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
- Use Fiverr.com for purchasing logos, soundbites, artwork, and creative services.
- 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?
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
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
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.
How to use Injectable Composites to Treat Toothwear – PDP081
How to improve the resistance form of ceramic onlays: Use a big fat round bur, sink it into your composite core (be sure you’re drilling into core material and not sacrificing healthy tooth structure) and allow your ceramic to extend into that to help your onlays stay on when you’re trying them in.
Recession Defects – Refer or Reassure? – Specialising in Periodontics – PDP082
What do you do if your patient is bleeding after an extraction and you’re struggling with haemostasis? You can try placing a hot tea bag on the socket (no, really!) – the tannic acid in the tea bag will aid blood clotting. So next time you have a bleeder in the chair, remember, ‘time for a cup of tea!’
When Should I Replace This Ancient Amalgam Restoration? – [B2B] PDP083
How to make sure your equipment doesn’t keep getting lost? Use color coded tapes on your own equipment and tell your team that stuff is super important because it belongs to you.
Hot Pulps, Painless Palatals and ID Block Failures [B2B] – PDP084
Give painless local anaesthesia (aside from topical anaesthetic, we know that already!) by massaging the mucosa and the lip with your index finger and thumb. Get just a few drops of LA first and give it a minute to work. Then you can go back in and deliver your anaesthetic much faster and the patient will love you for painless anaesthesia!
Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth [B2B] – PDP085
Be able to section teeth. If you can learn how to section roots and know WHEN to do it and HOW to do it safely, you will dramatically increase your success rate for dental extractions.
Communication Masterclass for Periodontal Disease [B2B] – PDP086
Have some tools to be able to communicate via drawing (draw teeth, draw bone or periodontium etc) whether it’s digitally, on whiteboard or paper. There is beauty and magic about being able to draw something while your patients are watching beside you.
Basics of Dental Photography [B2B] – PDP087
AACD Dental photography guide, have this document at hand when start taking dental photographs because it will help you to remember your settings before they eventually become second nature.
And also be sure to check this video tutorial I made on how to take perfect Occlusal Dental Photographs (the trickiest shot!)
Basics of Treatment Planning in Dentistry [B2B] – PDP088
If you are unsure what is the best treatment plan for your patient, it likely means you haven’t asked enough questions. Ask more questions and seek your patients’ drivers and goals.
Vertiprep Revision and How To Go Digital for Vertical Preps – PDP089
Impressions vs Digital. Remember, if you’re going digital, you need to be more aggressive in your tissue retraction compared to impressions. If the light from the scanner tip does not reach beyond your margin, it will not be recorded. Whereas with impressions, the wash material can flow beyond the margin and capture the sulcus, even if you cannot see it.
Basics of Occlusion – PDP090
If you think your patients are in Canine Guidance, check again. This time check while the patient grinds really hard. You will notice that most people are really group function and even have non-working side guidances!
Next Level Occlusion (Basics Part 2) – PDP091
When you’re checking occlusion after placing your restoration, check on the contralateral side with the articulating paper (19 microns, for example) to see if it is ‘passing through’. If it does pass through, double up the articulating paper (now 38 microns). You can keep doubling-up if you need to, until the paper holds. How does this help? You’ll know right away if you need to adjust anything, and if so, you’ll get a better idea of how much adjustment is likely.
Wisdom Teeth Extractions – SURGICAL TOP TIPS – PDP092
When you are sectioning a mesio-angular impacted tooth, start your section 1-2 millimeters more mesial to where you think the furcation is – you will have a tendency to drift distally and therefore more likely to HIT that furcation which is when the magic begins.
What We Ought To Know About Full Arch Implant Dentistry – PDP093
Instead of booking patients for a ‘fit appointment’ for crowns or bridges, rebrand it to ‘try-in appointment’. This takes the pressure off of you and your technician – in the small chance that things are not perfect, you can correct it and book their fit. If everything is good at the ‘try-in’ you can go ahead and fit your work definitively. It’s just a good way to manage expectations and reduce the chance of disappointments and surprises.
Occlusal Equilibration Ain’t Dead! With Dr Koray Feran – PDP094
When you have a patient who has a crowding and they want veneers, and you want to convince them to have some orthodontics first….. Instead of saying, “Oh, I have to remove this part of the tooth.” You could instead say “I don’t want to have to remove your healthy body parts to be able to achieve this goal.” Language is powerful!
Burnout and Continuing Education in Dentistry – PDP095
Before starting on a course or program, be sure to have a patient in mind already that will benefit from you going on this course or gaining this piece of education. That way you will be able to apply what you learned ASAP and implementation is key!
Finally, Some Clarity on Teeth Whitening for Under-18s with Linda Greenwall – PDP096
When taking before and after photographs of teeth whitening cases, switch to manual flash settings instead of ETTL in order to provide the same colour of your patient’s skin and gums.
Facebows – When and Why (Not) To Use Them – PDP097
If you’re planning to increase the occluso-vertical dimension (perhaps for multiple restorations or an occlusal appliance) and you know the final vertical dimension, try recording your Centric relation record (or whichever bite religion you follow) AT that desired vertical dimension and NOT at the ‘first point of contact’. This is because traditionally when we send the technician a first point of contact bite, they will open up the pin to give you the space that you need for the restorations and optimal aesthetics. The problem with this is that it introduces an error because the arc closure/opening of the patient is likely going to be different (even with the best Facebow in the world) to the arc on the articulator. Therefore, reduce that error by doing your bite registration, not at the first point of contact, but doing it at where you want to finish. Read that again!
Cracked Teeth Management with the Direct Composite Splint Technique – PDP098
Get the largest magnification loupes you can afford and you can think you can sustain. I personally use 7.5x for EVERYTHING! A sharp probe has a resolution of 40 microns, at 8x magnification the resolution is 25 microns. We need high magnification to treat cracks!
Occlusion Wars: Which is the Best Occlusal Religion? – PDP099
Check the Video on How to successfully give lower first molar anesthesia using buccal articaine (without an inferior alveolar nerve block)
Pascal Magne at BACD Experience – PDP100
If ever you wanted to read or just take notes of everything we’ve said on the podcast, just scroll down below the blog post. Every episode has been fully transcribed!
Occlusion Wars II: Beyond Teeth – PDP101
When checking someone’s occlusion after a restoration, do not just check it while they are supine (lying down), sit them up then check their occlusion again because posture does change our occlusion, even just a little.
How to Handle ‘Difficult’ Patients (Without the Emotional Trauma!) – PDP102
Never to say ‘No’ to patients. Instead, be tactful by pitching it and phrasing it in a different way – you are still saying ‘No’ but in a much less harsh and patient-friendly way. I give some concrete examples in this episode.
Adhesive Full Mouth Rehabs in 11 Appointments (Part 1) – PDP103
Write down one good thing that happened each day of 2022 on a post-it note, fold it and put it in a jar. By the end of the year, you’re gonna have 365 post notes of all the good things that happened that year. Check out the RipeGlobal Facebook Groupthat inspired this pearl!
Back to Back Class II Secrets (Sectional Matrix Troubleshooting) – PDP104
The ‘Wedge Test’ (as inspired by Dr Chris O’Connor): Before restoring the tooth, make sure to test the size of the wedge you are using in order to make sure that the wedge is doing what it’s supposed to do, ie it’s compressing the papilla, the active part of the wedge should below the margin of the cavity, and to make sure that you are getting enough separation.
2 Important Uses of Acupuncture and Trigger Points – PDP105
How I communicate an Oro-Antral Communication: I will pull up the radiograph and show it to the patient and warn them that the root of THEIR tooth is so close to the sinus. “If your roots live in your sinus then there is a chance that you will have a new party trick: when you drink water through your mouth, it could come out through your nose via the sinus”, and that creates a memorable warning/consent.
Adhesive Full Mouth Rehabs Part 2 – Wax Up and Temporaries – PDP106
How I communicate a high RCT risk: For ordinary patients, I would always say “YOUR tooth decay (in YOUR tooth)/ YOUR filling was very deep.” But for some patients who you feel would make trouble, I would continue to add “…if we do nothing, then your tooth will eventually be in a worse situation. And you may lose your tooth. This could be a painful process as well. If I do something, then that involves drilling your tooth decay, drilling the soft bits of your tooth away and drilling away the old filling that’s leaking. Drilling is not a nice thing. So by drilling, the drill is damagingyour nerve. Your nerve may die and need a Root Canal.”
IPR Techniques – Strips vs Burs vs Discs vs Oscillating Handpiece – PDP107
No matter how much IPR you think you have done, do some more. You probably haven’t done enough. Don’t believe me? Check out this paper below by Dr. Tony Weir.
Fixed Retainers Demystified – PDP108
Head out to my Email Newsletter for some goodies and updates from me and also for the upcoming Protrusive App!
Articulating Paper is Lying To Us – Measuring the Occlusion Digitally with Force and Time – PDP109
Classically on glazed ceramic, articulating paper marks will be difficult to show up. A little hack to overcome this is to get a tiny smear of vaseline on a micro-brush, paint the articulating paper and get the patient to bite together because the Vaseline has an effect on the articulating paper which allows it to stain or ink the teeth more effectively.
Adhesive Full Mouth Rehabs Part 3 – FULL WORKFLOW! – PDP110
A video pearl from the Premium Protrusive Guidance App on How to diagnose a Myofascial Pain that mimics 9/10 severity toothache
3 Simple TMD Exercises – How To Prescribe Them – PDP111
Handing Composite for a Class IV Restoration: When restoring a Class IV on incisors, you will need to decide how to manage the interproximal area. In the ‘immediate’ technique (called Immediate because you will manage this straight after the palatal wall build up) you can use some form of an interproximal matrix (posterior sectional matrix used vertically, for example).
The tip here is to roll the composite between your gloved fingers first, roll it into a sausage, then you will then place that ‘sausage’ into the interproximal area. This will help you get a better interproximal shape. Inspired by Dr Dipesh Parmar from Mini Smile Makeover course.
Record Keeping and Emotional Intelligence – PDP112
One great way to build rapport with your patients is to write down on your note-taking software. That way you can re-read and remember even the fine details of your patients.
Consent Is Like An Onion – Are You Consenting Your Patients Correctly? – PDP113
Be sure to subscribe to my email newsletter for the PDF Flowchart for Consent made by Dr. Shaun Sellars
Dental Suturing Tutorial – PDP114
Use the power of video messages to communicate with patients (think post-op instructions) or your lab technician (they love the detail). Currently I am using LOOM which allows me to seamlessly record my screen and my voice/video and creates a sharable link.
A ‘Secret’ Interview(!) with Smile Direct Club – PDP115
In terms of efficiency in doing your IPR, be sure to plan your IPR and your ClinCheck so that a lot of the IPR happens in one go when the contact is more aligned. Watch the full episode on IPR Review – Strips vs Burs vs Discs vs Oscillating Handpiece PDP107
4 Invisalign Challenges – A Guide for New Providers – PDP116
Correct a rotated tooth by means of HYPERCORRECTION. This means adding a few extra clicks of rotation so that on the clincheck it looks like you have done a little bit too much. This works because orthodontic movements are NOT 100% predictable.
Dental Ceramics in 2022 – Which Ceramic Should I Use? – PDP117
How to mask a metal post?For me, a post-core is just a space-filler, it’s a way to retain some sort of foundation/core restoration. I do not mind cutting it back a little bit – below I share a video of How to mask a metal core using Paracore White Opaque, to help my ceramist. You can also use an opaquer resin such as Ivoclar Direct Opaque – it’s like Dental Tipex!
What Happens When Occlusal Splints Don’t Work? – PDP118
Head over to the Premium Protrusive Guidance App where I posted an 8-minute walk- through video on how to screen which patients are at risk for getting a bite change or AOB after an occlusal appliance and how you can minimize that risk.
20 Years of Composite Excellence Part 1 – PDP119
Check out this Casi 3C instrument distributed in the UK by Enlighten who are the sole distributors of Cosmedent Products. This is a non-stick instrument that provides a perfect curved shape that beautifully forms the palatal contours of your incisors. Watch the video
on Protrusive Guidance App
NITTY GRITTY Composite Techniques PART 2 – PDP120
There is a benefit of having nice tight contacts on our temporary crowns – but how can we polish our temporary crowns without ending up with open contacts? The trick is to get a Sharpie pen or indelible pencil and color in a small circle (maybe about two to three millimeters) mesial and distal of where the contact area is.
Now finish and polish your temporary crown using burs/discs BUT do not touch that penciled mark. Ta da! You have just maintained the contact area. I know, why didn’t anyone tell you before?!
Additive Equilibration Technique – PDP121
Keeping PTFE tape secure– a straightforward trick I found to keep the PTFE so it doesn’t get sucked away is to floss the PTFE through more distal contacts. It gives the PTFE some security and resistance to being sucked away. So it’s not going to make that horrible sound and you get to keep that PTFE in the stable place!
Shell Temporary Crowns with Basil Mizrahi – PDP122
Preventing Bisacryl Temporary Crowns from Cracking: Hollow out the inside of the temporary crown (just enough space for the cement) and therefore create the space for the temporary cement to flow and exit, preventing cracking of the temporary crown.
Botox for TMD – Indications and Protocols – PDP123
How do you routinely check the masseters and the temporalis at your new patient examination? As a restorative dentist, the most important thing I want to know (and what will influence the occlusal risk for my patient) is the size of the masseters.
Start palpating and feeling for the size of the masseters to understand how much force these patients can generate!
The Ultimate Dentist with Devang Patel – PDP125
Principles of Raising Clean Flaps – PDP126
Nice and Clean Extraction Sites – Use the spoon end of Mitchell’s trimmer to clean the surgical site for 30 secs to 2 minutes.
Atraumatic Extractions – WHY and HOW? – PDP127
Life Advice: “Never take advice from anyone who you wouldn’t switch places with”
Interceptive Orthodontics for the General Dentist – PDP128
Prevent misdiagnosing ectopic canines by palpating the permanent canine early (from age 10 onwards). Put your index fingers a little bit apical and a little bit distal to the lateral
incisors and you should be able to feel a 5-10 millimeter bulge
4 Rules of Planning Aesthetic Dentistry (Ortho-Resto) – PDP129
Don’t start complex/comprehensive treatment on someone who is not sure or not motivated.
Last Tooth In the Arch Syndrome – 2nd Molar Conundrums – PDP130
Watch out for the patient with quite flat teeth as they are more susceptible to the last tooth in the arch syndrome / bite change. They do not have good posterior coupling/stability and therefore more likely to ‘forget’ their bite as the cuspal inclines do not guide the mandible back in to maximum intercuspation.
10 Commandments for Staying Out of Trouble – PDP131
‘I don’t have time’ is just not true. It’s a lie we tell ourselves. We should reframe it. Instead, we should say “I’m not making [task / activity / necessity] a PRIORITY in my life right now”. We should reflect on what are we making a priority in our lives right now.
Success with Resin Bonded Bridges – PDP132
Always visualise your path of insertion – do you need to do some additional prep to get a more favourable path of insertion? It’s not just for dentures! For any indirect crowns/bridges, it is important to assess for a path of insertion. Make a visualisation of this – you may have to prep more or prepare the adjacent tilted teeth to allow for a suitable path of insertion sometimes.
Pulpotomies for Irreversible Pulpitis? The Rise of Vital Pulp Therapy – PDP133
Check if your anesthetic is successful by carrying out an objective test by placing EndoFrost (-50 °C) on the tooth (about 10 secs) and checking for a cold response. If the patient is not fully numb yet, they will still feel something. If they are sufficiently numb, this test gives you (and some nervous patients!) confidence. I like this before placing rubber dam as I hate ever removing the dam to top up LA!
Chrome Partial Dentures Guide – The Scandinavian Way – PDP134
DENTURE DESIGN CHEAT SHEET! Dr. Finlay came up with a Universal Design Sheet. It covers all aspects of missing teeth – all different combinations and patterns of tooth loss. It covers teeth with good prognosis and also teeth with dubious prognosis
Biomimetic Dentistry – What Actually Is It? – PDP135
How to block out a metal post. Use something like ‘Ivoclar Direct Opaque flowable resin’, a masking agent that is highly opaque. Paint it on the dark tooth substrate or cover metal (eg a cast post) with it. Other brands include Pink Opaque by Cosmedent Inc
Sedation in Daily Dentistry – A Guide – PDP136
Communicating Risk to Your Patient: Be calm and SLOW your pace down when communicating with your patients to EMPHASISE certain words. Becoming a visual educator to the patients is also a really good way to communicate risks – intra-oral camera is the best investment you will ever make.
Q&A with a Dental Technician – Shade Matching to Contact Points – PDP137
It’s high time that you find your ideal dental technician, build a relationship and grow together. Whether you are using a big lab or small lab, try to visit and meet them and be open to getting feedback and criticism from that ONE technician that will elevate you.
Don’t forget to give credit to your technician for their craftsmanship – take a photo of their work being fitted and email them – credit them on social media!
Is Caries Detector Dye BS? – PDP138
How can you remove the appropriate amount of caries to get the best bond strengths possible WITHOUT risking removing too much dentine and causing a pulp exposure: Use your perio probe and measure key landmarks. Measure 5mm from the cusp tip and 3mm from the adjacent marginal ridge – do not remove caries beyond this point. As a guide, this will help you not expose the pulp so you achieve very clean dentine for highest bond strengths, without worrying about ‘when to stop’.
Sleep Disordered Breathing and Dentistry – PDP139
Removing Aligner Attachments – Watch this step-by-step protocol including the use a UV torch to see if there’s any resin left and which different burs and polishers I use.
ICON Resin Infiltration – Step by Step FULL PROTOCOL – PDP140
Download the Protrusive Treatment Guide for White Patch management Icon Resin Infiltration inspired by this episode – the Infographic that summarizes this episode with the exact micro-steps and the little nuances with helpful diagrams and tips all in one flowchart.
Stop Blaming Bruxism! How to Spot Frictional and Constricted Chewing Patterns (CCP) – PDP141
Acknowledge, understand, and believe the fact that often our patient’s centric relation (CR) is NOT more distal/posterior to their maximum intercuspation (MIP) – it can actually be anterior to their MIP!
Stop Blaming Bruxism Part 2 with Sandra Hulac – PDP142
Overjet is King.We don’t want tight bites. We want a bit of overjet that gives chewing space – this will reduce the chances of a functional attrition and avoid ‘too much anterior guidance’ or locking the patient in.
Articaine ID Blocks and the ‘CIA Technique’ for Local Anaesthetic – PDP143
Check out the couple of videos I posted on the Protrusive Guidance App
Robin Hood Dentistry – a careful and well-considered enameloplasty
No More High Restorations 2023 Update – Stop Grinding Away Your Composites!
Lingual Infiltrations and Adrenaline for Cardiac Risk Patients (Part 2) – PDP144
Do NOT use the technique of lingual infiltration that I did! There IS a better way! (Lingual Infiltrations are not bad – just the way I did them was not ideal)
If you’re curious what technique that was, if you’re on Premium Protrusive Guidance, you will get to see it in the middle of this episode including Dr Williams’ ‘live’ unedited, uncut reaction. This is GOLDEN content!
Rochette Bridges and Provisional Prostheses for Implants – PDP145
Steal my Resin Bonded Bridgesconsent form!It is a visual aid for patients and helps with information and consent for RBBs. If you are on Protrusive Premium, head to the ‘Protrusive Vault’ to download it. Otherwise you can request your copy for free. Download here!
Internal Whitening Protocols Pt1 (Non Vital Bleaching) – PDP146
When carrying out internal bleaching make sure to clean out the entire pulp chamber especially the necrotic pulp horns – clean the necrotic tissue inside using ultrasonics.
Ensure the entire chamber is de-roofed – remember that these are mostly trauma cases and the pulp went necrotic in youth – hence large pulp chambers. No role for Ninja access here!
Internal Whitening Protocols Pt2 (Non Vital Bleaching) – PDP147
The full protocol workflow – summarised PDF of Part 1 and 2 of this Internal Bleaching Series plus the patient advice sheet AND lab instruction sheet by Dr. AJ Ray-Chaudhuri
Apicoectomy Tutorial – When, Why and How – PDP148
The PeriradicularSurgeryGuidelinesissued by BES and the Royal College of Surgeons. Download the guidelines about periradicular surgery or on the app under the ProtrusiveVault(where all the different files and infographics and the different things that you get as a Protrusive Premium member)
Bruxism and the Airway – PDP149
Parafunctional Screening Sheet– A simple PDF that you can look for in terms of your extra-oral examination, intra-oral examination and the history – to give a clue that a patient might be a bruxist in just 2 minutes
Occlusion on Class IV Composite Restorations – PDP150
OcclusionWhisperer– Ask your patient to bite together and listen – in a “good” occlusion you should hear lots of tooth-to-tooth contact, whereas a thud indicates an issue. Use this in addition to more traditional methods of assessing the occlusion, and make sure you are satisfied with the occlusion before asking the patient “how does that feel?”
Prescribing Antifungals as a GDP – Diagnosis and Management – PDP151
What are you Waiting for? If there’s something you’ve been putting off (meditation, exercise, diet, work, etc.), the best time to start was years ago. The second-best time is today! Write it down, tell someone, keep yourself accountable and start right now.
The ‘Anti-Biomimetic Dentist’ – Restorative Lessons from Pasquale Venuti Part 1 – PDP152
New Restoration Needed and the Patient has an existing occlusal appliance. What can you do?
Imagine a Stabilisation Splint– For patients who rely on an occlusal appliance – how do you manage the scenario if they need a restoration? Do you need to make a new occlusal appliance? ? Not really. You just have to gouge out the acrylic where the new restoration was placed (intaglio surface of splint). If the splint fits well, no further adjustments are needed otherwise additional acrylic can be added to provide retention (like a partial reline of the splint over your new restoration. Don’t forget that vaseline!)
No Post? No Crown? The ‘Anti-Biomimetic Dentist’ Part 2 – PDP153
Mouth props are super helpful for long appointments! They serve a crucial purpose in allowing the depressor muscles to relax. By preventing muscle fatigue during extended treatments, these props contribute to patient comfort and overall treatment success.
Dr. Jaz shares his approach to communicating the use of mouth props to patients, employing relatable examples to ensure their understanding and cooperation.
Post Crowns – Historical Technique or Necessary Solution for Compromised Teeth? – PDP154
How to Bone Sound for Ovate Pontics– Imagine you have a missing upper lateral incisor, and you want to use an ovate pontic for an aesthetic bridge. To achieve the ideal emergence profile, Jaz demonstrates how to assess gingival thickness using ‘bone sounding’ using a periodontal probe (please see video).
This technique helps determine how thick the tissues are overlying the edentulous area and whether an ovate pontic is feasible (or perhaps a connective tissue graft is necessary).
4 Ways to Boost Osseointegration of Your Implants – PDP155
CompositeBondingTimeManagement– 50% of the appointment time should be reserved for placing the composite, the other 50% should be reserved for finishing, polishing, and occlusion. Allocating enough time for these final steps will provide better aesthetics, longevity, and stain-resistance!
An Idiot’s Guide to Restoring Single Implant Crowns (Part 1) – PDP156
How I use the software Motion to better manage my time and productivity. Check out the 7-Day Free Trial Here
Ovate Pontics for Bridges – The Complete Guide with Dr Jason Smithson – PDP158
Jaz’s Rule for Resin Bonded Bridges
- For Metal winged adhesive bridges, do not accept more than 1 compromise
- For Zirconia RBBs, do not accept any compromises!
- Examples of compromises: small abutment teeth (and thus smaller surface area for bonding), poor quality enamel, awkward path of insertion, dodgy occlusions etc
How to Manage Children in Dental Pain – Paediatric Emergencies – PDP159
Fuji Triage by GC – this material can be used as an alternative to a conventional fissure sealant material when your patient’s co-operation isn’t the best!
All you need to do is dry the teeth and smear it on using your finger, and it self-sets! It isbright orange, but it is great stuff and gets the job done quickly
Fremitus and Occlusal Overload – Dental Occlusion Geekiness – PDP160
Therma-CutBurs– taking crown preparation impressions/scans can be really tricky when the gingiva “sulks” onto your preparation. Even with the use of retraction cord and PTFE tape, this still can happen. Use a therma-cut bur (the ‘budget laser!’) to gently trim away that excess gingiva; it’s super easy to do, doesn’t cause a lot of bleeding, and will make your technician fall in love with you!
A Geeky Discussion on Adhesive Onlays – PDP161
Build in some ‘indexing’, ‘location’ and resistance form in to your onlay preps – don’t just make it flat because you saw it on the ‘gram!
Occlusion for Complete Dentures – PDP162
‘Enter Bolus,Exit Balance!’– find out why group function occlusion is the pragmatic choice of occlusal scheme, instead of painstakingly trying to achieve balanced articulation.
Stop Being Slow at Root Canals! Efficient RCTs with Dr Omar Ikram – PDP163
ConnectedCanals– to determine whether two canals are interconnected, begin by irrigating one canal with hypochlorite solution while monitoring for the second canal to fill as well. Then, retract the solution into the syringe and observe both canals for drainage. If both canals become filled with hypochlorite solution and subsequently drain, it strongly suggests that the two canals are indeed connected!
Another technique to confirm the connection between two canals is to place a GP cone in one canal and a K-file in the other. After removing the GP cone, examine it for any impressions left by the K-file
Dental Photography Settings – Getting Started and Common Challenges – PDP164
My philosophy on spending money.
If I am going to use something daily, I will buy the best I can afford.
If something is very temporary or very sporadic use, I will cheap out/borrow/rent.
By that logic, get yourself a decent camera body, lens and flash set up that will serve you well for years to come. It does not have to be mega expensive and we do recommend buying used/refurbished later in the episode.
How to Shade Match the Single Central Incisor – PDP165
Cross Polarised Filters– when taking clinical photos with a twin or ring flash, the reflection of light off teeth can create specular flash, which obscures details. To fully appreciate tooth anatomy and achieve a precise shade match for ceramic work, consider using a cross-polarised filter. This filter eliminates specular flash, providing essential information for dental technicians, and can also be beneficial for ICON resin infiltration cases!
Bleeding Sockets Management CLINICAL Exodontia – PDP166
HaveaPLANforyourextractions.Just like you have a plan for a crown preparation. For example, you should plan the sequence and also contingencies for when things do not follow your ‘Plan A’ – including at WHICH POINT you may decide to section the roots or raise a flap.
Pain after Crown Fit – an Upset Patient! How to Manage Tough Scenarios – PDP167
TooGoodToGo– this app connects users with restaurants and cafes to purchase surplus items at a heavily discounted price, providing a sustainable solution to prevent edible food from being thrown away! Caring for the environment, and your wallet too
Functionally Generated Path Technique – Conforming to Funky Occlusions – PDP168
Ensure you have an excellent relationship with your dental technician. – Working with a ‘big lab’ can sometimes have its issues. Try to visit your lab and become a familiar face so you have your specific technician that you can ask for whenever you send any indirect work. In that way, you can grow together – with that level of communication, the level of work you get back is so much better.
Cosmetic Dental ‘Failures’ – When Veneer Patients Change Their Minds (Medico-Legal Series) – PDP169
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!
Deep Bites and Aligners – How to Improve Predictability – PDP170
Check out the OXO 4K Camera – record clinical videos using a loupe-mounted camera.
Trusting Your Gut Instinct for Treatment Planning – PDP171
Make sure to feel the root tip fragment (rub with your gloved index finger) after extraction – it should feel nice and smooth. The presence of sharp or jagged edges may suggest a potential root fracture, indicating that a fragment of the root might still be lodged in the socket.
Deep in to TMD – An Orthopaedic Perspective – PDP172
TMDHistoryForm– which I send to all my patients before they come to see me for a TMD consultation. Premium members scroll down on the App to download.
Otherwise download from https://www.protrusive.co.uk/tmd-history
Immediate Dentine Sealing Tutorial Part 1 – PDP173
When dental work fails after a long time service, remind the patient that ‘it does not owe us anything’ and ‘What could they buy today that would last X years?’
Immediate Dentine Sealing Tutorial Part 2 – PDP174
Summarized Infographic of Immediate Dentine Sealing (IDS) Clinical Step-by-Step PDF For Premium Members of Protrusive Guidance, scroll down to download your PDF Copy
Click Here to Request your PDF Copy
Cracked Teeth and Dentistry’s Tough Questions with Dr Lane Ochi – PDP175
Intraoral Photographs:encourage your patient to capture intraoral photos on their phone, giving them a copy for reference. This empowers the patient to stay informed, facilitating their understanding and ownership of the situation
5 Ways to Stop Running Late – PDP176
Explore the Greater Curve Matrix Band for your restorations – it’s now my preferred choice for around 70% of my cases. Wherever you are in the world, find a Greater Curve dealer and discover their range of products.
Claim £100 voucher towards this matrix system when you sign up to the DRE Composite course – use coupon code PROTRUSIVE on www.drecomposite.com
The Fast Modelling Technique for Efficient and Esthetic Posterior Composites – PDP177
Composite does not like to be dragged– consider using composite brushes or a cutting action, as opposed to a dragging action, especially if using the Fast Modelling Bulk Technique.
The Bioclear Philosophy of Adhesive Dentistry – Part 1 (Posterior) –PDP178
If there’s a disagreement between you and your principal or associate about practice philosophies, arrange a face-to-face meeting. Work together to find common ground and reach a win-win solution that benefits both parties and aligns with the practice’s goals. Effective communication is key, whether it’s with our patients or our colleagues.
The Bioclear Philosophy of Adhesive Dentistry – Part 2 (Anterior) – PDP179
Protect the unrestored teeth and restorations from air particle abrasion! Using a soft steel matrix strip, similar but softer than a matrix band, protects the adjacent tooth’s enamel when air abrading the tooth.
Example one I found on the market: Polydentia soft matrix strip (no financial interest)
Managing Patient Expectations – What We Can Learn from Facial Aesthetics – PDP180
Tailoring consent to each patient involves discussing only the risks that matter to them, using standard forms for GUIDANCE, not for completeness. It’s about clearly explaining how we’ll minimize these risks, ensuring the patient feels secure and informed about the precautions taken.
For example ‘Mrs Smith, your tooth is very badly broken down and this can be a very tricky extraction. The way we are going to make it easier is by carefully dividing the tooth in to 3 roots’
NEVER Write Notes Again! How I Use AI for Awesome and Efficient Dental Records – PDP181
Register for a free EXTENDED trial with Digital TCO and transform your note-taking process by simply speaking into a microphone connected to your computer. Forget about typing out notes after appointments— the intelligent AI will craft them for you as you dictate, making everything sound fantastic.
Using the Protrusive link to sign up DOES mean that we get a commision, but I also ensured you get 50% off (for the lifetime of your subscription) AND 28 days to try this instead of 14.
‘Jaz Mode’ lets you speak to patients and nurses during consultations, with AI compiling the notes for you. Named “Jaz Mode” in my honor by Kevin, it’s still in beta but offers a glimpse into innovative note-taking. To try it out and see why I’m excited, visit protrusive.co.uk/notes.
Watch for a demo video, including my recommended microphone.
Canine Guidance vs Group Function – Does it Matter?! – PDP182
Using PTFE in the dental sulcus offers a better seal compared to cord, functioning like a dam to keep the area free of gingival fluid, ideal for Class 5 restorations.
However, PTFE may stick to instruments, which can be mitigated by moistening the instrument with water or saliva before positioning the PTFE, significantly lowering the likelihood of sticking.
Isolating the Last Tooth in the Arch #RubberDamFam – PDP183
“Cow Mode”as a technique to improve access to the mouth’s hard-to-reach areas, especially around the last molars. By instructing patients to shift their jaw to one side, akin to a cow’s chewing, this approach aids in better oral hygiene practices and facilitates procedures like rubber dam isolation when clamping the terminal molar.
Stop Being a Perfectionist – it’s OK to Fail – PDP184
We cannot be depressed AND grateful at the same time. Let us find moments in our day and in our Dentistry to be grateful.
Mental Health in Dentistry – PDP185
What are you doing on a daily, weekly and monthly basis to look after your Mental Health? Do not wait until a crisis, as we already know that prevention is better than the cure. Take the first steps in looking after your mental health with Mahrukh and her Mind Flossing Toolkit
Your Ortho Questions Answered – Root Resorption, Retention, Interceptive and More!– PDP186
Retention is not a ‘one and done’ process. It should be customised for the individual and maintained appropriately – including at every routine check up.
The Semi-Indirect Technique for Toothwear Cases – PDP187
Practice finding centric relation on your general patients, even if they are just attending for a routine examination. It is a great way to get practice!
Class II Composites WITHOUT a Wedge + Contact Opening Technique – PDP188
Pre-wedging: Use this technique before beginning any restorative work on the tooth you are working on, this will allow a greater field of view to work in. It also helps suppress the papilla to get better access to the caries.
This can all be achieved by numbing the area first and wedging with adequate enough pressure for there to be separation. It also reduced iatrogenic damage and is also worthwhile considering using a wedge-guard/fender wedge.
Onlays Vs Full Crowns – Decision Making 2024 – PDP189
Use Vaseline on the gingivae when carrying out a ‘smile trial’ or bis-acryl mock-up – will result in an easier clean up!
Does Air Particle Abrasion ACTUALLY Improve Clinical Outcomes? – PDP190
Two advantages of slicing off a corner of the rubber dam are:
- Anterior Dam Stabilization: By flossing the cut piece through the front teeth, it acts as a makeshift wedge, securely fastening the dam in place without the need for traditional wedjet.
- Simplified Orientation: This technique aids in aligning the rubber dam properly, streamlining the entire setup process for more efficient dental work.
Check out ‘Quick and Slick Rubber Dam’ online course (on-demand) only available via the Ultimate Education Plan on Protrusive Guidance
Discoloured Centrals Incisors with Jason Smithson – PDP191
To help achieve great shade selection, take pictures sequentially during your assessment and throughout the procedure, then edit the pictures to show as black and white. By analysing the shade match through a black and white process and in steps throughout the treatment, the shade selection will be far more accurate than just attempting this once at the beginning, especially without using the black and white technique, as this will emphasise the value of the shade
Which Generation Bonding Agent is the Best? 2024 Adhesive Systems – PDP192
Always read the directions for use – ESPECIALLY for your adhesive systems!
Replacing Premolars with Wisdom Teeth – Autotransplantation by a GDP! – PDP193
Clinician Development Tool is an online quiz that takes just a few minutes, assessing your level of confidence with a few other parameters that are easy to answer. Completing it all will help you zone in on achieving great development in your career, check out the show notes on how you can find it today
Trials and Tribulations of Maxillofacial DCT/SHO/Residency – PDP194
Sometimes we can get quite frustrated during procedures and it can cause us to stress ourselves out beyond the point of being effective with our patients. If this ever happens, take a deep breath, stand back and away from the working field and just take a sip of water; collect your thoughts and return with a fresh set of eyes. This usually helps to reset your mind and let you break through that obstacle with great results…and a bonus tip, maybe think twice before working on family members!
Digital Dentures for Every Dentist – The Death of Impressions? – PDP195
With indirect dental work (crowns or dentures, for example) always remember the ‘WHY’ behind each record you take. Keep your technician in mind, what benefits are they gaining, what hurdles are you placing in their path? Moreover, the patient should also be kept in mind, so be mindful of every step and make the call as to whether it is a required step or not.
[Occlusion Month] Indirect Restorations For Guiding Teeth – PDP196
Bleeding papilla? Use the HOW technique to QUICKLY stop bleeding – insert a Wedge obliquely (Haemostasis with Oblique Wedge technique) as taught by Dr Sunny Sadana from Drecomposite.com
[OCCLUSION MONTH] Vertical Dimension – Don’t Be Scared! – PDP197
Use Duralay copings for guide planes to ensure stable dentures with a single path of insertion. While eyeballing the prep can be challenging, he suggests requesting acrylic copings from the lab for precise preparation. He explains that technicians survey models to identify undercuts and determine the path of insertion, and instead of manual prepping, he advises using lab-created reduction copings and acrylic jigs to simplify and accurately guide the preparation process.
Treatment Planning Bridges vs Dentures – The Art and Science – PDP198
Failure is inevitable for our Dentistry, but try to set yourself up for smaller failures and not giant catastrophes! The real magic is in proper case selection. Practise at the EDGE of your comfort zone, but NOT out of your depth.
How to Eliminate Sensitivity During Teeth Whitening – PDP199
We’ve made an infographic to summarise this awesome episode. This one is available freely under the episode in our Protrusive Guidance App.
How to Place Posterior Composites without Destroying Your Anatomy – PDP200
When finishing off your composite work on posterior teeth, use a soft flex disc to help smoothen everything out and attain great exit angles; the same can be used in anterior teeth, to help reinforce your bevels. Jaz suggests a coarse disc with backwards strokes to achieve these lovely angles
Diamond Burs Made Tangible – Clinical Applications and Guidance – PDP201
When drilling off a zirconia crown, do not be tempted to use a coarse or super coarse bur as these are inefficient, slow and generate a lot of heat. Instead, try a blue or red grit diamond bur to be more efficient with your cutting
Elective Endodontics? It’s all about Communication – PDP202
Dr. Pav Khaira suggests using Alvogyl, commonly used for dry sockets, to treat pericoronitis! After cleaning and disinfecting the area, place a small amount under the operculum for immediate relief and to soothe inflammation.
Endodontic Irrigation – How to Get Better Success – PDP203
Before performing a molar extraction, challenge yourself to first complete an endodontic access on the tooth. This will enhance your understanding of the canal anatomy and improve your precision in sectioning the tooth. By visualizing the canals and the pulpal floor, you’ll refine your angulation for more accurate sectioning.
Implant Occlusion that Makes Sense! – PDP204
Dr. Pav Khaira has created a free implant assessment form, now available to the Protrusive community. Accessible at www.protrusive.co.uk/implant – this responsive PDF includes key areas like patient goals, biotype, and occlusion, with an 8-minute video guide for easy use.
Making Awesome Dentures – Border Moulding and Beyond – PDP205
When checking denture occlusion, it’s crucial to keep the patient relaxed. Mike suggests one simple trick: ask the patient to close their EYES before closing their teeth. This can sharpen their senses, helping to improve the bite assessment.
White Patches – When to Refer + Diagnoses ORAL MED – PDP206
A new infographic summarizing Dr. Amanda Phoon Nguyen’s key teachings. Jaz describes it as an easy-to-follow “cheat sheet” designed to simplify complex ideas and make it easier to apply the concepts discussed in the episode.
Step by Step Functional Crown Lengthening – PDP207
Using a periodontal probe, go into the depth of the sulcus, pushing deeply until you hit bone, all while recording the measurement with the probe. This measurement will then guide you on how to carry out your crown lengthening procedure. Push hard to pass the connective tissue and ensure you are touching the bone.
The Most Important Part a Beautiful Smile – Pink Esthetics with Dr Tidu Mankoo – PDP208
- Composite button technique – a small blob of composite is applied to a dry tooth without etching or bonding to assess shade match and translucency, avoid excess thickness, which can affect opacity and aesthetics (Jason Smithson’s Tip: take a black-and-white photo to evaluate the composite’s value and ensure it matches the natural teeth)
- Using a custom composite shade guide like Smile Line by Style Italiano for more precise shade matching.
12 Key Lessons – New Year Special Episode – PDP209
Take time to reflect on your goals for 2025 and consider what sacrifices you’re prepared to make to achieve them. Emphasizing the importance of writing down both your objectives and the trade-offs they require, align your time and priorities with your personal and professional aspirations.
“You overestimate what you can achieve in a year and underestimate what you can accomplish in ten years.” Productivity is about knowing how badly you want something and what you’re willing to sacrifice to achieve it.
Managing Extractions Complications with Nekky Jamal – PDP210
The “Niche Kebab” concept encourages dentists to narrow their focus by reducing the variety of procedures they perform and prioritizing those they genuinely enjoy. By evaluating every new skill or treatment added and strategically dropping less-loved procedures, dentists can avoid overextension and the “jack of all trades, master of none” pitfall.
Decision Making for Anterior Composites – PDP211
Use a zirconia primer which contains 10-MDP (e.g. Monobond, Z-Prime Plus) on the intaglio of crowns to enhance bond strength, even with conventional cements like GIC. This low-risk, high-reward tip improves retention, especially for teeth with limited height. Incorporating a zirconia primer can significantly improve outcomes without switching to resin cement.
How to Manage TMD When The Evidence Base Sucks – PDP212
Let emotional patients fully express themselves without immediately offering tissues—listen attentively and allow them to finish their story before responding. This fosters deeper connection and understanding.
TMD New Guidelines! Evidence-Based Care – PDP213
Important takeaway: Download the New TMD Guidelines
How to Temporise Veneers Step by Step FULL GUIDE – PDP214
Aodhan recommended a chlorhexidine-based mouthwash to reduce inflammation but advises using an ADS (Anti-Discoloration System) mouthwash to avoid staining. The ADS system helps maintain healthy tissue response, preventing bleeding and inflammation on the day of veneer placement while eliminating the discoloration commonly associated with standard chlorhexidine products.
Medication Related Osteonecrosis for GDPs – What You Need to Know (MRONJ) – PDP215
It is so important to assess patients before they start taking high-risk medications like bisphosphonates or biologics, using radiographs to identify potential issues. Extractions should ideally be done before medication starts to avoid complications, as MRONJ risk increases once treatment begins.
Working Lengths and Troubleshooting Apex Locators – PDP216
Buy a small whiteboard and marker for patient communication. Draw details, highlight the treatment plans, and list pros, cons, and fees. This builds trust, improves consent, and makes treatment clearer. Snap a photo and upload it to the patient’s records.
Your Endodontics Questions Answered! – PDP217
For a more visual learning experience, dive into the Pre-Endo Build-Up on Protrusive Guidance and see Jaz and Samuel’s insights in action.
Decontamination CPD Made Enjoyable! – PDP218
Pete’s Expert Recommendation on Cleaning your Loupes
- Ideally, loupes should be disinfected between every patient, but at the very least, at the end of each clinical session
- Avoid submerging loupes in any liquid – instead, use distilled water and a microfiber cloth or cotton buds for frames and nose pads
- For lenses, use 70% isopropyl alcohol wipes – no acetone or bleach!
- If you’re using a visor with your loupes, you won’t need to clean them as often
Minimal Preparation Veneers – PDP219
lways Wax Up for 10: When planning veneers, start with a 10-unit wax-up (even if the patient initially wants 4 or 6). This allows them to visualize their full smile with a mock-up, compare different options, and make an informed decision. It’s not about upselling – most patients will appreciate the fuller look.
My Neck, My Back (Fix Your Posture While Removing Plaque!) – PDP220
Motion is lotion. Staying active prevents back pain and keeps your career strong. If you’re not making time for exercise, it’s time to rethink your habits. Knowing isn’t enough—action is what matters. Prioritize your health now.
Pascal Magne on Occlusal Veneers and Material Selection – PDP221
After applying silane, don’t just let it evaporate—let it react for 30 seconds, then air dry, and crucially, use a heat source (like a hairdryer) for 60 seconds to activate it properly and achieve optimal bond strength. This enhances the effectiveness of silane and significantly improves the bond strength of indirect restorations like composite or lithium disilicate.
Connective Tissue Disorders and Dentistry – PDP222
Don’t just take a “relevant” medical history—take a comprehensive one! Encourage patients to share all health issues, even those they don’t think relate to dentistry. You might uncover important clues about conditions like connective tissue disorders or sleep-disordered breathing, leading to better care and stronger patient trust.
Understanding TMD Radiographic Imaging – Pano vs CBCT vs MRI – PDP223
Don’t lose touch with the magic of in-person learning — balance online education with attending live conferences to connect with peers, meet mentors, and experience the true essence of dentistry!
Basics of 3D Printing, Milling and Digital Dentistry – PDP224
Achieving the same effect (of the ‘Soft Clamp’ by Kerr) with a metal clamp without requiring a potentially painful palatal injection – Dr. Jo Cape (Protruserati) suggests using a cotton bud to apply topical anesthetic to the gingiva where the clamp will be placed, leaving it for a minute, improving patient comfort!
Occlusion Myths and Red Flags with Lukasz Lassmann – PDP225
Use a comprehensive TMD history-taking form to effectively triage patients into urgent (red), moderate (amber), or low-risk (green) categories—this allows you to prioritize care appropriately and build rapport by focusing on examination rather than data collection during the appointment.
5 Airway Patients In Your Dental Practice Right Now with Dr Liz Turner – PDP226
“Don’t stay stagnant—keep learning, keep growing, and reinvent yourself every 5–10 years.” Think of your dental career in seasons—explore new areas, refine your interests, and let go of what no longer brings you joy. This keeps your passion for dentistry alive and evolving.
Zirconia vs Metal Hall Crowns vs Conventional with Dr Tim Keys – PDP227
One of our best ever Protrusive Infographics! This week’s Pearl is a handy downloadable PDF infographic summarising the key points from this episode on Children’s Crowns Techniques. Grab your copy here!
Why Injection Moulding Composite is Superior to Layering – PDP228
- When in doubt between two shades (e.g., A1 vs. A2), always choose the lighter shade. Higher-value shades blend better and result in higher patient satisfaction.
- Techniques: Use the composite button method and black-and-white photography to objectively evaluate shade blending.
- Outcome: Lighter shades minimize the risk of patient dissatisfaction and rework.
Airway Dentistry with Jeff Rouse – PDP229
Plan your breaks 12 months in advance to avoid burnout and ensure quality time with your loved ones. Prioritize rest and connection before reaching exhaustion—your body, mind, and heart will thank you.