Protrusive Dental Podcast

Let’s be honest - the occlusion after Aligner cases can be a little ‘off’ (even after fixed appliances!) How do you know if your patient’s occlusion after aligner treatment is acceptable or risky? What practical guidelines can general dentists follow to manage occlusion when orthodontic results aren’t textbook-perfect? Jaz and Dr. Jesper Hatt explore the most common challenges dentists face, from ClinCheck errors and digital setup pitfalls to balancing aesthetics with functional occlusion. They also discuss key strategies to help you evaluate, guide, and optimize occlusion in your patients, because understanding what is acceptable and what needs intervention can make all the difference in long-term treatment stability and patient satisfaction. https://youtu.be/e74lUbyTCaA Watch PDP250 on YouTube Protrusive Dental Pearl: Harmony and Occlusal Compatibility Always ensure restorative anatomy suits the patient’s natural occlusal scheme and age-related wear. If opposing teeth are flat and amalgam-filled, polished cuspal anatomy will be incompatible — flatten as needed to conform. Key Takeaways Common mistakes in ClinCheck planning often stem from occlusion issues. Effective communication and documentation are crucial in clinical support. Occlusion must be set correctly to ensure successful treatment outcomes. Understanding the patient's profile is essential for effective orthodontics. Collaboration between GPs and orthodontists can enhance patient care. Retention of orthodontic results is a lifelong commitment. Aesthetic goals must align with functional occlusion in treatment planning. Informed consent is critical when discussing potential surgical interventions. The tongue plays a crucial role in orthodontic outcomes. Spacing cases should often be approached as restorative cases. Aligners can achieve precise spacing more effectively than fixed appliances. Enamel adjustments may be necessary for optimal occlusion post-treatment. Retention strategies must be tailored to individual patient needs. Case assessment is vital for determining treatment complexity. Highlights of this episode: 00:00 Teaser 00:59 Intro 02:53  Pearl - Harmony and Occlusal Compatibility 05:57 Dr. Jesper Hatt Introduction 07:34 Clinical Support Systems 10:18 Occlusion and Aligner Therapy 20:41 Bite Recording Considerations 25:32 Collaborative Approach in Orthodontics 30:31 Occlusal Goals vs. Aesthetic Goals 31:42 Midroll 35:03 Occlusal Goals vs. Aesthetic Goals 35:25 Challenges with Spacing Cases 42:19 Occlusion Checkpoints After Aligners 50:17 Considerations for Retention 54:55 Case Assessment and Treatment Planning 58:14 Key Lessons and Final Thoughts 01:00:19 Interconnectedness of Body and Teeth 01:02:48 Resources for Dentists and Case Support 01:04:40 Outro Free Aligner Case Support!Send your patient’s case number and get a full assessment in 24 hours—easy, moderate, complex, or referral. Plus, access our 52-point planning protocol and 2-min photo course. No uploads, no cost. [Get Free Access Now] Learn more at alignerservice.com If you enjoyed this episode, don’t miss: Do’s and Don’ts of Aligners [STRAIGHTPRIL] – PDP071 #PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and C. AGD Subject Code: 370 ORTHODONTICS (Functional orthodontic therapy) Aim: To provide general dentists with practical guidance for managing occlusion in aligner therapy, from bite capture to retention, including common pitfalls, functional considerations, and case selection. Dentists will be able to - Identify common errors in digital bite capture and occlusion setup. Understand the impact of anterior inclination and mandibular movement patterns on occlusal stability. Plan retention strategies appropriate for aligner and restorative cases.

Do you have a “hopeless” retained root you’re ready to extract? Think implants, dentures, or bridges are the only way forward? What if there’s a way to save that tooth — predictably and biologically? In this episode, Dr. Vala Seif shares his experience with the Surgical Extrusion Technique — a game-changing approach that lets you reposition the root coronally to regain ferrule and restore teeth once thought impossible to save. Jaz and Dr. Seif dive into case selection, atraumatic technique, stabilization, and timing, all guided by Dr. Seif’s own SAFE/SEIF Protocol, developed from over 200 successful cases. https://youtu.be/2TyodqgAP9w Watch PDP249 on YouTube Protrusive Dental Pearl: When checking a ferrule, consider height, thickness, and location of functional load. Upper teeth: prioritize palatal ferrule. Lower teeth: prioritize buccal. Tip: do a partial surgical extrusion, rotate the tooth 180°, then stabilize. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Surgical extrusion is a technique-sensitive procedure that requires careful planning. Case selection is crucial for the success of surgical extrusion. A crown-root ratio of 1:1 is ideal for surgical extrusion. Patients are often more cooperative when they see surgical extrusion as their last chance to save a tooth. Surgical extrusion can be more efficient than orthodontic extrusion in certain cases. The importance of ferrule in dental restorations cannot be overstated. Proper case selection is crucial for successful outcomes. Atraumatic techniques are essential for preserving tooth structure. The 'Safe Protocol' offers a structured approach to surgical extrusion. Patient communication is key to managing expectations. Flowable composite is preferred for tooth fixation post-extraction. Understanding root morphology is important for successful extractions. Highlights of this episode: 00:00 Surgical Extrusion Podcast Teaser 01:07 Introduction 02:38 Protrusive Dental Pearl 05:53 Interview with Dr. Vala Seif 08:57 Definition and Philosophy of Surgical Extrusion 15:30 Indications, Case Selection, and Root Morphology 21:37 Comparing Surgical and Orthodontic Extrusion 25:54 Crown Lengthening Drawbacks 28:39 Occlusal Considerations 33:53 Midroll 37:16 Definition and Importance of the Ferrule 43:07 Clinical Protocols and Fixation Methods 01:00:01 Post-Extrusion Care and Final Restoration 01:05:04 Learning More and Final Thoughts 01:09:29 Outro Further Learning: Instagram: @extrusionmaster — case examples, papers, and protocol updates. Online and in-person courses in development (Europe + global access). Loved this episode? Don’t miss “How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique” – PDP061 #PDPMainEpisodes #OralSurgeryandOralMedicine #OrthoRestorative This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C. AGD Subject Code: 310 ORAL AND MAXILLOFACIAL SURGERY Aim: To understand the biological and clinical principles of surgical extrusion as a conservative alternative to orthodontic extrusion or crown lengthening for managing structurally compromised teeth. Dentists will be able to - Identify suitable clinical cases for surgical extrusion, including correct root morphology and crown–root ratios. Describe the step-by-step SAFE Protocol for atraumatic surgical extrusion, fixation, and timing of endodontic treatment. Evaluate the advantages, limitations, and biomechanical considerations of surgical extrusion compared with orthodontic extrusion and crown lengthening. Click below for full episode transcript: Teaser: I always had a problem with extracting teeth. Not a problem technically, ethically. If highly damaged teeth get properly treated and correctly maintained, they are always going to outlive implants. [Teaser]So what I'm referring to here is that the most sophisticated and complicated solutions are not always the smartest one. It's not about most expensive. It's not about most advanced. It's not about most complicated. It's about the best possible for the patient. We must keep that in mind that there is no such thing as a master key that opens up all of the doors for us. Surgical extrusion, over the years... it actually was presented to dentistry in the early eighties. They were really trying to work on surgical extrusion. And guess who comes out? I have done over 200 cases with a follow-up of up to six, seven years. That is something that you can rely on. In such cases, I take out the tooth and rotate it and put it back in. No way. Jaz's Introduction: Yeah, so you have a retained root and you think this is hopeless and you're headed towards an implant, denture, a bridge or whatever. But then this episode comes along and reminds you about the power of the surgical extrusion technique. In plain terms, you are partially extracting the root, and now you have the most important thing in restorative dentistry. You have ferrule, you have tooth structure, you can now crown. Whereas before everything was subgingival and it was impossible to restore. Hello, Protruserati, I'm Jaz Gulati and welcome back to your Favorite Dental Podcast. This is the podcast where you make dentistry tangible and make you fall in love with dentistry again. Four years ago, with Dr. Peter Raftery, the endodontist, we spoke about this very topic, the surgical extrusion technique. I'll put that episode in the show notes ’cause that was really valuable as well. But in this episode it is special because it's an update from someone who's done more than 200 cases. So what he believes, and what I also believe, is he is the most experienced clinician in the world when it comes to the surgical extrusion technique. I haven't seen anywhere in the literature the kind of numbers that he's done—so, so much. We can learn from Dr. Vala Seif from Iran, and Protruserati, you're gonna absolutely love him, right? His storytelling, his analogies. I actually really geeked out and had a great time, and I know you're gonna love him. Even all the way to the end, the last few seconds, he still gave another tip of how to stop bleeding when you do this technique so you can then add your composite splint to secure the root. He'll give you that right at the very end. So make sure you don't miss any of this episode. Dental PearlNow, every PDP episode I give you a Protrusive Dental Pearl. This one’s an occlusion conceptual one, a biomechanical one when it comes to restorative dentistry, but it's also very relevant to this episode ’cause a really cool, fascinating technique was advised by Dr. Seif, which I really am excited to share with you. So firstly, conceptually, the pearl I'm giving is to remember the following: that when you have supragingival structure all the way around 360 degrees, we call that the ferrule. Something a crown can grab onto, and it's important that this ferrule is as tall as possible vertically—ideally two millimeters plus—but it's also important that the tooth structure remaining is thick because if it's very, like, if it's paper thin, that's not really a ferrule, that's not really contributing biomechanically. Now the conceptual pearl I'm giving to you is to think about the position of the ferrule. If you have three millimeters on the palatal side and one millimeter on the buccal side, then this is still pretty good, especially for upper teeth, because the location of the ferrule is actually really important. Think of the way that the upper incisors are loaded in a class one and class two patient. When a patient is chewing, the palatal of the upper incisors is taking load in clenching, is taking load in mastication and chewing as the food is pushed into centrals, and as you are cutting and incising, the crown is kind of going in a buccal direction. The tooth, the crown of an upper incisor, is heading in a buccal direction, and so it is trying to grip onto that palatal tooth structure. And in a lower incisor, the buccal part of tooth structure is gonna be under more strain because the lower incisor is trying to bend inwards. So why is this important? Well, pragmatically speaking, if you have a scenario where you're trying to restore a canine and you've got lots of tooth structure palatally and not very much tooth structure buccally, then probably you're gonna still be okay because that palatal tooth structure for an upper tooth, that's usually more valuable and more precious. It just helps us to remember how teeth are loaded in a biomechanical way. Now, the absolutely fascinating thing that Dr. Vala Seif spoke about is: let's say you have a scenario where we have a retained root, like a crown–root fracture, and let's say you have loads of tooth structure buccally but you don't have much palatally for an upper incisor. Remember: upper incisor, we want more palatal tooth structure. Well, the fascinating thing that he spoke about is: let's say you do the surgical extrusion technique. You partially extract this tooth out, and so now you've got more tooth structure to work with. And don't worry, the entire protocol will be broken down in this episode. But the thing he said which really wowed me was: okay, you have this scenario. But how about now? You partially extract it and then you basically twist it 180 degrees, and that's the new position of this tooth. Suddenly you've gone from a situation where you had a lot of buccal tooth structure and not much palatal, to now rotating the tooth 180 degrees, and so now you've actually created ferrule palatally for this upper incisor. I thought, wow, that's really clever, because guess what? The PDL don't care if it's the buccal or the palatal. The PDL don't know. The healing mechanism will still be the same,

Are you confident in replacing a single missing central incisor? When is a denture the right option — and when should you consider a bridge or implant instead? Why is the single central incisor one of the hardest teeth to replace to a patient’s satisfaction? In this Back to Basics episode, Jaz and Protrusive Student Emma Hutchison explore the unique challenges of replacing a single central incisor. They break down when each option — denture, resin-bonded bridge, conventional bridge, or implant — is appropriate, and the biological and aesthetic factors that influence that decision. They also share key communication strategies to help you manage expectations, guide patients through realistic treatment choices, and avoid disappointment when dealing with this most visible and demanding tooth. https://youtu.be/czjPQxKpwPw Watch PS018 on YouTube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways:  Replacing a single central incisor isn’t just about technical skill — it’s about communication and case selection.  Success comes from helping patients understand that a restoration replaces a tooth’s function and appearance, not nature itself.  Clear conversations about expectations, limitations, and maintenance are what turn a difficult aesthetic case into a satisfying long-term result. Highlights of this episode: 00:00 Teaser 00:28 Intro 01:56 From Dental Nurse to Final-Year Student 07:38 Challenges and Considerations in Replacing Central Incisors 12:51 Patient Communication and Treatment Planning 18:33 Discussing Treatment Options and Enamel Considerations 21:16 Communicating Options and Guiding Patient Decisions 25:51 Choosing Between Fixed and Removable Options 27:10 Midroll 30:31 Choosing Between Fixed and Removable Options 31:05 Handling Old Crowns and Patient Communication 34:17 Conventional vs. Resin-Bonded Bridges 37:57 Occlusal Load, Function, and Implant Considerations 43:40 Digital Workflow in Dentistry 45:54 Managing Aesthetic Expectations 48:34 Final Thoughts and Recommendations 52:59 Outro 🎧 Want to feel confident with prosthodontics? Explore these essential follow-ups to this episode: Dentures vs Bridges with Michael Frazis Crowns vs Onlays with Alan Burgin Dentures with Finlay Sutton RBB Masterclass on the Protrusive Guidance App Quick, practical lessons to sharpen your planning, communication, and anterior aesthetics — all in your pocket. #ProsthoPerio #OcclusionTMDandSplints #Communication #BreadandButterDentistry This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C. AGD Subject Code: 610 – Fixed Prosthodontics Aim: To provide a clear, clinical overview of replacing a single missing incisor — focusing on when to choose a denture, bridge, or implant, and how to communicate realistic expectations. Dentists will be able to - Identify the key biological, functional, and aesthetic challenges in replacing a central incisor. Compare the indications, advantages, and limitations of dentures, resin-bonded bridges, conventional bridges, and implants. Communicate realistic outcomes, limitations, and maintenance expectations effectively to patients. Click below for full episode transcript: Teaser: Have you heard of something called central dominance? Teaser:No. So in the face, the central incisors should be the star of the show, should be in the middle, and the centrals should be like twins. When we lose a central incisor, we have to discuss how was that central incisor lost, and most common cause is trauma. The most important predictor success of a resin bonded bridge is the same as it is for veneers. If you're not sure what the treatment plan should be, you probably haven't asked a patient enough questions. Jaz's Introduction:Welcome to this Back to Basics episode on replacing the single central incisor, why the single central incisor is the most important tooth, obviously, but so that we can just go a little bit deeper into this topic rather than talking about replacement options in general, which you've already done on the podcast. There are certain features which are very special when you're replacing the central incisor and why it is regarded as the most difficult treatment to deliver in terms of patient satisfaction expectations. We're joined by the Protrusive student, Emma Hutchison, where we're gonna go into the basic overview of decision making. When is a denture appropriate? Is it ever appropriate for an incisor? How about bridges and what type, and what are the implant considerations, and actually choosing between these options? I think one of the biggest takeaways you might get from this is communication. There's a specific way I communicate to patients about this, and that's what I think you'll probably take away the most from this episode. Hello Protruserati. I'm Jaz Gulati and welcome back to the student edition of your favorite dental podcast. I know we call it Protrusive Students, but young practitioners or those returning back to work often find these episodes very valuable. Of course, we've got so much more where this came from. We've got all sorts of genres and topics covered in Protrusive Podcast and recently on YouTube. We've done the playlist so you can actually pinpoint the different themes of the podcast. On our app, Protrusive Guidance, head over to protrusive.app if you're interested in that. It's the community of the nicest and geekiest dentists in the world. We put some extra videos, not on YouTube, on there as well. Let's now join Emma, and I'll catch you in the outro. Main Episode:Emma Hutchison, the Protrusive Student, welcome back. How are you doing? How is clinics going? Final year, you've done your exams, but it's the actual more clinical exposure. How's everything going? [Emma] Mm-hmm. Yeah, it's going good. So as I was saying last time, it's just more, lots more experience this year, which is good. So I'm up in Falkirk in Scotland every second week, just Monday till Friday, nine till five, seeing about four or five patients a day. And then the other second week I'm in Glasgow doing more specialized stuff, watching some consultants in restorative and things. So it's good. It's good. Just plodding along quite nicely, which is good. [Jaz] Good. And you obviously have been a dental nurse. So once you're seeing four to five patients a day, you have this extra level of insight that maybe your colleagues don't have. Like, in the real world it's 30, 40 patients sometimes, sometimes 12, sometimes one. Like, it's such a variation. 'Cause obviously you've been an implant nurse as well. So what advice do you want to give to your colleagues who are maybe listening to this and they're seeing these four to five patients, and you want to prepare them for the real world? What would you say with your very unique perspective? [Emma] Yeah, I think when I was working as an implant nurse, I remember speaking to the dentist I was working with and he was saying why he moved to private dentistry initially is just because the real life just isn't like the gold standards that you're taught at dental school. In the NHS especially, you're time restricted. So I think I do have that in the back of my head. I know that I won't have the luxury of such long appointments when I graduate. So yeah, I'm just getting myself prepared for the real world. 'Cause I am gonna do VT or DFT so that I can work in the NHS to start off with and then see where I go from there. But I do know that in the back of my mind it's gonna get a lot busier as soon as I start VT practice. So yeah, just that you're not gonna have the best materials that you do in dental school. I know in Glasgow anyway, we tend to have really quite good materials. Good rubber dam. I know I've spoke to you about things like that before, and just that it might not be like that in the real world when I graduate and get out there and start working. So just to prepare myself for that. I'm aware of it, it's fine. And I'm just trying to relish the opportunities that I have at the moment and the staff around me that I have as well. I think that's one thing. [Jaz] You've gotta be like a leech, Emma. You've gotta be like a leech, like a sponge. [Emma] And just ask all the questions whilst you have all these specialists and consultants around you and just take note of everything that they're saying. Especially the way that people communicate with their patients and pick up little things that they're saying to their patients and make it your own. So I'm trying not to wish away my last year, so that's good. [Jaz] No, enjoy it. Enjoy the comfort and the bubble and the protection you get in school before you enter the big, bad world. Do you think your experience as a nurse and seeing over the shoulder, you're suctioning, you're seeing things close up? Having said that though, I always find that maybe the nurses, we think they've got a great view, but they often don't, especially when you are trying to juggle a million things. 'Cause recently I've been using my clinical loupe camera more and more, and so now the nurses who've been working for 20, 25 years, they're like, "Oh, now I got to see what you are seeing." So maybe it hasn't been that much of an advantage that you come from a nursing background. What do you think about that? Just be honest. [Emma] I think initially, when I got into dental school, first and second year, it helped obviously. Premolars, molars, all the very basic stuff. And then maybe second, third year when I started to see patients, I was pretty much at the same level as everyone else. Apart from communication. I've found the big thing is that patient communication has came quite naturally to me,

What if one bad decision completely changed the course of your career? In this exclusive, members-only episode, Jaz sits down with a fellow dentist from our community who shares his raw, honest story about a moment of misjudgment — committing fraud — and the painful lessons that followed. This isn’t about blame. It’s about insight, accountability, and redemption. From the shock of investigation and court hearings, to the struggle of rebuilding trust and identity, this conversation shines a light on what really happens behind closed doors when things go wrong. The aim of this podcast was to hopefully deter colleagues from temptation which can affect anyone at any time. https://youtu.be/QF-UNrlYjcw Watch PDP248 on YouTube How to Watch the Full Episode This is a members-only podcast episode due to its sensitive nature. You can access it by creating a free Community account at: https://www.protrusive.app Highlights of this episode: 00:00 Teaser 00:49 Introduction 05:49 End Screen Love this episode? Don't miss Divorce, Alcohol and Rough Patches - Overcoming Adversities (IC040) #PDPMainEpisodes #BeyondDentistry This episode is eligible for 0.5 CE credits via the Quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and D AGD Subject Code: 555 Ethics in Dentistry Aim: To reflect on the ethical, professional, and emotional lessons learned from a real-life case of dental fraud, highlighting accountability, insight, and rehabilitation while identifying practical steps to prevent similar incidents. Dentists will be able to - Recognise how workplace pressures, lack of mentorship, and poor oversight can lead to ethical lapses. Understand the legal, professional, and emotional consequences of dishonesty and poor record keeping. Identify support systems, coping strategies, and self-reflective tools to prevent burnout and maintain integrity.

Ever had a patient swear their bite feels “off” - even though the articulating paper marks look perfect and you’ve adjusted everything twice over? Or maybe you’ve placed a beautiful quadrant of onlays, only to have them return saying, “these three teeth still feel proud.” If that sounds familiar, you’re not alone. In this episode, I’m joined (in my car, no less!) by Dr. Robert Kerstein, who was back in the UK to teach about digital occlusion and the power of the T-Scan and ‘disclusion time reduction therapy’. We dig into why a patient’s bite can still feel “off” even when everything looks right, how timing is just as important as force, and why splints and Botox don’t always solve TMD. Robert explains why micro-occlusion is the real game-changer, how scanners could mislead you, and why dentistry still clings to articulating paper. So if you’ve ever wondered why “perfect” cases still come back with bite complaints, or whether timing data can actually prevent fractures and headaches, this episode will give you plenty to chew on - pun intended. https://youtu.be/0lCAsjFhsXI Watch PDP247 on YouTube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Micro-occlusion, not just “dots and lines,” is the real driver of patient comfort and long-term tooth health. T-Scan measures both force and timing, which scanners and articulating paper cannot capture. Many patients show signs of occlusal damage without symptoms. Disclusion Time Reduction (DTR) treats TMD neurologically without splints, Botox, or TENS. Relying on occlusograms alone for guiding reduction is risky. Dentists can reduce post-treatment complaints by balancing micro-occlusion with T-Scan. Adopting T-Scan requires proper training. CR can be a convenient reference point, but MIP works well in most cases if micro-occlusion is managed. Objective, repeatable data builds patient trust and provides medico-legal reassurance. Highlights of this episode: 00:00 Teaser 01:13 Intro 4:41 Protrusive Dental Pearl -  Removing a Temporarily Cemented Crown 06:39 Introduction 08:48 Global Training Footprint 09:32 What Robert Teaches (DTR & T-Scan) 09:55 Occlusion as Neurologic 10:33 Macro vs Micro-Occlusion 11:33 Neural Pathway 15:00 MIP vs CR Framing 16:48 Signs Without Symptoms 19:16 Silent Majority 20:08 Why Treat Asymptomatic Signs 20:50 Disclusion and MIP 22:28 Occlusogram Caveats 24:53 Midroll 28:14 Occlusogram Caveats 28:29 Why Occlusograms Mislead 29:21 Don’t Adjust From Color Alone 31:47 What Pressure/Timing Enable Clinically 33:02 Prosthetic Reality Check 34:46 Patient-Perceived Comfort 35:29 Why Isn’t T-Scan Everywhere? 36:29 Political Resistance 37:42 CR as Utility 38:18 MIP and Vertical Dimension. 39:48 Macro ≠ Micro 41:00 Material Longevity Benefits 41:57 T-Scan Training 42:58 Three Competencies to Master 44:20 Micro-Occlusion Rules 44:46 Outro If you want to get more clued up on TMD, tune into this episode for the latest insights and guidelines! PDP213 - TMD New Guidelines -  however be warned that the guidelines are contradictory to what Dr. Kerstein advises….ah the wonderful world of TMD!  #OcclusionTMDandSplints #OrthoRestorative This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A, C. AGD Subject Code: 250 – Clinical Dentistry (Occlusion/Restorative) Aim: to explore the role of micro-occlusion and timing in TMD and restorative success, highlighting how tools like T-Scan provide data that other tools cannot. This episode seeks to give dentists practical insights into diagnosing, preventing, and treating occlusal problems with greater accuracy. Dentists will be able to: Describe the role of micro-occlusion and disclusion time in TMD symptoms and tooth wear. Recognising the limitations of traditional methods of occlusion adjustment. Understand how objective occlusion data supports comfort, longevity of restorations, and preventive care. Click below for full episode transcript: Teaser: Pressure is a force over surface area. And when it gives us the red, the blue, yellow, it's not measuring the force, so it cannot tell us the pressure. So tell us about what the nuances of being careful with the occlusogram and where it fails in the face of something more sophisticated, like the T-scan. The essence of a scanning technology is that all the teeth are scanned with the patient's teeth apart. No one's biting. There's no forces captured. There's no contacts. There's no gathering of teeth banging together or rubbing around. So it completely is falsely representing. These colour coded occlusograms have no force information in them at all. Anyone who's used articulating paper, which most of us do, and the T-scan, you still mark the teeth with paper, but you choose the contacts to treat based on the data, not based on where the paper marks look. And very often, the most pressure points of contacts are small, scratchy little marks that dentistry says are light force, which you're completely wrong because again, the load is applied over area. So if you have a very small area, you have the potential for very high pressure. Jaz's Introduction:Protruserati, the occlusogram is lying to us. Does that sound familiar? Well, we welcome back again, Dr. Robert Kerstein. If you remember way back in episode 109, we made an episode called, "Articulating Paper Is Lying to Us," and you guys absolutely loved it because Arctic paper is lying to us. You should totally listen to that episode if you haven't already. And if you haven't, essentially the arctic paper marks you see on teeth are flawed in the sense that you can't look at a mark and accurately say that, oh yeah, that's more force, or that's less force, or that's hitting first. You don't get that data. And not only that, but you also get false positives when it comes to articulating paper. Now, similarly, I've got Robert Kerstein back again talking about the occlusogram. Now the occlusogram is that heat map you see when you do a scan, when you do an intraoral scan of a patient, upper arch, lower arch, and then you do the occlusion. Most modern scanners will give you some sort of a heat map of the occlusion and we call that an occlusogram. And we may all at the beginning make this mistake, this very simple error, that when you see red on the occlusogram that means high force. Well, we will absolutely and emphatically bust that myth today. You see the heat map or the occlusogram is just a measure of proximity. How close in space is that cusp to that fossa? And if it's very close, it's gonna be red. And if it's maybe a few microns away, it'll be a colder colour. Absolutely does not tell you how much force or timing or pressure, none of that stuff. Just contact proximity. So we must be careful in how we interpret that data. It would be misinformation to tell a patient that a certain tooth is having more load because of the colour. Hello Protruserati. I'm Jaz Gulati and welcome back to your favourite dental podcast. Today's guest is none other than Dr. Robert Kerstein. Rob Kerstein is like the godfather of digital occlusion. When I was in New Mexico a few months ago with Dr. Bobby Supple, he described Dr. Kerstein as the Einstein of occlusion, and it's an absolute pleasure to chat with him again. It's a different format of the podcast. We're driving, well, I'm driving, he's my passenger. And so one of the team members, when they were listening to this, they said, it's like carpool karaoke vibes. And don't worry, we will not start doing a little singing and dance in the middle of this episode, but something a bit different, a bit fresh. Me and Dr. Kerstein were on the way to some DTR training in the UK. DTR is Disclusion Time Reduction, essentially, if you listen to that episode that we did with Nick Yiannios. We talked about frictional dental hypersensitivity, and essentially lots of friction between the back teeth could cause your teeth to become sensitive. So this posterior dental friction is also implicated in TMD, thus resurfacing that old debate: is occlusion a causative factor of TMD? Now, we all know some CAMs and some reviews that suggest that occlusion has no relationship to TMD. Whereas my guest, Dr. Robert Kerstein, says that TMD is a neurological condition and has everything to do with occlusion, and particularly that muscular TMD group would greatly benefit from an occlusal adjustment or something to change about their occlusion, to reduce that sensory input and their noxious muscular spasms. And I saw all this freehand. I can't wait to share my experience of what I witnessed when Dr. Robert Kerstein came to my practice and I treated three patients. So I'll leave you on that teaser if you like, 'cause we have another episode coming with Dr. Jeremy Bliss talking all about occlusion, TMD and Disclusion Time Reduction, aka DTR. Dental PearlBut for now, let's enjoy this episode of occlusogram. And just before we join the main interview, I need to give you your Protrusive Dental Pearl. Every PDP episode, I'll give you a top tip that you can use right away. And today's one, like many pearls are, are from Dr. Mohammed Mozafari. Mohammed's one of the most selfless and caring and giving people on our Protrusive app community, always helping our colleagues. And today it was our good colleague Yazan. And just yesterday on the group, Yazan had a query. He's got these crowns, definitive crowns, temporarily cemented with TempBond. Now we all know of that scenario that it could have happened to you or a colleague, whereby you put these crowns in temporarily. Even some colleagues, they try in a crown, let's say a PFM crown without any cement, and they put the crown on and they just cannot take it off,

Is social media killing professionalism in dentistry? Are young dentists really “clowns” online—or is lightheartedness perfectly fine? Is social media a disease? Where’s the line between humor, banter, and outright disrespect? In this episode, Jaz is joined by Joseph Lucido from the States to tackle these tough questions head-on. Sparked by a fiery Facebook rant, they dive into whether social media is harming our profession, how dentists should present themselves online, and if there’s still room for fun without crossing the line. Whether you love or hate dental content on social media, this conversation will make you rethink how we represent our profession to the world. Shout-out to two US doctors creating excellent, entertaining content on social media Dr Brady Smith Dr. Nicholas J Ciardiello Check out the 3-Step Modern Dental Marketing Plan from Clear to Launch Dental — designed to help you simplify your marketing and grow your practice without the overwhelm. https://youtu.be/W7Uh-ML9dZg Watch IC063 on YouTube Need to Read it? Check out the Full Episode Transcript below! Takeaways Social media etiquette is crucial for healthcare professionals. Avoid controversial topics to maintain professionalism. A social media presence is essential for modern dental practices. Patients often check social media to verify a practice's credibility. Content should reflect the personality of the dentist and practice. Highlight satisfied patients to build social proof. Consistency in posting is key to maintaining engagement. Separate personal and professional social media accounts. Batch content creation to save time and effort. Engaging content can lead to more patient inquiries. Highlights of this episode: 00:00 Teaser 00:31 Intro 01:47 Introducing Joseph Lucido: Social Media Expert 03:21 Social Media Etiquette for Dentists 06:14 The Importance of Social Media Presence 12:04 Balancing Professionalism and Humor Online 17:39 Authenticity in Social Media 19:51 Balancing Personal and Professional Content 21:51 Effective Social Media Strategies 25:27 Time Management for Social Media 27:26 Do's and Don'ts of Social Media 29:43 The Power of Social Proof 30:49 Conclusion and Resources 32:47 Outro Love this episode? Don’t miss Best Practices in Social Media for Dentists – How to Stay Out of Trouble Yet Be Impactful (IC035) #InterferenceCast #Communication #BreadandButterDentistry This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan, including Premium clinical walkthroughs and Masterclasses. Click below for full episode transcript: Teaser: What is the correct etiquette in 2025 and beyond for social media for dentists? Teaser:The biggest shortcut a lot of social media questions get would be, we tell a lot of docs, this is social media, it's social in nature, so your job is not to directly sell 24/7. The most extreme version of yourself is gonna get the most attention. So you might get, oh, look, I'm getting a lot of views. But going back to what I said earlier, it's, well, what are people thinking when they see this? Jaz's Introduction: I saw a rant on Facebook. Obviously it was on Facebook. Where else do rants belong, right? It was saying, what has happened to our profession? What has happened to our beloved dentistry? The kind of crap we're seeing on social media. This dentist, who's basically vexing about the way that he thinks young dentists are portraying themselves on social media, this anonymous poster of course, was saying we're being clowns, we are disrespecting patients, we're doing all sorts of unsavory things to get views and likes. So Protruserati, is this the death of professionalism in dentistry? Is social media a disease? Is there a proper way to conduct yourself on social media, or is a bit of humor and banter and a bit of lightheartedness acceptable? I'm a bit of an idiot on social media sometimes, but I know someone who does know. Today we've got our guest, Joseph Lucido from the States, and I asked him all these tough questions. He knows a thing or two about social media. So in this episode, you'll find out what is the proper way to conduct yourself and whether Joseph thinks there is a space for idiots like me. Hello, Protruserati. I'm Jaz Gulati and welcome back to your favorite dental podcast. This is an interference cast. This is a nonclinical arm of the podcast. Hope you enjoy the main interview and I'll catch you in the outro. Main Episode:Joseph Lucido, welcome to the Protrusive Dental Podcast. For those who are listening right now, Joseph has sat in this wonderful, you've got this wonderful background, that common look of the books behind you, so it makes you look like you've got so much authority. And he totally looks badass. But I had to ask him, is this real or is it fake? And actually he reached out, man, this is a very beautiful library behind you. Joseph, welcome to the show, my friend. How are you doing? [Joseph] I'm doing great. Happy to be here. [Jaz] Tell us about yourself. You're not a dentist, but tell me how you are connected to dentistry. What makes you an authority? Talk about social media for dentists today, which I'm really excited to get into. [Joseph] Sure. Probably starting around eight years old, I wanted to be a dentist. Just being in the dental office, I always loved getting my teeth cleaned. I had a few uncles that were dentists. It was just exciting for me. And then just through my education, formally marketing degree, and then half of the books behind you are on marketing or psychology. And then it comes down to just different reps over and over and over on different platforms with docs, seeing what works, seeing what doesn't work. I guess that gives me, I don't know about the authority, but it gives me a pretty sharp edge on what works and what doesn't. [Jaz] Well, I think that does give you authority. The fact that they have skin in the game, the fact that you work with people on this, so you totally have the authority. Interesting title we've opted for, right? Social media clown or healthcare professional. I really like this. When I first read it, I thought, oh crap, he's onto me. He's seen my videos. Because sometimes I'm a bit of a clown, and sometimes I'm very professional. I'm really looking for what your thoughts are on this. So I guess the first place to start is, what is the correct etiquette in 2025 and beyond for social media for dentists? It's a big topic and we can break it down and go anywhere you like. [Joseph] Yeah, there's gonna be a bunch of nuance to it, but the biggest shortcut a lot of social media questions get would be, what is the potential patient, the person viewing this, the followers, what are they gonna think after seeing whatever I post? That should just be your starting point for everything social media related. Before you post, you want to be intentional in thinking. Now it becomes intuitive after a while to do it the right way, second nature. But from an etiquette standpoint, we wanna be thinking, I don't wanna post anything that's too controversial or too polarizing. Now I'm talking specifically through the lens of a healthcare professional. If you're trying to get attention some other way, that's fine. But if we're talking about being a professional in healthcare, we don't want to talk about politics or religion. Avoiding these topics can alienate 50% or more of your audience, and it also kind of speaks to your self-awareness. You probably shouldn't be posting this from a business perspective. Arguing online, never a good look. Taking a combative stance, anyone who sees that, even if you're defending yourself, even if you're 100% in the right, that's not what you wanna do from an etiquette standpoint. We tell a lot of docs, this is social media, it's social in nature, so your job is not to directly sell 24/7. Everyone's seen the doc that posts and all they're doing is selling, and you're not gonna follow them. [Jaz] So what you mean by that is, "Come in for our new patient Invisalign offer," and just banging on about it every single day, and that's it, it's like repeat. [Joseph] Even the other post is too much. And what we'd even argue is, the way that we operate it is we have the docs say, you do nothing from an office level organically. You should be fun, entertaining, posting like that, and then we'll take care of the direct selling, because that's what our team has experience in. You don't have experience in, how do I sell something, specifically the language that needs to be used, the call to actions, where the buttons go. That is so outside of your purview. But what's inside of you, you're an expert on you and your office. That's what you should be posting about. [Jaz] I think one thing that perhaps I should have asked, and I will now, is taking a step back. I think I went too deep too soon. I'm trying to understand what you are trying to say and what we can learn. Like I said, building on that correct etiquette and top mistakes we make. Now we are at a stage where virtually every dental practice has a website, I would imagine. But not all dentists have a social media presence. But those that do, a significant majority of those would probably post on 4th of July and then post on Halloween and then completely abandon it. So let's tackle that for a second. Do we need a social media presence in this day and age to be a thriving clinic? Because in the past it was, word of mouth is the best and patients refer other patients of the similar kind of caliber and likeness, which works well for clinics. What do you think about that question of the need of social media for every practice? [Joseph] So I think practices still, word of mouth,

Cracked teeth — the diagnosis we all hate as Dentists! How do you decide when to monitor and when to intervene? What is the recommended intervention at different scenarios of cracks? Should we be chasing cracks and reinforcing with fibers; is there actually enough long-term data to support that approach? Over the years, we’ve had some epic episodes on this topic — from Kreena Patel’s “I Hate Cracked Teeth” (PDP028) to Dr. Lane Ochi’s Masterclass on Diagnosis and Management (PDP175). But in this brand-new episode, Jaz is joined by Dr. Masoud Hassanzadeh to bring it all together — not just the diagnosis of cracks, but their management. They explore when to intervene, the role of fibers in preventing propagation, and even the fascinating possibility that cracks in teeth may have some ability to heal, just like bone! This one’s a deep dive that will change how you talk to patients — and how you approach cracked teeth in your own practice. https://youtu.be/VHYRBnfJS3I Watch PDP246 on YouTube  Protrusive Dental Pearl Your patient’s history predicts the future! Ask if past extractions were difficult → clues you into anatomical challenges. Ask how they lost other teeth → if cracks, be proactive with today’s cracks. History isn’t just background—it’s a clinical tool. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Cracks in teeth can be diagnosed using magnification and high-quality imaging. Patient factors such as age and muscle strength play a significant role in crack prognosis. Symptomatic cracks should be treated to prevent further propagation. Understanding the anatomy of the tooth is crucial for effective treatment. The healing mechanism of cracks in teeth is possible but varies between enamel and dentin. Fibers can be used to strengthen restorations and manage cracks effectively. Long-term studies are needed to assess the effectiveness of current crack management protocols. The use of fluorescence filters can help identify bacteria in cracks. Chasing cracks should be done cautiously to avoid pulp exposure. A comprehensive understanding of crack mechanics can improve treatment outcomes. Highlights of this episode: 00:00 Teaser 00:47 Intro 03:08 Protrusive Dental Pearl - The Importance of Dental History 07:18 Interview with Masoud Hassanzadeh 08:22 Diagnosing and Managing Cracks 21:13 When to Intervene on Cracks 25:50 Restoration Techniques and Materials 28:30 Chasing Cracks: Guidelines and Techniques 36:50 Mechanisms of Crack Healing in Teeth 45:11 Exploring the Use of Fibers in Dentistry 52:43 Introducing the Book on Cracked Teeth 54:57 Percussion-Based Diagnostics (QPD) 56:44 Key Takeaways 57:21 Conclusion and Final Thoughts 01:00:07 Outro As promised, here are the studies mentioned during the discussion: Why cracks do not propagate as quickly in root dentin: Study 1a & 1b Root dentin has significantly higher fracture toughness compared to coronal dentin—nearly twice as tough, as demonstrated in multiple studies. The key difference lies in their structure and toughness. Root dentin’s unique collagen orientation adds strength, while its fewer lumens and thinner peritubular cuffs make it less brittle. In contrast, coronal dentin has thicker cuffs, which increase brittleness. Unlike coronal dentin, which fractures uniformly, radicular dentin is anisotropic—its fracture behavior varies depending on direction. These structural features give root dentin greater resistance to cracking, making it more durable under stress. Studies on decreasing crack length due to crack repair in enamel. Study 2 The importance of the modulus of elasticity of the final restoration in arresting crack propagation. Study 3 The role of fiber in restoring cracked teeth and how it can increase fracture strength—even surpassing that of natural teeth. Study 4 Decision Making for Retention of Endodontically Treated Posterior Cracked Teeth - A 5-year Follow-up Study The Cracked Tooth: Histopathologic and Histobacteriologic Aspects Historical Studies on Enamel Crack Healing– 1949 (Sognnaes): The Organic Elements of the Enamel: III. The Pattern of the Organic Framework in the Region of the Neonatal and other Incremental Lines of the Enamel – 1994 (Hayashi): High Resolution Electron Microscopy of a Small Crack at the Superficial Layer of Enamel – 2009 (S. Myoung): Morphology and fracture of enamel Don’t miss out — get instant access to all the research papers discussed here at protrusive.co.uk/cracks! Dr. Masoud Hassanzadeh has written two essential books every dentist should own: 📘 Glossary of Biomimetic Restorative Dentistry🔑 Your quick-reference guide to the language and principles of biomimetics — explained in a way you can actually use chairside. 📕 The Cracked Tooth: A Comprehensive Guide to Cracked Teeth🦷 Everything you need to know about diagnosis, management, and the science behind one of dentistry’s biggest headaches. 🌴✨ Dubai 2026: Occlusion + Family Fun ✨🌴 This Easter, join Dr. Jaz Gulati and Dr. Mahmoud Ibrahim for something truly special — a tax-efficient holiday that mixes world-class occlusion training with plenty of family time in Dubai. 🦷 What’s included? ⏰ 20 hours of hands-on occlusion (mornings only: 9 am–1 pm) 🏖️ Afternoons & evenings free to enjoy Dubai with your family 📚 Pre-learning + online content to deepen your understanding 🥂 A not-for-profit event — just dentists, families, and fun! 👉 Learn more & get your quote at: globaldentalevents.co.uk 💡 Make memories with your loved ones while making your CPD hours tax-deductible Want to level up your knowledge on cracked teeth? 🎧 Don’t miss PDP098: Cracked Teeth Management with the Direct Composite Splint Technique #PDPMainEpisodes #EndoRestorative #BreadandButterDentistry This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and C. AGD Subject Code: 070 ENDODONTICS Aim: To provide clinicians with practical, evidence-based guidance for diagnosing, monitoring, and restoring cracked teeth, with emphasis on prognosis, risk factors, and restorative decision-making. Dentists will be able to - Differentiate between enamel and dentine cracks, and recognize when prognosis is hopeless. Apply appropriate diagnostic tools and clinical criteria to decide when to monitor versus intervene. Select suitable restorative strategies and materials to manage cracked teeth effectively. Click below for full episode transcript: Teaser: After 48 hours, they started to see that the crack is just decreasing, like it's just healing. Is it really possible? But it is possible. Like how there is a crack healing mechanism in the bone, there is also crack healing mechanism in the tooth. When I started to learn about cracks, actually the studies were not from dentists. Teaser: They were fracture mechanic engineering that they just studied about the crack, and nowadays there is a new system, it is called quantitative percussion diagnostic, QPD. There is a stress concentration in that point where the crack is started, so we have to distribute the stress in that place, in that plane. That is the important one. If we are just going to remove the crack and put the restoration on it, I'm afraid it's just going to happen again. Jaz's Introduction: Over the years, we've had some awesome episodes on cracked teeth. If you go all the way back to PDP028 with Krina Patel, the episode was titled, I Hate Cracked Teeth, and you know what? I still hate cracked teeth. They're a damn nuisance. They're everywhere, and it creates major consent and if the tooth goes non-vital, that kind of conversation, which no one likes. Now, years later, we did this epic episode with Dr. Lane Ochi, PDP175. You need to check these two episodes out if you want to geek out on cracks. But you know what? This episode really does a wonderful summary of cracks. Not just the diagnosis, but the actual management. Should we be chasing cracks? Are fibers actually indicated? Is there enough long-term clinical data to support the use of fibers in crack propagation? And the question of, okay, when should you actually intervene? And you know what? The most important one I haven't even mentioned yet. So, Dr. Masoud, the way I got acquainted with him is on social media. I posted this image of a crack, a really nasty crack, and he said something absolutely ridiculous. He said that cracks have an ability to heal a bit like cracks heal in bone. Now, you said that because in this image I posted on social media, it was all about how I communicate cracks to my patients. I say to them, look, when you have a crack in a bone, the bone can heal, it can regenerate, but a crack in a tooth can never heal. Patients seem to resonate and they understand that. But he was suggesting that actually cracks can heal naturally a bit like bone. And so if you listen to the end of the podcast, you will see how that is actually possible. Hello, Protruserati. I'm Jaz Gulati and welcome back to your favorite dental podcast. I've had a month in August which was pretty crazy. I didn't do much recording of new podcasts. We were working on some of the older recordings I had done. We've got a huge backlog as a team, which is a wonderful position to be. We are having so much fun creating these episodes. Thank you to everyone who returns to our podcast, and of course all the new people that find us. If you're not already, you need to join 5,000 of the nicest and geekiest dentists in the world on the Protrusive Guidance app. Go on protrusive.app, make an account. Your only requirement is you must be nice and you must be geeky. If you are those two things, you should come and join us to geek out, discuss, share challenges, share wins.

With the final places remaining for our Occlusion Getaway, we present the official FAQ Podcast! Dreaming of combining occlusion learning with a luxury getaway? Want to earn 56 hours of CPD while soaking up the Dubai sunshine? Looking for a course where you can master PRACTICAL occlusion in Restorative Dentristry and make it a family-friendly, tax-deductible trip? Easter 2026 is set to be unforgettable. Join Dr. Jaz Gulati and Dr. Mahmoud Ibrahim for an extraordinary Occlusion Excursion in Dubai — a blend of serious CPD and sunshine that redefines what “continuing education” can be. We’ve always believed in mixing work and pleasure, and this time, we’re taking it to the next level. Think luxury, learning, and laughter — all under the warm Dubai sun. Watch IC062 on Youtube 🦷 What Makes This Course Different? 56 hours of CPD/CE credits, including 20 hours hands-on in Dubai Full online occlusion curriculum and live webinars before you travel Morning workshops (9 AM–1 PM) and free afternoons to explore Dubai Bring your family (Easter school holidays!) or come solo — many dentists are already flying in from around the world. REQUEST A QUOTE - Limited Places Remaining as of November 1st 2025!: https://globaldentalevents.co.uk/  Spaces are limited and flights are rising, so secure your place early.👉 Easter 2026 – Occlusion, sunshine, and CPD in Dubai. 📅 28 March – 4 April 2026 📍 Dubai, UAE 👨‍⚕️ Dr. Jaz Gulati & Dr. Mahmoud Ibrahim, Organised by Global Dental Events Highlights: 04:06 Meet the Organizers 05:59 Why Dubai? 10:40 Delegate Experiences and Expectations 13:21 Course Pricing and Tax Benefits 19:05 Course Itinerary and Logistics 24:49 Final Thoughts and How to Join

Do all whitening gels work the same, or is the brand actually important? Are lights and in-office “power whitening” just marketing hype? And what’s the deal with the infamous white diet - do your patients really need to give up coffee and red wine? In this episode, I sit down with Dr. Wyman Chan, the man who literally hung up his drills in 2002 to dedicate his career to whitening alone. With over 20,000 cases under his belt (and a PhD in the science behind it), Wyman shares his three golden rules for whitening success: trays, communication, and conscious bleaching. We’re also joined by Dr. Niki Shah, who brings his own insights into whitening and patient care, making this a conversation packed with both science and clinical experience. Wyman introduces his latest invention—Magic 3, a fizzing gel that reveals and removes plaque while calming gums. Plus, Wyman busts some of the biggest whitening myths (sorry, “white diet”) and explains why he no longer bothers with internal bleaching. If you’ve ever wondered how to make whitening safer, more predictable, and less stressful for you and your patients—this is the episode you’ll want to tune in for. Protrusive Dental Pearl Innovation in Hygiene with Magic 3 - What is Magic 3? A colorless plaque indicator gel developed by Wyman Chan. Fizzes on contact with plaque. Cleans teeth, removes superficial stains, and softens soft calculus. Clinical Application Alternative to scaling/polishing for routine patients. Nervous patients who dislike ultrasonic scalers. Children (6+) – safe as a Class I medical device. Orthodontic patients – helps prevent white spot lesions. Learn more at https://protrusive.co.uk/magic3 https://youtu.be/ImpHJP3Wxec Watch PDP245 on YouTube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Teeth whitening success depends on tray design, formulation, technique, and compliance. Conscious bleaching helps minimise sensitivity. Sensitivity is due to peroxide reaching the pulp. Patients should adjust wear time gradually, starting short and increasing if comfortable. Communication and treatment planning are crucial to match whitening regimes with lifestyles. The “white diet” is not scientifically necessary - normal eating and drinking can resume within minutes. External bleaching alone can be effective, even for single dark teeth. Tetracycline-stained teeth can respond to whitening with the right protocols. The brand is less important than protocol consistency and clinician experience. In-office light-assisted whitening adds risk, cost, and chairside time without proven benefit. Allergic reactions are more likely caused by gel additives, not peroxide itself. Emerging products, such as peroxide-based gels for plaque disruption and gingival health, may complement whitening in the future. Highlights of this episode: 00:00 TEASER 1:00 INTRO 3:13 PROTRUSIVE DENTAL PEARL 07:05 Dr. Wyman Chan Introduction 13:32 Niki's Journey in Dentistry 17:03 Whitening Products and Techniques 23:09 Three Keys to Whitening Success 30:03 Addressing Sensitivity in Teeth Whitening 37:43 MIDROLL 41:04 Addressing Sensitivity in Teeth Whitening 46:15 Whitening as Treatment Planning 49:10 Myths and Misconceptions 01:00:27 Lights and In-Office Whitening 01:03:13 Introducing Magic3: A Revolutionary Dental Product 01:16:10 OUTRO Discover Magic3 and Dr. Wyman Chan’s inventions If this episode piqued your interest, continue the whitening theme by listening to PDP199 “How To Eliminate Sensitivity During Teeth Whitening”. And don’t miss the upcoming visual follow-up to this episode! #PDPMainEpisodes #BreadandButterDentistry This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A, C, and D. AGD Subject Code: 780 – Esthetics/Cosmetic Dentistry Aim: To deepen dentists’ understanding of teeth whitening by exploring evidence-based protocols, tray design, and methods to reduce patient sensitivity. It also aims to challenge common myths and introduce innovations that can improve both patient comfort and clinical outcomes. Dentists will be able to: Evaluate the importance of tray design, communication, and conscious bleaching as critical factors for safe and effective whitening outcomes Identify the common causes of whitening sensitivity and apply strategies to minimise or prevent pulpal irritation during treatment Assess the evidence behind common whitening myths, including the “white diet” and the use of heat/light for activation. Click below for full episode transcript: Teaser: What is the three most important features in getting a good whitening result? Number one, because- is it true that patients should try a white diet when having treatment? Teaser:I heard of that when I was started bleaching 30 years ago- because I don't have the drill anymore. They say I can't do internal bleaching. It's just because I give myself restriction. I have no drills at my clinic. If you've got a good protocol, it works- like I can show you some cases just two weeks. It's amazing result. Get from a C4 to B1, just two weeks. Two weeks for Tetracycline staining. This is a colorless plaque indicator. Remove plaque at the same time. Also reduces gingival inflammation. They say we have nothing like that. Is this solution a substitute for mechanical plaque? It's substitute for mechanical cleaning. To me, there's no need to do polishing. Jaz's Introduction:Protruserati. We have got THE Wyman Chan and how I pull this off, this is the guy who I've been watching the whitening space for so many years, and actually he kind of disappeared. Where did Wyman Chan go? Was on the lips of every UK dentist for so many years. But guess what? He is back. Alright, lemme tell you about Wyman Chan. This guy hangs up his drills in 2002 to solely focus on teeth whitening. That's it. Imagine that. Right at a time where teeth whitening wasn't even like a proper thing. So since then he's been like whitening the teeth of celebrities and all the famous people will go to a central London clinic, get their teeth whitened by him using his formulas, his patented technology and his knowledge. Like he's a PhD and he's so passionate about teeth whitening. The guy's done over 20,000 whitening cases. I was actually thinking. I don't even think I've seen 20,000 patients in general in my career so far. So that just tells you the volume of teeth whitening he's done and he's like a mega geek. Like what he doesn't know about whitening is not worth knowing. So we take advantage of that. I literally ask him all of your questions that you submitted on Protrusive Guidance, the usual stuff like is the light thing, is it a fad or is there some science behind it? Do you need to adopt a white diet two hours after whitening to make sure that you get a good effect from teeth whitening? Like that's all standard. We actually talked about it before, but we revisit it in this episode. But of course, every episode we have a game changers and there's a few game changers. About three, well, there's more than three, but the three that are top of my mind right now while recording this introduction. One is that for non vital bleaching, imagine you get that black central incisor. Usually the way I would treat it is make sure that the root canal treatment is good, and then re-access the access cavity of course, and place my gel inside and whiten from inside and also outside. Now, what Wyman Chan discusses is a protocol of not doing the internal part of non vital bleaching, doing it externally only, which is very fascinating. The other cool thing he teaches in this episode is this concept of conscious bleaching, which I'd never come across before, but it makes so much sense. It is the number one thing that reduces and eliminates sensitivity. And I'm a little bit upset that no one told me before. It just makes so much sense. I can't wait for you to listen to this episode and learn about what is conscious bleaching. Dental Pearl:And the final game changer is today's Protrusive Pearl. Hello, Protruserati. I'm Jaz Gulati. And every PDP episode we give you a Protrusive Dental Pearl, something to reflect on, something to digest, something to apply to your patients right away. We have all sorts on here. And today's pearl is about innovation. Wyman Chan is just like this awesome guy in whitening and he has got so many patents I didn't even know about this. And one new invention he's come up with is called Magic three. So remember I said that Wyman Chan went missing? What I meant is he went to China, okay? He went to to Asia, developed a whole bunch of things and protocols, and does loads of teaching there. And he is launched some products there as well as in Dubai. And now he's bringing Magic three to the UK. And so in a nutshell, 'cause I don't wanna take up too much time here, I really want you to listen to this episode, but essentially Magic three is this like colorless gel. It's this clear gel that you put on the teeth, and then if there's plaque anywhere, it'll start fizzing. So they call it a colorless plaque indicator, which sounded really crazy to me. I still calling that my head around it and the way I understood it and seeing the product myself, it just fizzes when there's plaque. So it is indeed a a plaque indicator in that way you're looking for fizzing. What it does is it cleans the teeth. It replaces your polishing stage. For many patients it replaces your scaling stage. So if these are regular patients that you're seeing every six months in hygiene and you haven't got like mountains of this hard calculus, then this gel actually replaces your hygiene work.

Why should Dentists be talking about screen time with parents? Are smartphones even safe for children? What is the right age to give a child their first phone? Laura Spells and Arabella Skinner join Jaz in this thought-provoking episode to tackle one of today’s biggest parenting challenges: smartphones and social media in young hands. Together they explore the impact of early phone use on children’s health, development, and mental wellbeing—and why healthcare professionals should be paying close attention. https://youtu.be/7RUJZqtEr18 Watch IC061 on YouTube  Protrusive Dental Pearl: Live by your values—not your profession, spouse, or children. Don’t sacrifice for them; choose what aligns with you, so love never turns into resentment. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Screen time is a significant public health concern. Mental health issues are rising due to social media exposure. Early childhood screen time has long-term effects. Parents need clear guidance on screen time limits. Community support is essential for children's well-being. Health professionals must ask about screen time in assessments. Regulatory changes are needed for safer screen use. The impact of social media on self-esteem is profound. Misinformation about health trends can lead to dangerous practices among youth. Dentists play a crucial role in educating patients about safe health practices. Parents should engage in conversations about social media with their children. Creating a family digital plan can help manage screen time effectively. Collaboration among health professionals needs to raise awareness about the dangers of unregulated products. Empowering parents with knowledge is essential for effective parenting in the digital age. Role modeling healthy behaviors is important for parents. Highlights of this episode: 00:00  TEASER 01:18  INTRO 03:13 PROTRUSIVE DENTAL PEARL 04:54 Introducing Our Guests: Arabella and Laura Spells 09:24 Statistics and Scale of the Problem 18:09 Early Years and Screen Time 22:27 Safer Alternatives and Regulation 27:08 MIDROLL 30:29 Safer Alternatives and Regulation 30:53 Ideal Guidelines for Screen Usage 34:01 The Role of Dentists in Addressing Social Media Issues 44:59 Parental Guidance and Digital Plans 53:53 Final Thoughts and Resources 56:06 OUTRO ✅ Action Steps 🔹Seven Habits of Highly Effective People by Stephen Covey for habits that support balanced parenting and leadership.🔹 Kindred Squared School Readiness Survey on how early screen use impacts child development. 🔹 Follow Health Professionals for Safer Screens for practical tips to share with families, and on their Instagram for bite-sized advice🔹 Support the Smartphone-Free Childhood Campaign to delay smartphone use in children. If this episode gave you new insights, you’ll definitely benefit from Parenthood and Dentistry (Even if You’re Not a Parent!) – IC025 #InterferenceCast #BeyondDentistry #Communication This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and B. AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS Aim: To provide dental professionals with an understanding of the health risks of early smartphone and social media use in children, and how dentists can play a role in safeguarding and guiding families toward safer digital habits. Dentists will be able to - Recognize the health and developmental impacts of early and excessive screen use. Identify how social media contributes to anxiety, body image concerns, and misinformation (including dental-related fads). Discuss practical strategies that families can use to create healthier digital habits. Click below for full episode transcript: Teaser: We have to address the issue in early years because if you've had your child sitting on a screen from day one, by the time they get to eight or nine and they want a smartphone, which is the ubiquity in their pocket, it's really hard to explain to them why they can't have it. Teaser:What is the right age for a smartphone? Yeah. We would say that smartphones with full internet connectivity and everything involved and social media, it's- This smartphone usage has become almost the norm for every teenager across the country. And of course what a smartphone does is allow people 24 hours to access to the internet, to social media, to all the unfettered things that we need to, they can see. If you think about whole child health, and that's how we should be approaching health for our children. Obesity's gone up. There's huge linkages between the seditary behavior of being on screens, but not just the seditary behavior. Because actually if you are sitting on social media or you're sitting on gaming, you are targeted by fast food manufacturers in a way, way more than you would be on TV. You could have a big argument about the quality of what children are doing on screens when they're 15, 16. Or they learning to make music. Are they revising and doing things, but for a two, three, 4-year-old, there are no benefits of being exposed.  Jaz's Introduction:What a time to be alive as a parent. Back when I was a kid, I would go and play football for hours. My parents, they kind of knew where I was, but there was no way to reach me. And the other thing I remember is that when I was a kid, I wanna go to cinema. And then so you agree with your friends that, look, I'm gonna see you at 11:00 AM, at the cinema on Saturday. And there was none of this like texting and WhatsApp and Snapchat and that kind of stuff, and you would just show up at 11:00 AM on Saturday, and that's a simple life that we lived. But now with smart phones and social media, I really worry for our children, which is why I brought some experts on to discuss phone use in children and best practices for screen time and smartphones. And so you are thinking Jaz, what has this got to do with dentistry? Well, we have an active role to play as healthcare professionals. Early smartphone usage and social media is absolutely detrimental to the health of our children. And as healthcare professionals, we have a duty to know about this and to spread the good word. And many of you, like me, are parents, and we need to hear this stuff. We need training. We need guidance, and that's exactly what we bring you today. You're gonna love our guest, Arabella and Laura. But I wanna say thank you to Protrusive community member, Lydia, Dr. Lydia Roulston. It's been so nice to chat to you on the app, give each other book recommendations, and you are part of this very organization that's helping schools and communities to realize the dangers of having smartphones in young hands. Dental Pearl:I'm so grateful that you're part of our nice and geeky community. Now, this is an Interference Cast, which is like the nonclinical arm of the podcast, and I usually reserve my Protrusive Pearls for the actual PDP episodes. And as many of you know, I actually struggle when it comes time. I freeze up when it comes time to give a pearl, 'cause I've given like 300 in the past. I'm kind of running out of nuggets. Like obviously there's an endless amount of dental nuggets and gems out there, but to suddenly pull one out can be a bit tricky. But you know what? I've got one from the heart. So even though it's an icy, I still want to give a pearl. And it's like from the heart as a parent. In the book, I think it was Seven Habits of Highly Effective People by Stephen Covey. It talks about being value centered and not being like a profession centered, like your entire world shouldn't be about being a dentist. Your number plate shouldn't be dentist. You shouldn't introduce yourself to, hey, I'm Jaz, I'm a dentist. Like, your identity should not be your profession. The world also shouldn't revolve around your spouse, nor should your world revolve around your children. Your world should revolve around your values. And how I'm linking it even more to this theme of parenthood is that, I have a 6-year-old and we go through all the tantrums and behavior issues that all parents do. It's very normal. And I love talking about being a parent to my patients. I learn a lot from my patients. I do have an elderly patient base, and so I do get to benefit from their wisdom. And one thing I've come to conclude over time is that if you want to do something for your children, don't do it for them. For example, if you're making career sacrifices, make sure you are clear that you're not doing it for them. Or if you are not going to the gym because you can't fit in because everything you're doing, you're prioritizing your children and you're doing it for them, then I'm gonna suggest you're doing it for the wrong reasons. Don't do it for them, do it for yourself. Whatever you want to do for your children, do it because you want to do it. Because when the messy times come in, any family dynamic and they start answering back and you have an argument and it gets be heated, you don't wanna be like, oh, that little s*** can't believe how much I sacrifice for my son or daughter, and that kind of stuff. You don't wanna feel like that. They don't owe you anything. Any sacrifice you do, anything you do, do it because you wanted to do it. Not for them. I hope that made sense. It just came from the heart, was totally unscripted, spontaneous, and for those on Protrusive Guidance particularly, I wanna know what you felt about that. Anyway, hope you enjoy the main interview. I catch you in the outro. Main Episode:Laura and Arabella, welcome to the Protrusive Dental Podcast. I'm so, as a father of two boys, i'm so excited. I read books like Anxious Generation and I follow so much, and I wanna thank Lydia for connecting us. There's so much I wanna speak to you about,

How can you tell if a root canal treatment is truly successful? Do you always need cuspal coverage after a root canal? Are hand files still relevant, or has rotary completely taken over? And does GP pumping really improve the effectiveness of irrigants like hypochlorite? Emma returns for another Protrusive Student Series episode as she heads into her final year of dental school. Together, we explore the fundamentals of endodontics - covering restoration choices, success criteria, instrumentation, and irrigation protocols. This episode breaks down the basics every student and young dentist should understand, while also tackling the common debates and real-world challenges of endo. https://youtu.be/DK1ZAEPE_E4 Watch PS017 on YouTube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Understanding the 'why' behind dental procedures is crucial for effective practice. Both hand files and rotary files have their place in endodontics, especially for beginners. Good irrigation techniques are essential for effective endodontic treatment. Rubber dam isolation is critical for safe and effective endodontic procedures. Learning to determine the master apical file size is a key skill in endodontics. The use of EDTA helps in removing the smear layer during root canal treatment. Endodontic specialists often use advanced techniques and tools for more efficient treatments. Success in endodontics is not just about radiographs, it is sometimes defined by patient comfort and healing. Cuspal coverage is often necessary after root canal treatment. Patient communication is key to managing expectations. Consent forms should be tailored to individual cases. Understanding proprioception is important for tooth preservation. Highlights of this episode: 00:00 Teaser 00:51 Intro 02:50 Emma's Final Year Reflections 04:34 Exploring Specialties 07:02 Endodontics: A Student's Perspective 08:15 Rotary vs Hand Files 11:45 Step-by-Step Notes for Students 14:24 Patency and Recapitulation 14:55 Determining Master Apical File Size 16:58 Irrigation Protocols and Techniques 21:22 Typical Irrigation Protocol 23:51 Rubber Dam Importance 27:25 Rubber Dam Importance 28:21 Role of 17% EDTA 28:59 Success Factors in Endodontics 29:46 Success Factors in Endodontics 30:46 Real-World Endodontic Practices and Challenges 32:11 Understanding Success and Survival in Root Canal 34:26 Successful Outcomes 36:24 Success vs Survival 38:12 The Debate on Cuspal Coverage and Timing 40:48 Proprioception 41:54 Pre-Endodontic Build-Up 42:29 Direct Cuspal Coverage 44:03 Consent and Communication in Endodontic 47:25 Conclusion and Future Topics 49:02 Outro Resources mentioned: Outcome of primary root canal treatment: systematic review of the literature – Part 1  Outcome of primary root canal treatment: systematic review of the literature – Part 2. Influence of clinical factors  Radiographic Assessment of the Quality of Root Canal Fillings Check out Simple Re-RCT Cases – ‘How To’ Guide – PDP233 for more Endodontic insights #BreadandButterDentistry #EndoRestorative This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcome C. AGD Subject Code: 070 – Endodontics (Endodontic infections, microbiology, and treatment) Aim: To provide dental students and early-career dentists with a structured understanding of endodontic fundamentals, including instrumentation, irrigation protocols, success factors, and restorative considerations. Dentists will be able to: Differentiate between hand and rotary file systems and identify their advantages and risks. Evaluate the factors influencing the success and survival of root canal treatment. Recognize when cuspal coverage or pre-endodontic build-ups are required. Click below for full episode transcript: Teaser: You go to dental school, you're going to be using hand files. You're gonna get taught with hand files, everything's gonna be hand files, and that's how you're taught in dental school. Teaser:As long as you understand when you're doing, you're trying to like determine tug back and you're trying to determine the master apical file size, for example, right? Those skills you do with hand files and they're universal. The most important thing is more important than the final system - Root canal without rubber dam is like doing heart surgery in the toilet. The thrill of the fill. Okay. You put your GP in and it looks as though it is to length and it doesn't have any voids in it. And we think, wow, this is success. Right? But the thing is, when you see a radiograph, the radiograph cannot tell you. Whether rubber dam was used, whether hypochlorite was used, whether the coronal seal was really that good, and what protocols were used in terms of this disinfection. Jaz's Introduction:Basics of Endodontics. Welcome back to another Protrusive Student Series. This arm of the podcast is for students, young practitioners, those returning back to practice, or you just love listening to the podcast and you want validation. Welcome new listeners and welcome back to the returning Protruserati. We were joined with our Protrusive Student, Emma. As she transitions into her final year of dental school, she asked all the right questions. Do you always need cuspal coverage after root canal? What kind of cuspal coverage should we go for? What determines if your root canal has actually been successful? Like we've all seen root canal treatments that been there for 30 years and they look questionable on the radiograph. But there's no pathology. Does that still count as a success? How about hand files versus rotary? Are hand files obsolete? And lastly, how significant is GP pumping to agitate your arrogance such as hypochlorite? All these questions are much more discussed in this episode. And as of a few episodes ago, these episodes are also eligible for CPD. So if you want some easy CPD for those who are paying subscribers on the Protrusive Guidance app, don't forget to answer the quiz. You would've done all the hard work of listening. You might as well get the CPD saying so by time December comes, you're absolutely laughing. Let's join the main interview and I'll catch you in the outro. Main Episode:Emma, welcome back to the podcast, a Protrusive Student. How is your summer going? You know, I mean, I remember specifically this transition from fourth year to fifth year. And it's really strange because like for you, it is different in a way 'cause you've finished your finals, right? You've passed. So congratulations, congratulations once again. But it's like you're about to enter the final chapter. It's a bit emotional the next round when you finish finals and then you have like, you enter the rat race. That's an even bigger, weirder scenario. But tell us about where your headspace is at the moment. [Emma]I think for my final year, now that I have my exams over, I'm actually kind of excited. I think a lot of people are finding the same. I find a lot of people at Glasgow say that final year is their favorite year, because you don't have that stress of exams. You're more just working as a wee dentist and getting put into different outreach placements and you're just clinical all day, every day, pretty much. So it's just purely building on your clinical skills and getting more knowledge. So no more lectures. So I'm actually kind of excited for it.  [Jaz]I think that's so cool. I'm very envious of you actually, because in most dental schools, the final year is like this crushing one. I mean, I can remember, the sheer emotions that you experienced during fourth year, but then it all culminates and I think it's great that you managed to get out the way in fourth year, and I could really just focus. Your focus shift towards how can I get myself prepared for the real world, right?  [Emma]Yeah, for sure. But definitely this time last year, very nervous. But this year I'm feeling good. I'm feeling excited for it.  [Jaz]Good. I'm really happy, I think this is the best way because now that your focus is, how can you prepare yourself for the real world of practice? You learn differently. 'Cause I find like with anything, most of the learning happens right towards the very end. There's a very valuable amount of learning in any cycle that happens towards the end. And when you have a traditional model of schooling in dental school, whereby your finals exams are in the final year, you are kind of learning to pass an exam, not learning to serve your patients better, improve your clinical skills to as much as you want to. Yes, that's always, there is a constant theme in the background, but it's never at the forefront. But now I think you and you guys at Glasgow get to experience this, which is wonderful. So, amazing. And today we're talking about Endo, right? So students' perspective. Emma had asked me, Jaz, do you want the questions as I know, let's go with the flow, right? Because I'm no endo specialist. I'm no endo expert. In fact, I do less endo now, like over the years I do less and less and less endo. Actually, funny story about that, Emma. One stage I wanted to specialize and I couldn't decide where. So when I initially entered dental school and I was like 19, I was like, I wanna do ortho, right? 'Cause I had like braces and I had teeth align. I was like, wow, how do I bottle this up and give this to people? So, I'm gonna do ortho. And then in dental school, ortho clinics were like the most confusing things ever. Like, what the hell's going on? No one knew what was going on, it was madness. And I decided very quickly that, okay, ortho is probably not for me. And then my focus shifted towards endo. And I was enjoying my endo.

How should you  gain consent for ELECTIVE treatments? Is selling in dentistry something to avoid, or an essential part of patient care? How much does emotional intelligence really matter for your success and happiness? Dr. Colin Campbell joins for a powerful episode that dives into consent, sales, and the balance between profit and ethics in dentistry. He also unpacks the huge role of emotional intelligence—not just in clinical practice, but in life. Expect real talk, strong opinions, and communication gems that can reshape the way you connect with patients and approach your career. https://youtu.be/Wtugp1t-IrM Watch PDP244 on Youtube Protrusive Dental Pearl: Read (or listen to) the book Let Them by Mel Robbins — a powerful reminder to take control of your own life and emotions instead of letting outside events dictate them. Need to Read it? Check out the Full Episode Transcript below! Takeaways Building trust with patients is crucial for effective consent. Consent should be a relationship management exercise, not just a legal formality. Understanding the patient's perspective is key to effective communication. Elective treatments should be approached with caution and ethical considerations. Sales in dentistry is not a dirty word; it's about providing solutions to patients. Emotional intelligence is a vital skill for dentists to develop. Good dentistry is about doing what is best for the patient, not just for profit. Continuous education and self-improvement are essential for success in dentistry. HIghlights of this episode: 00:00 Teaser 00:44 INTRO 01:44  Protrusive Dental Pearl 02:58 Welcoming Dr. Colin Campbell 04:55 Colin’s Background and Philosophy 05:36 The Importance of General Dentistry 08:40 Finding a Niche vs. Being a Generalist 11:14 Understanding Consent in Dentistry 17:42 Fear of Losing the “Sale” 18:50 Building Trust with Patients 22:09 Consent Process Overview 22:49 Patient Consultation Process – Building the Bridge to Trust 29:00 Developing Emotional Intelligence (EQ) 30:00 Patient Consultation Process – The Mechanics 30:58 Patient Consultation Process – Exploring Options 31:13 Join Protrusive Guidance 34:34 Patient Consultation Process – Exploring Options 34:36 Patient Consultation Process – Follow-Up and Consent Pathway 35:54 Patient Pathways After Consultation 36:48 Treatment Plan Letters & Legal Angle 38:45 Approach to Consent Letters 40:21 Personality Types in Consultations 42:21 Systematizing Your Process 43:37 Ethics in Elective Treatments 53:15 Guidance for New Dentists on Elective Treatments 56:33 Interjection 57:48 Guidance for New Dentists on Elective Treatments 57:56 Sales in Dentistry  01:03:05 Conclusion and Final Thoughts 01:05:20 OUTRO ✨ Transform Your Dentistry ✨ 🦷 Campbell Clinic – world-class private care in Nottingham. 📚 Campbell Academy – ethical implant training from beginner to expert. ✍️ Colin Campbell Blog – daily insights to challenge & inspire. If you liked this episode, check out ‘How to Win at Life and Succeed in Dentistry’ with Richard Porter #PDPMainEpisodes #CareerDevelopment #Communication #BestofProtrusive This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and D AGD Subject Code: 550 – Practice Management and Human Relations Aim: To explore the ethical, emotional, and practical aspects of private dentistry, with a focus on gaining valid consent, balancing profit with ethics. Dentists will be able to - Explain the importance of trust and rapport in the consent process. 2. Recognize the ethical challenges of elective treatments. 3. Outline strategies for building long-term career satisfaction and avoiding burnout. Click below for full episode transcript: Teaser: When you think about the number they have per hour, less than five is normal, right? Less than five of these breath holds is normal. Between five and 15 is your mild category. 15 to 30 is moderate, and above 30 is severe. You see patients that have what we call an AHI Apnea-Hypopnea Index of 60, and sometimes these breath holds can be 30 seconds. Teaser:Profit is oxygen for my business. Get that? It's essential for life, but it's not the meaning of life. I do not wake up in the morning going, oh, I'm gonna get some oxygen today, but if I don't breathe, I'm dead. Right? So we need to- I don't think that's the question. I think the question is what would I do if you or my wife, brother, mother, daughter, son? And so I'd say what you want me to do is use the experience that I have to pigeonhole you as a member of my family. The world consent is a relationship management. You can't treat your patient as if they were you. You have to treat them as if they are them. I would like to say to the guys is if you want to be really successful in the industry, both in terms of financially and in terms of the respect you get from your peers and in terms of the satisfaction you get from your job, try and- Jaz's Introduction:Gaining consent for elective treatments, selling in dentistry, the monumental role of emotional intelligence for your happiness in your life and your career. Hello, Protruserati. I'm Jaz Gulati and thank you for tuning in to what I think will be a Protrusive Hall of Famer. This episode gave me vibes of Richard Porter. The OGs will remember way back when we did an episode called How to Win at Life and Succeed in Dentistry, and we talked a lot about emotional intelligence in that episode. Brilliant episode Richard Porter. Do go back in the archives and check it out, and this episode builds so nicely on that. Dr. Colin Campbell is absolutely scintillating inspiring. I'm so excited for you to be able to listen and watch this from wherever you're tuning into. Thank you so much. There are some real great gems on communication and some absolute real talk, controversial, real talk from Colin, which I absolutely loved. So if you're doing a lot of composite veneers, you may wish to skip this episode. Colin does not mince his words. Dental PearlNow this is a PDP episode, so I owe you a Protrusive Dental pearl. And you know what, I might have actually given you this pearl before. Like recently, maybe I perhaps gave it in a recent episode, but it's in my head and it's so relevant for this episode, right? This audiobook, I listen to, "Let them." Now if you are even slightly into audible books or had a look at which books are on sale right now. This book Let Them is everywhere. And for good reason, I listen to an audiobook and Mel Robbins, honestly, this audiobook is so, so brilliantly done. You literally feel like she's talking to you. It's so easy to listen to, so conversational and my friends, I think this book will change your life. I'm desperately pleading my wife to read this book and she won't because she doesn't read. So as per the philosophy of this book. Let her, let her not read, let her not gain from this book, but let me drip feed the lessons to her. Let me induce a degree of osmosis, informational osmosis, and take control of the situation. So you kind of get a flavor of this book already. I'll put the link in the show notes. This book is all about taking control of your life and not letting what happens around you to control you and your emotions. It's about you taking control of your life. So once again, Let Them by Mel Robbins. I put the link in the show notes. And now let's check out this absolutely cracking episode with Colin Campbell. Main EpisodeDr. Colin Campbell, welcome to the Protrusive Dental Podcast. How are you, my friend?  [Colin]I'm very well, and I'm very excited to be here. Actually.  [Jaz]You're the one who's super excited.  [Colin]No, no, no. I just spent a few minutes, when I was preparing just eyeing Jaz Gulati and who he was. So I always like to do my research just to get the background because I don't think we've ever met. So I'm really pleased I used to be on. Thank you very much for inviting me.  [Jaz]Well, I've been on the receiving end, some of your lectures, and I want to start by saying that as a public speaker, honestly, up there with one of the most charismatic, energetic and human, like really the way you speak, when I'm listening to you speak, Colin, it's like no one else in the room. You are speaking to me honestly, like you have this gift. I dunno if anyone's told you this. If not, then you need to hear it then, the way you came my radar is dentinal tubules. Maybe in 2019 or something you might done a talk about leadership. Do you remember?  [Colin]Yeah. Maybe.  [Jaz]That and a few other lectures you done on, on digital dentistry, implants kind of stuff. So honestly, the pleasure is all mine to have you on the podcast and I know of all the wonderful things you get up to, but for those who are listening around the world, many in the UK, some in Australia, many in the US. Tell us about yourself, Colin.  [Colin]Geez, that's a terrible question. So my name is Colin and I'm a dentist. I'm Scottish and I'm very proud of that. I live in England, so I'm doing, I'm trying to do the good work at, do missionary work in England of converting them to the way of the Scottish guy. And I've been doing that, I've been here for nearly 30 years. And so I live in Nottingham in England, home of Robin Hood. I am married to Allison and we've been together nearly 30 years. I have three children, Grace and Rosie, and Callum. I'm a big into family, love my family to bits, so obviously, and that's a big part of my life. I am very proud to be a dentist. I'm like first generation university student in my family. So no one had ever been at uni before. So my mom and dad, did amazing things to get me to university, which I'm so grateful for.

Can and should Dentists carry out home sleep testing? It’s actually super easy and I have been doing it for 18 months! What happens after you screen them—do you know what to do next? This episode will teach you! Dr. Jaz Gulati shares his personal journey into incorporating sleep testing in practice—after 1.5 years of doing it, the impact has been nothing short of game-changing. https://youtu.be/H4rTkIuOHWI Watch PDP243 on Youtube Joined by clinical sleep scientist Max Thomas in this jam-packed episode, they deep dive into what it really means to go beyond awareness of sleep-disordered breathing. He breaks down the practical steps for dentists who want to do more than just refer—and start making a difference in their patients’ lives. You’ll learn how to bridge the gap between theory and action, how to screen effectively, and why you play a pivotal role in the patient’s journey to better sleep, more energy, and a healthier life. Protrusive Dental Pearl: If a patient has been seen gasping, choking, or stopping breathing during sleep — that’s pathognomonic for sleep-disordered breathing. 🛑 Don’t ignore it — they likely need a sleep study. Ask this in every history! Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Understanding obstructive sleep apnea is crucial for dentists. Dentists are in a unique position to screen for sleep disorders. The Malampati score is an easy tool for assessing airway obstruction. Sleep disorder breathing can significantly affect quality of life. Patient history is vital in diagnosing sleep apnea. Quality of sleep is more important than quantity. Dentists should ask specific questions to identify sleep issues. Sleep position can significantly affect sleep quality. Screening tools like Stop Bang and Epworth are essential for identifying sleep disorders. NHS sleep testing can vary greatly in wait times depending on location. Snoring is often a precursor to more serious sleep disorders. Dentists can play a crucial role in sleep disorder management. CPAP is the gold standard for treating sleep apnea. Understanding the legalities of sleep screening is vital for dental professionals. Remote monitoring became essential during COVID-19, shifting paradigms in sleep medicine.. Remote monitoring helps ensure patients are truthful about their usage of devices. Mandibular advancement devices may be more effective for certain patient profiles. Patient compliance is crucial, with many struggling to adapt to CPAP. Highlights of this episode: 00:00 Teaser 01:15 Intro 04:51  Protrusive Dental Pearl 05:52 Introducing the Expert: Max Thomas 09:39 Importance of Screening and Diagnosis 13:41 “Crowding” at the Back of the Mouth 14:46 Mallampati Score 18:54 Understanding Sleep-Disordered Breathing 25:35 Screening Tools and Techniques 32:09 Screening Questionnaires 37:24 Midroll 40:44 Screening Questionnaires 40:53 Athlete Sleep Screening and Marginal Gains 44: 20 Identifying Patients for Sleep Testing 46:15 Snoring: Risk Factor for OSA 51:44 Mandibular Advancement Devices and Legalities 55:33 Diagnostic and Treatment Options 56:57 CPAP: The Gold Standard for Sleep Apnea 01:08:33 Retesting Before MAD 01:14:41 Dentists Warning about DVLA Implications 01:17:18 Final Thoughts and Recommendations 01:19:19 Outro Resources for Screening Sleep Apnea S4S Pre-Screening Questionnaire Mallampati Score Epworth Sleepiness Scale STOP BANG Questionnaire Screening Tools The Acupebble Device  WatchPAT as an alternative Send your sleep test for reporting to Max Thomas - excellent service and affordable Max Thomas’ LinkedIn If you loved this episode, don’t miss Sleep Disordered Breathing and Dentistry – PDP139 #PDPMainEpisodes This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A, C, and D. AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Sleep Medicine) Aim: This episode is aimed at empowering general dentists with the knowledge and practical steps to actively participate in the screening and co-management of sleep-disordered breathing through the integration of home sleep testing in their clinical practice. Dentists will be able to - Understand the role of general dentists in identifying signs and symptoms of sleep-disordered breathing, particularly obstructive sleep apnea (OSA). Identify when and how to refer appropriately to sleep physicians or medical specialists after screening. Explore collaborative workflows between dentists, sleep scientists, and GPs to ensure effective patient management. Click below for full episode transcript: Teaser: When you think about the number they have per hour, less than five is normal, right? Less than five of these breath holds is normal. Between five and 15 is your mild category. 15 to 30 is moderate, and above 30 is severe. You see patients that have what we call an AHI Apnea-Hypopnea Index of 60, and sometimes these breath holds can be 30 seconds. Teaser:You end up looking at these studies and there's actually more time spent not breathing than there is breathing. In some areas, you are six weeks away from a test because they're not only on top of their list, but their numbers are lower. In other areas, you've got high population density and low service output. So you know, I have seen sleep departments that have got 60 week wait list just for the initial diagnostic tests. You already got the suspicion that they have obstructive sleep apnea. They're already telling you that they're struggling, and then they're told to- Sleep apnea is one of those things that a patient may need to report and they may need to report it in the case where they have moderate or severe obstructive sleep apnea with sleepiness. And it's really important that with sleepiness part is the main focus of the DVLA guidance. 'cause the sleepiness is the symptom that affects safety on the road. If the patient has sleep apnea, but they don't wake up frequently from their breath holds, they don't have the interruption to sleep, they don't have the reduced cognitive function in the day. That sleepiness is what? This is all contingent on.  Jaz's Introduction:Protruserati, I think this is one of the most profound episodes we've done to date. You see, the problem is that everyone's telling us that sleep apnea is this huge thing and that as dentists we ought to know about it. And there's plenty of podcasts now out there. Plenty of content out there, plenty of courses out there that are kind of filling that gap of knowledge. The issue is we're still hungry. I'll tell you what we're hungry for. We're hungry for the following. Okay, so now you know what sleep apnea is. Now you've asked your patient, you've done some screening questions to your patient, but then what? What happens then? Because if you're not already actively in this space and you kind of refer and you lose that patient forever, what if you as a dentist want to do the sleep test? That's what I do. I've incorporated sleep testing into my clinic for about 15 months now and it's amazing the results we come back. Now, I just wanna start by saying that we as dentists, we cannot diagnose sleep disorder breathing. Okay, let me repeat. We as dentists cannot diagnose sleep disorder breathing, but we can screen and we play a pivotal role in its management. So what this episode will do is we'll bridge that gap between actually knowing about sleep apnea and actually doing something about it as a dentist. And that is only achieved by those who are testing in their clinic. And let me tell you, it's not mega expensive. It can be very convenient for your patients. And hey, even if you don't start testing yourself, you ought to find someone near you or a center near you that can get your patient tested for sleep disorder breathing, such as obstructive sleep apnea. And correctly reported so that you can genuinely help your patients, help them live a healthier life with more energy, less dozing off during the day 'cause of sleepiness, better quality of sleep for them and their partners, and adding quality life to their years. Hello Protruserati. I'm Jaz Gulati and welcome back to your favorite dental podcast. If you're new to the podcast, welcome, you picked a great one, and of course, if you're a returner, thank you so much. Really means a lot. Your time is important to me, so I'm gonna make sure we absolutely smash it in this episode. This episode is a bit longer than usual, but let me tell you, it is full of gold, full of protrusive pearls when it comes to sleep apnea and actually doing something about it as a GDP being proactive, rather than just screening and then leaving it there and doing a big tick. Like, oh yeah, I've screened, I've done my job, actually helping your patients get the correct treatment. And the person who's helping me today is a clinical sleep scientist. His name's Max Thomas, and he's such a knowledgeable guy and he explains things really well. The funny thing about this episode is we're talking about sleep here, right? And I was recording this like 10:00 PM after my evening shift at clinic, and Max said this just come from Japan, suffering the most major jet lag ever. Yet, I still think we've created a piece of art, which I hope you will love and you may wish to listen to again as a reference. But most importantly, I think this is the one where the penny drops and things actually make sense in terms of how you can play a role to help and serve your patients. Let me tell you, the done for you notes of this episode are absolutely brilliant. You're gonna absolutely love them because our premium notes,

Imagine your patient is choking on a rubber dam clamp...what’s the safest way to manage choking when the patient is lying flat? Your patient's hands are shaking and they're drenched in sweat - is it low blood sugar, anxiety, or a cardiac event? ​​Do you know exactly what to do if your patient has a seizure in the chair? This second part of the Medical Emergencies series with  Rachel King Harris dives even deeper into real-life scenarios that dental teams may face. From seizures and how (and when) to give buccal midazolam, to managing choking in a dental chair, this episode is packed with practical, clear guidance. We also explore key steps in treating diabetic hypoglycaemia, understanding glucagon vs glucose, and how to confidently manage patients with angina or previous heart attacks—when to use GTN, when to give aspirin, and when to simply wait for the ambulance. It’s all about staying calm, being prepared, and delivering safe, effective care when it matters most. https://youtu.be/fyIIsT0dlIc Watch PDP242 on Youtube Protrusive Dental Pearl: Assign a clear lead to regularly check the expiry dates and supplies of emergency medications and equipment. This isn’t just about ticking regulatory boxes — it’s about saving lives. Little checks like this can make a big difference in a true emergency. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 00:00 Teaser 00:44 Intro 03:09 Protrusive dental pearl 04:14 Recap from Part 1 06:58 Seizures: Personal Experiences and Practical Tips 13:45 Seizure Emergency Kit: Buccal Midazolam 21:29 Emergency Drug Kit Overview 22:10 Choking: Techniques and Guidelines 29:19 Midroll 32:40 Choking: Techniques and Guidelines 34:05 Handling Infant Choking Emergencies 36:11 Recognizing and Managing Hypoglycemia 41:11 Emergency Protocols for Hypoglycemia 47:35 Managing Cardiac Emergencies in Dental Practice 58:59 Final Thoughts and Training Recommendations 01:00:39 Outro Stay up to date by reviewing the latest guidelines from the Resuscitation Council UK. Grab your Anaphylaxis Summary + Medical Emergency Cheatsheets from https://protrusive.co.uk/me. And make sure you’ve listened to Part 1 of Medical Emergencies so you don’t miss any crucial information. #PDPMainEpisodes #CareerDevelopment #BeyondDentistry ​​This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C and D. AGD Subject Code: 142 Medical emergency training and CPR Aim: To equip dental professionals with the knowledge, confidence, and practical skills to recognize and effectively manage common medical emergencies in the dental setting, ensuring patient safety and optimal outcomes. Dentists will be able to: Identify signs and symptoms of common medical emergencies in dental practice, including anaphylaxis, asthma attacks, seizures, angina, hypoglycemia, and stroke. Describe the immediate management protocols for each emergency, including correct drug doses, routes, and timings. Demonstrate appropriate use of emergency equipment and drugs available in the dental setting. Click below for full episode transcript: Teaser: And you're saying that you deal with one hole only and it's the mouth and not anywhere else. Teaser:When you're becoming a dentist and you have to choose between medical and dental school, you either look up one and you look down the other, and so I said, let me look down, not up. So here we are. That made me realize, and the advice on that Facebook post was, anyone age five or under choke on grapes. And so you totally agree with that? I do. I do. I just think it's not worth it. Sweaty. Sweaty. Very, very clammy. You know, there's pools of sweat that I mentioned with hypose. You can get exactly the same with an MI. Yeah. Nausea, vomiting, sweaty, clammy, impending doom. So again, a bit like anaphylaxis, they say they feel like they're gonna die. Blood pressure drops usually. Not always- But here's the thing where this is happening, right? I'm going back to- Jaz's Introduction:Welcome back to Part Two of Medical Emergencies to get you that big fat tick for your annual CPD requirement for medical emergencies, and hopefully in a way that you can leverage the time of commuting so it doesn't feel like something extra you're doing. Also in a way that was conversational, something that was easy to listen to, and hopefully the retention will be really good. And to enhance that retention, don't forget, we have got our premium notes, like a revision summary done for you notes for every episode for our premium subscribers. If you're not on the already, head to www.protrusive.app. In the last episode, we covered the most common medical emergencies that we see or could see vasovagal syncope, anaphylaxis, which is worrying and common nowadays, but with serious consequences. And we talk a lot about oxygen, like which medical emergencies should we be giving oxygen for and how do you actually give the oxygen? The thing is right, we as dentists, we hardly ever administer oxygen. We only are told to do it when there's a medical emergency, but I want to cover it because when push comes to shove and we need to deliver the auction, I'm hoping you found it useful to hear and to watch for those of you're watching how to actually activate the damn thing. And what it all looks like and works like. So that was all covered in part one. In this part two, we're covering seizures, how to handle a patient that is having a seizure, including how you might actually deliver the buccal midazolam. What does it actually look like and feel like? And interestingly why in many scenarios you may not even need to give it. Then we moved to choking. And we all know about back slaps and abdominal thrust, but we simulated choking and we discussed choking specifically for your patient that is like laying down the chair the exact steps you should do when your patient's in your dental chair and why. Therefore, you may need to do a one handed abdominal thrust. And so you get to hear about that and watch that again, if you're watching on the app. The last two things we discussed were diabetics and how the whole glucose and glucagon works and how to administer each one, as well as our cardiac risk patients. These ones are very common patients that make me a little bit nervous. These are patients with a history of angina, history of heart attacks in the past, and so therefore, should we be avoiding using adrenaline containing local anesthetics. And what should be doing if they're having some sort of an episode in your chair. So once again, we're joined by Rachel King Harris, or today's part two, Deep Dive into Medical Emergencies. Dental PearlHello, Protruserati. I'm Jaz Gulati and welcome back to your favorite Dental Podcast. Every PDP episode I give you a Protrusive Dental Pearl. In the last one it was to download for each condition the kind of like cheat sheet prompts that when you open up your medical emergencies drug box, like it's so reassuring to see the step by step what you're looking for, what to do next. It was like a really helpful thing. I think every single medical emergency is boxing. Every dental practice should have this. So that was last episode's Protrusive Pearl. This one is a bit more simple, but equally important is that are you checking the expiry date of your meds? Who has been allocated as someone who takes a lead on this? Not only is this important to satisfy CQC or regulatory requirements to make sure your practice can run and stay in business. But this is life saving stuff. So who's the person who's checking monthly or quarterly to make sure that nothing is running out of date and that all the supply is there and it's working and you haven't run outta oxygen or your glucagon's not outta date, and all those things. So make sure you have a clear lead because that's how you Protruserati, these little things are the big things. Hope you enjoy the episode. I'll catch you at the end. I'll give you more instructions of how to claim the CPD. Main Episode:Rachel, welcome back again to the Protrusive Dental Podcast for part two.  [Rachel]Thank you for having me again. [Jaz]So in the last episode, we covered the common things. What I wanna do is make a really tangible piece of content with your help. So we covered the things that most likely common to happen. Okay. So, vasovagal syncope, ie the faint, super common, went deep into that. We went into anaphylaxis and I think we covered it really well. We also talked about the oxygen, about what is the right dose of oxygen? Can you actually do harm by giving oxygen? And generally the consensus was, no, actually, it's a good thing to have in practice. And I also took out the drug kit and it was really nicely how it was organized. And that might be inspiration for other practices. So one thing I did promise from the last episode, part one, is like the other, attach some downloads. So the laminated sheets you can actually put in your emergency drug kit box. But I wanna do in this episode cover the other more common ones. And also like I was thinking, should we do angina and should we not? But actually more important angina might actually be choking 'cause something that we might actually see out in the community. And also, like I'm using products all the time, which could are always a choking risk.  [Rachel]Absolutely.  [Jaz]Appliances. I remember using one of our drills before, like diamond drills and it was probably my silly error, but when we actually put, it's a friction grip. So you put the diamond in and then we release a chuck and then it stays. And so I always, since then, I always check, every time I put my bow in, I always check to make sure it's in. But I must have not checked that time. And I was,

HIGHLY RECOMMENDED CPD for all Dental professionals - without getting bored! Do you know exactly what to do if a patient faints in your chair? Could you spot the early signs of anaphylaxis—before it’s too late? How quickly could you find and deliver adrenaline if it really mattered? https://youtu.be/7b2oG4g12q0 Watch PDP241 on Youtube After six years of podcasting and creating CPD, we’re finally tackling medical emergencies the Protrusive way. In this two-part series, Jaz is joined by lead nurse and medical emergencies educator Rachel King Harris, who breaks down the real-life scenarios every dental team needs to prepare for—without the fluff or generic lecture feel. From vasovagal syncope to adrenaline protocols, you’ll learn how to stay calm, think clearly, and take action when it matters most. By the end of this episode (and the next), you’ll not only tick the box for your GDC-required CPD—you’ll actually feel ready. Because when emergencies happen in the chair, panic isn’t a plan. Let’s get you prepared. Protrusive Dental Pearl: Be emergency-ready! Download a free medical emergencies cheat sheet — a quick guide for symptoms, drugs, and actions during a crisis. You can download this ready-made cheat sheet for free at protrusive.co.uk/me. Print it, laminate it, and pop it into your medical kit. Your whole team will thank you! Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Medical emergencies in dentistry are rare but high-stakes — being prepared is essential. Guidelines change often — regular refreshers are vital. You don’t need to memorise everything — use validated resources and calm judgment. Vasovagal Syncope is the most common emergency in dental settings. If unconsciousness persists → consider other causes: meds, blood sugar, cardiac issues. Anaphylaxis can occur even without rash — don’t wait for it. Key signs: stridor, lip/tongue swelling, wheeze, “impending doom,” difficulty breathing. Keep emergency drug guides visible and updated (e.g., BDA laminated sheets). Ampules = longer shelf life, more doses than EpiPens, and more cost-effective. Don’t wait for the rash — airway signs matter most in anaphylaxis. Always carry two adrenaline auto-injectors — even for mild allergy patients. Highlights of this episode: 00:00 TEASER 00:53 INTRO 04:50  Protrusive Dental Pearl 06:01 Meet Rachel King Harris: Expert in Medical emergencies 09:42 Practical Tips for Emergencies 12:05 Understanding Vasavagal Syncope 17:01 GTN Spray 20:09 Recognizing and managing Anaphylaxis 30:05 Midroll 33:26 Recognizing and managing Anaphylaxis 34:41 Allergic Reaction to Chlorhexidine Gel 37:27 What’s Inside Emergency Bag? 41:51 Adrenaline Ampules vs Auto-Injectors 52:04 Oxygen Administration In Dental Practices 57:13 Oxygen and Emergency tools 59:05 Oxygen Contraindication 1:06:37 Outro Stay up to date by reviewing the latest guidelines from the Resuscitation Council UK. Check out this Anaphylaxis Summary Document Enjoyed this one? Make sure to check out PDP159 – How to Manage Children in Dental Pain, where we dive into real-life paediatric emergencies in dentistry. ​​This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C and D. AGD Subject Code: 142 Medical emergency training and CPR Aim:To improve the preparedness and confidence of dental professionals in recognising and managing common medical emergencies in the dental setting, with an emphasis on vasovagal syncope, anaphylaxis, and appropriate use of emergency medications and equipment. Dentists will be able to - Identify early signs and symptoms of vasovagal syncope and anaphylaxis in a dental setting. Apply appropriate first-aid management protocols, including patient positioning, airway support, and oxygen delivery. Understand the updated guidelines for prioritising adrenaline over antihistamines or steroids in anaphylaxis management. #PDPMainEpisodes #BreadandButterDentistry Click below for full episode transcript: Teaser: When you faint, essentially your blood pressure drops. So that quick event that happens, what you need to do is actually try and I know, I don't know whether your dentistry bed's tilt, but tilting is actually the best. Teaser:So you want their head down, if the bed's not quick enough getting up or it's not working or whatever, you actually can just manually lift the legs and hold them up or get their relative, if they've got a relative in with them or somebody that's come in and then just keep them like that until they come round. When histamine is released into the patient, they get widespread vasodilation and bronchoconstriction. So those two things combined is a bit of a car crash. Even 0.5 because really you're going to get an ambulance within five minutes.  It's true, you're not though. You need to be carrying two at all times and people don't. And particularly if you're teenagers, you know you've got a handbag that doesn't fit it. It's tricky I actually think that in a medical center am feels better-  Jaz's Introduction:When you are dealing with a medical emergency in your chair. That stuff can get really scary for dentists. It's not pleasant to have to deal with it, but we need to be sharp, we need to know exactly what to do because our patient's life actually depends on this.  This is why it's a legal requirement in the UK and probably around the world to do medical emergencies training every year, and I'm proud that after six years of podcasting and creating CPD, we can finally now cover this topic in the true protrusive way, and now give you core CPD or CE credits. The GDC recommends 2 hours per year and in a five year cycle, that means 10 hours of medical emergencies training for the dental team, and this is mandatory. Now, most practices arrange some sort of group session where they're doing simulation and hands-on CPR, which is amazing, but sometimes we're left to our own devices and we're watching these little bit slightly boring videos and lectures online. Always scrambling to buddy up with a neighboring practice to actually get this training done on time.  Now, in this episode, I've got a Lead nurse, an educator in medical emergencies. Her name is Rachel King Harris, and one of her roles as well as working in acute medicine is to teach dental teams everything they need to know about their medical emergence training every year. So I'm proud to say that after listening to this Part 1 and the next episode, you'll give a massive tick box for your annual requirement of CPD. But the key thing is that you do it in a true protrusive way. We're going to make it tangible. I'm hoping that Rachel and I, and mostly Rachel, we'll present things in a way that it actually sticks. Sometimes when the patient is feeling unwell in your chair, we start to get a bit of panic and confusion. Is this just a Vasovagal Syncope or could there be something going on with the patient's heart? Is this an anaphylaxis? Should I be giving oxygen? All these questions can come at you a million miles an hour, and you have palpitations and you're sweating, and medical emergencies are just no fun to deal with.  But after today and the next episode, you're going to smash your annual requirement of CPD and in a way that you're going to retain this information because every episode we make some premium notes and we just deliver it in a way that's a bit easier to listen to, it's not someone lecturing at you.  You are there by osmosis absorbing these things. And I really told Rachel, I told her I want to create a really compelling piece of content for the dental team. Which makes it tangible and relatable and real world. What I mean by that is the topics we cover in this 2 hour training are actually medical emergencies that you are likely to actually see in your practice and talking about some details that are really important, but no one ever talks about some.  I'm hoping through that, that should you be in that unfortunate scenario that you will face a medical emergency because of this training, you'll be feeling much more confident, much better prepared, and of course you won't be panicking in December trying to make sure you've done your medical emergencies mandatory CPD, because we got you covered. Now to listen to this episode is free for all. Okay? The podcast is free for you, but to actually get the certification, you have to answer some questions and do some reflections, and that's possible on the protrusive guidance app.  You can listen via Spotify through the app, all Apple Podcasts, again through the app, or watch the video on the app, and the benefit of that is you just scroll down and answer the questions and our CPD Queen Mari will look after you. And once you start doing more CPD with us, we actually send you quarterly certificates and an annual summary of all your certificates, how many hours you've done, and watch this space. There's some cool stuff regarding PDP coming your way as well. The point of saying that is why don't you get started?  Come and join one of our paid plans. I guarantee you'll love it because the nicest and geekiest community of dentists in the world and you get all the CPD, which is not just a tick box for me CPD was like easy, I'd love learning, I have CPD coming out my ears, I probably claim way less hours than I actually do because getting CPD for me was never an issue.  But in this busy world, sometimes getting that mandatory training can be difficult. So why don't you head to protrusive.co.uk/ultimate, sign up and make this one the first one that you claim CPD on, and then it'll unlock the over 350 hours of CPD that's currently on Protrusive to date. Dental PearlNow, every PDP episode, since its inception,

How on earth can a neck injection eliminate teeth sensitivity? Can a patient’s tooth sensitivity really be linked to their occlusion? Is occlusal adjustment ever indicated for sensitivity? And what’s the actual mechanism behind those cases where everything looks fine — no cracks, no significant wear, no exposed dentine — yet the patient still complains their teeth are sensitive? In this episode, Dr. Nick Yiannios shares the concept of Sympathetic Dental Hypersensitivity (SDH), a groundbreaking way of understanding sensitivity that goes beyond the usual suspects like caries, erosion, or leakage. We dive into how the sympathetic nervous system in the pulp can drive unexplained pain, why traditional approaches often fail, and how objective tools like T-Scan and EMG can reveal what articulating paper misses. This could completely change the way you diagnose and manage those “mystery” sensitivity cases that just don’t add up. https://youtu.be/a2Mg72Y_zkw Watch PDP240 on Youtube Protrusive Dental Pearl: When fitting a resin-bonded bridge (RBB), if you’re unsure about the fit and cement gap, use light-bodied PVS on the intaglio surface of the wing. After setting and peeling it away, the thickness of the PVS shows you the expected cement layer. Ideally, it should be thin and even; a thicker area highlights where your gap is excessive. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: The T-scan technology revolutionizes occlusal analysis. Sensitive teeth can be linked to occlusion and bite adjustments. Frictional dental hypersensitivity (FDH) is a key concept in understanding sensitivity. Sympathetic responses may contribute to dental hypersensitivity. Innovative treatments include laser therapy and ozone application. Addressing root causes is essential for long-term solutions. Dentists should explore literature for new insights and techniques. Critical thinking is vital in dental practice. Advanced technology can enhance patient care and outcomes. Objective data is essential for effective occlusal adjustments. Understanding joint function is crucial for dental health. Differentiating between types of dental hypersensitivity is important. The sympathetic nervous system plays a significant role in dental pain. Educating patients about their conditions fosters better outcomes. The beaker of pain concept helps in understanding patient symptoms. Continuous learning is vital for dental professionals. Objective metrics are necessary for accurate diagnosis and treatment. Highlights of this episode: 00:00 Teaser 00:39 Intro 03:51 Protrusive Dental Pearl 05:42: Dr. Nick Yiannios’ Journey and Innovations 07:46 T-Scan and Digital Occlusal Analysis 08:29 FIRST INTERJECTION 13:46 T-Scan and Digital Occlusal Analysis 14:07 Discovery of Occlusion–Sensitivity Link 20:44 Second interjection 24:25 Student Case – Sensitivity from a Bridge 26:04  Dentine Hypersensitivity 28:39 Cervical Dentine Hypersensitivity 30:44 The Role of Lasers and Ozone in Dental Treatment 35:24 Alternatives for Dentists Without Lasers 43:12 Alternatives for Dentists Without Lasers 44:00 Frictional Dental Hypersensitivity Explained 47:15 The Importance of T-Scan in Dentistry 50:57 Neck Blocks and Sympathetic Responses. 58:24 Third interjection 01:00:01 Neck Block Mechanism 01:12:34 The Beaker of Pain Concept 01:14:38 Fourth interjection 01:16:23 The Beaker of Pain Concept 01:16:59 Community and Collaboration 1:20:57 Outro Curious to dive deeper?You can explore more of Dr. Nick’s work and insights through these resources: Upcoming course: CNO6 – Sympathetics in Dentistry: The Missing Link in General & Specialty Practice AES (American Equilibration Society) – check out their upcoming conference for world-class learning in occlusion and TMD. CNO – Center for Neural Occlusion Facebook community: Neural Occlusion YouTube channel: Dr. Nick DDS – packed with case examples, lectures, and protocols. CNO YouTube playlist Studies & Resources Sympathetic Dental Hypersensitivity - An Alternative Etiology for Dental Cold Hypersensitivity Greater Auricular Nerve Block Reduces Dental Hypersensitivity to Intraoral Cold Water Swish Challenge: A Retrospective Study Dr. Mark Piper Lecturing at the American Academy of Craniofacial Pain: Sympathetics & CRPS1  If this episode helped you, check out PDP199: How to Eliminate Sensitivity During Teeth Whitening #PDPMainEpisodes #OcclusionTMDandSplints #BreadandButterDentistry This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C. AGD Subject Code: 180 OCCLUSION Aim: To provide dentists with an updated understanding of tooth sensitivity, highlighting the role of sympathetic nervous system involvement, occlusion, and modern treatment approaches beyond traditional desensitizers. Dentists will be able to - Explain the concept of Sympathetic Dental Hypersensitivity (SDH) and its link to occlusion and cervical nerves. 2. Identify diagnostic tools (e.g., T-Scan, JVA, imaging) that provide objective data for managing sensitivity. 3. Evaluate treatment options, including laser-ozone therapy, occlusal adjustments, and neck block techniques. Click below for full episode transcript: Teaser: I want you to think the sideways incursive movements like speed bumps. The more speed bumps, the more likely the nervous system doesn't like all that extra bump, bump, bump, bump. So you want to kind of smooth out the ride when you're going left and right. Imagine you're in a car, you want it to be a little smoother. Teaser:Remember misfolded proteins? If you as a human, which is rare die of prion disease, you are a complete biohazard. They don't even know what to do with your body. Cremation is not enough, but guess what kills prions? Well, they're not alive. Guess what destroys prions? Their misfolded proteins. Ozone, trigeminal, cervical,*** and this all ties into sensitive teeth because it's not just trigeminal. It's also***- Jaz's Introduction:Most of us have the same protocol for managing sensitive teeth. We check the patient's oral hygiene, we check for acid erosion, be it intrinsic or extrinsic. We try and take care of the acid basically. Most of us are heavily recommending some sort of desensitizing toothpaste, like a Sensodine or an Oral B sensor version, or a pro relief from Colgate, whichever it may be. Some of us are scrubbing desensitizing agent into tooth, perhaps even fluoride. And if the sensitivity is coming from like a Class five region, like abrasion a fraction, we might slap a composite in there hoping that the sensitivity will improve. Unfortunately, have those patients who no matter which brand of toothpaste they try, like it all helps, but they forever have sensitive teeth. I already have some patients in my mind that fall into this category. So what's going on there? Why are these patients' teeth sensitive? Well, hello there, Protruserati, I'm Jaz Gulati, and welcome back to your favorite Dental podcast. For those of us dental geeks who like to spend a lot of time on YouTube, you probably already know today's guest: It's Dr. Nick Yiannios. I remember seeing his videos like, 10 years ago, 12 years ago. And I was like, what on earth is going on? This guy is using a computer to inform him about the bite, and he had all these like EMG leads on the patient and you are thinking, what on earth is going on? I've never seen anything like this before. And then you hear about all these patients problems like they've got like clicking, popping, muscular pain, headaches, sensitive teeth, and by the end of the video it shows on the computer screen what the new bite is showing. But amazingly, the patience and their response was pretty spectacular. When I look back in my journey into occlusion, and now how I'm diving deeper into digital occlusion, like using the T scan for example, and next month, I myself am getting those EMG leads flying out to America to shadow Dr. Bobby Supple. Who's a previous guest of this podcast and his podcast was called Occlusion Wars and was just a brilliant summary of the history of occlusion. You have to check it out. Anyway, Bobby's the current president for the AES and their conference in February in Chicago is one that me and Mahmoud Ibrahim are speaking at. But we are small fish we are tiny tadpoles in this ocean of giants that they have presenting, including Mark Piper and Dr. Nick Yiannios who we'll be hearing from today. So that's my plug in there you guys have to check out the AES. If you can come to Chicago in 2026, February, I'll put the details in the show notes. It'll be great to see you there. Anyway, I'm digressing I'm just sharing my excitement from learning from all these people and what Dr. Nick has to share is pretty mind blowing. We will answer that question of can a patient's sensitivity be linked to their occlusion? Is occlusal adjustment indicated for sensitivity? What is the mechanism behind that? And as per the title of this episode, you'll get to know the real cause of sensitivity. And once you check for caries and exposed dentine and that kind of stuff, that the most common cause of sensitivity, like leakage and stuff like once you've accounted for that and you found that, "Hmm, actually this patient has no signs of cracks, there's not significant amount of wear, there's not much exposed dentine, why is my patient saying that my teeth are so sensitive?" Then the diagnosis, my friends, is likely sympathetic denting hypersensitivity. And if you want to know what that's about, wait all the way to the end of the podcast. Honestly, it's going to blow your mind. I learned a lot from this podcast.  Dental PearlNow, just before we dive in,

Is it time to say goodbye to your DSLR? Are mirrorless cameras really the future of dental photography? If your DSLR is still working perfectly, should you upgrade now or wait for the right time? Jaz is joined by Dr. Ashish Soneji in this game-changing episode to discuss the death of the DSLR and why the shift to mirrorless cameras is inevitable. They break down whether you should proactively switch or strategically hold off, plus what this means for your existing lenses. You'll also learn the rules of mix and match—can you use your current DSLR lens on a mirrorless body? And most importantly, which mirrorless lenses are worth buying and which ones to avoid (hint: if they don’t have markings, you might be in trouble!). If you care about consistent, high-quality dental photography, this episode is a must-listen! https://youtu.be/Y29Mnz26ZIU Watch PDP239 on Youtube Protrusive Dental Pearl: Jaz introduces the 21-Day Photography Challenge for beginners, featuring 21 short videos to help dentists take clear, well-framed photos. In just three weeks, participants will master essential shots, including tricky occlusal views, at their own pace. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Investing in quality equipment pays off in the long run. Mirrorless cameras offer significant advantages over DSLRs. Lighting is crucial for capturing quality images. Standardized images require barrel markings on lenses. Second-hand DSLRs can be a cost-effective option for beginners. The evolution of camera technology impacts photography practices. Choosing the right lens is essential for dental photography. Flash consistency is vital for accurate representation in images. Upgrading to mirrorless is a smart move for future-proofing photography. Upgrading your camera setup should align with your clinical progression. Mirrorless cameras are lighter and offer better image quality. Consider the size and transportability of your camera kit. Timing for upgrades can be linked to job changes or equipment failures. Image quality is influenced by megapixels, especially for presentations and printing. Using the right tools, like smaller mirrors and retractors, can improve photography outcomes. Testing second-hand cameras before purchase is crucial to avoid issues. Mobile photography is improving, but may not match the quality of dedicated cameras. Investing in good photographic equipment is essential for quality results. Highlights of this episode: 00:00 Teaser 00:47 Intro 01:41 Protrusive Dental Pearl 03:30 Ashish's Journey into Photography 09:06 The Shift from DSLR to Mirrorless Cameras 13:33 Choosing the Right Camera Setup 15:32 Upgrading to Mirrorless Cameras 19:22 Camera Recommendations for Beginners 27:23 Investing in Reliable Flash Equipment 32:20 Investing in Reliable Flash Equipment 33:48 When to Upgrade Your Camera Setup 38:08 Getting HQ Images: Mirrorless vs DSLR 42:03 Avoiding Newer Lenses 43:23 Posterior Quadrant Photography 47:50 Tips for Buying Second-Hand Cameras 49:54 Mobile Dental Photography: Are We There Yet? 53:20 Getting Your First Mirrorless Camera 55:40 Course Information 57:53 Outro 💡Catch Dr. Ashish Soneji’s upcoming course The Magic of Dental Photography this November 2025! 📅 Friday 14th November 2025 – Exclusively for BUPA dental care professionals at Bupa Head Office in Staines📅 Saturday 15th November 2025 – Open to all dental care professionals at the A-dec Showroom in Bracknell You can head over to https://www.magicofdentistry.com/ and add yourself to the waitlist. Further details on how to book will be sent directly to your email. Course overview: Understanding an SLR camera it's features Understanding a mirrorless camera and its features Discussing the process of recording an image Overview of SLR equipment available and custom set-up for dental photographs Overview of mirrorless equipment available and custom set-up for dental photographs Understanding how to record a standardised set of clinical photographic views and posterior quadrant photographs Logistics of effective clinical photography workflow Introduction into more advanced techniques Introduction into recording portrait views Case presentations Hands-on implementation of the concepts discussed  If you liked this episode, you will also love Basics of Dental Photography [B2B] – PDP087 #PDPMainEpisodes #PDPMainEpisodes  This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject Code: 130 ELECTIVES (138 Dental photography) Aim: To explore the transition from DSLR to mirrorless cameras in dental photography and highlight the advantages, optimal setups, and key considerations for upgrading. Dentists will be able to: 1. Recognize the benefits of mirrorless cameras, including focus peaking, real-time adjustments, image stabilization, and high ISO performance. 2. Choose appropriate mirrorless cameras, lenses, and flash setups based on their clinical photography needs. 3. Assess whether transitioning from a DSLR to a mirrorless system is the right choice based on their current equipment and practice requirements. Click below for full episode transcript: Teaser: Is it RIP DSLR? It actually is because around sort of 2020, Nikon and Canon have pretty much stopped developing the cameras. There's many advantages of that, mainly from the fact that prices are coming down. Teaser:And also from the fact that technologies moving forward, but also from the fact that you're not getting so much support from the suppliers. If you have problems or if your camera is going to break or issues like that, you're not going to get so much support. Yeah posterior shots exactly. The point that I sort of made at the beginning is it's about the light, right? It's about getting that powerful exposure of light, which you're just not going to get with a camera and there's so much more better quality images. And even the way that you're holding your DSLR the mechanics of how you're holding that, you're going to a better frame shot, you're going to create better angles. So if I'm on to invest in the good clip-- Jaz's Introduction:I'm actually a little bit emotional, guys. It's the death of the DSLR camera. You'll find out in this episode why? The future, the now is mirrorless cameras. They are perfect for dentistry and they are the future. They're not going to make any more DSLRs in the future. But the million dollar question is if like me, you already have a decent camera. It's a DSLR, the photos are fine, you have no issues with it, should you? Proactively or preemptively upgrade now to a mirrorless? Or is there perhaps a more strategic time to do that? What are the rules of mix and match? Can I use my existing lens on a mirrorless body? And you'll also find out which mirrorless lens to buy and which ones to avoid because they don't have any markings, that they don't have any markings. How are you going to keep your photographs in consistent reproducible framing? We cover all that with our guest, Dr. Ashish Soneji. Dental Pearl:Every PDP episode, I give you a Protrusive Dental Pearl, and this one is pretty special. This one's dedicated to anyone who's new to dental photography. Like you'll hear the importance of dental photography and you know why it's important. That's why you're listening to this episode. You just cannot develop as a clinician without a camera. So dedicated to the absolute new beginner to photography I've created. The 21 day photography challenge. Just give me three weeks and I'll get you taking consistent, beautiful, nicely framed, nicely exposed photographs. It's like an online challenge if you like, right? 21 videos. Now they are short little videos that you can consume day by day, and like I said, within three weeks you'll be taking great photos, like you'll be proud of them as a beginner, including the dreaded occlusal photo. The 21-day Photography Challenge starts with which kit to buy and then develops into all the different shots and all the different settings and why you do each setting. You can choose to do one video a day, or you can actually binge the whole series in true Netflix fashion. The choice is yours at the time of publishing this episode, it is now available on the Protrusive Guidance app. You'll see it listed in the Jaz's Masterclasses section. And it's got all the cheat sheets you need as well. So if you're brand new to gender photography and you love our content, then do check it out. Now do I think you need a hands-on course? Ideally, right? So what my 21 day challenge does, it gets you started, it gets you to pick up the kit and start taking photos and start practicing those dreaded shots, but to go to the next level I would recommend an in-person hands-on course, which really does elevate you. This could be from our guest Ashish today, or anyone local to you who takes good photos that you admire and is passionate about teaching dental photography. I know you're going to love Ashish. Let's check him out and I'll catch you in the outro. But remember, if you're interested in a 21 day challenge, check out the Protrusive Guidance app. Catch in a bit. Main Episode:Dr. Ashish Soneji welcome to the Protrusive Dental Podcast, my friend. How are you doing? [Ashish] Not too bad, man. Glad to be spending the time with you. [Jaz] Dude, you've been in task with like a huge one, right? This is a huge one. Photography is like the most important, most foundational, most primitive thing in dentistry. I see I mean that in a good way not primitive as in like it's slow down,

Should we be doing more to save questionable teeth? What if you could buy more time — without compromising patient care? Dr. Omar Ikram returns for a powerful episode diving into the real-world decision-making between endodontics and implants. Together with Jaz, they explore tough scenarios — like teeth with nasty cracks or minimal remaining structure — and ask the critical question: when is it truly time to extract? They break down concepts like retained roots, root burial, amputation, and a new term Jaz introduces — palliative endodontics. Because sometimes the best outcome isn't immediate replacement, but smart, strategic delay. https://youtu.be/5msP908JvuI Watch PDP238 on Youtube Protrusive Dental Pearl: When discussing treatment longevity with older patients, tailor your language to be more relatable. Instead of saying, “I plan my dentistry to age 100,” say, “I want this to last well into your eighties or nineties.” This makes the conversation more personal and realistic, helping patients better connect with the concept of long-term outcomes. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Understanding the limitations of implants compared to natural teeth is vital. Medical history significantly impacts dental treatment decisions. Managing patient expectations is crucial for satisfaction. Palliative endodontics can provide temporary relief and management. Reading and interpreting CBCT scans requires skill and experience. If it's not that five millimeter defect, it's up to you. The second molar is a good one because often second molars can't be replaced with an implant. Retaining roots is definitely a good way to go. You need to risk assess the patient before extraction. Palliative endo is technically always an option. Success in endo can be often difficult to achieve. Asymptomatic and functional is a good criteria. If endo is on the table, it's feasible. Highlights of this episode: 00:00 Teaser 00:35 Introduction 01:48 Protrusive Dental Pearl 04:15 Interview with Dr. Omar Ikram: Philosophy and Growth 10:17 Endodontics vs. Implants: Treatment Planning 16:35 Antidepressants and Dental Implant Failure 19:37 Managing External Cervical Resorption (ECR) 22:30 Patient Communication 24:16 Cracks and Complications in Endodontics 29:12 Endodontic Protocol 30:50 Challenges with CBCT and Cracks 32:07 Second Molars: Retain or Extract? 35:05 Retaining Roots for Future Implants 36:21 Root Burial and Special Cases 40:08 Root Amputation: A Niche Solution 40:57 Key Signs to Rethink Root Canal Treatment 43:17 Cracked Teeth: Poor Prognosis 47:08 Stained Crack Tooth 50:19 Success vs. Survival in Endodontics 56:02 Final Thoughts and Upcoming Events Want to sharpen your endo game even further? Watch Stop Being Slow at Root Canals! Efficient RCTs with Dr Omar Ikram – PDP163 Check out Specialist Endo Crows Nest — led by Dr. Omar Ikram, offering expert care, hands-on courses, and practical tips for real-world endodontics. This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and C. AGD Subject Code: 070 ENDODONTICS (Endodontic diagnosis) Aim: To help clinicians develop a deeper understanding of when to preserve a tooth through endodontic treatment versus when to consider extraction and implant placement. Dentists will be able to - Identify key red flags that may contraindicate definitive root canal treatment. Understand the concept of palliative endodontics and how it can be used to delay or defer implant placement responsibly. Recognize the value of retained roots in maintaining alveolar bone, particularly in medically compromised or high-risk patients. #PDPMainEpisodes #EndoRestorative #BreadandButterDentistry Click below for full episode transcript: Teaser: Biggest difference between implants and retaining the tooth through root canal treatment is that implants, that's the big difference. Sometimes when you say to patients, you'll be dealing with an implant failure in your lifetime. Teaser:They look at you like, really? I thought implant would last till I was a hundred. How long anyone's gonna last on this planet? But in my planning, I plan to age 100. So I see everyone as living to age 100. And so my planning, I don't think this will make it, therefore-- Your health is within your own control. Also, it might be only 50%, 25%, but some of it's within your own control. I want the patient to go on holiday and not be sitting there worrying about whether their tooth might be bothering and they have to go to a dentist and take antibiotics-- Jaz's Introduction:Endodontics versus Implants: is this even a worthy battle? Let's be honest, right. Any implant dentist worth their salt would agree that for themselves or their family member where an Endo is feasible and you have a good prognosis, that that is the obvious choice first before having an implant, because an implant will still be an option for the future. And that's pretty much easy and unanimous in dentistry. Unless of course your patient suffers from titanium deficiency disease. Now where this becomes more pertinent is those dubious scenarios, lack of tooth structure, those nasty cracks we've particularly discussed these two scenarios. Whereby perhaps we should be considering implants. But wait, Dr. Omar Ikram may have a few things to say about that and why we should be considering perhaps root filling, retained roots, root burials, amputation, and a term I introduced called Palliative Endodontics. Why that might have a growing role so that we can defer implants because we know implants do not last forever, Endo doesn't last forever, nothing lasts forever. So important about seeing the bigger picture when it comes to longevity. Dental PearlHello, Protruserati I'm Jaz Gulati. Welcome back to your favorite Dental podcast. Every PDP episode, I'll give you a Protrusive Dental Pearl. Now, there is a theme in this podcast where we discuss about the age of the patient. We all know it's better to have an implant when you are 60 or 70, than when you're 40. And one thing I always did is when I communicate to patients, I was inspired by a consultant in Restorative Dentistry Dr Chander used a line to a patient.  He said, "Look, I don't know how long anyone's going to live for, but I always plan my dentistry to age 100." And I've been using this line to my patients, and yeah, it's okay it works well, they get to see the bigger picture. But a lot of patients can't relate to that. A lot of my patients, their 60's, 70's, and 80's they just can't relate to that. They immediately start thinking off topic and thinking, oh, I probably won't make it. So one of the changes I've made in communication based on what Omar discussed with me today, and really the pearl I want to pass on to you is instead of saying to age 100 for everyone, look at your patient. Let's say they're in their 70's and then you wanted to say, "Look, I want this to last well into your 80's maybe into your 90's.  Now, they may still think, "Oh, I probably won't make it." But it's just a bit more relatable than putting a number age 100, because chances are most people don't know a 100-year-old, but they might have friends in their 80's and 90's. Do you see what I mean? Obviously, it's a very niche scenario. But me personally, I have a very age population that I look after my patients on average are 60. And so this change in terminology in the way I communicate to patients in terms of longevity of treatment. I think's gonna really help me to get the point across well into your 70's well into your 80's. And you'll hear this again in this episode being a big part of today in this episode with specialist ended on Dr. Omar Ikram.  Before we join the main episode, have you downloaded the app yet? The best way to do it, if you haven't already, is visit the website www.protrusive.app. Once you're there, make your account. Then once you've made your account, you could download the iOS or Android app and log in to find the nicest and geekiest community of dentists in the world. What I've found is that dentists join the app for the content. The premium notes, the transcripts, the Protrusive Vault, our Mini Master Classes and Courses, just a better overall listening and watching experience. But what they stay for is the community. What they find is that they fall in love with dentistry all over again because dentistry can feel so lonely and isolated.  And on some of these social media groups, you get shot down when you ask for opinions. But really, we've brewed a culture very hard to brew, a culture of kindness, being considerate and selflessly sharing information. So remember, the website is protrusive.app. The app is called Protrusive Guidance, I would love to see you on there. Let's join the main episode with Dr. Omar Aram and at the end, of course, you can answer the quiz to get your CE credits on the app. Main Episode:Omar, welcome back to the show. I just saw you post on Instagram, so you are on the bike doing a marathon. Tell me more about that. [Omar]Oh no, it was just one of those big days at work and I was doing an extra bit of punishment for exercise. I tend to do this to myself when things get tough, I think what's something I can do for 20 more minutes? You've had that big day, you think I can't do it anymore. And it's like, you can, and by doing that, what you're doing is you're just pushing yourself that extra bit and saying, "You know what? Even those hard days in clinic, I can still do a bit more. " [Jaz]I love that. It reminds me of a book. The David Goggins book? Can't Hurt me.  [Omar]Yes, yes, yes. Have  [Jaz]You read that one?  [Omar]Yep. That's a favorite of mine. That's a good one.  [Jaz]I mean,

Is Practice Ownership worth the stress?  What's the most difficult thing you have to do as a practice owner?  Thinking about starting your own squat practice? How long does it really take before you see profit, and what sacrifices do you need to make along the way? In this episode, Jaz is joined by Dr. Shabnam Zai to unpack the real highs and lows of running a dental practice. From the loss of control as an associate, to the resilience needed during COVID, to the challenges of leadership and managing a team—nothing is sugar-coated here. They also tackle the big money question: when does a squat practice finally become profitable, and is it worth the grind in those first few years? If you’ve ever wondered whether practice ownership is for you—or why it might not be—this episode will give you the clarity (and reality check) you need. https://youtu.be/Tf1bgOWMA2A Watch PDP237 on Youtube Protrusive Dental Pearl: “DO NOT COMPARE YOUR WORK TO WHAT YOU SEE ON SOCIAL MEDIA” Most cases shown online are the very best results, done under perfect conditions by clinicians with thousands of hours of experience.  Instead of letting that trigger self-doubt or imposter syndrome, use it as inspiration: respect it, aspire toward it, and occasionally achieve it — but remember that real-world dentistry is different. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Engagement in work is crucial for job satisfaction. Time management is essential for balancing work and family. Marketing and patient relationships are vital for practice growth. Quality time with family is more important than quantity. Coaching can help surface potential and provide accountability. Delegation is essential for effective practice management. Vulnerability can arise unexpectedly in practice ownership. Managing people requires empathy and clear communication. Being an associate can be fulfilling and offers flexibility. It's important to have projects outside of dentistry. Balancing family life with practice ownership is challenging but possible. Financial planning is crucial before starting a practice. Understanding your priorities helps in making career decisions. Documenting staff performance is key to effective management. Continuous learning and self-improvement are vital for success. Highlights of this episode: 0000 Teaser 00:25 Intro 06:10: Guest Introduction – Dr. Shabnam Zai 08:38 Journey into Dentistry and Practice Ownership 15:08 Practice Philosophy and Security 16:33 Decision Making and Growth 19:10 Hardest Part of Being a Practice Owner 24:30 Balancing Parenthood and Dentistry 26:10 Coaching and Supporting Others 30:44 Compliance and Personality Types 34:15 Compliance and Personality Types 35:55 Navigating Career Vulnerability During COVID-19 37:06 The Importance of Self-Awareness and Managing People 40:07 The Forever Associate Trend 43:01 Projects vs Goals 48:33 Balancing Parenthood and Professional Growth 50:47 Financial Considerations for Starting a Practice 59:05 Final Thoughts and Mentorship Opportunities 59:42 Outro Enjoyed this episode? You might also like Treatment Co-Ordinators – Are They Right For Your Practice? – IC043 #PDPMainEpisodes #CareerDevelopment #BeyondDentistry Connect with Dr. Shabnam:Website → shabnamzai.comInstagram → @drshabnamzai This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes: B: Effective management of self and working with others in the dental team. AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS Aim: To provide dentists with an honest, practical insight into practice ownership—particularly squat practices—covering the challenges, rewards, financial realities, and mindset shifts needed for success. Dentists will be able to - Explain the main motivations for becoming a practice owner versus remaining an associate. 2. Describe the key challenges of practice ownership, including compliance, leadership, and financial planning. 3. Outline the realistic financial commitments involved in setting up a squat practice. Click below for full episode transcript: Teaser: Sometimes when you take a step back, you can actually take a bigger step forward. When people say, how much does it cost to set up a spot, I laugh because it's completely the wrong question to be asking. Teaser:The reason I say that is, is because how much your practice is gonna cost depends on, but I did it by reducing clinical day, but I cut down from five to four. What was interesting, my income didn't change. You know, you have to be honest. Sometimes practices don't work out. You know, and that's okay, but-- Jaz's Introduction:Practice ownership, it makes a lot of sense. In fact, in a lot of countries that is the culture. You qualify, you buy a practice, you do your own brand of dentistry. You are never truly fulfilled until you are a practice owner. In fact, in some countries, the associates are rare. Now, here in the UK, US, Australia, there is a big associate culture, if you like. There are many associates out there. And you know what? As an associate, myself, there are so many good things, but there are also some bad things, the lack of control. What if tomorrow a corporate takes over the practice completely changes the culture? It's what happened to me. And then you have to jump ship and start your patient base all over again. You lose that security, you lose that control and security control are too major reasons we explore today and why one may consider to become a practice owner. And particularly we're talking about a squat practice. A squat practice is when you buy a building and you turn it into a dental practice. So whilst the themes we cover in today's episode with Dr. Shabnam Zai, it does apply to buying an existing dental practice because we talk about leadership, we talk about being the boss, being the principal. A lot of our advice, especially when we talk about money towards the end, is about when you are doing a startup or a squat. Hello, Protruserati I'm Jaz Gulati, and welcome back to your favorite Dental Podcast. You'll find out why I don't think owning a practice is right for me at this stage of life. And maybe never, maybe you'll never be right for for me, there are a few really good and really important reasons why I hate the idea of running my own practice. So you'll get to hear about that later, but then you get to hear about so many benefits and good things and why it might be the best thing that ever happened to you, as explained by Shabnam. The kind of themes that we cover are: Is it right for you to be a practice owner? What are the sacrifices you have to make? What's the most difficult thing you have to do as a practice owner? How long would it take for you to make a profit? Does it mean that you may have to give up your clinical dentistry? What's the most challenging thing about being the boss? Dental PearlAnd so many other themes explored in this one hour podcast. Now this episode is eligible for CE credits as Protrusive Education is a PACE approved education provider, and so when you answer the quiz at the end on the app, you'll get your CE and CPD. Talking of the app, the app has inspired today's Protrusive Dental Pearl. I'd like to give you a quick win at the start of every PDP episode. So, as you know, we built this community of 4,000 of the nicest and geekiest dentists in the world. It's absolutely magic. Waking up and seeing all these notifications and all these cases being posted, and all the advice that's being given and all the, just camaraderie and kindness. Now, I'm very careful about promoting the app outside of the podcast. We have a very niche audience here of either the most engaged and caring dentists in the world, or dentists who want to be more engaged with what they do, and they've all found a home in Protrusive guidance. So if you're not part of it, check out Protrusive.app that's the website, www.protrusive.app. Make your account at the time of publishing, it is free to make an account. There are paid plans available if you want amazing value that we offer, but you can just join the community and meet your tribe. You can then download the app on iOS and Android. But recently Hannah Cooper for a dentist student in Slovakia posted a case and she said deep breath this is my first anterior case, and she felt really beat up by it. Okay. And I thought she's being very critical of herself bless her. Okay. So she did some good work. And what I love is that Hannah, she made herself vulnerable. She really put it out there as like, guys, can you help me? And the advice that was given, the reflections by the Protruserati, shout out to the usual suspects. Okay, Mohammad Mozaffari, an absolute legend on the app, so giving with this time. So just a massive shout out to Mohammad. Massive shout out to Richard Coates. I love it every time you dissect a protocol, and I just love how deeply you think. Also, Richard did a special podcast episode just for us private podcast on the app, all about finances and the importance of investing as a dentist, you know, and saving money for the future. So you can check that out as well. And then Michael King, again michael King is another one of those dentists on the platform, which are just so giving with their time and expertise. So his is the pearl that I picked for today. Okay, he says, something that we've echoed on this podcast before and it's relevant for everyone, whether you're starting a new practice and then you're looking at other people, or you are wanting to be better at clinical dentistry. Whatever it may be. His advice was in capital letters. Do not compare your work to what you see on social media.

Are you living your career by design—or just letting it happen to you? Do you know what your ideal day as a dentist looks like? What about your ideal week? In this episode, Jaz is joined by Dr. Andrea Ogden to explore how you can design a career—and a life—in dentistry that feels purposeful and fulfilling. They dive into why many of us get stuck on autopilot, chasing goals we’ve never truly chosen, and how to break free by aligning work with your values.  Andrea also shares practical techniques to help you fall back in love with dentistry, so you can build a career that energises you—inside and outside the surgery. https://youtu.be/XDxlUFeEpbw Watch IC060 on Youtube Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 00:00 Teaser 00:21 Introduction 04:49 Guest Introduction – Dr. Andrea Ogden 06:05  Andrea's Journey in Dentistry 08:51 Pivotal Moments in Dentistry 14:51 Trial and Error in Career Development 15:51 Current Role 16:59 Identifying Strengths vs. Enjoyment in Dentistry 18:18 Challenges for Young Dentists 21:51 The Importance of Career Awareness 24:05 Impact of Social Media 26:57 Understanding the Decline in Dentist Morale 31:51 External Factors Contributing to Stress 35:09 Internal Factors and Cognitive Dissonance 41:17 Practical Steps to Reignite Passion for Dentistry 47:32 Resilience Through Adaptation 48:59 Community and Support Networks 51:46 Enjoying the Journey 56:30 Outro Key Takeaways:  Dentistry is more than fillings and crown preps—it’s a career you can shape to truly excite you. Choose Variety & Joy – Build a mix of roles that energise you, not just ones you’re good at. Ditch the Comparison Game – Your journey is unique; stop measuring it against 15-year veterans on Instagram. Guard Your Values – Burnout often comes from a mismatch between what you believe in and where you work. Align the two. Create Space to Reflect – Slow down, think, and use SMART goals to plan your next step.  Find Your Tribe – Mentors, colleagues, and community will keep you inspired and resilient. Celebrate the Wins – Small or big, they’re proof you’re moving forward. Loved this conversation? You’ll also enjoy Passion and Values in Dentistry – PDP014 #CareerDevelopment #InterferenceCast #BreadandButterDentistry This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes  B: Effective management of self and working with others in the dental team. C: Maintenance and development of knowledge and skills within your field of practice. D: Maintenance of skills, behaviours and attitudes which maintain patient confidence in you and the dental profession, and put patients’ interests first.  AGD Subject Code: 770 – Practice Management and Human Relations Aim: To provide dentists with strategies, insights, and practical steps to rekindle passion for dentistry, align their work with personal values, and develop sustainable career satisfaction. Dentists will be able to - 1. Identify personal values and career drivers that contribute to long-term job satisfaction. 2. Recognise common stressors affecting dental morale and their underlying causes. 3. Apply structured decision-making frameworks (e.g., SMART goals) to career planning. Click below for full episode transcript: Teaser: There's a definite difference between doing more of something or because you are good at it and doing more of something because you enjoy it. You know your values are a compass. As to, you know, where you are gonna go in, in, in life. I think if you are listening to this conversation and you are really struggling, is that the first thing you need to do is you- Jaz's Introduction:Hello Protruserati. I'm Jaz Gulati and welcome back to your favorite Dental podcast. This is the interference cast, like the nonclinical arm, but a very important arm of the podcast. One of the things that Andrea mentioned, is that when she was studying in dental school, that's what it was all about. It was just about studying and becoming a dentist and passing your exams, and I resonated with that so much because our date was 6th of June. I knew that on 6th of June 2013, we were gonna get our results.  And I could not imagine life beyond the 6th of June. Like it was all about am I gonna become a dentist? This is what I've been building up my last sort of eight to nine years to do. Like I wanted to be a dentist since I was 14, but I couldn't even think about the future and what it will actually be like to be a real dentist in the real world. Now, fast forward so many years, I have a lot of real world insight and I'd love to share it with you today along with Andrea. I love people like Andrea because they are all about helping us feel fulfilled in dentistry.  There are plenty of people out there who perhaps dentistry didn't go the way they planned. They leave and now they want to coach you on your exit plan, which I understand, but what I don't believe in is making permanent decisions based on temporary feelings and actually attempting to figure out exactly how to make dentistry work for you. Now, some things I didn't discuss in the conversation with Andrea, because she was on a roll and I want to give her the space and time to talk about all the wonderful things, including the latter part, the end of the podcast, whereby she actually gives real techniques, is about five techniques she shares to help you feel more fulfilled from dentistry. But one thing I wanna just talk about while I have this opportunity in the intro is the following. Have you actually put pen to paper to write down what your ideal day actually looks like? Like you are actually allowed to have an ideal day. Have you thought about it?  I didn't do this until a few years ago, and it made a big difference to my clarity of thinking and where I want to take my career. And the other one, of course is what does your ideal week look like? Once you've decided what your ideal day and ideal week looks like, then make that your goal, that's your aim.  Why wouldn't you make some decisions right now to make your ideal day and your ideal week become a reality. For example because I think examples really help. I'm someone who if I don't exercise at least three or four times a week, I don't feel like I'm living to my truest value. I become grumpy I don't feel like I'm enjoying my life as much as I could be. And so I know in my ideal week I need that.  Now, I've had a few years in my career where that wasn't happening, especially when we are building OBAB that was such a huge project. I had to wrongly sacrifice some health for that. But now I'm back on track. And so slotting that into the ideal week for me is really important, and you make it work and you make some key life decisions. And something that you do with your significant other, you decide that you design your perfect life how do you actually want it to look like, where you're gonna live? What gym membership will I will have to make sure this all happens. And so it's about living a life of purpose, allowing you to live to your truest values. And that was just one example of me making sure that I designed my ideal day and my ideal life to make sure I get to go to the gym 3-4 times a week. Another thing that was important to me is like I'm someone, I'm not good at multitasking. I think most, most of us aren't, and we shouldn't be multitasking. It's better to focus on one thing, and I'm particularly bad and like sometimes I get distracted and I feel like really overwhelmed easily. And so when I'm in clinical mode, I'm in clinical mode. And because I love my clinical dentistry, it's not a big deal for me to do a 12 hour shift. I know it's not for everyone, but I'm more than happy to do an 8:00 AM till 8:00 PM if it means I can work less days. So for me that made perfect sense that I have a really long Monday and now I don't have to work a Thursday anymore, for example. And this has only just come to fruition. It's something that we agreed on about a year ago, and then we had to wait for my Thursday patients to diminish, if you'd like. And now I really consolidated my clinical days. This allows me to be in the zone on Monday. And whilst I don't get to see my kids much on a Monday, I get to make up for it on the other days. because now three days a week, I get to do either school drop off or a pickup, or both. And the main point of sharing this detail with you, my friend, is that everything I'm trying to do is with great intention, it's on purpose and it's by design. And it doesn't happen overnight. It actually took a discovery process first, and then you put your action plan, and you relentlessly chase that. And that ideal week may look different for everyone. But if you don't decide what your ideal day or ideal week looks like, then you'll never get it. If you don't know where you're going, how do you know when you'll get there? Alright, that's quite enough of my rambling. I'll catch you in the outro. Enjoy, enjoy, enjoy this podcast with Andrea. Main Episode:So Doctor Andrea Ogden, it is absolutely a pleasure to have you on Protrusive Dental Podcast. How are you?  [Andrea]I'm very well, and I'm very excited to be here. So thank you so much for the invitation to come and talk to you today.  [Jaz]For those of you listening on Spotify, Apple it's a sunny, beautiful day today in the UK for once. And Andrea's looking bright and vibrant and that would really, I think be a great descriptor of some of the content I'm seeing from you, Andrea. And the top word I'd probably say is relatable. I reached out to you because I'm loving what you're putting out to the universe. So much of the podcast over the last six years. Our tagline is Fall in Love with dentistry again,