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Protrusive Dental Pearls

Protrusive Dental Pearls

from The Protrusive Dental Podcast

Expat Dentist in Singapore – PDP001

Whatever it is that you KNOW you ought to do, go out and take MASSIVE ACTION and get it done!

If it was not for this advice, I would never have started Protrusive Dental Podcast.

The American Dental Dream – PDP002

Visit the following link:

https://howrichami.givingwhatwecan.org/

Enter your income and country in the above website and appreciate how lucky and privileged we are to work in a rewarding profession.

Transition to Private Dentistry – PDP003

Too many of us make decisions based on our FEAR. We cannot live a fulfilled life in Dentistry like this.

The pearl here is to make decisions based on PASSION!

For example, many Dentists are stuck in practices they are unhappy with. They have settled. It is scary to leave stability and jump out of your comfort zone.

Instead, you should chase your passion. Find what you love in Dentistry and take massive action.

Microscopes, Loupes and Diva Mode – PDP004

  1. Use Fiverr.com for purchasing logos, soundbites, artwork, and creative services.
  1. How to minimize occlusal adjustment of composite restorations and avoid ruining your beautiful anatomy; Measure with a William’s probe once you remove half of the restoration (e.g. existing Amalgam) this will give you a guide on how much you build up your composite resin in terms of depth and height of the restoration. Remember – teeth that have been flat and worn down will likely not tolerate youthful anatomy!

Dentist Downunder – PDP005

How to get perfect moisture control for those difficult class V restorations:

  • Use PTFE tape packed into the sulcus – it’s way better than retraction cord for Class Vs (and rubber dam is not always the answer if it makes your life more difficult!)
  • Depending on the biotype you’re dealing with, you can use it rolled up (like a retraction cord) or like a napkin packed inside the sulcus.

Say hello to a bone dry working field!

Should you specialise? – PDP006

I am a big fan of showing your human side to your patients. This will help calm your patients down and build rapport.

Whether it’s through memorabilia of your favourite football team, or the music you play, ‘you do you!’

Are Class I Molars Important? – PDP007

As we qualify, our standards can drop very quickly. Try to be as textbook as you can. Take pride in achieving a high standard of care!

Do AMPSAs cause AOBs? – PDP008

The BRB technique for incisor Class IV build ups to create an ‘instant wax-up’ within the putty. You can read more about this technique at Style Italiano.

Restorability with a Specialist in Restorative Dentistry – PDP009

Use an Iwansson gauge to measure the thickness of restorations, burs, cusp widths and anything else! You can buy one on the cheap from Amazon. It’s an essential tool for any Restorative Dentist.

Think Comprehensive – Communication Gems with Zak Kara – PDP010

Use a UV torch to clearly see composite as it fluoresces! Perfect for removing aligner attachments or checking if there is still any composite left on a tooth. 

Communicating with a Bruxist – PDP011

Basic Implant Occlusion and Work Life Balance – PDP012

It is totally OK to change your protocol or your belief system time-to-time as new evidence and data emerges!

Dental Student Edition – Ace your Finals exams – PDP013

If you’re a Dental student, I recommend attending the Dentinal Tubules Student Congress. It is jam packed with great speakers and really fits well with students. GREAT value and I wish we had something like this when I was a student!

Passion and Values in Dentistry – PDP014

Take part in a Values Discovery process. This blew my mind!

Check out Scott Jeffrey’s Value Discovery System and be sure to get your family and staff involved!

Your Occlusion Questions Answered by Dr. Michael Melkers – PDP015

How can we give our patients the experience of what a splint might feel like, as if to test tolerance and compliance? 

“How will I know if I will be able to wear one in my sleep?” 

The solution: make a Putty impression in a non perforated tray, take a full arch impression, then remove the putty from the plastic tray and stick the putty back in the patient’s mouth to recreate a similar feel to a Full arch occlusal appliance!

Why do some Dentists find Dahl Distasteful? – PDP016

BDJ Article about Dahl Technique

Dahl Part 2 (The Spicy Bit) – PDP017

Use heated composite to ensure it flows into all the nooks and crannies and to prevent air gaps/voids in your restorations.

How can you heat it in a cost effective way? 

A £30 composite heater

This COSORI mug warmer looks really posh and can be used to heat composite and local anaesthetic and even occlusal mirrors to prevent them heating up.

Don’t Get Sued – PDP018

Watch this YouTube video if you use the SOE Exact software to create a New Patient Custom Screen

Download my EXACT examination Custom Screen for free! (I had to move the link to the Facebook group where you fill find all the custom screens – wait for group approval)

eMax Onlays and Vertipreps – PDP019

I made a group just for you where we can share content, knowledge and files for each other: Protrusive Dental Community

If You’re Not In CR, You Will Die – PDP020

Have you located your local physiotherapist who has an interest in treating Temporomandibular Disorders? You can find them on the following website: ACPTMD

You can download the latest Glossary of Prosthodontic Terms from Protrusive Dental Community Facebook group alongside hundreds of other papers and downloadable resources.

Everything Veneers – PDP021

NON CLINICAL: At the start of the Pandemic, I wanted to remind everyone that this is NOT the end. There will always be ups and downs. Use this downtime to reconnect with loved ones and to harness the power of self reflection. Re-evaluate your goals. Reflect, reflect, reflect!

CLINICAL: When asking for feedback from your patient after a restoration (to check for sharp or rough bits) – encourage the patient by asking, ‘Which is the bit that’s bugging you the most?’

Myth Busting Occlusion and TMJ – PDP022

If you’re thinking about the SmileFast course. Do it. It is very clinically applicable and will save you time and money.

I have been planning some tooth wear cases with it! The use of stents with a metal separator is very clever, and whilst not novel, I like how SmileFast have packaged it.

Paediatric Dentistry – Communication and Prevention Part 1 – PDP023

Dr. Libi shared a very good Paediatric Dentistry Blog aimed at Dentists called Tooth FaiRead.

Paediatric Dentistry Masterclass – Clinical Part 2 – PDP024

“Eat that frog!” – Bryan Tracy

When you wake up in the morning, do the most difficult thing and get it out of the way.

“Mind like water.” – Bryan Tracy

Have a system to create and strictly keep up with a written To-Do list so you never have to worry about your tasks and mentally tracking them.

Got Your Back – Physios and Dentists – PDP025

Check out my favourite (non-dental) books (my reading list) for self-development, social sciences and personal finance.

Rubber Dam Isolation – PDP026

Custom Screen. Just go to my website and when a pop up box will come up, sign up then you will get the welcome email with the custom screen and the youtube link on how to make a custom screen.

P.S. There are most custom screens on the Protrusive Dental Community FB group!

To Drill or Not to Drill? – PDP027

When you place an immediate resin bonded bridge, consider a split pontic technique.

This is essentially when the pontic comes in 2 components – the inner-core and the individual crown that seats on top.

Why?

Because think of the aesthetic risk we take every time we place an immediate bridge! In case the patient is not happy, you can temporarily cement the pontic and get a new one ordered even after the framework has been bonded in.

I Hate Cracked Teeth with Kreena Patel – PDP028

When checking for cracked cusp syndrome using a tooth sleuth, make sure to jiggle it a little bit because it can help to get a more accurate result!

Completely Dentures with Mark Bishop – PDP029

How to know exactly where to adjust the ill fitting of complete dentures that is causing an ulcer:

Use the base paste (white) of the Dycal (calcium hydroxide), dry the ulcer and put a little bit on the ulcer and press. Now do a ‘pick-up’ of this dycal with the patient’s Denture – you will now know exactly where to adjust/ease for that ulcer! 

Composite vs Ceramic with Dr. Chris Orr – PDP030

I’m pretty sure I was so star-struck for having Dr. Orr on that I forgot to give you a pearl! I guess this shows we all make mistakes and that to Err is human!

Posterior Guided Occlusion Part 1 – PDP031

How do you give Oral Hygiene feedback on a patient that is slacking? This is the technique I found works best as it is non-judgemental.

Basically, you should ask the patient’s permission first.

‘May I kindly give you some feedback about how your brushing technique is going?’ and show them with a mirror and probe regarding their plaque.

This is better than just lecturing at them!

Posterior Guided Occlusion Part 2 – PDP032

When taking portrait photos for your patients with a ring flash, point the ring flash at the ceiling, rather than at the patient’s face. This creates a softer, nicer image!

Airway – Dentistry’s Elephant in the Room – PDP033

When placing rubber dam:

Instead of using regular dental floss to floss the contacts, use these little flossettes, try and buy one with the double floss (one in higher up and one lower down) – your nurse will find it so much easier to floss!

How to Win at Life and Succeed in Dentistry – Emotional Intelligence – PDP034

“Don’t be shy with a tooth of poor prognosis.” Tell your patients they have a very poor or hopeless prognosis and just go for it.

Case Acceptance in Smile Design with Dr Gurs Sehmi – PDP035

Video I shared on Protrusive Dental Community (FB page) using an Endodontic tool to squirt peroxide gel deep into the access cavity to treat an internal bleaching case.

It’s all about using tools to get the whitening gel as deep as it will go.

Not Your Average Young Dentist Journey – PDP036

How to make cementing crowns less messy using Vaseline! 

Get a microbrush and dip in vaseline and paint a little bit on the gingiva a little bit around on the crown (on the external surface) and a thin amount on the adjacent teeth proximal surfaces.

Easiest clean up ever! You’re welcome.

Personal Branding for Dentists, Logos and Websites with Shaz Memon – PDP037

Are you Google-able? Are you one page 1 of Google when patients and potential patients search for you? 

This is so important and is the reason companies pay MILLIONS for ‘Search Engine Optimisation’ or ‘SEO’ (not to be confused with SOE Exact!). A great way for Dentists to harness the power of being found in Google is to collect verified patient reviews using Doctify

Which is the Best Dental Splint? [SPLINTEMBER] – PDP038

Protrusive Dental Pearl: A quick way to remove temporary crowns and onlays using a haemostat!

Stay away from TMD! [SPLINTEMBER] – PDP039

Check out the Otter app for transcribing your voice, lectures or any audio/video! This is great for anyone who wants to convert audio into notes, for students, and for content creators.

Also a Download:

Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) PDF file 

Michigan Splints Are Overrated [Splintember] – PDP040

Call your patients to check up on them – after a tricky procedure or after an extraction, and just asking how they are, giving them some advice and follow up advice and telling them ‘If you have any issues, I’m always here for you!’

Correct Rubber dam hole spacing – you get a pen or a marker, put the rubber down all over the study model, mark the middle of each tooth and then you punch your holes like that it will be extremely accurate 

OR put the rubber dam on the teeth and then get your pen and mark the teeth with the pen while the rubber dam is wrapped over the teeth, and then that gets you perfectly spaced holes, which allows you to get a better sealed better inversion, less chance of exposing a papilla!

Understanding AMPSAs Part 1 [Splintember] – PDP041

Any patient who has a history of joint issues and you’re giving them any treatment that involves opening their mouth for a long time it is really important that you give them a mouth prop. It gives the lateral pterygoid to relax, to have a break. 

Example bite blocks on Amazon: https://amzn.to/3vQUpjn

10 Habits of Highly Successful (and Most Valued) Dentists – PDP042

Shadow a Dentist you respect!

Email, call or tweet a local Dentist and shadow someone and learn a lot. 

Understanding Fixed-Movable Bridges with Prof Tipton – PDP043

Where to place your grooves for crowns and bridges

Crowns: place grooves mesial or distal, or mesial AND distal. Ideally in tooth and not in core material (we elaborate in the episode). Why mesial and distal for crowns and bridges? The forces will be transmitted bucco-lingually on a crown – therefore grooves perpendicular to this force vector to resist it would be mesial/distal.

Conventional bridges: grooves are placed buccal or lingual, or buccal AND lingual. This is because the forces are now acting antero-posteriorly on the bridge via forces on the pontic(s). The buccal/lingual grooves will resist antero-posterior forces.

Money – 5 reflections to help you get started with Investing – PDP044

Have you been a victim of ‘lifestyle creep’? This is when your income increases, your lifestyle and expenditure also increases. This is all good and well, but it is so important to watch your savings rate (how much money you save).

IPR for Dummies – PDP045

If you view a ClinCheck or a similar 3D simulation, make sure that the initial bite/occlusion is set up correctly. You will be surprised in how many cases this may be wrong and it has not been picked up!

Why and how you need to Improve your Tooth Morphology – PDP046

Use a Thermacut bur (by Dentsply) to remove the interdental papilla when managing very deep, subgingival caries – an example case was posted on Instagram and Facebook for you to see how this works.

Can Occlusion Cause Perio? – What Do We Know? – PDP047

A pearl from Dr Dipesh Parmar on his fantastic Composite course Mini Smile Makeover:

Use a sectional posterior matrix band (like the B100 from Garrison or Tor VM) in a vertical fashion to create perfect mesial and distal contours for your anterior composite restorations such as Class IVs.

Presenting Treatment Plans the Comprehensive Way – PDP048

Ebook Download for 16 Steps to get more Treatment Plans Accepted Today

Crystal Clear Treatment Plans that Wow Patients and are Easy to Understand – PDP049

Do the 21 Day Free Trial for MakeMeClear and do not make the same mistakes I did of not taking action! (It will be more clear when you listen to the episode).

If you fall in love with MMC, use the code ‘protrusive’ to secure 25% off for life!

What Every Dentist Should Know About Managing Dental Anxiety – PDP050

Check out Anydesk (it’s free!) to gain remote access to your work computer in a secure way, so you can access X-rays and treatment plans any time, from anywhere! This has helped me on so many occasions!

Getting Started With Dental Implants – Is it for me? – PDP051

The ADI Whitepaper on Bisphosphonates

BAIRD Implant Course 

Wex for Refurbished Photography Equipment

Implant Assessment for GDPs: from Space Requirement to Ridge Preservation – PDP052

How to use a pencil to draw line angles for anterior aesthetic composite restorations. I learned this from Dipesh Parmar on the Mini Smile Makeover course

Which is the Best Matrix System for Class II Restorations – PDP053

If you are in the UK and Ireland and want to avoid fake Tor VM matrix bands from eBay, buy from a reputable source: Incidental Ltd.

5 Lessons from Lincoln Harris – PDP054

Understanding Anterior Occlusal Splints Part 2 – PDP055

Remember at Dental School where they taught us that 3 fingers worth of mouth opening is considered ‘good’ or normal? Well, make sure you remember it’s the patient’s fingers, NOT your fingers! I showed how to use a range of motion scale and the benefits of checking mouth opening objectively: https://youtu.be/LAlKNwedd6w

Chrome Dentures Made Easier with Finlay Sutton – PDP056

Suturing:

How to know which way to pull to tighten your suture.

The direction you move the needle towards IS the direction you will pull to tighten! The first knot is the most important knot.

A Story of Digital Occlusion – PDP057

Teeth Whitening Secrets for Success – PDP058

Using the patients’ aligners as a whitening tray – and better yet, the use of Vivera retainers and Enlighten whitening to Guarantee B1 shade!

Ceramic Onlays from Preps, Temporisation and Bonding Protocols – PDP059

Use air abrasion on your Tanner/Michigan splints to help to see articulating paper marks more easily. 

Also it can be used to test compliance of your patients, as they will polish/grind away the abraded surface. Thank you Dr. Tilly Houston for sending that one in!

How to Pass the Dental ORE Exam UK – PDP060

How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique – PDP061

Have you used Viscostat clear? It is my preferred astringent and will not interfere with bonding

The Associate that Bought an iTero (How to Make your Own Luck) – PDP062

Make yourself indispensable to your dental team. 

Buy an ‘associate box’ to transport kit between practices

TMJ Physiotherapy – When to Refer and How They can Help – PDP063

Have you checked out the ‘Bruxchecker’ foil as a tool to help diagnosis of Bruxism and much more? I comprehensively reviewed this product and thought it was very clever! 

TMD Full Exam with ‘The TMJ Doc’ Dr Priya Mistry – PDP064

The two other arms of Evidence-based Dentistry, aside from the Best available evidence, are patient values and the clinicians expertise. Sometimes we forget about the last two!

Dentistry is STRESSFUL – this Podcast will help you – PDP065

“Listen to everyone, but do what feels right to you.” 

Listen to all schools of thoughts but do what feels right to you!

Philosophy of Functional Occlusion with Riaz Yar – PDP066

General Dentists Doing Orthodontics [STRAIGHTPRIL] – PDP067

I use a Disney ‘Beauty and the Beast’ themed Mirror to ask patients what they hate most about their smile. It injects personality and humour – but you also find out exactly what the patient does not like about their smile!

GDP Alignment vs Specialist Orthodontics [STRAIGHTPRIL] – PDP068

For better portrait photos (Extra-oral) – point the ring flash to the ceiling! I use F8.0, ISO 800 with my Canon 60D body, 100mm lens and Canon Ring flash. This is the difference in lighting compared to point the ring flash at the face:

Retention Protocols with an Orthodontist [STRAIGHTPRIL] – PDP069

The Harridine paper helps to explain that wisdom teeth likely do not cause lower incisor crowding.

Elastics for Invisalign – The Long and Short of it [STRAIGHTPRIL] – PDP070

The Bethell IPR Technique! Click Here for the Video of how Dr Bethell uses the bur for IPR. To access this video, you need to be a member of Aligner Nation Facebook Group.

Do’s and Don’ts of Aligners [STRAIGHTPRIL] – PDP071

How to place a direct fixed retainer the easy way!

Use floss to create loops and use a chain retainer, like Ortho-Flextech which has made it much easier in my hands.

Productivity with a Prosthodontist – PDP072

Do you carry out virtual consultations with your patients to discuss Orthodontics (Invisalign) or Smile Makeovers? 

How do you make notes for this? I am enjoying using Otter.ai to transcribe our Zoom virtual consultations

Suction Lower Complete Dentures – Improve your Removable Prosthodontics – PDP073

The power of silence! When you present your patients a solution or treatment plan, or tell them the fee, there may be silence. 

Embrace it. Expect it. Don’t panic. 

This is normal! 

DO NOT butt-in with a ‘why don’t you just think about it…’

5 Things your Technician Wished You Knew – PDP074

Use websites like Loom or even Whatsapp to communicate with video and voice with your technician. Great, clear communication will ensure expectations are met for both parties.

Composite Veneers vs Edge Bonding – Biomimetic Dentistry with George The Dentist – PDP075

I love the Eve Twist Composite Polished by DiaComp (Not sponsored by the way). It’s my favourite polisher in the whole world. If you are looking for a new polishing system for your composites, you should definitely try the Eve Twist. It gives a high lustre relatively quickly. Check them out.

Finding Your Niche in Dentistry – PDP076

Grab a pen and paper and write down ALL the clinical procedures that you LIKE to do, and then also what procedures you would like to do MORE OF. Figure out where your niche could lie. And don’t forget, it’s not a race! It helps helps to make a list of procedures that don’t excite you (for me, I have no affinity to facial aesthetics!)

I Can’t Believe This Sticks – EXTREME BONDING EXPOSED – PDP077

How can you show patients what shorter anterior teeth might look like to them discing them down? Use a black Sharpie marker, colour in the part of the edge (maybe 0.5-1mm) that you’re considering removing. Take photograph and show it to them! It helps if their mouth is open for the photo so we see the dark backdrop of the oral cavity.

Why You Need to Take Massive Action for Success in Dentistry – PDP078

Write something down that you’re going to change in your life or your work, and then COMMIT to it until you get the desired result. I’ll say it again, commit until you get the desired result!

40 Minute Crown Lengthening Tutorial with Reena Wadia – PDP079

How to find out what kind of biotype you’re dealing with: Use a ball ended Perio probe and use the ball-end/tip (sometimes it’s coloured) and probe in to the sulcus – if you can see the tip of the probe shining through the gingiva then that’s a THIN biotype. and if you can’t see the tip of the probe then that is a THICK biotype.

[Spear Education] Piper Classification and TMJ Imaging with Dr McKee – PDP080

Observe the patient’s path of opening. If someone’s jaw opening makes a ‘V’ shape, that’s a DEVIATION. If someone’s jaw opens, and then it goes all the way to one side, and it doesn’t go back to the middle, that’s a DEFLECTION.