non-clinical parts of their own practice that energise or drain them, and use this to guide decisions about focus, referral and further training.
Describe strategies for managing the emotional impact of clinical failures and complaints, including the role of peer support and mentorship.
Apply checklists and structured team protocols to reduce errors caused by omitted steps rather than by a lack of knowledge.
"Why I Don't Work August" — Designing a Career on Your Own Terms (Part 1) - PDP289
Wednesday, October 21, 2026 • Duration 01:07:41
Is your diary running you — booked weeks ahead, no white space, drowning by Thursday?
Do you really have to specialise to get referrals?
How does an associate negotiate a month off every August — and get a yes?
And what changes when you start treating yourself as your most important instrument?
This is Part 1 of a two-part conversation with Dr Ronit Patel — a Richmond GDP of 20-odd years, an associate at the White House Dental Clinic in Kew, and one of the nicest and geekiest members of the Protrusive community. He works three and a half days a week, takes Wednesdays off, and typically takes the whole of August off. This episode is how he got there: staying a generalist when specialising beckoned, buying a microscope he wasn’t allowed to see, building a referral book without social media, and — the big one — taking control of the diary.
It’s a warm, reflective conversation rather than a technique masterclass, and Ronit is refreshingly honest that it hasn’t always been smooth. Part 2 goes into fuel versus friction: what fills you, and what drains you.
Protrusive Dental Pearl: Get Good, Then Get Passionate
“Follow your passion” is actually bad career advice. What most of us call passion is really interest. When you applied to dental school, you may have said you were passionate about dentistry and oral health — but you had barely scratched the surface. That wasn’t passion; that was flirting with the idea of dentistry. Then you married it, and disillusionment arrived: is this really what I signed up for?
Passion develops once you start to get good at something and you’re helping people — and dentistry has so many avenues to do both. You don’t become passionate first, then good. You become good, then passionate. So the better advice: become good at something, help people, develop a passion, and follow it through.
Entrepreneurship in Dentistry - Could it be Right For You? - IC080
Friday, October 16, 2026 • Duration 01:06:26
Ever felt like being a good clinician is just the entry fee?
Have you got an idea you’ve been sitting on — and no one telling you to go for it?
Practice ownership, a side business, or staying a happy associate: how do you know which is right for you?
And when you tell a patient the fee… do you stay silent, or start talking?
This is an Interference Cast — a non-clinical episode designed purely to inspire. My guest, Dr Jawad Abbas, is a young associate who’s already building two ventures alongside his clinical work: an AI tool for radiographic analysis and treatment-plan communication, and a luxury oral-care brand. We start with the communication skills that turn patient trust into comprehensive care — then dig into what it really takes to build something of your own, and whether you even should.
We’re living through a moment where, if you can think it, you can increasingly build it. If there’s a big enough problem out there and you have a good solution for it, this episode might be the spark you needed.
Protrusive Dental Pearl: Say the Fee, Then Stay Silent
When you present a treatment fee, say the number clearly — then stop talking. Don’t justify it, don’t over-explain, don’t rush to fill the gap. The pause feels endless to you, but for the patient it passes in a second or two, because they’re busy doing the mental maths: what’s in savings, what the monthly commitments look like, whether they can make it work. Give them that space.
What undermines a fee is rarely the number; it’s the delivery. Closing your eyes as you say it, your voice rising in pitch, launching straight into justification, or avoiding it altogether and letting the patient discover it at reception all signal that you’re not sure of your own fee. Remember what sits behind it — your training, and what your surgery costs to run every hour — and say it like you mean it.
You’re Probably Using Your Ultrasonic Wrong - PDP288
Wednesday, October 14, 2026 • Duration 01:10:46
Beyond Scaling: How to Get More From Your Ultrasonic
Do you really need your ultrasonic on 100%? (Probably not — and it may be costing you precision.)
Which part of the tip should actually be touching the tooth — and is that why the hygienists keep complaining about blunt tips?
Could the scaler tip you already own refine your margins, find a calcified canal and cut gutta-percha like a hot knife through butter?
And if you’re in the market for a new unit, which features are actually worth paying for?
Every dentist uses an ultrasonic — but most of us use it as a perio tool and nothing more. In this episode, Dr Hussain Hassanali, a general dentist who has gone properly geeky on ultrasonics, walks through how they really remove tooth tissue and how to put them to work in restorative dentistry and endo. It’s foundational, practical, and full of things you can try at your next session. Jaz’s biggest takeaway? Stop whacking the power up to 100%.
Protrusive Dental Pearl: Trim Gutta-Percha With Your Scaler Tip
You’ve just obturated a canal and need to remove the excess gutta-percha. The old ways: heat a ball burnisher in the flame until it glows red (that smell, and the GP smearing everywhere — or lifting out entirely because the sealer hasn’t set), or sink a long-neck bur into the GP while it spins and hope you don’t gouge the dentine.
Instead, take your bog-standard ultrasonic scaler tip, turn the water off, and set the power to around 10%. Sweep it across the orifice and it cuts through gutta-percha like a hot knife through butter — the water is off because here you want the heat. Then drop the power right down (around 2%) and gently compact the coronal GP, leaving roughly 1–1.5 mm of space for your restorative material to lock into the orifice. No flame, no burn risk, and a thin tip that doesn’t block your view. Try it once and you won’t go back to heated pluggers.
Painless Local Anaesthetic with "No-Pain Nigel" - PDP287
Wednesday, October 7, 2026 • Duration 44:06
Would you dare promise patients a refund if they felt any pain?
Why do so many of us still skip topical — and what does that say to the patient in the chair?
How do you take the sting out of an inferior alveolar nerve block, a palatal, or a screaming hot pulp?
And when the lip is numb but the patient still feels it — what went wrong before you even picked up the handpiece?
My guest is Dr Nigel Kennedy, known to his Brighton patients as “No Pain Nigel” — a dentist who backed his injections with a money-back guarantee, and who has recently retired. Fair warning: there is no revolutionary technique or new anaesthetic agent in this episode. It is the foundations of painless anaesthesia, done properly and done every time — a great reminder of the why for experienced colleagues, and an aspirational one for younger dentists. We finish on something bigger: how to stay calm, stay well, and enjoy a long career in dentistry.
Protrusive Dental Pearl: Plateaus Are Normal, Growth Compounds
Growth in dentistry is not exponential and ever-rising. Like most careers, it plateaus — and you will feel stuck, sometimes for years. That is normal. Progress comes in small increments, and one of the best things about this profession is that you learn something new every working day.
Trust the process. Keep investing in yourself and aim to be 1% better. Give each month a theme — rubber dam this month, photography the next — and the breakthroughs arrive.
A useful marker of how far you have come: early on, many of us check tomorrow’s day list so we can revise for the deep filling, the molar root canal or the denture records. Years later you walk in not knowing what is booked — even a full-mouth rehab — and think, “Okay, cool. Let’s do this.” It may not feel rapid, but it is compounding.
What You’ll Take From This Episode
Thoughts Become Things - How to Be Happier in Dentistry - IC079
Friday, October 2, 2026 • Duration 48:56
When a filling doesn’t go to plan, how many times do you replay it on the drive home?
Have you fallen out of love with dentistry — or just with the way you’re experiencing it right now?
Why do the habits that could help your headspace get forgotten by Wednesday?
And when did you last ask yourself: have my thoughts been serving me today?
This is an Interference Cast episode — no margins, no bonding protocols. Jaz is joined by Neo Positivity, a former Camden, New Jersey police officer turned mindset speaker, who now spends his time in dental practices in the US and the UK with one message: thoughts become things.
Neo is big energy, and not every part of his philosophy will land for everyone — it doesn’t need to. Underneath it are habits any dentist can use tomorrow: stepping back from the “what if” spiral after a treatment goes wrong, catching autopilot thinking, remembering how badly you once wanted this job, and building reminders into the day so you actually follow through. Jaz leaves with a very personal takeaway about the version of himself that shows up at home.
This episode discusses suicide in the dental profession. If you’re struggling, please talk to someone today — in the UK and Ireland, Samaritans are free and available 24/7 on 116 123; in the US, call or text 988. The Canmore Trust (thecanmoretrust.co.uk) supports dental professionals affected by suicide.
What You’ll Take From This Episode
Step back from the thought — the press-conference technique for the “what if I get sued?” spiral.
Watch what you water — why the thoughts you rehearse most become the easiest to repeat.
Get home first — the step to take before you quit a job, or dentistry.
Reach for the cookie jar — using past wins to reset a bad day and repair a strained nurse relationship.
How to Explain Treatment Risks and Fees Without Scaring Patients - PDP286
Wednesday, September 30, 2026 • Duration 01:21:38
How do you explain everything that could go wrong with a root canal — without the patient walking out?
Why does a signed consent form protect you far less than you think?
What should you say in the exact moment after you tell a patient the fee?
And which single word is quietly sabotaging every future conversation you have about maintenance?
This is Part 2 of our communication masterclass with Dr Zak Kara, principal dentist at Smile Stories in Bournemouth, who coaches and mentors dentists on exactly these conversations. We tackle two questions sent in by the community: how to explain risks without discouraging patients from treatment, and how to present fees — including future maintenance and complications — clearly and confidently. Expect two live role-plays (a molar root canal and a lower wisdom tooth), a respectful disagreement about whether to call people patients or clients, and the fee-presentation sequence I wish I’d had years ago, when I hated every part of talking about money.
Protrusive Dental Pearl: Could They Retell It at Home?
Measure a consultation by one question: was I understood? Not conversion, not uptake — understanding. The ethical approach tends to deliver the conversion anyway.
The practical test: when the patient gets home and someone asks “How was the dentist today?”, can they summarise in a few sentences exactly what the appointment was about and what they need to do next? If not, the explanation isn’t finished — however thorough it felt from your side of the chair. That clarity is a skill, and it gets built deliberately.
What You’ll Take From This Episode
Six moves for explaining risk — how to make every risk proportionate, personal and paired with your plan to reduce it.
— plain-English wording, an honest success rate, and the analogy that makes recovery make sense.
How to Talk to Patients Who Only Want One Tooth Fixed - PDP285
Wednesday, September 23, 2026 • Duration 01:21:57
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What do you say when a patient comes in wanting one tooth fixed, but you can see eight more heading the same way?
How do you tell a patient who has had a scale and polish every six months for twenty years that they now need something deeper without making it sound like you’re suddenly trying to sell them more dentistry?
Is there a magic sentence that makes patients say yes to comprehensive care?
And why can the patient you’ve known and liked for six years sometimes be harder to move forward with than a complete stranger?
This is Part 1 of a two-part communication series with Dr Zak Kara — co-founder of Smile Stories in Bournemouth, and the most-returning guest on this podcast. It’s also our first-ever call-in episode: the questions came in from the community as voice notes, and this episode answers two of them. Part 2 takes on the awkward stuff — discussing fees, and communicating risk without frightening people off.
Protrusive Dental Pearl: Reactive or Proactive Associate?
When the diary goes quiet, what do you actually do? Wait for the practice to work some magic and fill it — or go and fill it yourself? The mentality of “the clinic supplies the patients, I just treat them” is worth a hard look. The strongest associates pull their weight: writing, school visits, social media, and simply having conversations out in public that bring people through the door.
The logic behind it runs straight into the rest of this episode. You never get to do the clinical dentistry unless your communication is good — and you never get to communicate at all unless there’s someone in the chair.
What You’ll Take From This Episode
Studying Dentistry in Bulgaria / Spain / Hungary and Beyond - IC078
Friday, September 18, 2026 • Duration 55:32
Ever wondered what it’s really like to study dentistry abroad?
How different is it to train in Bulgaria, Slovakia, or Valencia compared to the UK?
And what happens when it’s time to come back home — can you easily register with the GDC and start practicing?
Dr. Hugo Medd joins Jaz for an honest and insightful conversation about taking the path less traveled — studying dentistry in Bulgaria after not securing a UK dental school place.
They dive into the realities of living and learning abroad, including language barriers, different teaching styles, and how much clinical experience international students actually get. Hugo also shares how he navigated GDC registration, what it’s like finding work after graduation, and why he has no regrets about choosing this unconventional route.
Highlight of this episode: 00:00 TEASER 01:21 Introduction 02:49 Meet Dr. Hugo Medd: A Journey to Bulgaria 06:09 Financial Considerations and Support Systems 09:56 Why Bulgaria? DMD vs BDS explained 13:13 Language Barriers and Communication Skill 17:47 Tuition Fees, Cost of Living, and Financial Realities 20:47 Navigating Post-Graduation and GDC Registration 23:23 Accredited EU Universities and Recognition Rules 25:09 Social Life, Culture, and Student Experience 28:14 Midroll 34:47 Differences in Teaching Styles Abroad 40:54 Navigating the UK Dental Job Market 43:03 Advice for New Graduates 50:24 Pursuing a Master's in Oral Surgery 54:45 Final Thoughts and Contact Information 57:11 OUTRO
Inspired to study abroad? helps you land top dentistry and medicine placements in Europe and guides you from application to graduation.
No More Air Polishing or Prophy Paste! Revolutionary New Technique for Non Mechanical Prophylaxis - PDP284
Wednesday, September 16, 2026 • Duration 59:34
Have you ever removed plaque using a scaler or ‘air-polisher’ and notice that the demineralised enamel flaked away?
Scaling and polishing is a routine part of preventive dental care — but could some of our traditional cleaning methods be doing more than we realise? A whitening specialist who works without a drill, scaler or air polisher argues that some approaches to cleaning may affect the enamel, and that hydrogen peroxide gel can remove plaque without touching the tooth surface.
Dr Wyman Chan has done nothing but tooth whitening since 2002, when he closed his general practice for a dedicated whitening centre, and he developed the chemical-polishing gel which is at the centre of this episode. He is joined by Dr Niki Shah, a UK general dentist and practice owner whose company distributes the product in the UK, and who now runs most of his hygiene this way.
In this episode, they explain which patients they believe may benefit most, walk through the full chairside protocol, and discuss the limitations of the approach and where it may not be appropriate.
Worn lower incisors sit sharp against the upper teeth, concentrating stress. Take a Sof-Lex disc and manicure them, rounding the edges from pointed to smooth. Show the patient in the mirror first and, borrowing Dr Michael Melkers’ framing, ask if you can make their teeth look a little younger. It is surface topography, changed for force management, and the patient feels it with their tongue.
What You’ll Take From This Episode
On sound enamel, prophy paste and air polishing are low-risk; on demineralised enamel hidden under plaque, the same abrasion can flake the surface.
Chemical polishing does not lift calculus; where calculus is present, ultrasonic or hand scaling is still required.
Protrusive Dental Podcast, a podcast by Jaz Gulati - Stats, Episodes and Rankings - My Podcast Data
What You’ll Take From This Episode
The diary control sequence — four moves that turn a chaotic book into a business case: audit, price, zone, pitch.
Slack, rhythm and energy — why white space isn’t waste, and what time-of-day research means for when you book your hardest work.
The referral engine — how a handful of colleagues, not a social following, can fill a niche book.
Specialise or invest? — the decision filter for cutting your book, and how full it should really be. Scripts for the principal conversation — the exact lines for asking for a zoned diary and protected time off.
Highlights of This Episode 00:00 TEASER 00:59 How to Take Control of Your Dental Career (Without Quitting) 03:33 Dental Pearl: Why "Follow Your Passion" Is Bad Career Advice 07:57 Generalist vs Specialist: Why Stay a General Dentist? 11:26 Buying a Dental Microscope as an Associate 14:50 How to Get Endo Referrals as a Non-Specialist 21:49 Why Word of Mouth Beats Social Media for Referrals 26:59 How to Audit and Zone Your Dental Diary 29:51 Morning vs Afternoon: Decision Fatigue in Dentistry 32:22 What Is Slack in Your Diary? (And Why You Need It) 37:01 How Associates Can Negotiate Diary Control 45:50 Creating Scarcity: Building a Referral Funnel 48:30 Why Every Dentist Needs a Mentor or Coach 51:49 How to Negotiate Time Off as an Associate 57:48 Going Part-Time as a Dentist: The Real Trade-Offs 1:06:27 How Far Ahead Should Your Diary Be Booked?
From the Guest
Dr Ronit Patel is a general dental practitioner and associate at the White House Dental Clinic in Kew, where his book is now largely referrals — endodontics, restorative work under the microscope, and the tricky cases other dentists have become stuck with. Before that, he was a clinical lead for a corporate group, mentoring dentists across the South of England.
In the community: members of Protrusive Guidance will already know Ronit from his short, helpful clinical videos inside the app. No courses, books or social channels were promoted on this episode — fittingly, for a referral practice built without social media.
References & Further Reading
Books and research mentioned in this episode:
Kleitman N. Sleep and Wakefulness (rev. ed., 1963). The ~90-minute basic rest–activity cycle, proposed to continue through waking hours (daytime evidence is still debated).
Kahneman D, Sibony O, Sunstein CR. Noise: A Flaw in Human Judgment (2021).
Pink DH. When: The Scientific Secrets of Perfect Timing (2018).
Danziger S, Levav J, Avnaim-Pesso L. Extraneous factors in judicial decisions. PNAS, 2011;108(17):6889–6892. The parole-decisions-and-food-breaks study.
Newport C. Slow Productivity: The Lost Art of Accomplishment Without Burnout (2024).
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 B.
AGD Subject Code: 550 Practice Management and Human Relations.
Aim & Learning Outcomes
Aim: To help dental practitioners take deliberate control of their clinical diary and career design — using audit data, scheduling principles and professional networks — so they can sustain high-quality care, develop a clinical niche and protect their own wellbeing.
Learning Outcomes — by the end of this episode, dentists will be able to:
Describe how auditing an appointment book and calculating the hourly value of each appointment type can be used to zone a clinical diary and build a business case for changes to working patterns.
Explain how planned slack and time-of-day considerations in scheduling can protect clinician energy, decision quality and patient care.
Identify strategies for developing a non-specialist referral niche through professional networks, incremental skill development and case audit.
What You’ll Take From This Episode
Four communication habits that build trust — from asking what matters to matching your information to the decision-maker.
The cost of doing nothing — how to make an unconcerning problem an informed choice, without selling.
What a fee actually covers — the one question every associate should ask their principal.
The three hats — entrepreneur, manager or technician, and why so few people wear all three well.
From problem to prototype — five steps to test a business idea before you sink money into it. The decision filter — six honest questions to tell you whether building something of your own is right for you.
Highlights of This Episode 00:00 TEASER 00:59 Entrepreneurship in Dentistry: Why Now Is Different 07:14 Patient Communication: Ask What Matters to Them 10:39 How to Explain the Cost of Doing Nothing 14:19 Short-, Medium- and Long-Term Treatment Plans 16:57 Fast-Lane vs Slow-Lane Patients: Personality Types 20:09 How to Present Your Dental Fees With Confidence 24:07 How Profitable Is a UK Dental Practice? 26:29 Why Dentists Become Entrepreneurs 31:08 Associate, Principal or Entrepreneur? 36:19 The E-Myth for Dentists: Which Hat Do You Wear? 41:09 Building an AI Treatment-Planning Tool 44:06 How to Validate a Business Idea Before You Build It 49:51 Creating a Luxury Mouthwash Brand 53:24 How to Find a Business Idea — In or Out of Dentistry 58:54 Dentistry as Your Safety Net: Starting a Side Business 1:04:58 OUTRO
From the Guest
Dr Jawad Abbas graduated from the University of Manchester and is completing a diploma in restorative and aesthetic dentistry at Smile Dental Academy, while working as an associate in Ipswich and Peterborough. Alongside clinical work, he’s developing two ventures, both at prototype stage: an AI tool that flags decay and presents tiered treatment options as a communication aid, and Jawdouré, a luxury fragrance-led mouthwash brand. During foundation training he wrote for dentistry.co.uk about the anxiety of charging for treatment.
Books, brands and episodes mentioned in this episode:
Gerber ME. The E-Myth Revisited. The source of the entrepreneur / manager / technician model. A dentistry edition also exists: Gerber ME, Kwong Hing A, Barrow C. The E-Myth Dentist. Michael E. Gerber Companies, 2014.
Erikson T. Surrounded by Idiots: The Four Types of Human Behaviour. The four-colour personality model discussed in the communication section.
Squibb S. What’s Your Dream? Penguin, 2024.
MAISON de SABRÉ — the luxury leather-goods brand founded in Sydney in 2017 by brothers Omar and Zane Sabré, who trained as dentists.
Previous Protrusive episodes: Dr Colin Campbell on consent and personality types (PDP265); Professor Avijit Banerjee on caries management (PDP269).
Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.
This episode is not eligible for CPD/CE — but most of our episodes are. Find them, and earn your CPD, inside Protrusive Guidance.
What You’ll Take From This Episode
The three rules of the ultrasonic — why it abrades rather than cuts, why the side of the tip beats the pointed end, and why power is a dial, not a switch.
A settings guide by task — where to start for enamel margins, fissures, soft dentine, endo access and gutta-percha.
Standard tip or specialist tip? — when the tip you already own is enough, and when diamond-coated tips earn their place.
Water on or water off? — the two endo jobs where the water has to go off.
Buying an ultrasonic — piezo versus magnetostrictive, and the one feature that changes patient comfort.
Highlights of This Episode 00:00 TEASER 00:59 Ultrasonic Scaler Tips Every Dentist Should Know 04:30 Why Ultrasonics Are Underused in General Dentistry 07:08 What Power Setting to Use When Cleaning Enamel Margins 09:28 Which Part of the Ultrasonic Tip Should You Use? 11:34 Ultrasonic Power Settings for Occlusal Fissures 13:47 Piezoelectric vs Magnetostrictive Scalers: Does It Matter? 21:37 Ultrasonics for PRRs, Fissure Sealants and Anxious Children 28:36 Selective Caries Removal With an Ultrasonic 30:42 Refining Crown and Onlay Margins With Ultrasonic Tips 39:02 Ultrasonics in Endo: Irrigant Activation and Finding Canals 45:35 How to Trim Gutta-Percha With an Ultrasonic 51:37 The Most Common Ultrasonic Mistake: Too Much Power 54:29 What to Look for When Buying an Ultrasonic Scaler 57:39 Are Ultrasonic Scalers Safe With Pacemakers? 1:00:55 Cementing Onlays With Heated Composite: Do Ultrasonic Tips Help? 01:09:01 OUTRO
From the Guest
Dr Hussein Hassanali is a dentist at Thorpe Dental Group and Implant Suite in York. He qualified from the University of Liverpool in 2009, completed a Postgraduate Diploma in Restorative and Aesthetic Dentistry in 2020, and is particularly passionate about preventative and minimally invasive dentistry — which is what led him down the ultrasonics rabbit hole. He is happy to answer specific questions, and he’s open to building a hands-on course if there’s demand.
Aim: To broaden dental practitioners’ use of the ultrasonic scaler beyond periodontal debridement, by explaining how ultrasonic instruments remove tooth tissue and how to apply them precisely and safely in restorative and endodontic procedures.
Learning Outcomes — by the end of this episode, dentists will be able to:
Describe how ultrasonic instruments remove tooth tissue by abrasion, and explain what this means for selective removal, tip orientation and power setting.
Apply appropriate power, water and tip choices to restorative uses of the ultrasonic, including margin finishing, fissure preparation for preventive resin restorations and selective caries removal.
Use ultrasonics safely in endodontics — for irrigant activation, canal location, scouting and gutta-percha trimming — and identify precautions for patients with cardiac implantable devices.
Topical done properly — the one preparation step that makes topical actually work, and why skipping it is a lack of empathy.
Tension, pressure and distraction — how to time the needle so the patient barely registers it.
The two-stage block — a simple sequence that takes the discomfort out of the IANB.
Slow down — how long a cartridge should really take, and why profound beats borderline.
When it’s hard to numb — the hot pulp, the palatal, and the last moment of an extraction.
Phrases for patients — the exact words to use before the needle, the palatal and the final pull.
Highlights of This Episode 00:00 TEASER 01:00 Painless Local Anaesthetic: The Money-Back Guarantee 03:21 Feeling Stuck in Dentistry? Why Plateaus Are Normal 06:20 How to Market Pain-Free Dentistry to Anxious Patients 08:20 How to Build a Dental Practice Patients and Staff Stay With 11:56 Can You Promise Patients Pain-Free Dentistry? 15:29 Why Topical Anaesthetic Is Non-Negotiable 16:56 How to Give a Painless Dental Infiltration 18:49 Painless Inferior Alveolar Nerve Block: The Two-Stage Technique 20:13 How Slowly Should You Give a Dental Injection? 21:22 Midroll 25:44 Lip Numb but Still Feeling It? Testing for Profound Anaesthesia 27:44 How to Numb a Hot Pulp 29:51 Painless Palatal Injections: Two Techniques 32:31 Communication vs Technique in Pain-Free Dentistry 35:52 Pain-Free Dentistry: What to Change Tomorrow 39:19 Stress, Longevity and a Fulfilled Career in Dentistry 45:41 OUTRO
From the Guest
Dr Nigel Kennedy qualified in Manchester in 1979 and owned his own practice in Brighton from 1994, selling it in stages to his associate before retiring at 71. The “No Pain Nigel” name started with a patient who told him she never felt his injections — and grew into a practice-wide promise of pain-free dentistry, backed by patient video testimonials.
Nigel is happy to hear from dentists, especially younger colleagues, who want advice. He is on Instagram, Twitter and LinkedIn: Nigel Kennedy
References & Further Reading
Sources and further reading from this episode:
Melzack R, Wall PD. Pain mechanisms: a new theory. Science, 1965;150(3699):971–979. The gate control theory of pain — why firm pressure beside the injection site helps.
HurriCaine topical anaesthetic gel (Beutlich; 20% benzocaine) — the topical discussed in this episode.
The Profitable Dentist magazine (Excellence in Dentistry, USA) and Tony Gedge of the Marketing Pirates of Dentistry — the practice-marketing influences behind the “pain-free” promise. Dr Mike Gow (Berkeley Clinic, Glasgow) — previous Protrusive guest on dental hypnosis and anxiety. [PDP050]
Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.
This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcomes A.
AGD Subject Code: 340 Anesthesia and Pain Management.
Aim & Learning Outcomes
Aim: To equip dental practitioners with practical, patient-centred techniques for delivering comfortable intraoral local anaesthesia and managing difficult anaesthetic scenarios, recognising the role of communication in the patient’s experience of pain.
Learning Outcomes — by the end of this episode, dentists will be able to:
Describe a structured approach to comfortable local anaesthetic delivery, including topical application to dried mucosa, tissue tension, pressure-based distraction and slow deposition. Apply strategies for difficult anaesthetic scenarios — the inferior alveolar nerve block, palatal injections and irreversible pulpitis — including staged and supplementary techniques and objective testing before treatment. Use rapport, honest expectation-setting and reassurance to reduce patient anxiety and perceived pain during local anaesthesia and treatment.
Lead the ripple — why a leader who walks out of the wellbeing session undoes it.
Highlights of This Episode
00:00 TEASER 00:57 Why Mental Wellbeing Belongs on a Dental Podcast 03:49 From Police Officer to Mindset Coach 09:12 Burnout in Dentistry: Facing the Problem Honestly 10:24 How to Stop Ruminating After a Treatment Goes Wrong 14:07 Your Thoughts Aren't Facts: The Press Conference Technique 16:10 Watering Seeds: How Repeated Thoughts Rewire Your Brain 20:03 Autopilot Thinking in the Dental Practice 22:31 Midroll 25:52 Energy, Vibe and the Patients You Attract 30:30 How to Fix a Difficult Relationship With Your Dental Nurse 33:14 The Cookie Jar: Using Past Wins to Reset Your Mood 33:54 Burnout or the Wrong Practice? Before You Quit Dentistry 39:57 Remember How Badly You Wanted to Be a Dentist 41:18 Leading by Example: Building a Positive Practice Culture 44:53 Accountability Partners and the Daily Mindset Check-In 46:51 Takeaways, Resources and Wrap-Up 50:31 OUTRO
From the Guest
Neo Positivity speaks to dental practices, conferences and teams, visiting practices and speaking at lunch breaks with his “Thoughts Become Things” message. His book, Your ATM (“Your Ability to Manifest”), is out in print and as an audiobook, and he produces short morning-huddle videos for practice teams.
Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.
This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcome B.
AGD Subject Code: 770 Self-Improvement.
Aim & Learning Outcomes
Aim: To help dental professionals recognise and interrupt negative thought patterns, and to give them simple, repeatable habits that support wellbeing for themselves and their teams.
Learning Outcomes — by the end of this episode, dental professionals will be able to:
Describe how rumination after a clinical or workplace setback reinforces itself, and apply a step-back technique to interrupt a negative thought loop.
Identify practical cues and peer accountability structures that help dental professionals sustain wellbeing habits during the working day.
Differentiate dissatisfaction with a working environment from dissatisfaction with dentistry itself, and outline steps to take before a major career change.
A root canal consent, live
Common vs rare risks — when a risk deserves a sentence and when it deserves a diagram.
The fee presentation sequence — seven steps from the reason to the objection, and why the pause matters most.
Words to ban — why fees beat prices and costs, and what to say instead of “permanent.”
Maintenance without the awkwardness — setting shared responsibility up front so “redo it for free” never comes up.
Highlights of This Episode 00:00 TEASER 00:48 How to Explain Risks and Fees to Dental Patients 04:10 The Biggest Lever in Dental Communication 06:53 How to Attract the Right Patients to Your Chair 14:29 What Makes a Super Associate? 19:58 How to Explain Treatment Risks Without Scaring Patients 26:22 Root Canal Consent: A Live Role-Play 33:59 Using Analogies to Explain Occlusion and TMD Risk 36:08 Wisdom Tooth Consent: Common vs Rare Risks 41:07 Why Consent Is a Process, Not a Signature 45:45 Midroll 51:34 Patients or Clients? What to Call the People You Treat 55:12 How to Present Dental Fees With Confidence 59:08 A Simple Framework for Presenting Fees 1:12:05 When to Discuss Treatment Alternatives 1:14:45 Why You Should Never Say "Permanent Crown" 1:20:15 A Communication Course for Dentists 1:20:51 OUTRO
From the Guest
Dr Zak Kara is principal dentist at Smile Stories in Bournemouth, and coaches and mentors dentists and their teams in communication. His communication course, developed with Protrusive, teaches from real consultation videos — filmed with patients’ permission — broken down play by play: what he said, why, and why he paused where he did.
Once the course is out, you’ll also get access to a 90-day accountability group with Zak and me, and the full course in podcast format for your commute.
Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.
This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcome A.
AGD Subject Code: 550 Practice Management and Human Relations.
Aim & Learning Outcomes
Aim: To improve how dental practitioners communicate treatment risks, fees and long-term maintenance, so that patients make informed, genuinely consensual decisions without being frightened or overwhelmed.
Learning Outcomes — by the end of this episode, dentists will be able to:
Explain treatment risks in proportion to the individual patient’s clinical situation, using plain language, relatable analogy and a stated plan to mitigate each risk.
Apply a structured sequence for presenting treatment fees that links the recommendation to the patient’s own goals and responds to objections without coercion.
Describe how consent is developed across multiple touchpoints, including discussion of alternatives, shared maintenance responsibilities and checks of patient understanding.
The two ladders of readiness — clinical readiness and interpersonal readiness rise separately, and a plan gets declined when they’re badly out of step.
Why “I’ll think about it” usually isn’t distrust — and the co-diagnosis move that stops you hearing it so often.
The conversation circle — open on goals rather than symptoms, and close the visit by tying the recommendation back to the patient’s own words.
Words that change the meeting — inflammation score instead of bleeding score, and why one word can decide whether a patient feels blamed or informed.
How to present a five-figure plan — when to name the number, and what to do in the silence afterwards.
Chairside scripts you can use tomorrow — permission questions, spot-the-difference, and the line that flips a treatment plan into something the patient avoids rather than buys.
Highlights of This Episode 00:00 TEASER 00:51 How to Talk to Patients Who Only Want One Tooth Fixed 03:45 Protrusive Dental Pearl: Reactive or Proactive Associate? 09:27 The First Protrusive Call-In: Your Communication Questions 13:40 Why There Is No Magic Sentence for Case Acceptance 15:58 Co-Diagnosis: How to Make It the Patient's Own Idea 22:36 The Conversation Circle: Start With Goals, End With Goals 26:58 Why "Inflammation Score" Beats "Bleeding Score" 30:50 The Peak-End Rule: What Patients Actually Remember 34:46 How to Ask Permission Before You Educate a Patient 39:32 Scale and Polish vs Deep Clean: Explaining the Difference 39:41 Midroll 44:54 How to Introduce Full Mouth Rehab Without Overwhelming 48:39 The Ladder of Readiness: Where Is Your Patient? 55:02 Two Ladders: Clinical and Interpersonal Readiness 59:23 How to Pre-Qualify Patients Before They Reach Your Chair 1:11:32 How to Present a Five-Figure Treatment Plan 1:20:26 OUTRO
Communication course — waiting list:Zak has a communication course in preparation. Protrusive is supporting it with a 90-day accountability group inside the app for anyone who enrols, plus retained lifetime access to Loom School.
The behavioural science referenced in this episode:
Norton MI, Mochon D, Ariely D. The IKEA effect: When labor leads to love. Journal of Consumer Psychology, 2012;22(3):453–460. People value what they helped build — the mechanism underneath co-diagnosis.
Bem DJ. Self-Perception Theory. Advances in Experimental Social Psychology, 1972;6:1–62. People infer what they believe partly from observing what they themselves say and do.
Kahneman D, Fredrickson BL, Schreiber CA, Redelmeier DA. When more pain is preferred to less: Adding a better end. Psychological Science, 1993;4(6):401–405. The healthcare application is Redelmeier DA, Kahneman D, Patients’ memories of painful medical treatments, Pain, 1996;66(1):3–8.
Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.
This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcomes A.
AGD Subject Code: 550 Practice Management and Human Relations.
Aim & Learning Outcomes
Aim: To improve dental professionals’ ability to communicate the need for comprehensive or more extensive treatment to patients who present with single-tooth expectations, using structured, permission-based and goal-led conversation rather than persuasion.
Learning Outcomes — by the end of this episode, dentists will be able to:
Describe how a patient’s readiness for comprehensive treatment can be assessed along two parallel dimensions — their understanding of their own clinical need, and the strength of the working relationship — and identify where an individual patient sits on each.
Apply permission-based and question-led techniques that help a patient identify disease for themselves, so that a recommendation is understood and owned rather than imposed.
Dr. Wyman Chan offers a 3% hydrogen peroxide gel as a plaque and biofilm adjunct, not a replacement for oral hygiene instruction.
The strongest cases for this are anxious, paediatric, orthodontic, special-needs and geriatric patients who tolerate scraping poorly.
The chairside protocol runs about twelve minutes and still ends with manual agitation using a single-tufted brush.
No published evidence supports the product’s clinical claims yet; Dr. Wyman Chan describes studies in progress.
Highlights of This Episode 00:00 Teaser 01:21 Rethinking How We Polish Teeth 03:36 Protrusive Dental Pearl: Manicuring Worn Lower Incisors 05:23 Meet the Guests: From Whitening to Chemical Cleaning 12:10 What Is Chemical Polishing? Prophylaxis, Not Whitening 20:05 Is Traditional Polishing Damaging Teeth? 21:54 How Abrasion Harms Demineralised Enamel 25:30 The Strongest Case: Anxious Patients 29:09 Children, Adolescents and Orthodontic White Spots 29:49 Midroll 35:22 Managing Pericoronitis and Gingival Abscess 38:15 Special Needs, Geriatric and Post-Surgery Care 40:43 Where Is the Evidence? Studies in Progress 43:59 The Cost and Business Case for Chemical Polishing 50:16 The Chemical Polishing Protocol: Step by Step using Magic3 53:14 Why Manual Agitation Still Matters 57:58 How It Changed a Working Day 1:00:35 Outro
Listen: Spotify, Apple Podcasts, YouTube, and inside Protrusive Guidance.
Earn CPD: This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.
Compliance: GDC Development Outcome C. AGD Subject Code 490 Periodontics.
Aim & Learning Outcomes
Aim: To give a mechanism- and evidence-aware view of chemical polishing as an adjunct for plaque and biofilm removal: where mechanical polishing can harm demineralised enamel, which patients the approach suits, how the chairside protocol runs, and the limits of the current evidence.
By the end of this episode, dentists will be able to:
Describe how the abrasivity of prophylaxis pastes and air-polishing powders interacts with sound versus demineralised enamel.
Identify the patient groups for whom a non-mechanical approach to plaque removal is most appropriate, and the situations, such as calculus, where it is not.
Evaluate the current evidence base for a 3% hydrogen peroxide chemical-polishing protocol, and apply appropriate attribution and consent where the evidence is not established.
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