Protrusive Dental Podcast

This podcast will change the way you think about pulpotomies and endodontics in general.  Georg Benjamin explains that severe throbbing pain (or classic signs of IRREVERSIBLE PULPITIS) does not necessarily mean a pulpectomy is needed. Instead, we can consider a pulpotomy for permanent teeth to preserve radicular pulp tissue and maintaining a vital tooth! Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE answering a few questions + EXCLUSIVE content: https://youtu.be/PoWDRz714uQ Check out this full episode on YouTube Protrusive Dental Pearl: 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! Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 2:02 Protrusive Dental Pearl4:47 Georg Benjamin’s Dental Podcast Journey7:10 Georg’s Endodontic Journey11:46 Case Discussion: Pulpal Diagnosis16:17 Pulpotomy19:37 Direct Pulp capping 22:26 Indirect Pulp Cap23:58 Pulpotomy Protocol26:59 Classifications of Pulpotomy 30:52 Bleeding Time Protocol33:31  Patient Communication 35:34 Treatment Decision-Making38:57 Success rate of pulpotomy41:10 Early and Late failures42:30 Long-term treatment45:14 Unhealthy pulp48:08 Materials and Products for Pulpotomy50:54 Leaving carious dentine as base For our German Protruserati, check out Georg's Dental Podcast If you enjoyed this, you might also like this episode with  Dr Ammar Al-Hourani 'Is Single Point Obturation Acceptable?' Click below for full episode transcript: Jaz's Introduction: Grab your onions Protruserati, because this podcast will change the way you think about a pulpectomy, you will probably do way LESS EXTIRPATIONS and committing to a root canal. Jaz's Introduction:And this episode really challenges our beliefs that we hold in terms of what requires a root canal treatment, ie we were trained that irreversible pulpitis equals pulpectomy, which is a root canal right? Now, that's what I was taught to. But what is happening now in endodontics, is brilliant. And Georg explains it really well, with his lovely German accent, we go over the fact that nowadays, whenever a patient comes to Georg, with irreversible pulpitis , that you know, severe throbbing ache, it does not mean root canal for him anymore, it means a PULPOTOMY OF THE PERMANENT TOOTH, it means a pulpotomy of a vital permanent tooth, which then hopefully, will preserve that radicular pulpal tissue, and therefore, the patient will not require a root canal treatment anymore. So, it's pretty different. Now, maybe you're already seasoned in this, maybe you've already using MTAs, and whatnot. And that's amazing. Good for you. But for a lot of dentists, I imagine this is like, wait, what do you what do you mean, we don't have to do I commit to a root canal anymore like we can, we can actually do a pulpotomy for an adult, let alone one that we have diagnosed as, quote unquote, 'irreversible pulpitis', which actually Georg argues, is a poor term. Welcome, Protruserati. I'm Jaz Gulati, I'm your host. And if you're new to the podcast, welcome. It's great to have you. If you're a veteran, and you've been with me for many years, it's always a pleasure to have you. This one's a really cool episode, I didn't think before I recorded it, that I'll be having so many moments of laughter with our guests, Georg Benjamin, who was not a specialist in Germany, he is pretty much limited to endodontics. And he's been following vital pulp therapy or pulpotomy of vital adult teeth for a long while now. And he's got some great views on it. And if you listen to the end,

Did you know that Dentistry was voted the unhealthiest career in the world? Multiple times. That's right, we're number one! The grim reality is that we take on all sorts of professional and personal risks on a daily basis. I had the opportunity to sit down with Dr. Rohan Verma, a clinical dentist and fitness coach to record this wholesome episode. We talked about what steps we can take to improve our health. At the end of our conversation, we also talked about diet as well. I hope this episode will address our unique professional challenges and help you become healthier and more mindful about everything you're doing for mental and physical well-being. https://youtu.be/xubc_XpSrzI Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 1:51 Dr. Rohan Verma’s Introduction3:46 Mental Health Awareness6:39 Biggest mistakes dentists are making with their health 11:09 Posture Issues14:50 The significance of sleep16:52 Importance of setting a routine for better health improvement24:16 Working out routine29:09 Dr. Rohan’s stand on different kinds of diet31:29 The benefit of calorie counting Check out Dr. Rohan Verma's Instagram to get some tips on how to improve your health - as well as a Dentist he's an online fitness coach. Monitor your calorie intake with this MyFitnessPal: Calorie Counter available on: iOS: MyFitnessPal: Calorie CounterGoogle Play: MyFitnessPal: Calorie Counter 📨 Download Protrusive App and Claim Verifiable CPD/CE + EXCLUSIVE content: iOS: Protrusive AppAndroid: Protrusive App If you enjoyed this episode, then do check out 5 Lessons from Lincoln Harris  Click below for full episode transcript: Jaz's Introduction: Did you know that Business Insider ranked DENTISTRY as the MOST DANGEROUS PROFESSION in the whole world for your health, and they did this multiple years in a row. So, why is it? Why is our job so dangerous? Jaz's Introduction:I think we know the answers. We're in this horrible posture, we've got this infection control risk, we are sat in this four walls with just one other person, usually. That's gonna drive you mad, as well as the extreme stress that we undertake in our profession of clinical dentistry. So, whether you are a dentist, a nurse or a DA as they're so affectionately called in the US, or if you're a therapist or hygienist. I think you have something to gain from this episode about looking after your health in the space of dentistry. Now, who better than Dr. Rohan Verma, who is a clinical practicing dentist, and also a fitness fanatic and a fitness coach to professionals. So, I brought him on to talk about different things like what are the big mistakes we're making in our profession? In terms of how we're NEGLECTING OUR HEALTH? How can we IMPROVE our WELL-BEING in this profession? And we also pivot and talk about some other things that I'm quite interested in like towards the end, we talked about diet, right? I know many of you know I do a lot of intermittent fasting. So, I will not eat my first meal quite often until, you know, one or 2pm and then I'll have like a five or six hour window where I consume all my food. So, what does Rohan think about that? What does he think about paleo diet or carnivorous diet or keto? So, I asked him about this kind of stuff. But before then, we talk about how we can recognize that something's not working for our health and what are the actionable steps that we can take to better improve our health. Welcome to the podcast. My name is Jaz Gulati. You are the Protruserati because now you're listening to this and if you're new to the podcast, welcome. This segment of the podcast is an IC, so an interference costs. So, slightly pivot away from clinical dentistry. If clinical dentistry is more your thing, then most of my episodes are that but I do like to talk about things that I'm interested in. So, whether it's well-being,

Do you believe that Resin Bonded Bridges are exclusively a temporary or short-term solution? Lots of our colleagues around the world mistakenly believe this. It's not a secret that I am a fan of this treatment modality—I want to break down the misconceptions about them because IN THE RIGHT CASE they can be a very predictable tooth replacement option. In this episode, Dr. Salman Pirmohamed shared successes and failures and what we can learn from them to improve our clinical protocols from abutment selection to adhesive techniques. Claim 75 minutes CE on Protrusive App. https://youtu.be/rKJyqcb6uqI Check out this full episode on YouTube The Protrusive Dental Pearl: 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. Salman's Webinar on Sunday 4th Dec LIVE: https://buy.stripe.com/4gw14Pb8Q47Q8yk5kk Need to Read it? Check out the Full Episode Transcript below! Highlight of this episode: 1:48 The Protrusive Dental Pearl3:17  Dr. Salman Pirmohamed’s Introduction 8:16 Resin-bonded Bridges being underutilized9:43 Resin-bonded bridges over the years and its Protocol12:18 RBB - functional for patients?17:26 Case Selection Criteria20:25 Case Number 122:43 Case Number 223:16 Dahl Technique on RBB24:57 Cantilever as the standard design of choice for RBB27:40 Case Number 329:25 Case Number 432:47 Mesial cantilever vs Distal Cantilever37:34 RBB Lab Prescription39:43 Incisal Overlap42:06 Pontic Design ideal for RBB47:48 RBB Clinical Protocol1:00:09 Zirconia RBB protocols1:06:46 Periodontal Splinting1:15:21 Two failures with Resin-bonded bridges Have a read about this evidence-based literature as referenced by Dr. Salman Survival-characteristics-of-771-resin-retained-bridges-provided-at-a-UK-dental-teaching-hospitalDownload Also, check out this paper written by Dr. Jaz Gulati Resin-Bonded-Bridges-−-the-Problem-or-the-Solution Part 1Download Resin-Bonded-Bridges-−-the-Problem-or-the-Solution-Part-2Download If you loved this episode, you might also love this Group Function talking about Dahl Technique and ‘Maryland Bridges’ Click below for full episode transcript: Jaz's Introduction: This episode is dedicated to any dentist in the world who thinks that RESIN BONDED BRIDGES, or dare I say Maryland bridges are a temporary or SHORT TERM SOLUTION. Jaz's Introduction:I've got plenty of friends in North America and in Singapore who felt that way. And I just feel like it's a massive misconception because resin bonded bridges, or sticky bridges or adhesive bridges, call them what you want. They are such a fantastic and UNDERUTILIZED TREATMENT modality to replace missing teeth. Hello, Protruserati. I'm Jaz Gulati. And it's no secret that I'm a huge fan of these bridges. I've published about this technique before and something that I did a lot of in dental hospital. And I took this into private practice. And the funny thing is that when I started to work in the practice that I work in now in Reading the dentist whose list I inherited, who was working there for 30 plus years, he was also a huge fan of resin bonded bridges. So, I've had the privilege of looking after and reviewing patients who've had their resin bonded bridges, both anterior and posterior in service for 34 years, 32 years loads in the 27, 28 year mark, plenty in the 20 year plus mark. So, he was fantastic at doing them. It really validated my belief system in resin bonded bridges. But I know what you're thinking, you're thinking, 'Jaz, that's like N equals 15. How is that even valid in this world of evidence based dentistry?' Well, let me tell you, the evidence is out there.

How often do you review your risk management? Do you follow the appropriate radiography guidelines or palpate canines when you are supposed to? These are not the exhilarating or rewarding parts of our clinical practice but they are fundamental and foundational. In this episode with Dr. Lucy Nichols, a general dentist who also does some dento-legal work in the UK, she shares her 10 commandments for safer dentistry and avoiding dento-legal claims. https://youtu.be/0MhOC-LLxbI Protrusive Dental Pearl: '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. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 1:17 Protrusive Dental Pearl4:33 Dr. Lucy Nichols’ Introduction8:08 10 Commandments for Staying Out of Trouble: Thou Shalt Take Bitewings on Children 9:08Thou Shalt take Bitewings on Adults 13:31Thou Shalt Always be Suspicious of a Non-healing socket 15:29 Thou Shalt Always be Suspicious of Sore Patches on the Side of the Tongue or on the Cheek 18:21Thou Shalt Know How to Deal with a Hypochlorite Injury 21:24Thou Shalt Not Use Chlorhexidine Mouthwash as your Root Canal Irrigant 30:34Thou Shalt do Further Charting when you have 3s and 4s on your BPE 35:06Thou Shalt Not Rely on Only a Single Visit Scaling without Local Anaesthetic on Patients with Increased Pocketing 40:42 Thou Shalt Not Underestimate ID Nerve Injuries 45:29Thou Shalt Always Palpate for Canines at Age 10 53:39 PDF Infographic available in the 'Protrusive Vault' in the App (iOS and Android) Check out Dr. Lucy Nichols website If you loved this episode, please check out Passion and Values in Dentistry Click below for full episode transcript: Jaz's Introduction: When was the last time you did some risk management CPD? What I mean by that is, you went on a course to learn about how to be a more careful dentist, how to follow appropriate radiography guidelines or cross infection protocols, that kind of stuff. The stuff that's not sexy, unfortunately, right? Jaz's Introduction:Let's face it, you know, it's a composite veneers. That's where we gonna go on. But you know, this is super, super important stuff. And today's episode which we streamed live to Facebook. So thank you, Dr. Lucy Nichols, for being part of that live. And so we do have a few shoutouts here and there. And thanks to all of you who joined live on Facebook, it's on the Protrusive Dental Podcast facebook page, if you're not part of it already. Occasionally we do the live and it was a great episode. These are the 10 COMMANDMENTS FOR STAYING OUT OF TROUBLE. And where they stem from is Lucy Nichols who is a general dentist, she does some dental legal work. And as part of seeing lots of cases, she saw a pattern that dentists, us dentist we're getting in trouble. And were tumbling down as easy victims, booby traps, were falling into these obvious errors, which she wanted to share with you to make sure that we can be SAFER DENTISTS and avoid getting claims and having legal troubles. So, hopefully you'd like all these 10 Commandments by Lucy, so I only knew the first one and I loved it so much. I said, 'Okay, come on. Let's do the podcast, tell me the other nine.' So, we'll share them all with you. The Protrusive Dental Pearl:The Protrusive Dental Pearl I want to share with you before we get to that main episode is kind of related to the first thing I said in my introduction, which is DO WE MAKE TIME FOR THE RIGHT TYPE OF CPD? And on that topic of time, let's take a step back right? MAKING TIME. We all have just 24 hours a day, every single one of us whether you're Richard Branson, or Rishi Sunak, the new Prime Minister of the UK, I try not to get into politics. So, I'll stay away from that one.

I am a big believer that the culture of your work place is probably the number one determinant of your fulfilment and joy from clinical Dentistry. https://youtu.be/cGFpxUn6WXw Check out this full episode on Youtube. In this non clinical episode I talk with Dr. Sandy about his past experiences and the reasons he had to make a significant change in order to find fulfillment in his career. We also discuss how to recognize a toxic culture in Dentistry and how to stand up for yourself if you're in one of those environments. We hope this episode inspires you to take some sort of action, whether it's small or large, that will improve your enjoyment of work. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 2:13 Dr. Sandy’s Introduction3:16 Dental Public Health Experience6:16 Dr. Sandy’s Transition from Public Health to Private Practice10:11 Taking massive action14:10 Recognizing a toxic working culture17:29 Stepping out of the toxic work environment19:33 Significance of having a plan for your career24:57 Importance of taking clinical photos29:26 Improving Dentistry through social media34:48 Dealing with litigations and patient complaints41:55 Recognize solutions rather than problems If you enjoyed this episode, you will also like Being Unstoppable with Ferhan Ahmed Click below for full episode transcript: Jaz's Introduction: Hello Protruserati, I'm Jaz Gulati and welcome to this interference cast, where we explore a NON-CLINICAL INTERRUPTION. And this one is huge. This one is so big picture. There's a lot of clinical themes in here. But this is very much bigger picture LIFE DESIGN stuff. Jaz's Introduction:What if you're in a scenario where you are really struggling in your workplace? Sometimes dentistry can be like super isolated, feel really lonely, it's just you and your nurse. And it can get a little bit depressing, especially in the winter months I find. So, community and mentorship and the right culture, oh my goodness, the culture at your workplace, the nurse at your workplace, the relationship with your nurse, or your DA is so, so key. So, these are all the themes that we cover with Dr. Sandy. So, Sandy is this dentist, who and you will hear his story in the podcast, but he was not in the happiest of places. And so, we discussed all about that, and how he had to make a major change and move hundreds of miles away to be able to gain fulfillment from his career. And that's why I wish for everyone I wish every Protruserati gains fulfilment from dentistry, because it's a truly wonderful profession. But guess what, this wonderful profession can be an absolute stinker, if in the wrong environment or even a toxic culture. So, in this episode, we'll discuss all about that, how to recognize it. And what can you do, you have to just stand up for yourself, you have to be your biggest advocate. And I hope this episode inspires you to take some sort of change. If you are identifying with all the things that Sandy saying today, I want you to stand up for yourself and make a change. It's never easy, because comfort zones are very comfortable, they're very nice to be in. But growth never happens in comfort zones. So, guys, I hope you enjoy this episode with Dr. Sandy. And I'll catch you in the outro. Main Episode: Dr. Sandy Rupra, welcome to the Protrusive Dental Podcast my friend. How are you? [Sandy]I'm very good. Thank you, Jaz. How are you? You, okay? Thanks for having me. [Jaz]Very good. Thanks. No, no, thanks for making time for this. So, we spoke a long while ago now, you're very inspiring. And the kinds of things that you're telling me in terms of helping dentists finding where they want to be in a more thriving environment, a better environment and while they're working, enjoy themselves. And it was from your own experiences of going through the LOWS, that we can speak about how to attain the HIGHS. So, before we delve into your story,

Have you ever prepared the last molar for a crown? And just when you check the occlusal reduction, the patient bites down and as if by magic, the reduction has all DISAPPEARED?! It is the phenomenon that we call ‘The Last Tooth in the Arch Syndrome’ This episode with Dr. Mahmoud Ibrahim will give you more confidence in recognizing, screening, and managing such complications in practice. But like I say in the main episode, optimistically, this phenomenon will never happen to you AGAIN if you follow these protocols for screening. https://youtu.be/gs1r5mlefHU Check out this full episode on YouTube Protrusive Dental Pearl:  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. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 2:41 Protrusive Dental Pearl6:09 Introduction to Dr. Mahmoud Ibrahim9:34 What is Centric relation?10:45 Last tooth in the arch syndrome13:14 Risk assessment for Last Tooth in the Arch Syndrome15:52 Screening patient's CRCP and the degree of slide17:33 Leaf Gauge protocol for screening CRCP30:23 Communication with High-risk patients34:35 Case Discussion44:36 Management of space loss after preparation46:24 Dr. Mahmoud's top tips to prevent the 'Last Tooth in the Arch Syndrome58:47 Occlusion Basics and Beyond Dr. Mahmoud Ibrahim and I are currently working on a huge project called OBAB, Occlusion Basics and Beyond - it will be the best occlusion resource in the Milky Way...and that's our mission! We want to finally demystify Occlusion and make it Tangible AF! Join the waiting list HERE! If you loved this episode, you will like If You are Not In Centric Relation, You Will Die Click below for full episode transcript: Opening Snippet: Because it sounds horrible, but if it's happened with all the sequelae of you losing space and bite changing, that is a big deal. I mean, this patient that might be looking at ortho might be looking at a rehab, who's paying for that? Chances are you. So for two minutes screen that you can do. And once you get good at it, it's, it's really, really quick. Just to buy yourself that peace of mind and being able to inform the patient and gain proper consent when you're restoring the terminal tooth or maybe the one in front. That two minutes is worth it in my opinion. Jaz's Introduction:Have you ever prepared the second molar or the last molar of the patient's mouth for a crown? And when you've checked the occlusal reduction, you get the patient to bite together. And it's as if you NEVER DID ANY OCCLUSAL REDUCTION. You think what the hell is going on? I swear I just sunk a two millimeter bur into this tooth. And now it's like there's hardly any space there. What's going on? Has that ever happened to you? Has that problem bitten you? Have you had that dreaded phone call from the lab saying, 'We need a bit more space here, Doc.' If you experienced this, you probably searched it and spoke to prosthodontics and got some information about LAST TOOTH IN THE ARCH SYNDROME where that space magically disappears. What's behind that? Why is that happened? Why, if you're not careful, it could happen to you could happen to anyone I know some great dentists. And it's happened to them. So no one is immune to this. However, the topics that me and Mahmoud Ibraham, my guest today will make sure that you will a be able to screen when this issue might happen. Have a conversation with your patient ahead of time and sometimes consider a change of treatment plan because you know that as soon as you prep the second molar, you're likely to lose space and to have that knowledge and screening for assessment is just absolutely fundamental. And of course,

From the entire Protrusive Community - we wish Sanj a speedy recovery - keep smiling Sanj and stay strong! In the previous episode with Sanj Bhanderi on 'how to extirpate properly and efficiently', we briefly touched on postoperative pain control. In this episode, we're focusing more on postoperative pain and the dreaded severe pain after the obturation appointment (or in-between visits). https://youtu.be/RJzQZNhBup0 Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Highlight of this episode: 2:27 Post-op pain after endodontic treatment7:43 Flare-ups9:46 Guidelines in antibiotic microbial management11:03 Flare up in between visits (RCT has not been finished yet) 13:40 Crown Down approach Dr Finlay Sutton is coming down South for his one-day signature RPD Masterclass on Saturday 14th of January 2023!  Limited to 12 delegates, reserve your seat now! If you enjoyed this, you might also like my episode with another talented Endodontist, Dr Ammar Al-Hourani, on Is Single Point Obturation Acceptable?  Click below for full episode transcript: Opening Snippet: I wanted to start this podcast with a get well soon message for our guest, Dr. Sanj Bhanderi who did such a brilliant job with our last group function on how to extirpate quickly and properly. Now, unfortunately, after we recorded that episode, and after we recorded this one, Sanj felt acutely unwell. It was actually scary hearing the news of him being ill. But I'm getting some positive updates. And so we the Protrusive Dental Community, and then all dentists around the world. We wish Sanj a speedy recovery. We hope you get well soon. We're so glad you're okay and on the mend. And we want to pass on these wishes to you. It's been quite clear on social media, what a likable guy you are, and how much we all want you to make a speedy recovery mate. So wishing you all the best and get well soon from Team protrusive. Jaz's Introduction:I bet this scenario sounds very familiar to you imagine you're on a course you having a great time. I personally love courses, I think you all know that. You're on your fifth coffee, and everything's going great. And suddenly your pocket starts vibrating. You've got a call from the practice or text message informing receptionist saying that, 'Mrs. Smith, you know, the root canal that you saw yesterday, she's in absolute agony.' And you curse because you think wow, you know, that was a completely straightforward root canal procedure. The patient was asymptomatic before you even started. Why is this happening for me? Look, post-op pain after endodontics is an absolute bitch. It's one of those annoying things ever actually puts me off doing root canal treatment because of the one in harmony of a chance that post op pain instance is going to happen. And I'm going to discuss with Sanj Bhanderi who does such a brilliant job in that GF016, where we talk about how to extirpate properly and efficiently. So if you haven't listened to that one, oh my goodness, you are in for a treat. Go back and listen to that one. But in this episode, we're focusing more on post op pain like how do you manage that kind of scenario? What do you say to the patient? How can you prevent this from even happening in the first place? You know, it's funny I've actually had four root canals on my own self and before you think, 'Oh, Jaz is disgusting, you got caries, etc.' No, it's actually trauma from orthodontics. Can you believe it? Orthodontics devitalize, my lower four incisors, and I've had all sorts of issues and root canals and fractures, etc, etc. And now have a resin bonded zirconia bridge, hence why I'm so passionate about those bridges. Anyway, I experienced post op pain myself, it was a nasty thing. It was lots of inflammation. And so I've been there and I totally empathize with my patients. Before we joined the main episode I want to say yesterday I released new tickets to Finlay Sut...

Have you ever been planning a smile (this could be a complete denture or some veneers!) and thought 'where do I begin'? Planning aesthetic dentistry involves more than just the teeth. A great smile is 'facially driven' - where do the teeth sit in relation to the face?Today we are joined by Dr. Josh Rowley to share the four rules of planning Aesthetic Dentistry (you will love them). https://youtu.be/2jbfK2WU1e4 The Protrusive Dental Pearl: Don't start complex/comprehensive treatment on someone who is not sure or not motivated. Need to Read it? Check out the Full Episode Transcript below! Highlights in this episode: 2:58 The Protrusive Dental Pearl - Communication Tip14:49 Screening for the first point of contact for Orthodontic patients16:36 Four rules of planning Aesthetic Dentistry35:10 SureSmile Aligners39:35 Low trim height41:24 High trim height44:03 Support system for Sure Smile Check out the courses that Dr. Josh teaches through IAS Academy and SureSmile Aligners Click below for full episode transcript: Opening Snippet: Because it sounds horrible, but if it's happened with all the sequelae of you losing space and bite changing, that is a big deal. I mean, this patient that might be looking at ortho might be looking at a rehab, who's paying for that? Chances are you. So for two minutes screen that you can do. And once you get good at it, it's, it's really, really quick. Just to buy yourself that peace of mind and being able to inform the patient and gain proper consent when you're restoring the terminal tooth or maybe the one in front. That two minutes is worth it in my opinion. Jaz's Introduction:The first rule of planning Aesthetic Dentistry is so key that everything about the smile just falls into place from this very first rule. I've got Dr. Josh Rowley today to share the four rules of planning Aesthetic Dentistry. Hello Protruserati, I'm Jaz Gulati and welcome back to your favorite dental podcast. It's been a crazy few weeks for Team protrusive. Just few weeks ago, we hosted Lincoln Harris live in London for his famous destress dental lecture. And let me tell you, this was a MASTERCLASS in theatrics, comedy, dental comedy, and public speaking. It was just a PHENOMENAL lecture. And I've actually got his slides on my desktop, and for eight hours that we spoke for seven hours, right. And he only had like 38 slides. This is a sign of a phenomenal speaker. He barely looked at slides, yes, so much conviction in his message. And the lessons he shared was so real, well, a lot of big, bigger picture communication type stuff to reduce our stress in dentistry and a few slides here and there and then delving deeper into it. It was just, such an engaging lecture. There's very few people I think, can hold and captivate an audience for six hours during the day and you learn so much at the same time. It's just absolutely brilliant. So, hats off to you Linc for that. And I met so many of you for the first time it was great to connect with the Protruserati. Safina came all the way from Northern Ireland. She's a dental student, it was great that you made that trip. She's part of our telegram group. So Safina, a personal thank you for, for coming out that way on a day where there were so many train strikes from around the UK. So, thank you so much. And a shout out I mean, I can't shout out all of you. There's like so many I met for the first time. It was to privilege but a shout out Sagar Patel. Sagar is someone who told me a story. When he met me, he said that the influence that protrusive had on him was so big. And the protrusive dental community Facebook group helped him to connect with his now principal. And he's in a good place and happy environment. And that just made me feel so warm and fuzzy and happy. And in fact, we've been connecting and exchanging messages on Facebook. And then we had this photo that we took together, and he said, 'May I owe my whole inspiration of dentistry back ...

When you Extirpate a Hot Pulp - do you need to find ALL the canals? Do you need to file to the apex? Which is the sedative of choice? In this episode, we've got specialist Endodontist Dr Sanj Bhanderi to talk us through the CORRECT way to extirpate teeth in acute pain WITHOUT wasting time or making things worse for future treatment. It's packed full of gems for pain relief, diagnosis and isolation. So, what is your protocol for extirpation? This episode is all about how to get the job done right and minimize discomfort for your patient. https://youtu.be/SjYWxr1sSDc Click Here to watch this episode on YouTube. For the full notes check out the Protrusive App on iOS and Android. “I call it Ninja endodontics - get in and GET OUT - Stealth!” Dr. Sanj Bhanderi Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 2:38 Dr. Sanj’s journey to Endodontics6:30 Emergency extirpations8:42 Diagnosis Protocol Irreversible Pulpitis11:57 Anaesthetic for Hot Pulps15:33 Caries and Restoration Removal Before Extirpating?19:16 Vital pulp therapy21:19 Isolation Protocol25:30 Sedative Dressing for Acute Pain28:42 Temporary restoration of choice31:39 Post Op Medicaments Tune in for the Part 2 of this episode - next week we cover post-operative pain after endodontic treatment. If you enjoyed this, you might also like my episode with another talented Endodontist,  Ammar Al-Hourani, on Is Single Point Obturation Acceptable? Click below for full episode transcript: Opening Snippet: /Jaz/ In ideal world, we'd love to remove the entire restoration. Remove any caries, access cracks but when I have 20 minutes we need to get in go for the kill. Is that okay? Can you forgive us? /Sanj/ At the end of this. This is about patient, this is about getting the patient out of pain. Okay, and you just need to get in there. I used to call it ninja endo get in there, get the job done. Get out before patient realizing it. That's my principal in endo whether it's emergency or Endo. You want to- /Jaz/ Stealthy. /Sanj/ STEALTH. Stealth. Okay? Jaz's Introduction:What is your current protocol for EXTIRPATION? So let's say you made a diagnosis of irreversible pulpitis. Your patient is in raging pain. And you have to squeeze in this pain relieving treatment, a extirpation probably of a lower molar or something in five minutes. What are you going to do? Well, some of you will listen to this and it will be validation and revision. And you'll be thinking wow, I've been doing it right all this time, even though I thought maybe I was taking shortcuts but actually I've been doing it right all this time and others will be like whoa, this is so much easier compared to what I'm doing at the moment because the big hint I can give you is that you don't even need a K file for your molar extirpation anymore after today, because I've got Dr. Sanj Bhanderi, specialist endodontist to talk us through what is the right way, the proper way to do an extirpation of your patient who is in pain. And there are just so many gems from pain relief, diagnosis, isolation, and what I love about Sanj in this episode, is that he's not dogmatic. Yes, he's a specialist endodontist and so easy for him or anyone say you must always use rubberdam. But yes, he does discuss a scenario that okay, if for whatever reason, you had to do it without rubberdam, how can you optimize the isolation? How can you reduce the saliva getting inside the tooth, so I really appreciated that about this episode. I'm sure it hope you will as well. It's very much in tune with the real world. And lastly, we do cover his step by step what is the right and proper way to do an extirpation without wasting time and without actually making things worse for future treatment. Main Episode:So hope you enjoy this episode. And I'll catch you in the outro. Dr. Sanj Bhanderi. Welcome to the Protrusive Dental Podcast. How are you my friend? [Sanj]Very well. Thank you,

Orthodontics for the mixed dentition is not well taught at Dental School - for which malocclusions should you intervene and by what age? Dr. Amanda Wilson will show you how to identify whether early or interceptive orthodontics is right for your young patients as part of their antero-posterior, vertical and transverse development. https://youtu.be/8OksXwy_yDQ The Protrusive Dental Pearl: 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 Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 1:58 Prevent misdiagnosing ectopic canines8:55  Difference between Interceptive and Phase one16:15 Phase 1 Interceptive Treatment Guidelines20:20 Arch Expander Guidelines  24:07 Crossbite Tendency 24:57 Rapid versus Slow Expansion27:42 Guidelines using functional appliances28:21 Invisalign Mandibular Advancement31:10 Deep Bite Guidelines34:08 Q: Percentage of patients that would undergo Phase 236:43 Patient(Parent) Communication39:51 Retention Protocol43:36 My Phase One Smile PDF Get this My Phase One Step-By-Step PDF Checklist by Dr. Amanda to get started and help you diagnose malocclusions Check out Straight Smile Solutions for more Orthodontic Consulting and StraightSmile Solutions Orthodontic Coach for GPs for Orthodontic Educational Videos If you enjoyed this episode, you should also check out General Dentists Doing Orthodontics  Click below for full episode transcript: Opening Snippet: If you have six millimeters, no vertical issues, no trans issues, no AP issues. Your child may not ever need braces. So that's incredible, right? So what we're aiming for? obviously, the part of the reason why kids have crowding it's actually a first world problem. Believe it or not, it's partially genetic, but it's also for the most part environmental. Jaz's Introduction:Welcome back Protruserati, I'm Jaz Gulati to your favorite dental podcast and today we're covering INTERCEPTIVE ORTHODONTICS. Why this topic? Well, actually, I've been a super busy boy. And I've got so many episodes recorded, a whole range of awesome topics. And so nowadays, I'm pitching it to you guys, which one do you want next? And on the Facebook group, gosh, it was extremely tight. But you guys just about voted for interceptive orthodontics. And this episode, what it serves to do is to help you the discerning GDP to gain some clarity on what you're looking for in our young patients. When you're thinking, would this patient benefit from EARLY ORTHODONTICS or for INTERCEPTIVE ORTHODONTICS ie to intervene in their mixed dentition so that they can benefit and have straighter teeth or a better occlusion for their later years and teenage years. Now, it's important to mention that this episode, it's not been made with any countries or systems in mind, per se, ie what I mean is, for example, if you're a dentist in the UK listening to this, you might be thinking, 'Okay, this is great knowledge. But how can I implement that in the system where I work in the country that I'm in with the political system and the public funding that I'm in, etc?' Well, that is irrelevant, because what I want to pass on to you from this episode is really good knowledge and fundamental orthodontic diagnoses. And then you can have a conversation with an orthodontist, or know when you should refer for a second opinion. That's what this is about. So if you're in the US, and you're worried about insurance, and whatnot, it's all about finding out all these issues. And really, I love the way that our guest Dr. Amanda Wilson breaks it down. If you really think about it, the main things we're looking for are any errors in development or any problems malocclusions that affect the anterior posterior, the vertical and the transverse.