Recession is one of the those diagnoses we make all the time - lots of our patients have recession. I always struggled to decide when we should be proactive with recession and suggest surgery - it is very easy to monitor recession through photos and measurements. Specialist Periodontist Dr Amit Patel discusses his decision making when it comes to recession defects. He also discusses his journey which is very encouraging as it teaches us that you DON'T have to have it all figured out from the start.... https://youtu.be/A1b0sL4rJUk Check out this  full episode on YouTube Need to Read it? Check out the Full Episode Transcript below!  Protrusive Dental Pearl: 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!' In this episode we discussed: Knowing when to refer recession to a Periodontist for surgery vs monitoring (23:39)Communicating to patients whether to have some treatment done now or later (26:02)Miller’s classification (30:05)Why can we get 100% root coverage (32:36)Do GDPs have a role in carrying out Perio surgery (42:53)Advice for patients to prevent recession to get worse (48:30)Realistic expectations to patients about what kind of aesthetic complications to accept as a compromise (52:01) If you liked this episode, you might also enjoy the episode, Should you specialise? Click here for Full Episode Transcription: Opening Snippet: I've got to be honest the referrals that I've had, the patients don't want to have the surgery okay which is interesting because you know they've obviously been told that they've got a problem, they've got recession but they're just thinking i don't want to go through this hassle, right? So which is fine but what i have noticed during lockdown, I've had a lot more patients contacting me about their gum recession... Jaz's Introduction: Hello, Protruserati. I'm Jaz Gulati and welcome to PDP 082, all about the management of recession defects not like the crazy like you know get the scalpel out let's all start doing root coverage. More like how to assess it as a GDP because i find that recession is one of those things right? Where it's like tooth wear in the sense that it's common but that doesn't make it acceptable, that doesn't make it something that we don't write down as a diagnosis because i find that you know people ignore tooth wear and people ignore recession because why we see it all the time of varying degrees. Some patients will take it really seriously whereas others will have recession for years and you might be the first dentist to have that conversation with them about recession and it can obviously lead to sensitivity and aesthetic issues So it's a huge issue and i think soft tissues as a whole is something that needs better coverage i guess if that's a pun i'm allowed to use. This episode i'm joined by Amit Patel, who is a i want to say, i want to say youthful like. This guy's like got a baby face right and he's such a good guy. He's one of the nicest guys in dentistry very knowledgeable and he's been on the lecture circuit for like years and years and years. Although you wouldn't tell from his face he like i said he's a baby face. He's going to talk all about how he assesses as a periodontist specialist the tissues and how he manages the cases that get referred to him with the recession and it's amazing how a lot of these cases, he's just reassuring patients he's not actually picking up a scalpel and it's great to know when we can reassure patients and how far we can go that versus when we actually kind of need to intervene or refer so that the situation doesn't get out of hand so we cover all those things including prognoses and the beginning we also cover the journey like Amit Patel's journey and i...

Protrusive Dental Podcast

Recession Defects – Refer or Reassure? – Specialising in Periodontics – PDP082

Online reviews for Dentists are a big thing in 2021 and it's only really just lifting off now. A few years ago I had an appointment with an ENT consultant and the first thing I did was google his name. Most of our patients are googling us and our online reputation is critical. In this episode I am joined by the founder of Doctify, Dr Suman Saha to help you get more high quality reviews for your practice. https://youtu.be/LiHSvoWBuPA Check out this  full episode on YouTube Protrusive Dental Pearl: How to increase the success rate of capturing review: Consider text messaging and/or having a tablet in your practice so they can leave it immediately after treatment. In this Group Function we discussed: What is the role of patient Reviews dentistry? (07:02)Doctify vs different online review sites/apps such as Google Reviews (08:39)How can we make sure the reviews are accurate? How to overcome fake reviews (12:18)How to create a win-win scenario between Principals (the practice) and associates (that want their reviews to stick with them) (17:48)How to get dentists (who might be introverts) to have awkward conversation with patients and ask for reviews (24:20) If you enjoyed this episode, you might also like this episode Think Comprehensive – Communication Gems with Zak Kara

How Can You Harness the Power of Reviews – GF009

Surely injection moulding composite resin is too ambitious to restore Toothwear? Well, let Dr Kostas convince you otherwise! Restorative Dentist Dr Kostas Karagiannopoulos will reveal all the the nitty gritty secrets from patient evaluation to the entire bonding protocol. https://youtu.be/hL5aAdzk-hk Check out this full episode on YouTube Protrusive Dental Pearl: 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. Whether this extension improves retention form is debatable Step by Step PDF Infographic. Click here In this episode we discussed: Role of injectable composites as a transition (and as a long term solution) (12:59)Follow-ups and maintenance of injection molded composites (16:52)Contraindication for injection molding (20:28)Indication for injection molding  (20:54)Minimizing voids when restoring with injection moulded composites (21:48)Filling the stent with composite (a thing of beauty!) (28:17)Other techniques vs Injection molding (31:29)Injection molding composite case sequence (35:04)Isolation during injection molding? (46:36) If you enjoyed this episode, check out eMax Onlays and Vertipreps Want to learn more? Do check out this one-day course by Dr Kostas with GC UK

How to use Injectable Composites to Treat Toothwear – PDP081

It's my sister's wedding but the Protrusive team managed to get this out for you - and boy it is a good one! Dr Omid Azami AKA The Noobie Dentist will inspire to you adopt a growth Mindset. https://youtu.be/NSEbShIeD04 Check out this  full episode on YouTube “Have that mindset like 'it's a journey', you're never 'there' necessarily. You can always get better, and do more.” - Dr. Omid Azami Here with me, Dr. Omid Azami, host of Noobie Dentist Podcast, who inspires and gives voices to clinicians all over the world and inspiring Dentists. In this Interference Cast, we discuss all about: Tips on making life more efficient, better and more productive. (09:26)Key attributes that help a young dentist to become great. (16:33)Tips and tricks to make a habit of taking photos. (20:54)Journey of self-discovery. Finding your pathways and niche. (24:20)Importance of mentorship, even remote mentorship. (32:58)Most inspirational guest from Noobie dentist and their takeaways (39:03) If you want to learn more, please do subscribe at  Dr. Omid Azami’s Noobie Dentist Podcast If you liked this episode, you will definitely love and will learn a lot from the episode 10 Habits of Highly Successful (and Most Valued) Dentists 

Champion Dental Mindset with Noobie Dentist – IC014

Stop taking OPGs/Panoral radiographs for TMD...they have limited benefit! In this episode I discuss the Piper Classification of TMJ with Dr Jim McKee from the Spear faculty. We also cover exactly when and why imaging of the TMJ may be beneficial (MRIs and CBCTs). I have found the Piper classification easy to implement and I hope this episode helps you understand it. https://youtu.be/n4lRWAQeA5A Check out full episode on YouTube Protrusive Dental Pearl: Observe the patient's path of opening. If someone's jaw opening makes a 'V' shape, that's a DEVIATION. Iff 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. If you want to Download the PDF version of the Piper Classification of TMJ Infographic we made, click here! Piper Classification PDF Dr Jim McKee is part of Spear Education - a platform that has taught me so much of my occlusion. In this episode I asked Dr. Jim McKee: What is the Piper Classification of TMJ?What are the risks of having to rehabilitate someone where you haven't the health of the TMJ? (19:22)Are there any other useful TMD classifications? (21:01)Is there any benefit of taking a Panoral radiograph? (24:48)What is the difference between an MRI and CBCT for someone with a TMJ pathology? (26:51) What type of imaging is best for TMD? (28:58)What additional information can a CBCT provide above an MRI? (33:59)How do we decide the most appropriate imaging technique? (35:22) Dr McKee's thoughts on idiopathic condylar resorption in adult patients? (32:58)Should we be taking routine MRI/CBCT for TMJ health diagnosis? Or only for patients who have a joint based history? (36:62)Is there a clinical way to determine which classifications patients are in (Piper III vs Piper IV)? (39:23)Is TMJ disorder always a progressive disorder? (40:51)How to manage asymptomatic clicks? (42:17)Deviation or Deflection as part of full workup and imaging of the way to get the exact diagnosis? (44:07)How does the Piper classification influence Restorative management? (47:12) If you enjoyed this episode, check out TMJ Physiotherapy – When to Refer and How They can Help  Check out SPEAR EDUCATION, a two-day seminar, where Dr. Jim McKee teaches 25% of the course!

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

Does Biological Width, apparently now known as 'Supra-crestal tissue attachment' confuse you? Or would you like an introduction or a refresher on the clinical stages of Crown Lengthening? Fear not, I twisted specialist Periodontist Reena Wadia's arm and finally got her on the show to teach us! https://youtu.be/No-8hjFsWNs Check out this full episode on YouTube Protrusive Dental Pearl: 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. “Don't complicate things, if something works in your hands and you're doing it well, keep things simple, don't have too many variations because then it just starts getting unpredictable. So test everything out, go on courses, and then see what works in your hand and then stick with that.” - Dr. Reena Wadia In this episode, we discussed: Bone sounding (10:35)Aesthetic crown lengthening (13:06) and Functional crown lengthening (18:02)Altered passive eruption and active eruption (14:21)Fundamental difference between the two types of crown lengthening (20:06)Biology of keratinised tissue (24:13)Steps involved in crown lengthening surgery (26:32)Using dental stents as a guide (29:44)Post-op management for flaps (30:35)Pre- and Post-operative care (33:05)Ideal case for beginner Dentists (35:19)Placement of sutures (36:28) Check out Dr.Reeda Wadia’s Perio School Check out Reena's Crown Lengthening Live course on a Sunday in London! If you liked this episode, you might also enjoy How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique 

40 Minute Crown Lengthening Tutorial with Reena Wadia – PDP079

Are you enjoying a fulfilling career? Is this how you imagined life would be in Dentistry? If not, are you going to do anything about it? My guest, Laura Bailey did! Growth and improvement is not linear. Taking MASSIVE action is the answer! https://youtu.be/nDloghDpYsE Check out this full video episode on YouTube! Protrusive Dental Pearl:  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! Here with me is someone who commits to take a massive action, Laura Bailey, whom I work with on Fridays (we are both a little crazy and we love cricket - dream team!) “But you can't expect to know everything and be able to do everything.” - Laura Bailey In this episode, we discussed: Principals taking risk with their young associates - business side, implementing treatment?Building healthy relationships with colleaguesSigns to look in a clinic for young dentists/therapists to work inTaking a leap of faithHaving a nurse support system Check out Laura Bailey on Instagram! If you liked this episode, you might also enjoy How to Win at Life and Succeed in Dentistry – Emotional Intelligence

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

TIME SENSITIVE - 50% off Maciek's Online Contact Point Ambassador Course! Click here - EXPIRES JUNE 30TH (thank you, Maciek!) Let's face it, Class IIs may be our bread and butter Restorative Dentistry but they are ANYTHING but simple. In some scenarios, achieving a perfect contact on a class II restoration seems impossible.You have likely been in a scenario where everything is going to plan and your matrix is looking like it will achieve a lovely contact area - however, as soon as you insert the wedge or tighten the band (circumferential matrices) the matrix leans away from the adjacent tooth, revealing a ghastly looking open contact. How can we overcome this? Is soft tissue removal an option? In this Group Function, I’m again joined by my boy Dr Maciek Czerwinski who answers this emphatically! https://www.youtube.com/watch?v=cvX-oaEaqUI How to do Teflon Floss Technique - the Main Interview Podcast Video has some syncing issues, please bare with us! “If you use the stiff wedge, if the wedge is too big it will just move the matrix (and you lose your contact), but if you've got something soft, it will go under the curvature of the matrix, and then it will just self adapt.” - Dr Maciek Czerwinski In this group function we also discuss: Is it necessary to remove soft tissue? - Why? How? What to use? How to improve the contact areaWhy and when to place an orthodontic separator to help your future restoration Tired of spending hours just to customise your stiff wedges and matrices? Check this gem shared by Dr Maciek - FINALLy the video on how to do the Teflon Floss technique (as promised in the episode): Also, Dr Maciek is giving 50% off to all Protruserati up until June 30. Click here to check it out! I have done his online course and it was very comprehensive and is guaranteed to improve your contact points no matter how tricky the situation. It is an all-encompassing direct restorations online course - with play by play explanation of matricing, wedging, ring selection and isolation! Click on the image to check out Maciek's course! If you have any other questions that would make a good group function, please do message me on @protrusivedental Instagram page or the Facebook Page If you enjoyed this, you might also like my other episode with Dr Maciek Czerwinski on Which is the Best Matrix System for Class II Restorations 

Stop Getting Open Contacts in Tricky Class II Restorations – GF008

A fun little comparison episode discussing the differences between Dentistry in the States and in the UK - in this episode I am joined by the host of Dentistry Rising podcast, Dr Bette Robin! Dr. Bette Robin, who desired to make a massive change in her life and left clinical Dentistry some years ago and went in to Law and practice sales - she never looked back!  Join us in this light hearted discussion where we chat about: Cultural differences in USA vs UK Dentistry - dental school, earnings, biggest barriers, treatment plansHow the national health systems compare Finding different paths out of DentistryHow to become a better communicator  SplintCourse update: Enrolment ends on Monday 21st June! Enroll now by clicking here to join a community of Dentists around the world who want to End Splint Confusion!  If you enjoyed this episode, then do check out Dr. Bette Robin on her Dental Rising Podcast You might also enjoy The American Dental Dream – PDP002 with Dr. Kristina Gauchan!

USA vs UK Dentistry – Money and Culture Differences with Dentistry Rising – IC013

How to do Deep Margin Elevation? What are the most important factors in achieving high bond strengths for our restorations? I sometimes look at modern onlay preps and think, 'God MUST exist', because I think it's a miracle how these flat, table-top onlays stay on! I am joined by a world-famous educator in Biomimetic and Adhesive Dentistry: Dr David Gerdolle David Gerdolle, based in Switzerland, introduced me to contemporary ceramic onlays 8 years ago. It took me 3 years to convince myself the techniques would work in my hands! In this episode I want to fast-forward your progress so you can gain more perspective on adhesive restorations and DME (Deep Margin Elevation). https://youtu.be/cOkEAaawgdI Super pragmatic and scientific bonding principles! Protrusive Dental Pearl: 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. With the knowledge of Dr. David Gerdolle and biomimetic dentistry, we discussed how it is possible to bond a material to the tooth structure in those 'table-top' style, flat onlays.  It doesn’t happen magically. It’s about the nitty gritty detail, the micro steps and respecting certain criterias. “If you don't remember anything of your bonding protocol, just remember that, it has to be clean and rough” - Dr. David GerdolleClean and Rough, that's it right there! In this episode, we also talked about: Failures in using biomimetic dentistry and what we can learn from thatHow these restorations have resistance formBonding protocol step-by-step for adhesive dentistryDeep Margin Elevation - how to do it As promised, DM me on Instagram @protrusivedental for the PDF copy of the steps of deep margin elevation.  If you enjoyed this episode, then do check out Dr. David Gerdolle for more courses. You might also enjoy Ceramic Onlays from Preps, Temporisation and Bonding Protocols by Nik Sethi!

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

'The Riches are in the Niches', apparently. In the last episode we already touched on the topic of finding your niche but this time we were able to dive deep in to this. Will your career sky rocket when you find your niche? Or are you better off being the jack of all trades?  What are the benefits of finding a niche, how to go about it? And what does it ACTUALLY mean? https://youtu.be/aGniihvrNpg Protrusive Dental Pearl: a Challenge for you - 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!) My guest, Dr Pav Khaira is a MASSIVE geek and I loved that he quite openly admitted to failure in the past and helped us learn some lessons. I also enjoyed hearing that it is TOTALLY FINE to change your niche as you mature as a clinician. In this episode, we talked about: Being a super GDP vs niching down?Young dentists rushing to find their nicheIs it okay to niche too soon or is too late to find your niche?The opportunities of learningBecoming a ‘go to dentist’The downside of niching  If you enjoyed this episode, then do check out the Dental Implant Podcast by Dr. Pav Khaira. You might also enjoy 6 Signs You are a Comprehensive Dentist!

Finding Your Niche in Dentistry – PDP076

When I see an already beautiful smile plastered with Composite Veneers, it makes me a little bit anxious. I think that maybe the patient just 'needs' minor edge bonding and teeth whitening. In our latest podcast, we are very lucky to have such an amazing, high caliber dentist and we get to hear his take on composite veneers. It's none other than George Cheetham aka George The Dentist. You'll also get to know a powerful communication/consent tip that I will implement in my workflow straightaway. https://youtu.be/k--Wjqjg2S4 Protrusive Dental Pearl: I love the Eve Twist Composite Polished by DiaComp (Not sponsored by the way). It's my favourite polishers 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. In this episode we discussed: Establishing a practice as a young dentistGeorge's take on composite veneersFinding your dental nicheTips and tricks in managing your case documentation (and social media)Dealing with and treating fellow dentistsBreaking down biomimetic dentistryGeorge's rapid quick fire about anything and everything dental If you like this episode, you’ll also like Alan Burgin's Journey with a Young Dentist!

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

'An average Dentist working with an excellent Technician can go very far', was the message my old training program director gave me. Technicians are often the unsung heroes whilst the Dentists collect all the praise and accolades. Who do we blame when things go wrong? Our technician, of course! Not fair at all - this is why I welcomed RDT Graham Entwhistle of Trueform Dental Laboratory to air his frustrations at Dentists - you will pick up some great tips here to improve your working relationship with your dental technician! https://youtu.be/NRDdRCg-9QI How to work better with your dental technician Protrusive Dental Pearl: 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. SPOILER - the 5 things that Technicians wished we Dentists knew: Dentists need to improve their communication! Back to basics - if you want better work, you have to fill a better prescription form. Even just the lack of basic info drives technicians mad! We also discussed about Ivoclar Ingots for your ceramicMake sure your tooth preparation is appropriate for your material selection! Decide the material BEFORE you prep the tooth!Your impressions need to be clearer please! Do you always check for distortions, drags or voids? Could you consider trying Impregum?Shade guides - they can vary and can discolour over time. It's important to ensure the shade guide matches your technician's and the materials they use. Acrylic shade guides will discolour over time! We share some shade taking advice for DentistsDo you etch your own ceramic? If not, why not? Take control of your bonding, consider etching yourself to prevent ceramic over-etching. You can't hold your technician accountable for your bond strength! Check our Graham's work on Instagram! If you liked this episode, you will also enjoy the classic with Jason Smithson on eMax Onlays and Vertical preps!

5 Things your Technician Wished You Knew – PDP074

Lower Complete Dentures are the bane of Removable Prosthodontics. I know many Dentists who 'hate making lower full Dentures', likely because they are difficult to master. So difficult that I got Dr Rupert Monkhouse to give the Protruserati a podcast masterclass on how to improve in this frustrating area of Dentistry! https://youtu.be/cW41CHiLgGI Why won't you stop floating, damn you! Full blog post to follow including links to Rupert's course!

Suction Lower Complete Dentures – Improve your Removable Prosthodontics – PDP073

Dentistry is busy. How can we make sure that we live a balanced and fulfilled life in our hectic profession? As an associate, I am already struggling with time, I often wonder how practice principals and specialists play this game?! I am joined by my dear friend, Dr. Ricky Bhopal Specialist Prosthodontist to discuss how we work smarter and not harder. https://youtu.be/KpsHgDR2q6M Work Smarter Protrusive Dental Pearl: 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 consultation In this episode we discuss: Ricky's top tips to be productive and overcome procrastinationHow to make time for our loved ones and hobbiesWhat is green space and why is it so important?How can we live a more fulfilling life as a Dentist? If you enjoyed this episode, you will enjoy How to Win at Life and Succeed in Dentistry!

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