Cosmetic Dental ‘Failures’ – When Veneer Patients Change Their Minds (Medico-Legal Series) – PDP169

Picture this: your patient is beaming with joy over her new veneers, giving high-fives and 5-star Facebook reviews! The next thing you know, she calls the practice demanding the removal of her veneers because her boyfriend claims she now looks like a horse (tip #1 – ditch the boyfriend!)

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In this episode I’m joined by Dr. Daniel Cattell and Dr. Neel Jaiswal on how to navigate such a situation. While we hope it’s not a common occurrence, we discuss the importance of consent protocols and thorough communication in hopes to avoid such scenarios. And in case things take an unexpected turn, know the right time to reach out to your indemnity company, and how to smooth out the bumps.

Protrusive Dental Pearl

Quick and Easy Smile Preview App

Download the ‘AirBrush’ app on iOS or Android which uses AI to produce a quick and surprisingly useful Smile design preview. Obviously, use it with caution!

Looking for a fresh indemnity quote? Visit www.protrusive.co.uk/insurance for an exclusive £100 off with PDI, and see how much you can save by shifting away from conventional indemnity agreements. For some informal advice, email Dr. Jaiswal at neel@professionaldentalindemnity.co.uk, or connect with him on Facebook.

Check out Dr. Cattell on Instagram @gentledentistrybournemouth, and Dr. Jaiswal @drneeljaiswal

Jaz mentioned he uses DAN audio for his note taking for TMD and new patients – check out  www.dentalaudionotes.com.

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

Highlights of the episode:
00:00 Intro
01:34 The Protrusive Dental Pearl
04:15 Dr. Daniel Cattell
06:23 Dr. Neel Jaiswal
08:27 The scenario
10:22 Smile previews
14:06 The preparation appointment
15:45 Temporaries
23:00 Consent forms
25:06 Cement protocol
25:28 Further clinical tips
31:48 Addressing patient concerns
38:46 Professional Dental Indemnity
40:04 Mentorship
43:04 Addressing patient concerns
45:44 Getting support
48:54 Job satisfaction
51:58 Outro

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

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Click below for full episode transcript:

Jaz's Introduction: Imagine that you've just placed some veneers and the patient is absolutely ecstatic. You're high fiving the patient, you have like a selfie together, the patient goes on Instagram, leaves you a video review, but then two weeks later comes back and she hates them. Now that is something that we dread as dentists, right?

Jaz’s Introduction:
People who suddenly change how they feel about an aesthetic outcome, because at the end of the day, beauty is in the eye of the beholder. So how can we protect ourselves? So this never happens to us. What are the steps that we can take at the very start of the consent process? And when we actually doing the veneers and temporaries to make sure the patient will love them and continue to love them, but also how can you manage this scenario if your patient falls? Out of love with veneers or crowns and bonding, whatever it could be. The patient has now changed their mind about what this looks like.

Hello, Protruserati. I’m Jaz Gulati and welcome back to the Protrusive Dental podcast, where I’m joined today by Dr. Dan Cattell, who’s been at the same practice for 25 years and is a fantastic clinician.

So not only do we talk about the medical legal sides, he really helps a lot in terms of unpacking the clinical gems, how to make sure that your temporaries are going to last for even up to a couple of years. He mentioned the podcast and to really ensure your patient is going to generally love them.

But I’ve also got on today, Dr. Neel Jaiswal, who’s going to help us if things don’t go quite to plan. How should we manage this scenario? At what point should we get our dental indemnifier involved in this scenario? Let me tell you, this episode was an absolute gem to record. I could have gone on for hours and hours talking to these two about such a relevant real world topic.

Protrusive Dental Pearl
But before we join the main episode, I’m going to give you the Protrusive Dental Pearl, which I know you’re going to love. One of the things that we’ve all been employing as part of the restorative dentistry is to give our patients a smile preview. Now, a lot of this stuff can be done on like Photoshop, particularly using the liquify tool, which can actually lengthen the teeth.

And that’s a cool thing to do. And there’s also some labs whereby you send them the photos of the patient and they will send back a photo of like a mock up or an example smile, a few different types of smiles. And that’s good as well. That obviously comes at a cost, but that’s a good option. And of course, there are very expensive dental softwares out there, which get you to design the entire thing and create this like mock up, this like virtual mock up photo, which again, you can show to the patient to kind of like inspire them or motivate them.

But let me tell you, this app that I’m going to recommend to you is absolutely insane. It costs something like 25 dollars a year or about 18 pounds a year. And it does exactly all those things really quickly and really well. Now I’m actually going to demonstrate this. For those of my listeners, don’t worry, you’ll still be able to follow along.

For those of you watching, you’ll see the app in action, and of course, I will put the link in the show notes. So it’s called Airbrush, and all you have to do is add the photo, you choose the photo, and then you can do all sorts of other things. There’s filters, AI. It’s actually a really great app for editing your photos, but you just go to this really magic tool called Align.

And you just have to click on Align, and then you have two options, Natural or Strong. Now it’s completely, it’s hilarious, because it’s completely messed up the midline on this patient. So struggled with this. But you get to have an idea basis. This is actually wrong. This is not looking like amazing.

It’s still the patient will think it’ll look nice, but the midline is all wrong here in this example. So that’s totally cool. But I actually ended up treating this patient. This is years for the apps came out and look at the result I was able to achieve for my patient. And I’d say the smile I achieved for her was better than what the AI showed me.

And that’s important because what you don’t want to do is over promise and under deliver. So remember, it’s a great communication tool, but it is not there as a promise. And that message should be remade clear to your patient. So if you want a quick and easy way to show your patient a preview, but with a caveat, you have to give the warnings, whatnot, but it’s really good.

Use those expensive softwares and it’s so quick and easy to do. Download the Airbrush app and I just want to give a little hat tip to Prav Solanki. He’s the one who told me about the app. He actually teaches on so many courses, communication and whatnot. And this one, whenever he shares it on his TCO course, he runs a course for treatment coordinators and the TCOs absolutely love it.

Because it’s a big part of what they do, right? Talking about the future and how they want things to look. So if you’re doing any form of orthodontics, aesthetic dentistry, talking to patients about their smiles, Airbrush app is amazing. Anyone in your team can use it. It’s so, so easy. And I just think it’s brilliant. So thank you, Prav, for showing it to me. And now I’m passing it on to you guys.

Now let’s join the main episode. Dr. Dan Cattell and Dr. Neel Jaiswal, welcome back again to the Protrusive Dental podcast. Dan, how are you, my friend?

I’m very well. Thanks, Jaz. It’s good to see you.

It’s good to see you again. We used to be doing a lot of the same educational circles. You’ve been an inspiration to me looking up to you as a practice owner, as a clinician. So it’s great to have you on the podcast. And I made this little joke before we hit the record button that you are someone known for being at a dental event education.

Any opportunity you get to go out for a jog or exercise, you’ll do it and hats off to you. I respect that very much. Neel, you’re not as active as Dan in that regard, but your brain is very active and that’s why you’re here today in the sense of inputting again in the whole medical legal series of doing.

But Dan, for those of our colleagues who perhaps haven’t seen you before, haven’t met you before, just tell us a little bit about yourself and your practice.

Well, my name’s Dan. I’ve been in the same practice now for nearly a quarter of a century, so I think I’ve got a pretty good insight into what works with my hands, and having cared for patients that long, how to maintain communication channels and relationships in the long term.

What’s your niche? What kind of dentistry do you love to do?

I’m very much a general dentist. I can spend my morning doing class 5 abfraction cavities or be doing sinus grafting, implant placing. I really like dentistry and want to be considered a dentist. I love my job.

It’s not the same job I started 25 years ago with technology and training and hanging around with people like you and Neel. What we offer here has dramatically changed and it keeps it so interesting, fresh. I’m very lucky. My clients are amazing. As I was mentioning, I’ve treated some for quarter of a century now. So obviously, I started young and yeah. Loving my job.

Amazing. And this is something I hear all the time, Dan. I respect all the clinicians who’ve been in one place for that long. Because what you learn is beyond far more than anyone who keeps changing every five years. So, I think there’s a lot to impact.

I think we can learn a lot from you today, Dan, in the scenario, which will cover shortly. But Neel, just in case, this is the first of the medical legal series that someone slipped onto and they like this because I’m coined this episode. Cosmetic dental failures, failures in inverted commas, because we’ll talk about how beauty is in the eye of the beholder and all that kind of stuff. But Neel, just for our listeners, just tell us about yourself and why you’re here today.

Hi, I’m Neel Jaiswal, I’m a director at Professional Dental Indemnity. And I run a private practice in Hertfordshire. I had a long career, going 20 plus years as well, a bit like Dan. I’m a bit older than Dan, although I’ve got more hair.

We were just making a joke about the lighting. But no, definitely my ethos is like Dan’s. It’s about comprehensive care. It’s about some of that American stuff that Jaz you well know about. The Pankey, Kois, Dawson and Spear kind of scenarios. And I’m really here to just help dentists stay on the straight and narrow.

Improve their dentistry. And you know, Jaz, obviously you’re one of the pioneers in that. And we’ve both known Dan for a long time. He’s one of those, one, he’s such a lovely man. He sent me a hamper out of the blue last two years ago, which I’m still smiling about that.

There’s no reason for him to send me that, but I was, that’s the kind of guy he is, and he’s a unicorn, he’s a bit like Roberetti, where one of these guys can do everything, which has a downside, when, if Dan leaves the practice, how do you replace Dan? That’s a different story, but no, he’s phenomenal, and with his implants, and cosmetic work, and on our chats with the group. Whenever there’s a, what should I say to a patient, Dan usually comes up with the kindest, golden hearted response.

Amazing. And one of the things that Neel offers, as well as being a clinical dentist and owning a practice and all those things, it’s really important to get the medical legal perspective on this, because you’ve dealt with some of these scenarios yourself, Neel, you’ve been involved behind the scenes with this kind of stuff.

So although we have covered kind of this veneers theme like it’s specific to veneers before I think there’s a lot more we can unpack when we just focus in a little bit more on the medical legal side and how best so we can preserve our colleagues by protecting them. And that is going to be preventing these scenarios from happening.

But if we’re unfortunate enough that this issue does happen. What’s the best thing to do from there? So I’m going to go ahead and read the scenario which Neel, you kindly wrote and looks like you probably dictated it to a phone and it’s interpreted. So I’ll have to be careful how I read this and then we’ll just break it down and we’ll go from there.

So the scenario is Ms. Geller has always wanted a perfect white smile. You’ve done your wax ups and you placed your tempories, which is important guys. I mean, it’s not part of the scenario, but it’s important because if you’re doing tempories and you’re not going straight to veneers, at least you’ve had some sort of communication with the patient. This is important part of it.

So you’ve done things in the textbook order, right? You’ve done the temporaries and you’ve done a smile makeover from the upper right canine to the upper left canine, and you proceed to fit the veneers. Now, she absolutely loves them. It’s a great moment when that happens to our patients.

And of course, as is the trend, she’ll leave you an Instagram review, right? So a testimonial. However, two weeks later, the dreaded phone call, right? She’s angry because her boyfriend who was away has come back and he has an opinion. And the opinion was that they look like horse’s teeth, right? Now she’s very upset and she wants all the veneers taken off.

As she was told, they were minimally prepared and she wants to go back to normal. So she essentially wants to control Zed. She wants to undo everything, right? She wants to undo everything. Wow. Okay. So firstly, I can say from my own experience. Has it happened before when I’ve done something cosmetic and the patient is happy, but then they come back and something has changed, the feelings have changed.

Yes, nothing major, but it’s a heart sinking feeling and I feel as though I got lucky at that time where I kind of said, listen, just take some time and think again. And she’s like, oh yeah, actually fine, they’re okay kind of thing, but there’s so many different things that can happen and there’s a lot to unpack here.

So I suggest we start with the clinical side first. So how can we prevent this by following good clinical and communication protocols? Let’s talk about preventing and then let’s assume we haven’t done an amazing job because it would have happened. And then once the complaint comes, how to handle that.

So in terms of preventing this, Dan, what is your top tips to dentists who are doing cosmetic dentistry, aesthetic dentistry to prevent this kind of stuff from happening? And in going with a scenario, let’s just go with the veneers because rather than going in any, Dan, let’s talk about veneers.

Super. So I’ve been placing up to full mouth veneers since early 2000. I did some training with Larry Rosenthal and the scenario as outlaid is good protocol. Initially a wax up, if you can now use some Photoshop to show them before you touch them with their smile. And if you can do a kind of Gürel trial in the mouth before you touch the teeth, that’s fantastic.

Now, before you continue then so younger colleagues listening, speaking to a few, and I say Gürel, and to me and it’s like, yeah, of course. We’re all going to do Gürel technique. A lot of people, yeah, they need to know, and it’s such an important technique to do, so a real gem coming from Dan here, guys. Listen up if you’re multitasking, this is really important. What is the Gürel technique?

So, if you have an additive waxer, and nearly always they are these days because we’re doing so much pre alignment. With orthodontics rather than very aggressive preps. For example, your class two division two. Most wax ups will now be leaning towards additive.

And so what you can do is use your stent without prepping the teeth and fit it with some temporary material over the teeth. You’ll get a little bit of a lock on. You can remove the excess. And then when you remove the PVS vinyl stent, the patient will be able to roughly see what their smile will look like. You need to warn them the coloration will be off. It will feel like the teeth have their socks on. But, they’ll be able to get a broad overview of what things would look like.

So this is like a bisacryl material. What are yous using? Just out of interest. What’s your favorite temporary bisacryl material?

Luxatemp. Fantastic material. Amazing in nightclubs.

Lovely. Super fluorescent then.

Yes. They’ve been to Turkey. Even in my hands when the UV gets on them.

Okay. Excellent. So the patient now gets a preview. And not only do they get like a visual preview, they get like something they can feel kind of, obviously, I love your analogy of it will still have the socks on. And then how long do they keep that for? And what’s your protocol in terms of sticking it on, bonding it kind of thing?

So I don’t bond it at that appointment. But what I always invite people to do, whether it’s for a denture try in or where there’s any significant cosmetic change for them to bring a significant other.

That is crucial. We’ll unpack more later what’s going on possibly with the boyfriend and why he said what he said potentially, but significant others when big decisions are going to be made either financially or aesthetically are key. It’s only fair on everyone. With these type of scenarios, you want the win win.

You want a patient to be super pleased with you, to tell their friends you’re amazing, and to form a lifelong relationship with them. And doing that is often baby steps. So yes, I would do a trial smile. They can go away for the morning with that if they want, and we’ll take some photos which we can send to them.

I certainly wouldn’t proceed to prepping at that appointment. And what I would do is very easily just flick off the Luxatemp that hasn’t been bonded. And that comes off really nicely.

Just be careful if you’ve got someone with multiple diastemas. I’ve had it before. I’ve been there for like half an hour. This was like a DCT person. I was a house officer in Sheffield. And literally spent like half an hour. The poor consultant was watching me just struggle. And he thought, let Jaz learn a lesson today. Kind of thing like multiple diastema and that kind of stuff. Black triangles. That’s when they can lock in.

Yes. You’ve just gone straight to permanence.

No, as in like when I did my, yeah. Well, yeah. Okay. I see what you mean. Yes. We kind of have accidentally, yeah, I see what you mean now. Okay. So you’ve done the Gürel technique. You’ve seen a preview and obviously when you prep, that’s going to help you to prep as well, so you get the correct depths and whatnot.

So in a separate appointment, yes, you will. What I prefer to do at that appointment, because when you’re prepping, there can be a small amount of vibration. I’ll spot etch. The middle third of the tooth, with some etch and no bond. And then when you put the stent in with Luxatemp again, to do your depth reduction cuts, it doesn’t start to ping off, especially where you’ll have a thinness of material around the gingival margin. So I’ll do a lock on technique with a little etch to help.

And then the whole act of prepping through this mock up is the Gürel technique, basically. Rather than looking at the tooth and prepping a margin, you’re prepping through the temporaries and then you’re getting the, you’re beginning with the end in mind.

So if anyone’s wondering what the Gürel technique is, that’s what it is. So, we’re doing good clinical protocols to do this. Now, what happens, like, obviously, You’ve done the mock up and if the patient has suggested any changes or you don’t like anything, how do you approach that? Like, do you just get the bit of flowable? Do you do soflex? Like, or is it back to wax up? How do you like to manage this?

So, it’d be very, very rare you would go back to wax up. With great communication with the lab and a great photo series before, maybe some Coachman-esque DSD, you should have the wax up there or thereabouts. Certainly, one of the hardest things to ever correct is a cant.

That would be one scenario where you would need to go back to a waxer. Trying to flow a cant out is not fun day at the office. So, generally speaking, we would finalize. There are going to be numb, so you’re going to lose your phonetic assessment and to some extent, the aesthetic. I went through a period of trying to numb the teeth in the upper arch, clearly the aesthetic arch palatally so they retain movement of their lip, but sometimes you didn’t get found anesthesia that if you were to engage into dentine.

So I went back to numbing through the buccal. So you need a separate appointment, a complete review. Also, you’ll have tired eyes by the end of the appointment. So you want to give it the best shot at making it look great, and then bring them back.

This is the temporaries we’re talking about, right? No, this is actually the temps, yeah?

It’s always the temps. Yeah. So a few weeks later. Bring them back for the the temporaries because what you’re going to need to do is scan the temporaries once they’ve been approved. But if I make any significant changes at that appointment, they go away for a few days to think about it I wouldn’t just do some tweets and go what do you think now put them under the spotlight?

It needs to be below and considered So if there’s any changes, I won’t scan them, and they’ll be aware of the process until they say, yeah, I love it. Stocks are going. You’re wasting my time. Let’s get cracking. I love them. And then you scan to make sure the laboratory understand any changes you’ve made. And then they go to the lab to be fitted. You’ve pre scanned the preps, so you only need to scan the approved temporaries at that point.

My question to you now, this is more clinical, obviously when we get to the medical legal part soon, where Neel, you’ll be a bit more in as well, but obviously I know you’ve done, you do veneers and small stuff as well, so please do feel free to chip in Neel, but what’s the longest time period that you’ve kept someone in temps until they’ve been in love with it?

And typically how many weeks would be for the average case? So it would be like, ranges from two to six weeks, how long they keep the temps on for usually. And then what techniques are using to make sure that when the patient’s functioning at home with these temporaries that they’re not chipping and falling out being the nature that they are in luxatemp at the end of the day.

Yeah. And so I love a weak temporary. It gives you absolutely the knowledge that if they don’t break, smash, wear at an accelerated rate, your temporaries, then your finals are going to be fantastic. So if anything’s going to go wrong, I’m desperate for it to happen during the temporary phase. If you’re doing smart design, and in this case, we’re talking about probably a rare case of doing 3 to 3.

I would tend to do 2 to 2, or 4 to 4, or 5 to 5, or further back. 3 to 3 tends to produce an A shape to the maxilla, rather than a smooth round curve. But I would nearly always address the bite and function and mainly guidance by doing lower 2 to 2 with bonding or smoothing to make sure you have the lovely smooth guidance.

If you have a Manhattan skyline on the lower incisors, likely the distal of your laterals are going to chip and ping off. So you need to address that. The longest I’ve had people in temps, couple of years, normal protocol.

Veneer temps?

Yeah. If you’re doing stuff further in the back of the mouth, grafting and putting, I learned the hard way. That if the same lab, using the same tech, with the same material, fires porcelain on a different day, it’s going to look different. So, if, say, we’ve done bilateral sinuses, we’re waiting for those to mature prior to implant basements, yes, veneers can be on a long time. Key to success with that is spot bonding them, so that they’re on really tight, glazing them and then putting glycerin over the glaze and curing to make sure there’s no oxygen inhibition layer so that they don’t tarnish. And you do occasionally need to just polish them up a bit.

Okay, brilliant.

Normally six weeks would be the protocol. Diagnoses, testing, trial smiles, review temps, any adjustments, secondary review, and then, scan finals fit. One key element that could have been avoided here, and I do as part of my protocol, is I will do a split mouth try in to demonstrate that the finals are an exact copy of the approved temporaries.

So if we’re doing 3 to 3, I’d remove one side of the tent and insert the veneers. A little bit of glycerin just to hold them in place, or you could use Triump paste if you’re feeling fancy. I only tend to use try and paste if there’s a colour change to be accounted for. Otherwise, if the prep’s a minimal, glycerin is just fine.

And then you take a photo of the temporarily looted finals next to the temps, and they should broadly mirror over.

This was a tip that was given to me by Dr Costas Karagiannopoulos, actually, prosthodontist, and it was great because he was showing these quote unquote failures whereby actually the lab thought they had copied it, but what came back was shorter, longer than your temps.

And that is a great moment because before you took everything off, and then, you put in new veneers, which are shorter and longer than what you agreed, then that is an instant failure. So that really is a top tip down that you’ve shared there. So you guys make sure you listen up.

Jaz with scanning, because we’re not using face bows as much. I’m now sending face bows separately so that they can mount the digital models. But there was a period where I didn’t do that, and because of the cant of the maxilla, it could disorientate the technician to make the teeth shorter or longer. Does that make sense?

No, absolutely. Just last bits then. So once you’ve done the veneer preps, you’ve scanned the veneer preps, then you’ve got your putty, you’ve loaded it with the LuxaTemp, and you’re going to deliver it. Now, just before then, that’s when you’ve done the spot etch and spot bond, is that correct?

No spot bond, just bond,

[Jaz] Spot etch, okay, and then so they’re fine, so that these long term temporaries are going to be okay with the spot etch only.

Yeah, and when you spot etch it, get your nurse to take a picture of where you’ve spot etched it.

Got it, fine, that’s a great show.

Or always put it in the same place, then you don’t need to know, but God forbid you got hit by a bus, it’d be lovely for the treating clinician taking over to be able to see where you’ve etched, so that they can work out where they need to do a little polish or air abrade to take off the book.

And so when you’re taking off the the putty, the luxatemp material is staying on the teeth, obviously, and you’re just trimming around the edges. How do you ensure that you don’t put too much material in the embrasures, that’s going to upset and blunt the papillae.

So, I’ve tried everything, from trying to insert a little wedget, to having a little bit of PTFE rolled up. None of that works, it slips and moves and gets caught in the luxatemp. So, what you need to do is, when you take off the luxatemp, before it’s fully set, just pass a small TePe brush through.


And that will just be enough. I don’t want people to have a compressed papillae. It’s a disaster. You will cause recession. Most likely, as long as you haven’t invaded Tarnow’s rule, then you’ve got five mil away from the bone and it will recover. But it’s not a good look at incisors if they’ve got black triangles.

And it looks like it skewches afterwards, so you’re absolutely right. If you’re doing, if you’re not adjusting. I’ve tried using flowable after having like a kind of snap on smile-esque Luxatemp that you’ve made from a putty. But they’re so fragile at the embrasures, it breaks, it just doesn’t work in my hands like that. So I’ll take a teepee to go through. I’m not averse to taking a burr if I need to and go.

Okay. And the final bit then, it comes a day of fit is top tip you’ve given already, whereby you do a split mouth. That’s wonderful. You show the patient a mirror. And they’re like, oh yeah, this looks great.

I love it kind of thing. Do you do consent forms? Now we’re getting a bit more medical legal. Are you practicing consent forms? Is something that you’re hot on? I can tell you now I’m not the hottest person consent forms. I’m very hot on having a really in depth conversation. My notes being there to back me up.

But for things like wisdom teeth, I do. For things, for awkward scenarios, awkward patients, I would. And for veneers, actually, before it goes in, I just make them sign something very simple, like, hey, I, patient, I love my veneers, and I understand that if I change my mind in the future about how they look, that’s totally cool, but I’m paying 800 pounds per unit to facilitate this change.

Signed patient and I get them to sign that. Now, I’m happy to hear both your opinions on that, but also keen to learn, Dan, how do you do it?

So all of my consent is done prior to treatment. So we provide comprehensive reports into which are embedded consent forms. For all tooth extraction, root canals and any preparation of teeth to indicate that devitalization can occur, which we’ll come on to later, because when someone wants veneers changed, it’s very important. You just don’t go prepping the teeth again because there may not be happy pulps if you do that.

So, we will put in our consent that once the temporaries are approved, then we will go to fit. You can’t show, I don’t think it’s fair when someone’s numb and that you’re doing a split mouth. That is purely to take a photograph so that if they were to question what there was any difference, or if again, as you pointed out, there’d been a lab error.

I wouldn’t either fit them, or I would show it to the patient two weeks later when they came and look, these are exactly the same as the temporaries. I don’t see there’s any point in when someone’s numb, and they will be, getting them to sign a consent form. You’re kind of all in at that point.

No, yeah, I absolutely agree. It’s more a built up understanding over time that, we’re going to try and copy the temporaries and we’ve got to make sure you’re happy kind of thing. So I totally respect that. And then you’re going to go ahead and bond them. And just because for clinical completeness, because people are going to ask in the comments, your cement and bonding protocol of choice is?


Variolink, okay, good by Ivoclar, very good one.

I’ve been using that for 20 years.

Yeah, you’re never going to change, right? Even if they bring all these fancy chairs, you know your system, it works. And so, you’ve been around long enough, doing the same procedure long enough that you know what works in your hands. Neel, any additions to anything clinical that we’ve said so far?

A few points. Firstly, I was just being seduced just by Dan’s tones and his passion. And I was, I almost feel like doing some prepping now because that’s the way to do it. And also I would charge accordingly. Don’t try and be the cheapest in your area.

Try and be the best. And you went in at 800 pounds and that might be right for you. Do you make sure you do your costings? Because sometimes younger dentists, they’re so busy getting the sale, they don’t actually work out, is it a win win? So it has to be right for both parties. But I would say, obviously I know Dan does tons of photos.

What I would probably add to that is, get the patient to annotate any changes. So they’ve sat down with the photo of the temps or whatever and said, yes, I like this or I understand that when it comes to the fits, what the people like about the temps is they like the monoblock look.

And sometimes when you put the veneers on and they go, oh, now there’s gaps. So I would just make sure that they’ve written it at the temp stage. I understand the shade will be different. I understand they won’t be joined together. That’s definitely something that’s caught me out in the before they prefer the temps to the real things.

The other thing is definitely I’d written down any significant other. At an early stage, just say if we were as part of the smile consent or whatever medical history, if you were making a big financial decision or a cosmetic change, would there be any significant person that should be involved?

So you almost kind of rather than It made a part of your protocol rather than just forgetting about it because I’ve had it as well where I closed the diastema up. Patient loved it. Went home his wife said doesn’t look like you anymore. There was nothing wrong what we did didn’t look like you anymore.

That was quite interesting. So I think the end and we don’t get these cases very often But it does tend to be someone said or someone at the gym said or that kind of stuff. A video I’d quite like I’m not sure about the you have to get consent and how you store it. That’s a different matter But if you’ve got a video of them looking at the temps looking at the try and say yeah, I love it that’s really hard to walk for the patient to turn around on a definitely-

That’s a really good idea. I like that.

Definitely record keeping. The problem is you don’t write down everything you say or the tone or the expression. So we’re just trialing Dan, I think you had the guys on your podcast earlier.

So I love using, I use it for all my TMD consults and new patient consults. I don’t know if you’ve heard DAN, have you heard of DAN?

I love it, Dan.

Dental Audio Notes. I absolutely love it. It generates a transcript and it’s just recording these important conversations that you have. And I think that kind of appointment where you’re in temps and you’re gaining approval, or you’re about to just try in split mouth and to record that important conversation, a peak moment is so great. I think so. I totally agree with you.

I did try just using my phone with permission as a voice recorder and then using an app to translate thinking. Let me see how close it gets it is wasn’t worth a hassle. There was all talks about elephants and wives and bouncy castles I don’t know what it was going on. But the Google Translate just did not pick it up. So let the experts do that for you. The other thing I find is with the temps there one tone a1, a2, a3 and some patients want that kind of. It’s not what we’d prefer but some people want that monoblock look whereas some people want natural look, and I think there’s a real discussion that youngsters miss out on in terms of characteristics.

So it’s not just write down A1, B1, BL3. It’s actually look at the line angles and look at the tints. And Komal Suri’s got a really nice book on it. I don’t know if you can still get it, but just, I would show that-

I just want to say there’s really good books that have like examples of vertical characterizations, horizontal, and like a catalog that you kind of do. Dan, do you do any of this, like in terms of planning with your patient, what their smile to look like, and how you might manipulate the secondary and tertiary anatomy to facilitate that?

Yeah, so co diagnosis is key. From the very outset, we talk about all the information as to what the smile should look like is there for us to glean.

So, the interpupillary line being level with the biting surfaces, the central incisors, the frame of the lips, the angle of the jaw, the buccal corridor, the color of the whites of the eyes relating to the color of the teeth. There’s so much information to get us there or thereabouts. With regard to line angles, that’s a brilliant point by Neel.

When I did my training, we used to prep one half at the temporaries we would adjust and alter the line angles to make the teeth look narrower and the other side to make the teeth look wider by moving the line angles out. And then seeing which side we preferred, and the patient preferred, man that tooks you time, but a very useful exercise.

If you can play with the way light reflects off the tooth’s surface, you really are in control of the aesthetics. As Neel pointed out, it isn’t about colour, it’s the way light reflects from the surfaces of the teeth. Be aware of people with beards, moustaches, darker skin, lighter skin. An A1 on. Dan will look different on an A1 than you, Jaz.

So again, I talked about patients, are you going to shave afterwards? Because are you going to have any lip filler? Because these things will make my teeth look darker. If you want bright teeth, I’m going for A1. But actually, if you suddenly have your lips done, or if a man grows a moustache, it’s going to be darker.

And same with those (class) 2 div2s, they’re always darker, no matter, when you whiten them as well, then don’t you find if you’re whitening, it doesn’t work well on (class) 2 div2s, because it’s not the teeth, but the shadowing? Yeah, the centrals always remain slightly darker. And the lip fillers is a massive case.

They don’t, when, again, I was always very, very conscious if you were converting with veneers a class 2 div 2 to a class 1 that you would put pressure on the lip and it would have the often wanted benefit of enlarging the lip. But if you pushed it too far, you’ll push the wet line out. So obviously you have a wet part of the lip behind and then the dry part.

The perfect image is to always have the dry part on show. It looks very weird if you can see a wet lip. If you’ve rolled the lip out, and that can happen with fillers too, but with veneers if the cervical margins push the lip too far, and you expose the wet dry margin, it looks, error, really baff.

And again, something that you can trial out in the temp stage, right? And there’s information that you get in addition to that. Enough of the clinical, which I’ve enjoyed thoroughly. That was really fun, Dan. Thanks. Let’s move on to a scenario whereby a colleague is stuck and we need to help them. Maybe listen to this, and they’ve skipped to this bit now, because they’re facing this scenario, and it could be crowns.

It could be a single crown. It could be an upper left canine crown, right? It could be veneers. It could be some composite bonding. The patient loved it at the time. But then they had a change of heart because of a comment. So let’s dissect that comment. I think Dan, you suggested something that it may mean some deeper meanings behind what the boyfriend might’ve said. I think you were alluding to that. Any reflections on that?

If you and the patient were really, really happy initially for a boyfriend to come away from a two week absence and say something, which is really astoundingly cruel, I ran the scenario past my team this morning. And they said, what you’ve got to do is replace the boyfriend, which, of course, that’s just being flippant.

What Neel alluded to is the win win. What’s the win win here? And that’s a happy patient, a happy dentist, a happy boyfriend, and be happy. So first of all, you just need to listen to them. You need to get them in for a meeting and show that you’re taking this issue seriously, but he needs to come to, and he needs to come with input.

You also then need to make it very clear that prepping teeth after. They’ve been prepped, temperized, and had veneers fitted. You need to leave things to let the inside, the living part of the teeth settle. And I would always recommend that would be for six years. It’s amazing what can happen in six months.

Mindsets can change, lives can change, boyfriends can come and go. But if after six months there’s still a concern, or if you can see a concern and can agree, it isn’t about sticking to your guns. When you’ve been in the same practice 25 years, if I had to redo a veneer case, at no charge, I promise you on my deathbed I won’t remember it.

But I will remember every six months high fiving the patient that it wasn’t an easy journey, but we got it right. The only warning to that situation is if you don’t feel you can improve upon the situation, and you’re just doing something for the sake of it. That would be when you’d need to have the honest conversation.

You would refer the patient to a specialist, liaise with them, and then come up with a roadmap for the way forward there. Whether that be a refund or you fund a specialist, but be kind to the patient. Be kind to yourself. Try not to lose sleep, but you will. Anyone who cared, you’d be pacing the floor at 4:00 AM wondering how it went wrong. But then with the six month period, I’d be surprised at what didn’t die down.

Do you have any sort of, is it just experience or do you have any kind of templates or warnings for any body dysmorphia type patients?

So when we do full arch implants where there’s removal of teeth involved, we do a psychometric assessment as to their expectations, as to what they hope, whether it’s going to be the platform for a new boyfriend, a new job, becoming the next Kardashian, and that would red flag away from treatment.

So, I’m in the fortunate position of not needing to do cases if I don’t feel I’m the best person to do them. And, you get better and better at picking up red flag patients. However, they often sneak in the back door through flattery. I’m a sucker for that, actually.

But I’ve heard you’re the best! But I’ve heard you’re the best, you can do it!

So yes, you do pick up on that. And saying No is so powerful. In a nice kind way.

It’s the issue with these guys casting a big net, trying to get all these smiling aligner bonding type patients in maybe at a younger age and then they’re going to have, they’re the ones that maybe haven’t got the experience to do the brilliant protocols that you just discussed, they haven’t got communication skills. They’re relying on rapport, because they’re maybe both young.

It’s so much, I mean, this conversation could go on and on because there’s so many tangents, but really being discerning is a win win because you’ll be happy and the patients will be happy.

You really wisely pointed out that it has to be the win win from a fee structure. And the way we structure our fees here is if I was just doing occlusal restorations on molars. I’d be earning the same hourly rate as if I was fitting veneers. So I’m at the point now and have been for years where I don’t want to do a case more than the patient. Whereas previously you’d come back from a Rosenthal course and you wanted to be prepping teeth. And it was exciting and you couldn’t wait for people, please say yes. Now no, I don’t need treatment more than the patient.

I think that’s the, one of our other podcasts, John Swarbrigg as well, very much same practice. You know, make sure it’s all about the rapport relationship, get the foundations right. The other thing I really would caution younger dentists is this minimally invasive.

We understand what it means in dentistry, but patients may not. So I’d always say anything we do isn’t reversible. Whether we do a filling, we do a root canal, we’re touching this tooth because we’ve had one complaint that we’re dealing with where it’s three to three composite bonding where there’s been some prep.

And the patient just thinks, take them off, I’ll have my own teeth back again, which they may do if you’re lucky if it’s abolishing, but I would always under promise, over deliver, do not say we can take them off often, there’s no harm.

No, I would go further than that, Neel. I don’t think you can reverse a bonding procedure fully, especially one that extensive. Yeah, when you see the occluded prisms or tubules with resin, you’re never going to get back to-

The luster of the tooth changes forever, right? It just won’t look the same.

That’s it, Jaz. so eloquently put.

Yeah. You raised a good point there. I mean, so many good points, but I just want to just in case someone missed it, they’re multitasking, is you assess the motivations of the patient, right?

And you, again, just going back to why they want this treatment, is it because it will help them find a better spouse. It will help them. get that job promotion. And so you need to disconnect the patient. Look, I want you to have this because you’re not unhappy with your smile and you want a good smile, not because it’s going to lead to a secondary outcome that is unpromised.

And if that secondary outcome doesn’t happen, which has nothing to do with the cosmetic work you’re doing, then that is a clear and obvious red flag. And I really appreciate your truthfulness Dan saying that when we are younger and when we go on courses, we want to do it right. You want to do the work and you really, really want to do those veneers and cases and the liners and that kind of stuff.

And we’ve all been there. And some of our experienced colleagues listening and watching today, they’ll be smiling and say, yep, I’ve been that kind of thing, but remember to keep a level head. And if you get that feeling, if you get that feeling in your tummy, that this patient is asking for a lot here, then listen to that feeling.

And eventually I wish everyone a good blessings that they can get to your stage down, then they can feel the same, that you know what, I’m going to do my best and I’m not chasing the work. The world could come to me and I’m going to enjoy my work and I’m going to do the best I can.

Hey guys, it’s Jaz here, interfering with this quick message. As you guys know, my own insurance is with PDI. That’s how I get my Medeco legal cover. And as you know, I only ever recommend the products and services that I use and pay for myself. This is why I’m happy to recommend and promote the good work that PDI does, with Neel being involved in it. And so they’ve passed on a discount to you.

You can get a hundred pounds off your quote. So if you’re just wondering, hmm, I wonder how much PDI is going to cost me compared to what I’m paying with any other indemnity organization. Then you can just head over to protrusive.co.uk/insurance, and they’ll send you a quote and you’ll be amazed about how much money you can save by switching to PDI.

And they’re very thorough and I wholly trust them to manage my medical legal affairs. And which is why I’m recommending it on to you. If you’re not sure about any of this stuff and whether your policy is right for you and the difference between a claims occurred and a claims made policy and why there’s some dangers of sticking with some indemnity organizations in terms of you not being fully protected, then do check out our main episode that I did with Neil talking all about Indemnity Versus Insurance, which is better and which is right for you.

I’ll put a link to that in the show notes, but it is episode GF019. It’s a Group Function 019. That website again is protrusive.co.uk/insurance. And if you do end up taking out a policy with them, then Team Protrusive do get a couple of quid. And I just want to make it very transparent that that’s the case. And I thank you for supporting us. Back to the main episode.

I get, I still get a thrill from doing a really nice occlusal on a six.


Yeah, love it. Love it, and you’re absolutely right, you’re an amazing connect between an outstanding clinician and empathy towards younger dentists, and it’s a challenge for them out there.

When I began, it literally was understood by everyone that you’re engaging in dental practice, and it isn’t the case now, unfortunately. I remember telling patients, this is the first time I’ve ever done this, would you like me to refer you, you have a go, and they were great, and it fortunately generally tended to work out, but yeah, it’s definitely a slightly different operating environment that we’re in now, which thank goodness Neel and PDI, who I’ve been with for about eight years, Neel.

Definitely over five, time has flown though.

I do love what you said there.

I think what you’re doing Jaz, by providing a connect between someone who is senior in the profession, but has an understanding of what it’s like to be junior is vital at the moment, because so we don’t particularly see it in my clinic with people who attend for interview, but you hear stories of.

Basic skills not being practiced, such as tooth extractions, yet a desire to commend much more complex and advanced treatments like ortho, which is essentially a full mouth rehab, just with their own teeth.

And I just remembered what I was going to say actually now. So yeah, extractions, root canals, we’re not even qualifying with enough totals. And then we don’t get taught much about cosmetic makeovers. We learn that as we go along. And then if we’re then starting to advertise on Instagram, they come to me if you’re aligners and bonding, you can’t then say to your patient, actually, it’s the first time doing it. Shall I refer you? And then the patient will be like, huh?

No, you have a go just like you done. And this happened to me as well. And it’s great that the patient trusts you so much that they know that you can do the best. And that’s when we learn and grow with that kind of a patient, basically. We’re at the edge of our comfort zone, but you want to do right by the patient.

If it’s something that’s so far out of your skill zone that you can’t do it, it’s a sin, but you need to, it’s okay to feel a little bit like, hmm, okay, I think I can do this. I’m going to ask some mentors, get some guidance, get some advice, basically. And that’s the difference, isn’t it?

That’s the jump gap is the mentor zone and I’ve been so blessed throughout my career to have some amazing mentors who never charge me any and so we have an open door policy here that if anyone ever wants to come and spend a day seeing what we do they might get to see something pretty cool and sexy or you might get to see me doing class fives all day, a waltz and all experience, but we are always welcome, both myself and my colleague, Ed Gasdorff, to have any young dentists who wish to come in. We stood nearly a couple of times a week, but since COVID, it dropped off.

Dan’s being generous. He might regret it, but I would definitely take it on that for a youngster because you only know what you’ve seen. So you think dentistry is one way and when you see a different paradigm, you realize, ah, and I’m sure if you see Dan, that’d be like, that’s what I want.

And it could be career changing, life changing. So, yeah. I would take him up on his generous offer. The other thing would be, if it was someone like Dan who had this scenario, we would 100 percent support him, because we know we can see the facts, we can see the conversations, we see the record keeping.

You’ve seen that initial report, that initial report with everything written that, did you cover the whole thing about a six month period or observation? Should they be unhappy? Is that a difficult thing to mention in a report in a consent form?

That is not in the initial treatment report. I’d be unaware as to what you needed to mention regarding likelihood of occurrence, but yeah, with this explaining that teeth should just be last. In a loving kind way saying we will address it in six months if it’s important to you, it’s important to me, but part of my job is to keep you safe and drilling down on these teeth is not doing that for you.

So we’re going to have to look back on this. You can check in with me. I’ll send you photos of your teeth. I think it’s a great point from Neil that, send them photos and give them a sharpie and give me somewhere to go because we need to find a way to do things differently in six months.

But sometimes Dan, you found it, you send them a photo, you show them a photo at the clinic or what their teeth used to look like and they’ve forgotten completely how bad they used to be.

Yeah, that’s very true Jaz, that really is. And sometimes they’ll have the hubris there and then to go, oh wow. This very scenario has probably happened to me about five times in 25 years. And I think they all resolve within six months. So like, yeah, I really love them. Other people come in with compliments.

They go to the gym, their girlfriends. Jordan Peterson, the Canadian, psychologist, said, If you want to know if someone is a true friend, tell them some good news about yourself. Because a lot of people will say something nasty and they’re not your friends. Whereas true friends will be genuinely pleased for you.

So, maybe the boyfriend isn’t the nicest guy. If he’s got a point and it’s dental, let’s fix it. And I’d want to fix it. I would be high fiving my patients. But if it isn’t, you need to protect your patient and not go drilling on teeth. Certainly if you’ve given it your best shot and you’re super satisfied with the work, then you need a cooling off period, and certainly a roadmap for where you’re going to go from that.

So a six month cooling off period, making sure that whoever said that nasty comment, the boyfriend in this case, actually attends, shows some skin in the game and actually attends the appointment where they do it. Listen to the patient, make sure they write down all their concerns and reassure them that you that you will address it, show them photos of what their teeth used to look like, but before all this, prevent it by just really respecting that temporary phase and make sure the patient’s in love with it.

Use videography at the point of try and spit mouth, try and get that reaction from the patient where they, by they do love it. I love that as well. And then now we’re going to talk about getting support. So Neel, if someone is in this kind of scenario. at what stage do you think they should write to their insurance or indemnifier, for example, PDI, to let them know that this has happened?

Like, should we email you say, hey, by the way, like, I think it’s going to be okay. The patient’s just going to think about it for six months and we’ll revisit it. Here are my notes kind of thing, or any other different suggestions you might have to best manage it, to protect ourselves.

Well, it’s a really good question, Jaz. When do you get somebody involved. And if you don’t want to, and speaking of the dentist, you don’t want to read every little thing that you have because it might tarnish your book, that’s what you’re scared of, versus you don’t want to not tell them something and they’d say you’ve actually jeopardized our position and we’re not covering you.

So we don’t penalize, if there’s no complaint letter or official complaint, we don’t penalize you for calling and asking us. So I get lots of people phoning me and just saying this is what’s happened, what shall I do? And I might say, actually, you’re doing the right thing, you’re okay, there’s no complaint here.

We’ve talked through it, I’ve got a call in about an hour, same thing, just going to talk through it. What’s the right thing to do? And we leave it at that. If the, the dentist tends to know, ah, I think this is going to be trouble, I think this may go somewhere. I say, let’s just log it. It won’t go anywhere, but we’ve logged it.

We said, this might happen. And we’ll get an email and we say, great, thanks for letting us know if anything happens, let us know. So I like people asking me questions, especially if I can give some advice or talk them through it. And it’s a mutual discussion on how to best forward. Had a call the other day, actually, similar kind of thing.

Patient’s not happy, wants a refund. And I talked through the case with the dentist, and I said, and we always support our dentist, and this was hopefully supportive, but I actually criticized her. I said, halfway through the treatment you realized she’s a Bruxist, and then gave her a free mouthguard because you realized a bit too late.

She had that Manhattan lower skyline that Dan was mentioning, but she had to shorten the laterals because they kept chipping off. And I said, take it as a learning point. The patient, she’s a nurse. She’s on low income. She wanted this outcome. Things are failing. And I’d probably say your due diligence wasn’t there.

And she said, no, Neel, you’re right. I have learned a lot. And I appreciate that. And I’ll do my best to resolve this with the patient. So again, have some humility and if your dad experienced, what you’re doing, you’re very likely to get into this issue. But if you have made a mistake, don’t just be arrogant and I’m the dentist and I know best.

Just actually reflect on it because that’s how you learn. So do call us if you need us. That’s what we’re here for. We’d love to hear from you. I’d like to talk to all our couple of hundred members. They’re all friends.

So how can someone get in touch with a member or they want to inquire about, how you can support their journey in getting the correct protection?

Absolutely. Well, obviously, as you know, we’ve got a huge team of lawyers, the biggest law firm in England, and we just recently did some CPD there in that fantastic building they’ve got in the city. So, got access to hundreds of lawyers, you’re very welcome to give me a call or go to the website and we’ll get you the contact details so you can talk to them.

If you need a chat, if you need an alarm around you, we’re always here to help. Gary’s always here to help. But yeah, we definitely got a strong team around us and also the personal approach, which is what we want.

Amazing, guys, it’s been really nice chatting. I just want just one thing before I forget it, right? One lesson that I learned which has really helped me is, from our mutual friend, Lincoln Harris, right? And Dan, I know you probably echoed this as well, is Never fit something in someone’s mouth that you are not in love with yourself. Now, this sounds stupid and you would think obviously, but think of that scenario whereby you just tried in a crown and you don’t love it, but the patient’s like, yeah, this is fine.

I don’t mind the shade. It’s okay. You know? Yeah, it’s a little bit off, but you know what, Jaz, I don’t mind, right? There’s a tolerance level, and sometimes I’ve done something and I’ve regretted it. Right? Now, if the patient comes back four months later and says, you know what? Yeah, you’re right. I don’t like that.

After all, you haven’t got legs. Stand on. Right? Because you yourself didn’t like it, right? So my personal policy I follow now is that, okay, if it’s like a 2 percent off difference and I’m being perfectionist, fine. But if I don’t genuinely fall in love with it, I don’t think this is servicing my patient. I don’t want to be hiding in the supermarket not to see the patient because I don’t want to see their smile because, oh, it reminds me of how ugly that crown looks, whatever.

I will not fit it. I will say, I’m really sorry. I’m going to send this back. We’re going to fix this. Even though you’re okay with it, please let me do it. Any reflections on that, Dan?

Yes. You’re absolutely right, and you will forget the extra work when you remember the result. The important thing to do though, is not blame the laboratory for it.

Of course.

That e factor. If you say, they’ve done a great job, but now I’ve seen how it looks in the mouth, there are a few tweaks I’d like to make, just to make sure it’s perfect for you. That’s great. But do not-

Patients love it, right? Patients love that. Usually paste like, you know what, I really appreciate that you’re going there. Even though I’m happy to glue in, you’re going to book me and not charge me extra. They love that word of mouth referrals, reputation, and just you feeling like you’re going to do a good job and nailing that post op photo.

And you will have the joy of that for every six months, hopefully for 20 old years, and that does loop back to what we were talking about before, that that scenario would have been avoided with all the protocols where someone just go, I don’t know how he could have done any better because he was just obsessed with detail.

That confidence, that self-confidence you have that, honestly, I did my best and it came out amazing. I love it. And then you’re suddenly less stressed. Like if you’re a scenario where it didn’t look great, that’s a stressful scenario for you. Cause the patient’s got something, if the patient starts going around showing people and be like, oh yeah. But if it generally looks great and you believe so, that’s a much less stressful scenario.

It is. Absolutely. I can’t remember who coined the phrase, but it goes back to pricing. And they said they have three different pricing structures. One when a patient looks at the teeth in a mirror over here, another when the mirror is here, and then when the mirror is there, they chastise them the most.

I like that. I might have heard Ken Harris say that actually.

It could have been, yeah. Ken knows what he’s talking about.

Absolutely. Guys, it’s been absolutely brilliant. We’ve talked about a lot of the clinical stuff, which I really enjoyed, Dan, Neel, thanks for all the clinical input and the medical legal side.

And of course, Dan, I love what you’re doing. I love the sort of thoroughness and report building. So, you’re a great chap to learn from. Keep doing more power to you, sir. Guys, it’s been good fun and we’ll catch you sometime again.

Thank you very much, Jaz. Thanks for having me.

Jaz’s Outro:
Well, there we have it, guys. So many clinical gems from Dan Cattell and such great input from Neel. As I said at the intro, I could have gone on and on. I’m sure you guys enjoyed the conversation as well. If you’re due a renewal and you think you’re paying too much, and maybe you’re not even getting the right level of protection, if you have some sort of discretionary cover, then you might not be fully covered, and that’s a scary thought.

So if you want to switch over to PDI or just want to get a quote, then head over to protrusive.co.uk/insurance, and they will honor your 100 protrusive discount. For those of you who listened on the app, then answer a few questions and get some CPD because you’ve made it this far. So why not?

If you’d like to get CPD for this and access a whole load of my mini courses like the isolation case library, VertiPrep for Plonkers, which is still ongoing at the moment. We’ve recently just hosted part two of five for the VertiPrep for Plonkers series. So we’re going to get you all doing VertiPreps on a premolars with ease.

And for all that stuff, you should want to head to protrusive.app, create a login, then you can even use that login on the iOS or Android app. But the web experience itself on Chrome is very good because you can just go from episode to episode and answer questions, get CPD and geek out with all the clinical videos that I have on there.

As you’ve listened all the way to the end, thank you. I really, really appreciate it. And I hope I’ll see you again. Same time, same place next week. Bye for now.

Hosted by
Jaz Gulati

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