Advertise on podcast: Protrusive Dental Podcast

Is your diary running you — booked weeks ahead, no white space, drowning by Thursday? Do you really have to specialise to get referrals? How does an associate negotiate a month off every August — and get a yes? And what changes when you start treating yourself as your most important instrument? This is Part 1 of a two-part conversation with Dr Ronit Patel — a Richmond GDP of 20-odd years, an associate at the White House Dental Clinic in Kew, and one of the nicest and geekiest members of the Protrusive community. He works three and a half days a week, takes Wednesdays off, and typically takes the whole of August off. This episode is how he got there: staying a generalist when specialising beckoned, buying a microscope he wasn’t allowed to see, building a referral book without social media, and — the big one — taking control of the diary. It’s a warm, reflective conversation rather than a technique masterclass, and Ronit is refreshingly honest that it hasn’t always been smooth. Part 2 goes into fuel versus friction: what fills you, and what drains you. Protrusive Dental Pearl: Get Good, Then Get Passionate “Follow your passion” is actually bad career advice. What most of us call passion is really interest. When you applied to dental school, you may have said you were passionate about dentistry and oral health — but you had barely scratched the surface. That wasn’t passion; that was flirting with the idea of dentistry. Then you married it, and disillusionment arrived: is this really what I signed up for? Passion develops once you start to get good at something and you’re helping people — and dentistry has so many avenues to do both. You don’t become passionate first, then good. You become good, then passionate. So the better advice: become good at something, help people, develop a passion, and follow it through. What You’ll Take From This Episode The diary control sequence — four moves that turn a chaotic book into a business case: audit, price, zone, pitch.Slack, rhythm and energy — why white space isn’t waste, and what time-of-day research means for when you book your hardest work.The referral engine — how a handful of colleagues, not a social following, can fill a niche book.Specialise or invest? — the decision filter for cutting your book, and how full it should really be.Scripts for the principal conversation — the exact lines for asking for a zoned diary and protected time off. Highlights of This Episode00:00     TEASER00:59     How to Take Control of Your Dental Career (Without Quitting)03:33     Dental Pearl: Why "Follow Your Passion" Is Bad Career Advice07:57     Generalist vs Specialist: Why Stay a General Dentist?11:26     Buying a Dental Microscope as an Associate14:50     How to Get Endo Referrals as a Non-Specialist21:49     Why Word of Mouth Beats Social Media for Referrals26:59     How to Audit and Zone Your Dental Diary29:51     Morning vs Afternoon: Decision Fatigue in Dentistry32:22     What Is Slack in Your Diary? (And Why You Need It)37:01     How Associates Can Negotiate Diary Control45:50     Creating Scarcity: Building a Referral Funnel48:30     Why Every Dentist Needs a Mentor or Coach51:49     How to Negotiate Time Off as an Associate57:48     Going Part-Time as a Dentist: The Real Trade-Offs1:06:27   How Far Ahead Should Your Diary Be Booked? From the Guest Dr Ronit Patel is a general dental practitioner and associate at the White House Dental Clinic in Kew, where his book is now largely referrals — endodontics, restorative work under the microscope, and the tricky cases other dentists have become stuck with. Before that, he was a clinical lead for a corporate group, mentoring dentists across the South of England. In the community: members of Protrusive Guidance will already know Ronit from his short, helpful clinical videos inside the app. No courses, books or social channels were promoted on this episode — fittingly, for a referral practice built without social media. References & Further Reading Books and research mentioned in this episode: Kleitman N. Sleep and Wakefulness (rev. ed., 1963). The ~90-minute basic rest–activity cycle, proposed to continue through waking hours (daytime evidence is still debated).Kahneman D, Sibony O, Sunstein CR. Noise: A Flaw in Human Judgment (2021).Pink DH. When: The Scientific Secrets of Perfect Timing (2018).Danziger S, Levav J, Avnaim-Pesso L. Extraneous factors in judicial decisions. PNAS, 2011;108(17):6889–6892. The parole-decisions-and-food-breaks study.Newport C. Slow Productivity: The Lost Art of Accomplishment Without Burnout (2024).Maltz M. Psycho-Cybernetics (1960). Want more? If you enjoyed this episode, check out: Better Dentistry Through Compassion (Not Just Technique) – IC073 Tags #PDPMainEpisodes #CareerDevelopment #BeyondDentistry Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes B. AGD Subject Code: 550 Practice Management and Human Relations. Aim & Learning Outcomes Aim: To help dental practitioners take deliberate control of their clinical diary and career design — using audit data, scheduling principles and professional networks — so they can sustain high-quality care, develop a clinical niche and protect their own wellbeing. Learning Outcomes — by the end of this episode, dentists will be able to: Describe how auditing an appointment book and calculating the hourly value of each appointment type can be used to zone a clinical diary and build a business case for changes to working patterns.Explain how planned slack and time-of-day considerations in scheduling can protect clinician energy, decision quality and patient care.Identify strategies for developing a non-specialist referral niche through professional networks, incremental skill development and case audit.

Ever felt like being a good clinician is just the entry fee? Have you got an idea you’ve been sitting on — and no one telling you to go for it? Practice ownership, a side business, or staying a happy associate: how do you know which is right for you? And when you tell a patient the fee… do you stay silent, or start talking? This is an Interference Cast — a non-clinical episode designed purely to inspire. My guest, Dr Jawad Abbas, is a young associate who’s already building two ventures alongside his clinical work: an AI tool for radiographic analysis and treatment-plan communication, and a luxury oral-care brand. We start with the communication skills that turn patient trust into comprehensive care — then dig into what it really takes to build something of your own, and whether you even should. We’re living through a moment where, if you can think it, you can increasingly build it. If there’s a big enough problem out there and you have a good solution for it, this episode might be the spark you needed. Protrusive Dental Pearl: Say the Fee, Then Stay Silent When you present a treatment fee, say the number clearly — then stop talking. Don’t justify it, don’t over-explain, don’t rush to fill the gap. The pause feels endless to you, but for the patient it passes in a second or two, because they’re busy doing the mental maths: what’s in savings, what the monthly commitments look like, whether they can make it work. Give them that space. What undermines a fee is rarely the number; it’s the delivery. Closing your eyes as you say it, your voice rising in pitch, launching straight into justification, or avoiding it altogether and letting the patient discover it at reception all signal that you’re not sure of your own fee. Remember what sits behind it — your training, and what your surgery costs to run every hour — and say it like you mean it. What You’ll Take From This Episode Four communication habits that build trust — from asking what matters to matching your information to the decision-maker.The cost of doing nothing — how to make an unconcerning problem an informed choice, without selling.What a fee actually covers — the one question every associate should ask their principal.The three hats — entrepreneur, manager or technician, and why so few people wear all three well.From problem to prototype — five steps to test a business idea before you sink money into it.The decision filter — six honest questions to tell you whether building something of your own is right for you. Highlights of This Episode00:00     TEASER00:59     Entrepreneurship in Dentistry: Why Now Is Different07:14     Patient Communication: Ask What Matters to Them10:39     How to Explain the Cost of Doing Nothing14:19     Short-, Medium- and Long-Term Treatment Plans16:57     Fast-Lane vs Slow-Lane Patients: Personality Types20:09     How to Present Your Dental Fees With Confidence24:07     How Profitable Is a UK Dental Practice?26:29     Why Dentists Become Entrepreneurs31:08     Associate, Principal or Entrepreneur?36:19     The E-Myth for Dentists: Which Hat Do You Wear?41:09     Building an AI Treatment-Planning Tool44:06     How to Validate a Business Idea Before You Build It49:51     Creating a Luxury Mouthwash Brand53:24     How to Find a Business Idea — In or Out of Dentistry58:54     Dentistry as Your Safety Net: Starting a Side Business1:04:58   OUTRO From the Guest Dr Jawad Abbas graduated from the University of Manchester and is completing a diploma in restorative and aesthetic dentistry at Smile Dental Academy, while working as an associate in Ipswich and Peterborough. Alongside clinical work, he’s developing two ventures, both at prototype stage: an AI tool that flags decay and presents tiered treatment options as a communication aid, and Jawdouré, a luxury fragrance-led mouthwash brand. During foundation training he wrote for dentistry.co.uk about the anxiety of charging for treatment. 👉  @jaw.dental on Instagram — questions and messages welcome References & Further Reading Books, brands and episodes mentioned in this episode: Gerber ME. The E-Myth Revisited. The source of the entrepreneur / manager / technician model. A dentistry edition also exists: Gerber ME, Kwong Hing A, Barrow C. The E-Myth Dentist. Michael E. Gerber Companies, 2014.Erikson T. Surrounded by Idiots: The Four Types of Human Behaviour. The four-colour personality model discussed in the communication section.Squibb S. What’s Your Dream? Penguin, 2024.MAISON de SABRÉ — the luxury leather-goods brand founded in Sydney in 2017 by brothers Omar and Zane Sabré, who trained as dentists.Previous Protrusive episodes: Dr Colin Campbell on consent and personality types (PDP265); Professor Avijit Banerjee on caries management (PDP269). Want more? If you enjoyed this episode, check out: How to Find a Mentor in 5 Seconds Flat! – IC058 Tags #InterferenceCast #CareerDevelopment #BeyondDentistry #Communication Listen & Subscribe Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is not eligible for CPD/CE — but most of our episodes are. Find them, and earn your CPD, inside Protrusive Guidance.

Beyond Scaling: How to Get More From Your Ultrasonic Do you really need your ultrasonic on 100%? (Probably not — and it may be costing you precision.) Which part of the tip should actually be touching the tooth — and is that why the hygienists keep complaining about blunt tips? Could the scaler tip you already own refine your margins, find a calcified canal and cut gutta-percha like a hot knife through butter? And if you’re in the market for a new unit, which features are actually worth paying for? Every dentist uses an ultrasonic — but most of us use it as a perio tool and nothing more. In this episode, Dr Hussain Hassanali, a general dentist who has gone properly geeky on ultrasonics, walks through how they really remove tooth tissue and how to put them to work in restorative dentistry and endo. It’s foundational, practical, and full of things you can try at your next session. Jaz’s biggest takeaway? Stop whacking the power up to 100%. Protrusive Dental Pearl: Trim Gutta-Percha With Your Scaler Tip You’ve just obturated a canal and need to remove the excess gutta-percha. The old ways: heat a ball burnisher in the flame until it glows red (that smell, and the GP smearing everywhere — or lifting out entirely because the sealer hasn’t set), or sink a long-neck bur into the GP while it spins and hope you don’t gouge the dentine. Instead, take your bog-standard ultrasonic scaler tip, turn the water off, and set the power to around 10%. Sweep it across the orifice and it cuts through gutta-percha like a hot knife through butter — the water is off because here you want the heat. Then drop the power right down (around 2%) and gently compact the coronal GP, leaving roughly 1–1.5 mm of space for your restorative material to lock into the orifice. No flame, no burn risk, and a thin tip that doesn’t block your view. Try it once and you won’t go back to heated pluggers. What You’ll Take From This Episode The three rules of the ultrasonic — why it abrades rather than cuts, why the side of the tip beats the pointed end, and why power is a dial, not a switch.A settings guide by task — where to start for enamel margins, fissures, soft dentine, endo access and gutta-percha.Standard tip or specialist tip? — when the tip you already own is enough, and when diamond-coated tips earn their place.Water on or water off? — the two endo jobs where the water has to go off.Buying an ultrasonic — piezo versus magnetostrictive, and the one feature that changes patient comfort. Highlights of This Episode00:00     TEASER00:59     Ultrasonic Scaler Tips Every Dentist Should Know04:30     Why Ultrasonics Are Underused in General Dentistry07:08     What Power Setting to Use When Cleaning Enamel Margins09:28     Which Part of the Ultrasonic Tip Should You Use?11:34     Ultrasonic Power Settings for Occlusal Fissures13:47     Piezoelectric vs Magnetostrictive Scalers: Does It Matter?21:37     Ultrasonics for PRRs, Fissure Sealants and Anxious Children28:36     Selective Caries Removal With an Ultrasonic30:42     Refining Crown and Onlay Margins With Ultrasonic Tips39:02     Ultrasonics in Endo: Irrigant Activation and Finding Canals45:35     How to Trim Gutta-Percha With an Ultrasonic51:37     The Most Common Ultrasonic Mistake: Too Much Power54:29     What to Look for When Buying an Ultrasonic Scaler57:39     Are Ultrasonic Scalers Safe With Pacemakers?1:00:55   Cementing Onlays With Heated Composite: Do Ultrasonic Tips Help?01:09:01  OUTRO From the Guest Dr Hussein Hassanali is a dentist at Thorpe Dental Group and Implant Suite in York. He qualified from the University of Liverpool in 2009, completed a Postgraduate Diploma in Restorative and Aesthetic Dentistry in 2020, and is particularly passionate about preventative and minimally invasive dentistry — which is what led him down the ultrasonics rabbit hole. He is happy to answer specific questions, and he’s open to building a hands-on course if there’s demand. 👉  Dr Hussein Hassanali at Thorpe Dental Group, York Want more? If you enjoyed this episode, check out: No More Air Polishing or Prophy Paste! Revolutionary New Technique for Non Mechanical Prophylaxis – PDP284 Tags #PDPMainEpisodes #EndoRestorative Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C. AGD Subject Code: 250 Operative (Restorative) Dentistry. Aim & Learning Outcomes Aim: To broaden dental practitioners’ use of the ultrasonic scaler beyond periodontal debridement, by explaining how ultrasonic instruments remove tooth tissue and how to apply them precisely and safely in restorative and endodontic procedures. Learning Outcomes — by the end of this episode, dentists will be able to: Describe how ultrasonic instruments remove tooth tissue by abrasion, and explain what this means for selective removal, tip orientation and power setting.Apply appropriate power, water and tip choices to restorative uses of the ultrasonic, including margin finishing, fissure preparation for preventive resin restorations and selective caries removal.Use ultrasonics safely in endodontics — for irrigant activation, canal location, scouting and gutta-percha trimming — and identify precautions for patients with cardiac implantable devices.

Would you dare promise patients a refund if they felt any pain? Why do so many of us still skip topical — and what does that say to the patient in the chair? How do you take the sting out of an inferior alveolar nerve block, a palatal, or a screaming hot pulp? And when the lip is numb but the patient still feels it — what went wrong before you even picked up the handpiece? My guest is Dr Nigel Kennedy, known to his Brighton patients as “No Pain Nigel” — a dentist who backed his injections with a money-back guarantee, and who has recently retired. Fair warning: there is no revolutionary technique or new anaesthetic agent in this episode. It is the foundations of painless anaesthesia, done properly and done every time — a great reminder of the why for experienced colleagues, and an aspirational one for younger dentists. We finish on something bigger: how to stay calm, stay well, and enjoy a long career in dentistry. Protrusive Dental Pearl: Plateaus Are Normal, Growth Compounds Growth in dentistry is not exponential and ever-rising. Like most careers, it plateaus — and you will feel stuck, sometimes for years. That is normal. Progress comes in small increments, and one of the best things about this profession is that you learn something new every working day. Trust the process. Keep investing in yourself and aim to be 1% better. Give each month a theme — rubber dam this month, photography the next — and the breakthroughs arrive. A useful marker of how far you have come: early on, many of us check tomorrow’s day list so we can revise for the deep filling, the molar root canal or the denture records. Years later you walk in not knowing what is booked — even a full-mouth rehab — and think, “Okay, cool. Let’s do this.” It may not feel rapid, but it is compounding. What You’ll Take From This Episode Topical done properly — the one preparation step that makes topical actually work, and why skipping it is a lack of empathy.Tension, pressure and distraction — how to time the needle so the patient barely registers it.The two-stage block — a simple sequence that takes the discomfort out of the IANB.Slow down — how long a cartridge should really take, and why profound beats borderline.When it’s hard to numb — the hot pulp, the palatal, and the last moment of an extraction.Phrases for patients — the exact words to use before the needle, the palatal and the final pull.Highlights of This Episode00:00     TEASER01:00     Painless Local Anaesthetic: The Money-Back Guarantee03:21     Feeling Stuck in Dentistry? Why Plateaus Are Normal06:20     How to Market Pain-Free Dentistry to Anxious Patients08:20     How to Build a Dental Practice Patients and Staff Stay With11:56     Can You Promise Patients Pain-Free Dentistry?15:29     Why Topical Anaesthetic Is Non-Negotiable16:56     How to Give a Painless Dental Infiltration18:49     Painless Inferior Alveolar Nerve Block: The Two-Stage Technique20:13     How Slowly Should You Give a Dental Injection?21:22     Midroll25:44     Lip Numb but Still Feeling It? Testing for Profound Anaesthesia27:44     How to Numb a Hot Pulp29:51     Painless Palatal Injections: Two Techniques32:31     Communication vs Technique in Pain-Free Dentistry35:52     Pain-Free Dentistry: What to Change Tomorrow39:19     Stress, Longevity and a Fulfilled Career in Dentistry45:41     OUTRO From the Guest Dr Nigel Kennedy qualified in Manchester in 1979 and owned his own practice in Brighton from 1994, selling it in stages to his associate before retiring at 71. The “No Pain Nigel” name started with a patient who told him she never felt his injections — and grew into a practice-wide promise of pain-free dentistry, backed by patient video testimonials. Nigel is happy to hear from dentists, especially younger colleagues, who want advice. He is on Instagram, Twitter and LinkedIn: Nigel Kennedy References & Further Reading Sources and further reading from this episode: Melzack R, Wall PD. Pain mechanisms: a new theory. Science, 1965;150(3699):971–979. The gate control theory of pain — why firm pressure beside the injection site helps.HurriCaine topical anaesthetic gel (Beutlich; 20% benzocaine) — the topical discussed in this episode.The Profitable Dentist magazine (Excellence in Dentistry, USA) and Tony Gedge of the Marketing Pirates of Dentistry — the practice-marketing influences behind the “pain-free” promise.Dr Mike Gow (Berkeley Clinic, Glasgow) — previous Protrusive guest on dental hypnosis and anxiety. [PDP050] Want more? If you enjoyed this episode, check out: What Every Dentist Should Know About Managing Dental Anxiety – PDP050 Tags #PDPMainEpisodes #Communication #CareerDevelopment Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A. AGD Subject Code: 340 Anesthesia and Pain Management. Aim & Learning Outcomes Aim: To equip dental practitioners with practical, patient-centred techniques for delivering comfortable intraoral local anaesthesia and managing difficult anaesthetic scenarios, recognising the role of communication in the patient’s experience of pain. Learning Outcomes — by the end of this episode, dentists will be able to: Describe a structured approach to comfortable local anaesthetic delivery, including topical application to dried mucosa, tissue tension, pressure-based distraction and slow deposition.Apply strategies for difficult anaesthetic scenarios — the inferior alveolar nerve block, palatal injections and irreversible pulpitis — including staged and supplementary techniques and objective testing before treatment.Use rapport, honest expectation-setting and reassurance to reduce patient anxiety and perceived pain during local anaesthesia and treatment.

When a filling doesn’t go to plan, how many times do you replay it on the drive home? Have you fallen out of love with dentistry — or just with the way you’re experiencing it right now? Why do the habits that could help your headspace get forgotten by Wednesday? And when did you last ask yourself: have my thoughts been serving me today? This is an Interference Cast episode — no margins, no bonding protocols. Jaz is joined by Neo Positivity, a former Camden, New Jersey police officer turned mindset speaker, who now spends his time in dental practices in the US and the UK with one message: thoughts become things. Neo is big energy, and not every part of his philosophy will land for everyone — it doesn’t need to. Underneath it are habits any dentist can use tomorrow: stepping back from the “what if” spiral after a treatment goes wrong, catching autopilot thinking, remembering how badly you once wanted this job, and building reminders into the day so you actually follow through. Jaz leaves with a very personal takeaway about the version of himself that shows up at home. This episode discusses suicide in the dental profession. If you’re struggling, please talk to someone today — in the UK and Ireland, Samaritans are free and available 24/7 on 116 123; in the US, call or text 988. The Canmore Trust (thecanmoretrust.co.uk) supports dental professionals affected by suicide. What You’ll Take From This Episode Step back from the thought — the press-conference technique for the “what if I get sued?” spiral.Watch what you water — why the thoughts you rehearse most become the easiest to repeat.Get home first — the step to take before you quit a job, or dentistry.Reach for the cookie jar — using past wins to reset a bad day and repair a strained nurse relationship.Lead the ripple — why a leader who walks out of the wellbeing session undoes it. Highlights of This Episode 00:00     TEASER00:57     Why Mental Wellbeing Belongs on a Dental Podcast03:49     From Police Officer to Mindset Coach09:12     Burnout in Dentistry: Facing the Problem Honestly10:24     How to Stop Ruminating After a Treatment Goes Wrong14:07     Your Thoughts Aren't Facts: The Press Conference Technique16:10     Watering Seeds: How Repeated Thoughts Rewire Your Brain20:03     Autopilot Thinking in the Dental Practice22:31     Midroll25:52     Energy, Vibe and the Patients You Attract30:30     How to Fix a Difficult Relationship With Your Dental Nurse33:14     The Cookie Jar: Using Past Wins to Reset Your Mood33:54     Burnout or the Wrong Practice? Before You Quit Dentistry39:57     Remember How Badly You Wanted to Be a Dentist41:18     Leading by Example: Building a Positive Practice Culture44:53     Accountability Partners and the Daily Mindset Check-In46:51     Takeaways, Resources and Wrap-Up50:31     OUTRO From the Guest Neo Positivity speaks to dental practices, conferences and teams, visiting practices and speaking at lunch breaks with his “Thoughts Become Things” message. His book, Your ATM (“Your Ability to Manifest”), is out in print and as an audiobook, and he produces short morning-huddle videos for practice teams. 👉  neopositivity.com — book Neo for your practice, and find Your ATM References & Further Reading Books mentioned in this episode: Eckhart Tolle — The Power of Now. On living in the present moment.Michael A. Singer — The Untethered Soul. On observing your thoughts rather than being carried by them.David Goggins — Can’t Hurt Me. Source of the “cookie jar” idea discussed in the episode.Rhonda Byrne — The Secret; and Napoleon Hill — Think and Grow Rich. The works that introduced Neo to the “thoughts become things” idea.Want more? If you enjoyed this episode, check out: Before the Breaking Point – IC071 Tags #InterferenceCast #BeyondDentistry #CareerDevelopment Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcome B. AGD Subject Code: 770 Self-Improvement. Aim & Learning Outcomes Aim: To help dental professionals recognise and interrupt negative thought patterns, and to give them simple, repeatable habits that support wellbeing for themselves and their teams. Learning Outcomes — by the end of this episode, dental professionals will be able to: Describe how rumination after a clinical or workplace setback reinforces itself, and apply a step-back technique to interrupt a negative thought loop.Identify practical cues and peer accountability structures that help dental professionals sustain wellbeing habits during the working day.Differentiate dissatisfaction with a working environment from dissatisfaction with dentistry itself, and outline steps to take before a major career change.

How do you explain everything that could go wrong with a root canal — without the patient walking out? Why does a signed consent form protect you far less than you think? What should you say in the exact moment after you tell a patient the fee? And which single word is quietly sabotaging every future conversation you have about maintenance? This is Part 2 of our communication masterclass with Dr Zak Kara, principal dentist at Smile Stories in Bournemouth, who coaches and mentors dentists on exactly these conversations. We tackle two questions sent in by the community: how to explain risks without discouraging patients from treatment, and how to present fees — including future maintenance and complications — clearly and confidently. Expect two live role-plays (a molar root canal and a lower wisdom tooth), a respectful disagreement about whether to call people patients or clients, and the fee-presentation sequence I wish I’d had years ago, when I hated every part of talking about money. Protrusive Dental Pearl: Could They Retell It at Home? Measure a consultation by one question: was I understood? Not conversion, not uptake — understanding. The ethical approach tends to deliver the conversion anyway. The practical test: when the patient gets home and someone asks “How was the dentist today?”, can they summarise in a few sentences exactly what the appointment was about and what they need to do next? If not, the explanation isn’t finished — however thorough it felt from your side of the chair. That clarity is a skill, and it gets built deliberately. What You’ll Take From This Episode Six moves for explaining risk — how to make every risk proportionate, personal and paired with your plan to reduce it.A root canal consent, live — plain-English wording, an honest success rate, and the analogy that makes recovery make sense.Common vs rare risks — when a risk deserves a sentence and when it deserves a diagram.The fee presentation sequence — seven steps from the reason to the objection, and why the pause matters most.Words to ban — why fees beat prices and costs, and what to say instead of “permanent.”Maintenance without the awkwardness — setting shared responsibility up front so “redo it for free” never comes up. Highlights of This Episode00:00     TEASER00:48     How to Explain Risks and Fees to Dental Patients04:10     The Biggest Lever in Dental Communication06:53     How to Attract the Right Patients to Your Chair14:29     What Makes a Super Associate?19:58     How to Explain Treatment Risks Without Scaring Patients26:22     Root Canal Consent: A Live Role-Play33:59     Using Analogies to Explain Occlusion and TMD Risk36:08     Wisdom Tooth Consent: Common vs Rare Risks41:07     Why Consent Is a Process, Not a Signature45:45     Midroll51:34     Patients or Clients? What to Call the People You Treat55:12     How to Present Dental Fees With Confidence59:08     A Simple Framework for Presenting Fees1:12:05   When to Discuss Treatment Alternatives1:14:45   Why You Should Never Say "Permanent Crown"1:20:15   A Communication Course for Dentists1:20:51   OUTRO From the Guest Dr Zak Kara is principal dentist at Smile Stories in Bournemouth, and coaches and mentors dentists and their teams in communication. His communication course, developed with Protrusive, teaches from real consultation videos — filmed with patients’ permission — broken down play by play: what he said, why, and why he paused where he did. Pre-order the communication course here: 👉  protrusive.co.uk/conversations Once the course is out, you’ll also get access to a 90-day accountability group with Zak and me, and the full course in podcast format for your commute. Want more? If you enjoyed this episode, check out: Presenting Treatment Plans the Comprehensive Way – PDP048 Tags #PDPMainEpisodes #Communication Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcome A. AGD Subject Code: 550 Practice Management and Human Relations. Aim & Learning Outcomes Aim: To improve how dental practitioners communicate treatment risks, fees and long-term maintenance, so that patients make informed, genuinely consensual decisions without being frightened or overwhelmed. Learning Outcomes — by the end of this episode, dentists will be able to: Explain treatment risks in proportion to the individual patient’s clinical situation, using plain language, relatable analogy and a stated plan to mitigate each risk.Apply a structured sequence for presenting treatment fees that links the recommendation to the patient’s own goals and responds to objections without coercion.Describe how consent is developed across multiple touchpoints, including discussion of alternatives, shared maintenance responsibilities and checks of patient understanding.

NEW: 15% OFF FIGS Worldwide 🌍 - use code FIGSPD15 at wearfigs.com What do you say when a patient comes in wanting one tooth fixed, but you can see eight more heading the same way? How do you tell a patient who has had a scale and polish every six months for twenty years that they now need something deeper without making it sound like you’re suddenly trying to sell them more dentistry? Is there a magic sentence that makes patients say yes to comprehensive care? And why can the patient you’ve known and liked for six years sometimes be harder to move forward with than a complete stranger? This is Part 1 of a two-part communication series with Dr Zak Kara — co-founder of Smile Stories in Bournemouth, and the most-returning guest on this podcast. It’s also our first-ever call-in episode: the questions came in from the community as voice notes, and this episode answers two of them. Part 2 takes on the awkward stuff — discussing fees, and communicating risk without frightening people off. Protrusive Dental Pearl: Reactive or Proactive Associate? When the diary goes quiet, what do you actually do? Wait for the practice to work some magic and fill it — or go and fill it yourself? The mentality of “the clinic supplies the patients, I just treat them” is worth a hard look. The strongest associates pull their weight: writing, school visits, social media, and simply having conversations out in public that bring people through the door. The logic behind it runs straight into the rest of this episode. You never get to do the clinical dentistry unless your communication is good — and you never get to communicate at all unless there’s someone in the chair. What You’ll Take From This Episode The two ladders of readiness — clinical readiness and interpersonal readiness rise separately, and a plan gets declined when they’re badly out of step.Why “I’ll think about it” usually isn’t distrust — and the co-diagnosis move that stops you hearing it so often.The conversation circle — open on goals rather than symptoms, and close the visit by tying the recommendation back to the patient’s own words.Words that change the meeting — inflammation score instead of bleeding score, and why one word can decide whether a patient feels blamed or informed.How to present a five-figure plan — when to name the number, and what to do in the silence afterwards.Chairside scripts you can use tomorrow — permission questions, spot-the-difference, and the line that flips a treatment plan into something the patient avoids rather than buys. Highlights of This Episode00:00     TEASER00:51     How to Talk to Patients Who Only Want One Tooth Fixed03:45     Protrusive Dental Pearl: Reactive or Proactive Associate?09:27     The First Protrusive Call-In: Your Communication Questions13:40     Why There Is No Magic Sentence for Case Acceptance15:58     Co-Diagnosis: How to Make It the Patient's Own Idea22:36     The Conversation Circle: Start With Goals, End With Goals26:58     Why "Inflammation Score" Beats "Bleeding Score"30:50     The Peak-End Rule: What Patients Actually Remember34:46     How to Ask Permission Before You Educate a Patient39:32     Scale and Polish vs Deep Clean: Explaining the Difference39:41     Midroll44:54     How to Introduce Full Mouth Rehab Without Overwhelming48:39     The Ladder of Readiness: Where Is Your Patient?55:02     Two Ladders: Clinical and Interpersonal Readiness59:23     How to Pre-Qualify Patients Before They Reach Your Chair1:11:32   How to Present a Five-Figure Treatment Plan1:20:26   OUTRO Communication course — waiting list: Zak has a communication course in preparation. Protrusive is supporting it with a 90-day accountability group inside the app for anyone who enrols, plus retained lifetime access to Loom School.  The waiting list is at protrusive.co.uk/conversations. Find Zak Kara in Instagram (@zakdentalkitchen) and Facebook (Zak Kara). References & Further Reading The behavioural science referenced in this episode: Norton MI, Mochon D, Ariely D. The IKEA effect: When labor leads to love. Journal of Consumer Psychology, 2012;22(3):453–460. People value what they helped build — the mechanism underneath co-diagnosis.Bem DJ. Self-Perception Theory. Advances in Experimental Social Psychology, 1972;6:1–62. People infer what they believe partly from observing what they themselves say and do.Kahneman D, Fredrickson BL, Schreiber CA, Redelmeier DA. When more pain is preferred to less: Adding a better end. Psychological Science, 1993;4(6):401–405. The healthcare application is Redelmeier DA, Kahneman D, Patients’ memories of painful medical treatments, Pain, 1996;66(1):3–8. Want more? If you enjoyed this episode, check out: Think Comprehensive – Communication Gems with Zak Kara – PDP010. The episode that started it all. Tags #PDPMainEpisodes #Communication Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A. AGD Subject Code: 550 Practice Management and Human Relations. Aim & Learning Outcomes Aim: To improve dental professionals’ ability to communicate the need for comprehensive or more extensive treatment to patients who present with single-tooth expectations, using structured, permission-based and goal-led conversation rather than persuasion. Learning Outcomes — by the end of this episode, dentists will be able to: Describe how a patient’s readiness for comprehensive treatment can be assessed along two parallel dimensions — their understanding of their own clinical need, and the strength of the working relationship — and identify where an individual patient sits on each. Apply permission-based and question-led techniques that help a patient identify disease for themselves, so that a recommendation is understood and owned rather than imposed. Dif...

Ever wondered what it’s really like to study dentistry abroad? How different is it to train in Bulgaria, Slovakia, or Valencia compared to the UK? And what happens when it’s time to come back home — can you easily register with the GDC and start practicing? Dr. Hugo Medd joins Jaz for an honest and insightful conversation about taking the path less traveled — studying dentistry in Bulgaria after not securing a UK dental school place. They dive into the realities of living and learning abroad, including language barriers, different teaching styles, and how much clinical experience international students actually get. Hugo also shares how he navigated GDC registration, what it’s like finding work after graduation, and why he has no regrets about choosing this unconventional route. Highlight of this episode:00:00     TEASER01:21     Introduction02:49     Meet Dr. Hugo Medd: A Journey to Bulgaria06:09     Financial Considerations and Support Systems09:56     Why Bulgaria? DMD vs BDS explained13:13     Language Barriers and Communication Skill17:47     Tuition Fees, Cost of Living, and Financial Realities20:47     Navigating Post-Graduation and GDC Registration23:23     Accredited EU Universities and Recognition Rules25:09     Social Life, Culture, and Student Experience28:14     Midroll34:47     Differences in Teaching Styles Abroad40:54     Navigating the UK Dental Job Market43:03     Advice for New Graduates50:24     Pursuing a Master's in Oral Surgery54:45     Final Thoughts and Contact Information57:11     OUTRO Inspired to study abroad? Study Medicine Europe helps you land top dentistry and medicine placements in Europe and guides you from application to graduation. If you enjoyed this episode, check out “The American Dental Dream – PDP002” This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan. #InterferenceCast #CareerDevelopment

Have you ever removed plaque using a scaler or ‘air-polisher’ and notice that the demineralised enamel flaked away? Scaling and polishing is a routine part of preventive dental care — but could some of our traditional cleaning methods be doing more than we realise? A whitening specialist who works without a drill, scaler or air polisher argues that some approaches to cleaning may affect the enamel, and that hydrogen peroxide gel can remove plaque without touching the tooth surface. Dr Wyman Chan has done nothing but tooth whitening since 2002, when he closed his general practice for a dedicated whitening centre, and he developed the chemical-polishing gel which is at the centre of this episode. He is joined by Dr Niki Shah, a UK general dentist and practice owner whose company distributes the product in the UK, and who now runs most of his hygiene this way. In this episode, they explain which patients they believe may benefit most, walk through the full chairside protocol, and discuss the limitations of the approach and where it may not be appropriate. Protrusive Dental Pearl: Manicuring Worn Lower Incisors Worn lower incisors sit sharp against the upper teeth, concentrating stress. Take a Sof-Lex disc and manicure them, rounding the edges from pointed to smooth. Show the patient in the mirror first and, borrowing Dr Michael Melkers’ framing, ask if you can make their teeth look a little younger. It is surface topography, changed for force management, and the patient feels it with their tongue. What You’ll Take From This Episode On sound enamel, prophy paste and air polishing are low-risk; on demineralised enamel hidden under plaque, the same abrasion can flake the surface. Chemical polishing does not lift calculus; where calculus is present, ultrasonic or hand scaling is still required. Dr. Wyman Chan offers a 3% hydrogen peroxide gel as a plaque and biofilm adjunct, not a replacement for oral hygiene instruction. The strongest cases for this are anxious, paediatric, orthodontic, special-needs and geriatric patients who tolerate scraping poorly. The chairside protocol runs about twelve minutes and still ends with manual agitation using a single-tufted brush. No published evidence supports the product’s clinical claims yet; Dr. Wyman Chan describes studies in progress.Highlights of This Episode00:00     Teaser01:21     Rethinking How We Polish Teeth03:36     Protrusive Dental Pearl: Manicuring Worn Lower Incisors05:23     Meet the Guests: From Whitening to Chemical Cleaning12:10     What Is Chemical Polishing? Prophylaxis, Not Whitening20:05     Is Traditional Polishing Damaging Teeth?21:54     How Abrasion Harms Demineralised Enamel25:30     The Strongest Case: Anxious Patients29:09     Children, Adolescents and Orthodontic White Spots29:49     Midroll35:22     Managing Pericoronitis and Gingival Abscess38:15     Special Needs, Geriatric and Post-Surgery Care40:43     Where Is the Evidence? Studies in Progress43:59     The Cost and Business Case for Chemical Polishing50:16     The Chemical Polishing Protocol: Step by Step using Magic353:14     Why Manual Agitation Still Matters57:58     How It Changed a Working Day1:00:35   Outro Start offering Magic3 Where to get Magic3:  UK: directoralcare.comRegister for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses.Use promo code PROMAGIC10 at checkout to receive 10% off Magic3.Outside UK: Please enquire from Dr Wyman Chan's website.Orders are invoiced rather than purchased directly through the website.Quote promo code PROMAGIC10 when enquiring to receive 10% off your Magic3 order.FREE Wyman Dental Retractors With your first Magic3 order, you’ll also receive 1 Wyman Dental Retractor free. The Wyman Dental Retractor is a multi-use, autoclavable retractor (up to 100 uses) designed for comfortable and effective soft-tissue retraction. Order 1–2 Magic3: Get 1 free Wyman Dental RetractorOrder 3+ Magic3: Get 3 free Wyman Dental RetractorsLearn more about their other products: https://protrusive.co.uk/magic3 Want more? New to Dr Chan’s work? Start with Trayless Whitening Technique Part 1 with Dr Wyman Chan - PDP277, on his whitening approach, sensitivity and how to let patients pick their target shade. Tags #PDPMainEpisodes Listen, subscribe, and earn CPD Listen: Spotify, Apple Podcasts, YouTube, and inside Protrusive Guidance. Earn CPD: This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. Compliance: GDC Development Outcome C. AGD Subject Code 490 Periodontics. Aim & Learning Outcomes Aim: To give a mechanism- and evidence-aware view of chemical polishing as an adjunct for plaque and biofilm removal: where mechanical polishing can harm demineralised enamel, which patients the approach suits, how the chairside protocol runs, and the limits of the current evidence. By the end of this episode, dentists will be able to: Describe how the abrasivity of prophylaxis pastes and air-polishing powders interacts with sound versus demineralised enamel. Identify the patient groups for whom a non-mechanical approach to plaque removal is most appropriate, and the situations, such as calculus, where it is not. Evaluate the current evidence base for a 3% hydrogen peroxide chemical-polishing protocol, and apply appropriate attribution and consent where the evidence is not established.

Full mouth reconstruction — is the aim really the flawless before-and-after you scroll past on Instagram, or is that a trap? How do you actually know you’re ready to step up from single teeth to a whole mouth? And when your comprehensive treatment plan keeps getting declined — psychologically, financially — is that the patient’s problem, or yours? This one is a “your questions answered” episode: the community sent in far more FMR questions than we could cover, and we put the best of them to two prosthodontists who literally wrote the book on it. This is a full-mouth reconstruction deep dive with Prof Riaz Yar and Dr Łukasz Lassmann — co-authors of the new Quintessence textbook Full-Mouth Reconstruction (foreword by Jeffrey Okeson). We cover screening before you commit, knowing when you’re ready, getting big plans accepted, choosing materials, setting the bite in centric relation, sleep apnea, and the honest truth about “perfect” versus “acceptable.” Protrusive Dental Pearl: Always Present the Best Advice When you present a complex case, offer three tiers. Best advice — take time and money out of the equation and describe the ideal: what would truly get this patient to the right result (gum grafting, orthodontics, the lot). A compromise — a good result without the parts the patient won’t consent to or can’t fund. And the minimum — the least that still helps, with the non-negotiables named. The most important of the three is the best advice. It’s tempting to self-censor — to decide a plan is too elaborate or too expensive and quietly leave it out. But if you never present the best option, you’ll never get to do those cases. Present the ideal option first, then offer the compromises. Don’t limit the patient — or yourself. What You’ll Take From This Episode Screen before you plan — a green / orange / red system that sorts patients before treatment planning even starts, so you know which cases are yours.How to get big plans accepted — why case acceptance is a confidence problem before it’s a skills problem, and how to present the best advice, compromise and minimum.Choosing materials — why it’s the case, not the material: repairability vs aesthetics vs durability, and why erosion changes the answer.Setting the bite — why centric relation is the reference position, what a night guard can do to it, and how sleep apnea changes the plan.Perfect vs acceptable — defining success and failure honestly, and knowing when you’re actually ready to take a full-mouth on. Highlights of This Episode00:00     TEASER00:53     Full Mouth Reconstruction: Your FMR Questions Answered05:08     What Actually Counts as a Full Mouth Reconstruction?10:48     Screening Patients for Full Mouth Rehab: Green, Orange, Red18:48     Is Perfect the Goal of Every FMR? Success vs Failure26:53     How Do You Know You're Ready for Full Mouth Dentistry?36:23     Is the Dahl Concept a Good Segue Into Full Mouth Rehab?38:50     Midroll42:49     How to Get Patients to Accept Full Mouth Treatment Plans49:34     Best Advice, Compromise, Minimum: Presenting the Options55:04     Give Yourself Permission to Fail in Big Cases56:14     FMR or Selective Restorations? Where's the Line on Tooth Wear?58:49     interjection 11:04:52   Composite, Ceramic or Zirconia? Choosing FMR Materials1:09:53   interjection 21:12:40   Centric Relation, Sleep Apnea and Setting the Bite1:17:25   Anteriors or Posteriors First in a Full Mouth?1:26:00   Does DTR Change How You Finish an FMR?1:27:35   The Full-Mouth Reconstruction Book & Where to Learn More1:30:37   OUTRO From the Guests Prof Riaz Yar is a specialist prosthodontist and Visiting Professor in Prosthodontics, with a 25-year focus on TMD, occlusion and full-mouth dentistry. Dr Łukasz Lassmann is a prosthodontist (DDS, PhD) whose PhD is in occlusion and the temporomandibular joint; he focuses on tooth wear, TMD and full-mouth rehab and founded Lassmann Education, whose multi-day “summer camp” FMR/occlusion course runs in Poland. Interested in Full Mouth Reconstruction? Check out their book:  Full-Mouth Reconstruction (Lassmann & Yar, Quintessence Publishing, 2026; foreword by Jeffrey Okeson) — a general-practitioner workflow from screening through orthodontics, perio, preparation, and cementation.  References & Further Reading Sources and further reading from this episode: Lassmann Ł, Yar R. Full-Mouth Reconstruction. Quintessence Publishing, 2026 (foreword by Jeffrey P. Okeson). ISBN 978-1-78698-153-0.Lassmann Ł, Calamita MA, Blatz MB. The “Smile Design and Space” (SDS) concept for altering vertical dimension of occlusion and esthetic restorative material selection. J Esthet Restor Dent. 2025;37(1):56–67.Loomans B, Opdam N, Attin T, et al. Severe tooth wear: European consensus statement on management guidelines. J Adhes Dent. 2017;19(2):111–119.Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig. 2008;12(Suppl 1):S65–S68.Okeson JP. Management of Temporomandibular Disorders and Occlusion. Elsevier (8th edition)  Want more? If you enjoyed this episode, check out: https://protrusive.app/posts/free-podcast-videos-pdp225-occlusion-myths-and-red-flags-with-lukasz-lassmann Tags #PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.5 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C. AGD Subject Code: 610 Fixed Prosthodontics.

When you walk through the door after work, are you actually present or are you still running the day’s to-do list in your head? Is there ever a “good” time to have a baby in the middle of specialist training and how do you fund it? How do the best dentist-parents you know protect time with their kids without their careers stalling? And can technology actually give you hours back — or is that just another thing to feel guilty about? This is one for the dads. In this Interference Cast episode, Jaz sits down with Dr Sunny Marwaha — a dentist completing part-time specialist training in prosthodontics at Guy’s, who became a father right in the middle of it. It’s not a clinical episode. It’s an honest conversation about doing the hardest career stretch (training, buying practices, building a name) at the exact same time you’re raising young children — the sleep, the money, the guilt, and the strategies that actually help. Two dentist dads, comparing notes. What You’ll Take From This Episode Priority management, not time management — Decide what this season of life is for, and protect it; priorities shift as the kids grow.Leave the day at the door — both directions — The driveway is dad mode, the clinic is showtime; you can’t take work home or home to work.Run the family like a small business — Regular family meetings and a “mind like water” system can help carry the load without living in your head.Use AI to buy back time — Make use of dictated notes, auto-drafted letters, and turning papers into audio for the commute. This is leverage, not cheating.Specialise or self-direct? — An honest filter for whether a structured training pathway or private courses and mentorship suits you better. Highlights of This Episode 00:00     Teaser00:42     Daddy Dentist: Balancing Fatherhood and Dentistry03:42     Should You Specialise or Learn Through Private Courses?10:12      How to Time Having Kids Around Specialist Training13:32     Paternity Leave for Dentists: What's Realistic?16:42     Funding Specialist Training With a Young Family20:02     Why Family Support Is a Privilege, Not a Given22:57     Time Management vs Priority Management23:42     The Two Moments With Your Kids That Matter Most29:12      Protecting Sleep, Fitness and Your Mental Health30:13     Midroll39:03    Top Tips for Dentist Dads41:53      Using AI to Buy Back Time for Your Family45:53     Run Your Family Like a Small Business53:33     How to Cut Kids' Screen Time (and Make It Stick)59:23     Life After Specialist Training: A Shorter Week59:57     Outro From the Guest Dr Sunny Marwaha is a dentist completing part-time specialist training in prosthodontics at Guy’s (King’s College London). He’s passed the MProst (Royal College of Surgeons), with his final MClinDent and GDC specialist listing still ahead. He became a dad to son Kabir midway through training; his wife Amrit is also a dentist. 👉  Follow Sunny on Instagram: @dr_marwaha References & Further Reading Listed for reference (mentions, not endorsements): NotebookLM — Google’s AI research tool; can turn a source document (e.g. a paper) into an audio, podcast-style discussion for the commute. Trello, Inkpad Notepad, and Google Calendar — The “mind like water” offload system.  Loom — screen/video-message tool, mentioned as an alternative to written tooth-by-tooth reports. Want more? If you enjoyed this episode, check out: [Screen Times and SmartPhones for Children – Best Practices – IC061]. The screen-time reset comes up near the end of this chat; that episode goes deeper.  Tags #InterferenceCast #CareerDevelopment #BeyondDentistry Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcome B. AGD Subject Code: 770 Self-Improvement.

Complete Dentures That Actually Work: Impressions, CR & Adaptation You don’t have to suck at complete dentures — there’s a science to them, and an art you gather with experience. Why do complete dentures feel so unpredictable — when a crown prep or an endo doesn’t? What’s the number-one impression mistake dentists make — and the tissue-conditioning step most of us skip? And when a new denture comes back painful — is it the extension, or the occlusion? This one is a whistle-stop tour of complete dentures with Dr Leif Stromberg — a Dallas general dentist who learned removable prosthodontics directly from the legendary Earl Pound and has taught it for decades. Recently nominated for the Texas AGD’s 2026 Texas Dentist of the Year™ Award, Dr. Stromberg brings a wealth of clinical experience, leadership and mentorship to the profession. Rather than drilling into a single appointment, Jaz put a stack of Protrusive Guidance community questions to him and covered the whole arc, from choosing the right patient to troubleshooting a painful denture at delivery. Expect breadth over depth — a lot of ground, a little from each stage — with plenty of technique, nuance and communication tips to take back to the chair. Protrusive Dental Pearl: Pick the Patient Before the Denture You don’t have to treat everyone. Before promising anything, work out whether you can meet the patient’s expectations — because you can build the world’s best denture and they still may not adapt to it. The single strongest predictor of success is the patient’s own adaptation, not the technical quality of the prosthesis. So read the markers of adaptation. The patient who has worn a technically poor, flimsy denture happily for years — and only needs a new one because the old one is worn out — is a home run: improve the retention and stability and they’ll do brilliantly, because their neuromuscular adaptation is already proven. The patient who has hated every set they’ve owned is the warning sign. Assess adaptation right from the first appointment; it matters more than the articulator you own. What You’ll Take From This Episode Pick the patient, not just the denture — the markers of adaptation that predict success before you start.Where the teeth actually go — Pound’s lingual control lines, and why “lingual” means stable.The number-one impression mistake — coverage versus overextension, plus pre-impression tissue conditioning.Records without the wobble — recording centric relation with a gothic arch tracer, and why the facebow ranks low.A painful denture at delivery — how to tell overextension from occlusal overload, and what to do about each. Highlights of This Episode From the Guest Dr. Stromberg teaches  the fundamentals of predictable complete dentures through a run of CE courses on Dentaltown — a five-part written series and a video series that walk through the exam, impressions, records, try-in and delivery. 👉  Stromberg’s “Keys to Complete Denture Success” CE courses on Dentaltown Learn more at: https://www.strombergdentistry.com/articles Want more? If you enjoyed this episode, check out: Occlusion for Complete Dentures – PDP162 Tags #PDPMainEpisodes #ProsthoPerio #Communication  Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C AGD Subject Code: 670 Removable Prosthodontics. Aim & Learning Outcomes Aim: To give clinicians a predictable, appointment-by-appointment approach to complete dentures — patient selection and adaptation, accurate records, functional tooth position, and troubleshooting at delivery. Learning Outcomes — by the end of this episode, dentists will be able to: 1. Assess a patient’s suitability for complete dentures and their likely adaptation, and manage expectations before treatment begins.2. Describe the sequence of clinical appointments for complete dentures and the key objective of each — impression coverage, recording centric relation and vertical dimension, and functional tooth position.3. Differentiate the common causes of pain at denture delivery (overextension versus occlusal overload) and apply an appropriate method to identify and correct each.

Holistic, biological, functional — is there actually a difference, or is it all just marketing?Are root canals really dangerous — or is that just what the algorithm keeps showing your patients?When a patient wants their sound fillings out, do you test, reassure, or drill?And how do you bring sleep, diet and blood tests into a dental appointment without it stopping being dentistry?This episode sits down with Dr James Goolnik (https://uk.linkedin.com/in/james-goolnik)— clinical dentist, founder of the London holistic practice Optimal Dental Health, past President of the British Academy of Cosmetic Dentistry, and one of Jaz’s earliest mentors. James openly calls himself a holistic and biological dentist, which makes him the ideal person to separate the thoughtful, evidence-aware end of this world from the online extremism that gives it a bad name. Expect a balanced, honest conversation: some of it you’ll adopt tomorrow, some of it you’ll want to pressure-test — which is exactly the point.Protrusive Dental Pearl: Dentistry Isn’t Just About Fixing Teeth This one isn’t a clinical tip — it’s a sentiment that frames the whole episode. Dentistry isn’t just about fixing teeth; it’s about improving health. You don’t have to agree with every claim made in biological dentistry — but you will struggle to disagree that a patient’s diet, sleep, breathing, stress and inflammation all influence oral health. So the pearl is simple: stay curious, stay open-minded — but stay critical, and never stop asking better questions. What You’ll Take From This Episode The holistic–biological spectrum — what each word actually means, and where thoughtful practice tips into online extremism. Test or reassure? — the three-question filter for deciding whether any test earns its place before you order it. Safe amalgam removal — the SMART protocol, and when a worried patient’s sound filling should be left well alone. The mouth-body connection — how sleep, glucose control and systemic inflammation affect the mouth, and where to refer. The balanced take on root canals and implants — whether root canals are dangerous, and titanium versus ceramic with metal-allergy testing.Highlights of This Episode 00:00     Teaser00:59     Holistic vs Biological Dentistry: What's the Difference?05:49    Why Listening Beats Perfect Margins in Dentistry10:29     Why Patients Started to Doubt Root Canal Treatment12:09     Mercury Fillings: Should You Remove Amalgam?14:09     The SMART Protocol for Safe Amalgam Removal19:59     The Mouth-Body Connection: Sleep, Diabetes & Alzheimer's24:59    How to Build Nutrition Into a Dental Practice26:25     Midroll34:01     Sleep Tests, Glucose Monitors and Blood Tests in Practice38:21     Is Biological Dentistry Dangerous? The Extremist Problem39:21     Are Root Canals Dangerous? A Balanced Take 41:51     Titanium vs Zirconia Implants and Metal Allergy Testing 46:51     When Removing a Healthy Tooth Becomes Negligent50:56    What Diet Should Dentists Actually Follow?53:41     How to Get Started in Holistic Dentistry56:30    Outro From the Guest Dr James Goolnik is a clinical dentist and founder of Optimal Dental Health, a holistic practice in London built around integrating nutrition, sleep and whole-health screening into everyday dentistry. He is a past President of the British Academy of Cosmetic Dentistry, a member of the International Academy of Oral Medicine and Toxicology, and the author of “Brush” (profits to Dentaid) and the “Kick Sugar” cookbook (profits to his Rewards Project charity). 👉  Optimal Dental Health — monthly practitioner newsletter, and connect with James on LinkedIn Want the Toolkit? We’ve turned this episode into a practical Holistic Dentistry Clinical Toolkit — with quick-reference guides for whole-body assessment, testing, patient conversations, and navigating the holistic–biological spectrum. Download the free toolkit at www.protrusive.co.uk/biological References & Further Reading Sources and further reading from this episode: IAOMT — Safe Mercury Amalgam Removal Technique (SMART). The protocol for safely removing amalgam (rubber-dam isolation, adsorbent rinse, sectioning, high-volume evacuation) to minimise mercury exposure for patient and team. MELISA test. A validated blood lymphocyte-transformation test for type-IV hypersensitivity to metals including titanium and mercury — used to guide titanium-vs-ceramic implant decisions. Tests, devices & materials referenced — a home overnight sleep test, a phase-contrast microscope, a national blood-testing partner, point-of-care fingerprick analysers (CRP / HbA1c), a blood/hair/urine mercury panel, continuous glucose monitors, and Biodentine for vital-pulp therapy.  Want more? If you enjoyed this episode, check out: Implementing Sleep, Airway and Myo to Restorative Dentistry Part 1 — PDP262 Tags #PDPMainEpisodes #Communication #BeyondDentistry Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C. AGD Subject Code: 150 Health, medicine and nutrition. Aim & Learning Outcomes Aim: To give dentists a balanced, evidence-aware understanding of holistic and biological dentistry — what the terms mean, how to integrate whole-health thinking and appropriate testing into practice, and how to navigate patient beliefs about root canals, mercury and metal-free dentistry without abandoning the evidence base. Learning Outcomes — by the end of this episode, dentists will be able to: 1. Differentiate between holistic and biological approaches to dentistry, and articulate where evidence-based, minimally invasive care ends and unsupported claims begin.2. Apply a structured decision filter to judge whether an additional test or intervention is justified — whether it will change treatment, provide a benchmark, or motivate the patient — while working within scope and referring appropriately.3. Describe t...

Injection moulding is meant to save you time. Too often it hands you a mouthful of flash and a cleanup that swallows the chair time you thought you were saving. Dr Sandra Hulac is a Clinical Instructor at the Kois Center in Seattle and an Accredited Fellow of the American Academy of Cosmetic Dentistry. She uses full-mouth injection moulding to road-test occlusions and stabilise breaking-down dentitions, and she teaches the technique hands-on. In this episode she works through where the mess actually comes from, and how design, matrix strategy, careful PTFE and a simple cleanup protocol keep a case clean from the first injection. This episode comes with an infographic: the whole no-mess workflow on one visual guide to keep beside you during design and cleanup. Download it at protrusive.co.uk/nomess. It is the fastest way to turn this episode into something you actually use at the chair. What You’ll Take From This Episode Most injection-moulding mess is prevented at the design stage, through thickness targets and clear lab communication, long before any cleanup. The alternating matrix technique, injecting every other tooth, is the biggest single cleanup saver and cuts the PTFE you need. Matrices cured in a pressure pot, with a spacer protocol, give even thickness and far fewer bubbles. Thin, careful PTFE prevents distortion; bunching it interproximally creates the very excess you are trying to avoid. An S-shaped motion with a Ceri-saw and several 12-plate blades clears resin while protecting the contact. Good pre-treatment hygiene, using diluted hypochlorite or povidone-iodine rather than chlorhexidine, cuts bleeding and contamination. Highlights of this episode: 00:00 Teaser00:54 Introduction02:17 Dental Pearl: Free Injection Moulding Infographic03:17 Main Interview with Dr. Sandra Hulac4:49 Innovations in Dental Education07:26 The Mess Problem in Injection Moulding15:38 Alternating Matrix Technique18:18 Every-Other-Tooth Technique27:54 Cleanup Instruments and Techniques31:35 Handling Teflon and PTFE36:41 Patient Oral Hygiene Tips37:27 Dilution protocol:39:24 Key Principles for Minimizing Mess40:42 Matrix Fabrication and Spacer Protocol43:55 Course Information and Conclusion46:19 OutroFrom the Guest Master Full Mouth Injection Moulding in this exclusive two-day hands-on course! 📅 Dates: Feb. 26-27, 2027📍 Location: Central London Venue (TBC)🌐 Learn more & secure your spot: protrusive.co.uk/FMIM Want more? Learn to treat tooth wear with injectable composite in Injectable Composites in PDP081 Tags #PDPMainEpisodes, #BreadandButterDentistry, #AdhesiveDentistry Listen, subscribe, and earn CPD Listen: Spotify, Apple Podcasts, YouTube, and inside Protrusive Guidance. Earn CPD: This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. Compliance: GDC Development Outcome C. AGD Subject Code 250 Operative (Restorative) Dentistry. Aim & Learning Outcomes Aim: To enable dental professionals to minimise cleanup during injection moulding by optimising design, matrix use, PTFE application, and interproximal finishing techniques. By the end of this episode, dentists will be able to: Explain how proper design and lab communication can reduce composite flash and cleanup in injection moulding. Demonstrate the alternating matrix technique and the correct use of PTFE in minimising mess. Identify and use appropriate instruments and techniques for efficient interproximal cleanup after injection moulding.

Your patient is nine years old. One first permanent molar is crumbling — the others look fine. Does it stay, or does it go? Is that broken-down first permanent molar really down to poor brushing — or is it Molar Incisor Hypomineralisation? When is the right time to take a first permanent molar out — and how do you read it off the X-ray? And how do you tell a parent their child needs an adult tooth removed — without losing them? First permanent molars of poor prognosis are one of the genuine head-scratchers of general practice — full of ifs, buts and timing. In this episode Jaz sits down with Dr Nicole Sturzenbaum, a paediatric dentist and the owner and clinical director of Toothbeary in Richmond, London, to work through the whole decision: getting the diagnosis right (molar-incisor hypomineralisation versus caries), reading the extraction window off an OPG, the restorative ladder from sealant to stainless steel crown, when to bring in the orthodontist, and how to handle the conversation with anxious parents. There’s no one-size-fits-all answer — but there is a clear way to think about it. Protrusive Dental Pearl: Painless Polishing for Anxious Kids The mechanical clean is what frightens children (and plenty of adults) — the scaler, the bristle brush, the gritty prophy paste. For the polishing part, a colourless plaque-dissolving foam gel does the job without any of it. It fizzes wherever there is plaque, so you can hand the child a mirror and show them exactly where to brush; it leaves the teeth satin-smooth, reduces gingival inflammation, and is painless and non-invasive. Two caveats: it does not remove calculus — you still need a hand or ultrasonic scaler for that — and you should agitate the gel gently at the gingival margin for the full effect. It is especially useful for orthodontic and adolescent patients because it reaches the nooks around brackets, which is where post-orthodontic white-spot lesions start. Product: Magic3 (3% hydrogen peroxide, colourless plaque indicator), by Dr Wyman Chan — protrusive.co.uk/magic3. What You’ll Take From This Episode Diagnosis first — MIH or caries? The distinction changes the plan, the prognosis and the whole conversation with the family. Reading the extraction window off an OPG — why chronological age tells you nothing, and what the second molar’s bifurcation tells you instead. The restorative ladder — seal, composite, preformed metal crown, or plan the extraction: matching the least invasive option that will actually hold. When to involve the orthodontist — essential or desirable, which teeth come out, and managing the space afterwards. Getting sensitive molars numb — why MIH teeth are so hard to anaesthetise, and the comfort stack that helps. Highlights of This Episode 00:00     TEASER00:59     First Permanent Molars of Poor Prognosis in Children02:51     Painless Chemical Polishing for Kids (Protrusive Dental Pearl)04:53     Meet Dr Nicole Sturzenbaum, Paediatric Dentist11:49     MIH or Caries? Getting the Diagnosis Right15:14     What Is MIH? Causes, Grades and 'Cheese Molars'17:23     When to Extract a First Molar: Reading the OPG20:08     Sealant, Composite or Crown for MIH Molars22:32     Stainless Steel Crowns for Hypomineralised Molars25:52     Do You Need an Orthodontic Opinion Before Extraction?29:15     Talking to Parents About Removing an Adult Tooth31:56     Anaesthesia Tips for Sensitive MIH Molars36:14     Managing the Space After First Molar Extraction41:15     Balancing and Compensating Extractions Explained47:53     Early Orthodontics and Prevention at Toothbeary51:15     OUTRO From the Guest Dr Nicole Sturzenbaum is a paediatric dentist and the owner and clinical director of Toothbeary, a paediatric dental practice in Richmond, London.  👉  Toothbeary — paediatric dentistry, sedation & early orthodontics, Richmond, London References & Further Reading EAPD guidance (cited on the episode). European Academy of Paediatric Dentistry policy documents on MIH (Lygidakis et al., best clinical practice guidance for clinicians dealing with children presenting with MIH) and on paediatric local analgesia (Kühnisch et al., 2017). Preoperative analgesia for MIH (further reading). Vicioni-Marques, F., Paula-Silva, F. W. G., Carvalho, M. R., Queiroz, A. M., Freitas, O., Duarte, M. P. F., Manton, D. J., & Carvalho, F. K. (2022). Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar: a triple-blind randomized clinical trial. Journal of applied oral science : revista FOB, 30, e20210538. https://doi.org/10.1590/1678-7757-2021-0538 Want more? If you enjoyed this episode, check out: Zirconia vs Metal Hall Crowns vs Conventional with Dr Tim Keys – PDP227 Tags #PDPMainEpisodes #OrthoRestorative Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C. AGD Subject Code: 430 Pediatric Dentistry. Aim & Learning Outcomes Aim: To help general dentists diagnose, assess and manage first permanent molars of poor prognosis in children — recognising molar-incisor hypomineralisation, timing extraction from radiographic development, and choosing between restoration and extraction with the wider team. Learning Outcomes — by the end of this episode, dentists will be able to: Differentiate molar-incisor hypomineralisation from caries of hygiene origin, and explain how that distinction changes management and communication. Apply radiographic developmental assessment — the second molar’s bifurcation and the presence of third molars — to judge the timing of first permanent molar extraction. Select an appropriate management pathway, from sealant and composite through preformed metal crown...