Protrusive Dental Podcast

Building on from Basics of Occlusion Part 1, I am joined Dr Mahmoud Ibrahim who takes us on his journey from hating Dentistry to eventually loving occlusion and aesthetic Dentistry. We geek out over occlusal contacts, the occlusal examination and freedom in centric! https://youtu.be/emfAS95VARU Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: 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. “Keep everything nice and smooth, the patient has nothing to grab hold of and push against. That's probably going to make sure your restorations last a lot longer.” - Dr. Mahmoud Ibrahim Jaz Edit to the above quote: By 'Smooth' we don't mean highly polished or glazed. We refer to the movements of the mandible being smooth, rather than jerky or abrupt. 3-minute Occlusal Examination PDF - Click here In this episode, we talked about: 7:59 Mahmoud’s journey in Falling in love back to Dentistry13:16 Tripodized Contacts19:55 How to maximize cusp to fossa26:54 Bonus little trick on avoiding high restorations28:40 What do we check in a basic occlusal examination?38:15 Freedom from Centric/Freedom in Centric49:11 Relevance of the Centric Relation Contact Point56:41 Disadvantages of doing MIP vs Centric Relation Contact Point Join us in our Telegram Community, where we can always help each other out! If you loved this, be sure to watch the Part One of the Basics of Occlusion! Click below for full episode transcript: Opening Snippet: As the mandible is moving, everything should be smooth, and then also everything to be shallow. If you can do that, like you will dramatically reduce your rate of failures with the anterior restoration, just those two gems that you gave there... Jaz's Introduction: Hello, I'm Jaz Gulati. And in this episode, we go one step further carrying on from basics of occlusion part one, right,? Thank you so much for the awesome feedback you guys gave for part one, and I'm so happy to have my brother from another mother cut from the same occlusal cloth, Mahmoud Ibrahim, who is a fantastic dentist, you see his work on Instagram. He is amazing. But just learning about a story from this episode is so, so great, because it's the first time we had a proper chat. I've been following him for a few years now. And I didn't realize that he hated dentistry when he qualified right? And I look at his work now. And I think whoa what happened so as well as so many clues or gems. So I'm going to give you a little preview of in a moment that we share with you. I love just him sharing his story with you of what happened, what was the spark that changed him from hating dentistry and actually trying to follow a career of making websites to then falling in love with Dentistry again in a big way. And they're really killing it at the whim as he is. Now, I hope you got your coffee ready because there's a lot of stuff that we're gonna cover in this very intense but very jam packed episode. Hope you like the analogies and stories and in cases that we discuss, we're trying to make it as friendly as possible for all my beloved listeners. The watchers is great to have you if you're on YouTube, hit subscribe. But for those who listen, you are the originals, I will always make sure that the content is easy for you to consume on your commutes. Right? So the kind of things that we cover is what is the difference between the so called tripodized contacts, and is it really better than cusp to fossa and how can we maximize stability w...

Dr Jane Lelean will teach us how to implement 'Hypnodontics' techniques so that we can calm our patients, create a positive environment and even reduce post-operative clinical complications! https://youtu.be/oesEIRfJvdE Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! “Hypnodontics isn't just for patients, many dentists are using it to reduce their stress levels and their anxieties too” - Dr Jane Lelean In this episode, we discuss: Is there an official qualification before practicing hypnodontics? 8:24Two general types of hypnotherapy 9:13Evidence-Base of hypnodontics in Dentistry 11:57How can we incorporate hypnodontics in our practice 15:45Reducing post operative complications and pain with hypnodontics 26:43Changing the post operative instructions 30:02Help from Hypnotherapist regarding Bruxism 36:28 Check out The Institute of Dental Business to learn more about Hypnodontics and Hypnotherapy with Jane Lelean. If you loved this episode, please do check out What Every Dentist Should Know About Managing Dental Anxiety with Dr. Mike Gow Click below for full episode transcript: Opening Snippet: So Hypnodontics isn't just for patients. Many dentists are using it to reduce their stress levels and their anxieties too... Jaz's Introduction: Hello, Protruserati. I'm Jaz Gulati, welcome to this interference cast a non clinical interruption today on Hypnodontics, hypnosis in dentistry and how you can apply it on Monday morning. I'm joined today by Jane Lelean. Now I hope you enjoyed that previous occlusion episode, I did the basics of occlusion. I've got basics of occlusion two coming up, I'm recording with Mahmoud Ibrahim tomorrow, and we're gonna put together our philosophies to come up with something even more impactful, try and build on that first episode, really just set the scene on why occlusion is confusing, why occlusion is both perhaps overplayed at some points and when it might be super important. So if you haven't listened to basics of occlusion, go back one episode and listen to that one. Anyway, today is about hypnosis in dentistry. And not like, not in a wishy washy kind of way. Like I want you to be able to apply some techniques on Monday morning with your patients to get results. The kind of results I'm talking about is this, right? I am very used to now when I'm explaining risks to patients, or once I've done let's say a deep restoration, I say to my patient, "Hey, you know what, you could get a severe throbbing ache. And if that happens, that's a sign that the nerve is dying. And that can be a very painful thing. It might be worse at nighttime. If you get a spontaneous pain, please give me a call, take some painkillers." This is very much a risk from this procedure, right? So I set them up, In my mind, what I was doing is I was underselling and over delivering so that when they don't get that pain, they think, 'Wow, Jaz is awesome.' So there's a benefit in that, I guess. So I guess I'm happy with the way I've done things. But today, what Jane showed me, what she's gonna share with you is to think about it in a slightly different way. How can we use the power of hypnosis? Which is basically like an altered state of the mind to benefit you and benefit your clinical outcomes. Like, if you tell your patient Look, there are certain patients who are almost like easy to hypnotize. So if you tell them, "Look, you're gonna get swelling, you get pain, like this." And then they come back two days later say "Yeah, it's swollen and painful." And you're like, "Well, that's normal." But they sort of, they made this like Mind-Body connection, they make themselves worse, they make themselves more sick. So equally, if you can sort of hypnotize people in a way for want of a better word, put these people in an altered state of emotion, altered state of mind, then your clinical outcomes might be better, might get less swelling, less dry sockets.

What is Occlusion? Canine Guidance.....Group Function...that's all right?! If only it was that simple! I hope to simplify Occlusion no matter where you are in your journey starting with this back to basics episode. Occlusion is the backbone of complete dentistry and full mouth rehabilitations. https://youtu.be/nCRepLglJBk Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: 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! "It's very difficult to say that one occlusion is perfectly correct for all individuals. And I don't think we've identified an ideal occlusion for a specific person." - Dr. Ed McLaren In this first episode on Occlusion I shared: Canine Guidance vs Group Function 5:54Evidence base about Occlusion and TMD 10:34Challenges in researching Occlusion and TMD 13:13Different Schools of Thoughts about Occlusion 19:42Centric Relation 23:27Centric Occlusion 30:34What is Occlusion? 35:29Occlusion vs Occluding 37:12Test driving the changes 46:11 Check out my 9 point checklist to never have high restorations again on YouTube: https://youtu.be/zX4fcYn7POM No More High Restorations Be sure to check out the best Dental Event of the year, the Dentinal Tubules Congress And as a reference for the terms, here’s THE GLOSSARY OF PROSTHODONTIC TERMS 9th Edition If you liked this episode, you will also enjoy Posterior Guided Occlusion  Click below for full episode transcript: Opening Snippet: And we also have excellent clinicians like Ed McLaren, who said it's very difficult say that one occlusion is perfectly correct for all individuals. And I don't think we've identified an ideal occlusion for a specific person... Jaz's Introduction: Hello, Protruserati, I'm Jaz Gulati and welcome back to the big episode I was telling you about this is the basics of occlusion carrying on from the the back to basics series in August, a lot of you messaged me with your occlusion questions, so I'm going to answer some of them today, but not in like a Q&A format. Because we've done that already in question 15 I'm just gonna take you through a journey, right? I'm gonna take you through a journey that's going to be mirroring some of the things that I've picked up in my journey. And the point of this introduction is to just tell you that we are all in a different place, in our own respective journeys. So some of you may be listening and you might be a dental student, right? And you may be placing your first ever restoration tomorrow, let's say and you are just thinking, Okay, when I stick that colored paper inside, articulating paper, and you get I get the patient to bite together, what are those dots going to look like? And you're just like, that's occlusion to you, right? When the patient bites together, how will it look, right? Whereas some of you may be beyond that. Some of you may be quite well versed in raising the occlusal vertical dimension, opening up bites, placing multiple units and multiple restorations at the same time and having some degree of control of the occlusion. So each individual is in a different place in their journey and the learning never stops. Now, if you are brand new to the world of occlusion. Welcome to deep dark world occlusion, I'm going to try and not confuse you too much. But try and give you a few things to think about. I'll hopefully make sure that as you learn, right? It's going to head you in the right direction. Because the thing with dentistry and the thing with occlusion is that sometimes the first time you learn something, right, it doesn't really, really sink in until maybe a few years later, it's happened to me so many times where a few years later, the same concept has been repeated and explained to me in a slightly dif...

Vertiprep? Dirtyprep? There are some Dentists who will literally opt for an adhesive onlay for every indirect restoration. That's not cool - they are not a panacea. On the flipside, there is a breed of Dentists who identify as 'Verticalists'. They will vertiprep their grandmother if they could. The answer lies somewhere in the middle - everything is case dependent. In this episode, with the return of my friend Jorge Cardoso, we revise Vertical Preparation, decision making protocols for indirect and then explore the nuances of digital scanning for vertical preps (even if they are super subgingival). https://youtu.be/AAWRJjEKN_U Check out this full episode on YouTube! Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: 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. Treatment Plan Letters with MakeMeClear discount - all of the Protruserati clan get 25% OFF the monthly or Annual plan with the code 'protrusive'! Trial it for 21 days and generate letters and listen to Episode 49 - Crystal Clear Treatment Plan Letters Fancy joining us for a POTENTIAL trip to Portugal for hands-on Vertical Prep? Click here and I'll email you if/when this gets the go-ahead. We are thinking Spring 2022! In this episode Dr Jorge and I talked about: What is vertical preparation 8:17Two types of vertical preparations (BOPT / Edgeless vs Shoulderless) 13:57Guidelines on temporising vertical preps 17:40Traditional vs Digital in Vertical Preparation 23:29Criticism of Vertical Preparation with Biological width 30:19Concept of “kissing the bone” 35:33Spacer Protocols for Technician 40:54Common mistakes with verti prep 45:02Digital Scanning tips for Vertical Preparation 49:37 Sorry that Dr Jorge's screen share did not show in the main video, we had some AV issues. Please find below an 8 min snippet where he shares his screen at various points https://youtu.be/e8psNUVMQ5g As promised here’s BOPT by Ignazio Loi Do Check out Dr. Jorge Cardoso’s episode with Crystal Clear Treatment Plans that Wow Patients and are Easy to Understand If you want to learn more about vertical preparations check out eMax Onlays and Vertipreps with Dr Jason Smithson Click below for full episode transcript: Opening Snippet: At the beginning I was going to be skeptical but then study start to come out to say that A) Zirconia feather edge margins behave as well as shoulder ones. So in terms of literature, in terms of safety, we are safe to go. Now the main advantages, you are saving more teeth, you are making your life easier, your impressions are easier, the fitting is easier and something which really attracts me periodontal stability is much, much higher... Jaz's Introduction: Hello, Protruserati. I'm Jaz, Gulati. Welcome back to another episode of the Protrusive Dental podcast. Now this was supposed to be if you listen carefully to the outro of the last episode. This is supposed to be the basics of occlusion as part of the bigger picture, splintember series continuing on from the back to basics episodes from August which I hope you really enjoyed. But the problem is this man, it takes a long time to script my solo episodes. Like if you if you think back to September last year, so September 2020, we did the splintember series. And, man, I forgot how much effort it takes to put something together, but I'm still determined and keen to put something together, that's gonna be you know, while you're commuting, while you're chopping, onions, gardening, whatever you're doing to make it a really valuable episode, all about my perceptions of occlusion, and just the very basics from like centric relati...

Ask 10 Dentists for a treatment plan, and you will get 12 different recommendations. Treatment planning is an art, but our diagnosis should be highly scientific. Making decisions of what specific treatment we should recommend to our patients is the very foundation of daily practice. With the experienced Dr Paresh Shah we discuss the How, What and Why of the Treatment Planning process in this Back to Basics in Dentistry series. https://youtu.be/raZiERy8U4o Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: 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. “Find an experienced mentor that will walk you through gathering the information.... [discover] why it's important to mount the cast rather than just holding it in with your hand.” - Dr Paresh Shah In this Episode, we discussed: Step by Step thorough Examination 12:50Importance of having a Checklist 27:34Records needed for a Comprehensive Exam 30:46Communication between patients and Dentists about Treatment Plan - in a way that doesn't confuse our patient 36:59Talking Money and Fees 47:18 Check out Dr. Paresh Shah’s Instagram to learn and be inspired! If you enjoyed this, you will of course love Zak’s Presenting Treatment Plans the Comprehensive Way  Click below for full episode transcript: Opening Snippet: And I don't know what it's like in the UK, but I'll tell you in North America, I've seen a lot of it. It's just hard. There's just not enough time because you're so focused on requirements and surfaces and canals and amount of teeth you're taken out rather than going 'Okay, let's just take a step back and let's focus on comprehensive dentistry.' And occasionally, you'll get a part time instructor that pulls you aside and teaches you all the stuff... Jaz's Introduction: Hello, Protruserati. I'm Jaz Gulati, and welcome to another episode of the Protrusive Dental podcast, back to basics series. Today we're covering this mammoth topic of treatment planning, right? Where do you even begin with treatment planning? Well, you begin here, because I'm going to break it down with Dr. Paresh Shah from Canada, all about the fundamentals of the kind of conversations you have with your patients. What is the sort of mindset you have when you're on treatment planning? What are the stages? How can you actually use your experience and use what the patient's goals are to help inform the best treatment plan possible for your patient? So it's something that I used to really puzzle me when I was a newly qualified dentist, I'd see a plan that was more complicated than just single tooth dentistry. And it will be like, how do I apply what I've learned from dental school to this patient in front of me. So it's something that you sort of refine as you gain more experience. Now, I'm hoping that after this episode, it shouldn't just give you that little bit more of an edge to allow you to think more rationally about your treatment planning. So like I said, hope you're enjoying this back to basic series. And it's been great fun to make it and the guests have been absolutely brilliant during this month. Thanks so much for watching. Now, if you have any more recommendations for topics, I'm always happy to hear them, you can DM me on Insta, you can comment below or you can email me jaz@protrusive.co.uk, I would love to hear your suggestions and I can get the right guests on as well as you want. The Protrusive Dental Pearl I have for this episode is very relevant to treatment planning. And it's this. If you have a patient and you're treating planning them, and it's a it's a bigger, more complicated problem. And I'm thinking like not just that it's multiple teeth, but even something like missing teeth, like something that's so common, right?

Want to upgrade your practice with dental photography but unsure where to start? I got early adopter and dental photography legend Dr Alessandro Devigus (the main man behind dentist.camera Instagram page) to share with us his fundamentals to make dental photography routine in for your clinical documentation. https://youtu.be/6WtCv9nb7HA Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental pearl: 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. AACD_2013_Photo_Guide And also be sure to check this video tutorial I made on how to take perfect Occlusal Dental Photographs (the trickiest shot!) https://youtu.be/PGTtZJnp9Pk “Every picture you didn't take is a missed one...” - Dr Alessandro Devigus In this episode we talked about: Setting up the camera 12:37The basic of taking photographs 14:19Importance of magnification ratio on lens 17:48Selection of materials ie mirrors and retractors 21:38Making your own signatures on photography 26:39Storing and Organizing photos 30:42 As promised, here are the basic dental photography camera settings by Dr Alessandro Devigus: Check out Dr Alessandro Devigus’ instagram page, the dentist.camera, to learn more about cameras. If you enjoyed this episode, you may also enjoy the ‘Which Dental Camera Should I Buy’? also with Dr Alessandro. Click below for full episode transcript:  Opening Snippet: So once you buy the camera, the second barrier I find Dentists have in terms of actually picking up and using it is because they've never devoted the time to actually sit down and learn what is the aperture? What is ISO? Why is this relevant? And then what they do is they just haphazardly put it on auto and they take photos and they get unpredictable inconsistent results, they get frustrated... Jaz's Introduction: When I qualified as a dentist, and I got my first ever paycheck, the first thing I did was buy a camera like yes, it was used because I need save money. But it was the first purchase because I knew I was taught by some mentors that to take good dental photographs is so so important to your career development. And I cannot echo this enough. So today I'm joined by Dr. Alessandro Devigus, the chap who owns dentist camera Instagram page, he's a world leading expert on dental photography. And we're going to cover the basic settings, how to get consistency and photos, and all the best tips to help you get started in dental photography. So if you're not already taking photos, you hopefully will be by the end of this episode, feeling more confident to start picking up the camera and taking more shots and becoming more consistent and a better dental photographer. Again, this is another episode as part of the back to basics series of August and this has been incredibly popular. I've been amazed at the comments, had one dentist, let's have a look on the previous episodes, I had Brendon Parker comment on the YouTube channel saying "Hey, Jaz just found this series and love it. I wish I had this 20 years ago." And honestly I didn't know the impact of such a back to basic series would have been you know, it's amazing. And thanks so much for for joining me in these episodes. I hope you find the real value from them. Now we're going to give you the Protrusive Dental pearl. So if you're new to the podcast, I give you a Protrusive Dental pearl in every main episode, and then we'll join the main interview with Dr. Alessandro Devigus. So the Protrusive Dental pearl I have for you is that on the comments below in YouTube or on the website protrusive.co.uk under this episode, I will have you ready to download the AACD Dental photography guide and what this is, and I found this really useful back in 2013 when I qualified the first purchase I made was it was...

When treating periodontal disease there is more to it than removing biofilm. Our role is to be a motivator and lifestyle coach - only then can we see successful periodontal outcomes in the longterm. What's your spiel to patients to explain what periodontal disease is? Do you show diagrams, draw or use your fingers? Listen to how Dr Ian Dunn explains Perio and you will want to implement his way of communicating on Monday morning! Brought to you by the Back to Basics series of August on Protrusive Dental Podcast. https://youtu.be/KAGHaWyacZs Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: 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. “Communication has to be a two-way street. It shouldn't be a monologue, it should be a discussion.” - Dr Ian Dunn In this episode we discussed about, Communication Masterclass between Dentists and Perio patients (12:38)How to communicate with more resistant patients (17:33)Referrals done by GDPs that could have been manage at their own practice  (21:22)Trying to get out of comfort zone in Perio (26:20)How to communicate risks in Perio treatment (32:08) Catch Dr. Ian Dunn’s Perio courses and be able to communicate to patients effectively about periodontal diseases. Do join us on our Facebook community, the Protrusive Dental community! If you like this episode, be sure to watch Finding Your Niche in Dentistry with Dr Pav Khaira Click below for full episode transcript:  Opening Snippet: So this is the bit where you explain to a patient that they're rubbish at brushing their teeth but you do it in a way that you don't offend them because that was the thing I find most difficult. Mrs. Jones bacteria builds up on teeth. It reaches your trigger points. Your body triggers inflammation, that inflammation damages the bone... Jaz's Introduction:I'm Jaz Gulati and welcome to another episode in the back to basics series of the Protrusive Dental podcast. You are going to be blown away by today's episode is with Dr. Ian Dunn of periodontist, on communicating. Communication in perio specifically, for example, how do you explain to a patient that they have periodontal disease like six significant things a chronic condition that could potentially live with for the rest of their life? It's such an important thing for them to grasp so that they can get better outcomes. And you can get better success as a clinician. Like what's your spiel? What's your way of communicating that I think lots of Dentists have different ways of doing it. Now, you will probably get your way whichever way you're doing at the moment. And Ian will show you the way to do it. I mean, his way of explaining to patients, how periodontitis works, and to get them on board is just the best I've ever heard. So I'm so excited to share these gems with you, we will talk about communicating risk of treatment with patients. And he does that in such a great way as well. And the relevant Protrusive Dental pearl I have for you today is to have something one-eight, whether it's digital, or whiteboard or paper base, an opportunity for you to be able to draw certain things because certainly one of the tools that Ian Dunn uses is to draw certain things draw teeth, draw bone or periodontium. So therefore, I think it's a really useful thing sometimes to be able to draw something. Yes, we have our intraoral cameras or DSLRs. But sometimes there's a beauty and magic of being able to draw something while your patients watching, you know annotating as you're talking to them. So that's the main Protrusive Dental Pearl. I hope you enjoy this episode. Stick around for the outro and if you're watching on YouTube, and if you haven't already,

Dr Zak Kara, an oral surgeon, helps dentists regain confidence in extractions by discussing the importance of sectioning and elevating teeth. They also cover topics such as reassessing difficult extractions, effective communication with patients, overcoming equipment limitations, and tips for successful tooth sectioning.

Do your ID blocks work all the time? How about your management of the dreaded 'hot pulp'? As a part of the Back to Basic series this August, I asked Dr Pynadath George, who practices advanced surgical and implant dentistry, about dental hacks for success with every dimension of local anaesthesia in Dentistry. https://youtu.be/F6l9glsEbuc  Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: 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! “If you want good success with the ID blocks, you need to look at and study the anatomy, even if it's on a skull, and then relate that to your patient..” - Dr George In this episode we discussed about: Is Lidocaine/Articaine enough to numb patients as a GDP, or do we need to stock other anaesthetics such a Mepivicaine? (15:09)Avoidance of Articaine for ID block in some countries - if that really necessary? (18:35)Shift of mindset with young dentists practicing defensively (20:38)Tips on achieving successful ID blocks (27:04)Hitting bone during ID blocks - do you HAVE to hit bone? Can that be harmful? (33:38)How to manage the dreaded hot pulp! (36:39)Moderate and advanced local anaesthetic techniques in Dentistry (47:31)Tips on getting painless palatal injections (especially on ultra nervous patients) (51:05) Want to learn more? Check out this Advanced Implant Training by Dr George Pynadath I hope you are enjoying this Back to Basics series of episodes! If you liked this episode, you will also enjoy Basic Implant Occlusion and Work Life Balance – PDP012 with Implant Ninja! Click below for full episode transcript: Opening Snippet: As i gave the intra pulpal, I didn't realize the sound was being recorded but as i gave myself an intra pulpal, as i was reviewing back the videos all i could hear was myself grunting going 'ah because it was that painful I had to keep my mouth open while i'm numbing myself up through the pulp but honestly after that was done it was like magic i could you know i found all four canals, extirpate it, done... Jaz' Introduction: Now to answer these questions I’ve got George. His first name is far too complex from around so we shall call him Dr George, who is a very well known name in the UK. He actually does lots of advanced surgical dentistry, pterygoid implants, zygomatic implants, full arches that kind of stuff. He also does some general dentistry as well but that’s his real niche that he’s known for and along with that he does teach on very advanced local anesthesia techniques like how to give extra oral blocks for example or how to give anesthesia in areas where you’re not really taught at dental school but we’re gonna really bring it back to basics in this episode to go through how to get success from the more basic techniques like what are the the factors involved in getting success in anesthesia and right at the end we even cover the top tips in getting painless anesthesia for palatal, those dreaded palatal injections.  Now it’s interesting when i was in Vietnam on my elective, I was with these dentists who are 25 years qualified and they were celebrating like having a reunion and we’re on this charity project in a village near Da Nang and it was a school. So were at the school. We were about to do restorations extractions and basically any sort of dentistry these children needed and there was a queue of children and before they’d have their treatment like for example a restoration or a tooth out, we would numb them up. I’ll never forget how these children were given id blocks so inferior alveolar nerve blocks before they had their restorations on their lower t...

A daily dilemma in Dentistry is deciding when (and HOW) to restore that extensive MODL amalgam restoration that was placed over 30 years ago! We go deep in to this, looking at single-tooth factors but also a full mouth 'bigger picture' view with Dr Andrew Chandrapal who has been trained by world-class clinicians including Dr John Kois and Dr Didier Dietschi, https://youtu.be/lulpENm4swo Check out this full episode on YouTube. Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: 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. https://www.instagram.com/tv/CNUi20EJ9Pk/ “Using things like air abrasion to then try and remove the apical amalgam whatever you can do to try and be gentle in your removal of that material is a good way to go” - Dr Andrew In this episode I ask Dr Andrew Chandrapal,  When to classify the large restoration has failed (12:45)Risk factors of a tooth with large restoration would undergo necrosis (18:33)About restricted anterior restriction or constriction (22:21)How to prevent yellow stains and if you should intervene for a long time restorations? (29:16)Little tip on special burs to use when cutting out caries (31:21)Cutoff point whether to cap the cusp tip or not (33:26)When to decide if you should intervene because of marginal staining and communicating to patients (37:44)What factors to consider moving from direct restoration to indirect restoration? (39:59)Treatment plan to reduce the risks of fracture (42:31) As promised in the episode, if you want to learn more of Composite courses by Dr Andrew Chandrapal - IndigoDent Education If you enjoy this episode, check out this Composite vs Ceramic with Dr Chris Orr Click below for full episode transcript: Opening Snippet: I've shied away many times I've made a treatment plan for a patient for quadrant but I will just work around that upper first molar we've got that behemoth amalgam because I don't want to touch it. Any help you can give me? We should not be responsible for owning the clinical problems that the patient presents with... Jaz's Introduction: Most of my patients are above the age of 60 actually nowadays and when I look into their mouths I see these huge amalgam restorations you know like it's MODB they've got very very thin cusps you can see the amalgam shining through. You can see craze lines, crack lines but they've been there for so many years, they've been there for two three sometimes even four decades i mean you look at these studies about longevity of amalgam and composite and you know my patients are the heavy metal generation patients are a living testament to longevity of amalgam however when things go wrong they can go catastrophically wrong like remember when you find secondary caries around amalgam it can be a huge huge mess and of course, we know that in time cusps can fracture around amalgams and that's like the most common emergency we find which is when someone just broken off a cusp and lo and behold there's a huge amalgam left behind. So when should you look at amalgam and say you know what I’m gonna decide now is a good time to crown this tooth or now is a good time to remove this amalgam because I worry about secondary caries or I worry about microleakage because if they've been like this for 30 years 40 years and I can't really justify enough a good reason to drill into it then why am I drilling into it okay? This kind of debate that I have with myself. So to help answer this as part of this back-to-basics series for August, I’ve got Dr. Andrew Chandrapal from the UK, who is just such a gifted clinician.He's well known throughout the world actually and I think he's done a really good job of covering these basics of you know when do I need to remove the stained composite like is that staining around a margin,