Protrusive Dental Podcast

At Dental School I was taught that we have 2 opportunities as clinicians to save a patient’s life. One was mouth cancer diagnosis (obviously) and the other was a patient with GORD who may develop Barrett’s Oesophagus. However, as I look back now, I do believe dental school missed something out….and that is Sleep Disordered Breathing (SDB). There is no formal acknowledgement of Airway in the dental curriculum. https://youtu.be/TKiX-J046JA Full Episode on the YouTube channel and soon to be on Dentinal Tubules for 1 hour of Enhanced CPD/CE What you will learn from this episode with a leader in this field Prof Ama Johal is that a team approach is needed. If the Sleep Physician is Team Leader, we as Dentists are SECOND in the pecking order, above ENT! That signifies the massive role we have to play in treating SDB. We discuss: How and why did Prof Ama Johal get in to this micro-niche of Airway within Dentistry Brief overview of anatomy with the ‘party balloon’ analogy What is Dental sleep medicine? What is sleep disordered breathing and sleep apnoea What is the contribution we can make in the dental profession? Is it just mandibular advancement splints? What is a CPAP What is the effectiveness or oral appliances vs CPAP? Why is the training at undergraduate level in both MEDICINE and DENTISTRY lacking? What are the barriers to Dentists who want to help patients with Sleep disordered breathing? How can we significantly improve the lives of some of our patients? What is the association between parafunction and sleep disordered breathing Should YOU get involved in treating the airway for your dental patients? Does premolar extraction orthodontics adversely affect the airway? What about children with massive tonsils/adenoids causing airway obstruction? Prof Ama Johal is highly regarded within Orthodontics and dentistry, for the standard of his clinical work and published research. He is the Vice President of the British Society of Dental Sleep Medicine (BSDSM) and Professor at Bart’s and The London School of Medicine and Dentistry. Resources and Downloads: British Society of Dental Sleep Medicine S4S Course Snoring & Obstructive Sleep Apnoea – a Role for the GDP – listeners of the podcast can get 50% until the end of August 2020 – use coupon code ME50 (this is not an affiliate link and I do not get commission from this – I am thankful to S4S for offering this to the community)

Dental Recruitment is Changing! https://youtu.be/1WmvW9-1YWE Would you rather work in a lavish dental clinic with all the bells and whistles, but with a high turnover of nurses and lacking a culture or ethos…OR, work in a ‘mediocre’ clinic with happy staff and a thriving culture? What makes an awesome dental practice, and how can associates and therapists find them? Where are they hiding? Are they as rare as a ‘good associate’? What is that even about? In the latest episode I chat with Andy Saunders and Simon Tucker about how dental recruitment has evolved – it is a purpose built episode if you are looking for a new opportunity or even if you are a principal looking to hire the right team member. We discuss: Why traditional methods of hiring Dentists, Therapists and Nurses may not be effective or good value any more The three types of CVs you need The power of the Video CV Importance of the same values within the team How to find your ‘tribe’ and the practice you belong in (and why you cannot just go by what their website looks like) The features and indicators we SHOULD be looking for in a new practice If you like the new face of dental recruitment (or finally, just a face!) and want Andy and Openwide to help you, reach out to Andy!

I left you on a bit of a cliffhanger last episode – but now you can finish off Andy’s ‘origin story’ of Posterior Guided Occlusion (PGO) and understand how this is practically implemented on patients. If you missed Part 1 and the ebook by Dr Andy Toy, check it out. https://youtu.be/WJxr1JPpDO0 The Protrusive Dental Pearl for this episode is continuing on the theme of Dental Photography I have been posting about on my Instagram. When taking portrait photos for your patients with a ring flash, point the ring flash at the ceiling, rather than at the patient’s face. This creates a softer, nicer image! If you missed out on my Butterfly Effect webinar, you can now check it out on www.protrusive.co.uk/butterfly – it’s about how seemingly small events in your career can compound and change the entire trajectory of your dental career. I added a new book to the book list – the Danish Way of Parenting! In this episode we discuss: Structural school of thought vs Functional school of thought The relationship between the condylar movement and the teeth The mathematical equation that is evidence for PGO I ask Andy questions to test PGO What does he mean by functional contacts? What is the healthy clench? We debate anterior guides vs posterior guides How does this apply to the patient with large masseter muscles who keeps breaking cusps? How many ‘centrums’ are enough? What Andy is prescribing in Clinchecks for the posterior occlusion How to finish the occlusion on an orthodontic case – and how Andy makes this ‘patient driven’ How Andy finishes 60% of his Invisalign cases with a ‘Dahl appliance’ Is Centric relation important to achieve? Andy tells us the birth of Canine Guidance

Do you worship canine guidance? I think I went through a phase where I placed a very high importance on the presence or absence of canine guidance. I then got thinking…how and why are my patients with AOBs doing just fine? Why is it that some studies suggest that only 5% of the population has canine guidance, and others suggest up to 60%? Is group function really the villain? This is why I am open to listening to theories that explain this. Posterior Guided Occlusion is one such theory. I am joined by Dr Andy Toy to explore PGO concepts I wanted to delve deep in to PGO – so we split this episode in to 2 parts. https://youtu.be/k6T8cbqSY1I What we cover in this episode: We hear Andy Toy’s stories How did he get in to ‘Posterior Guided Occlusion’, clear aligners and treating TMD? The journey that took him to Pankey The story of how Andy met Ron Presswood and the influence that he had in his views on Occlusion What is patient driven splint adjustment? Why was Andy getting good results with PGO splints, just as he did with traditional tanner appliances? Why are we trying to switch muscles off, but Andy is trying to switch them ‘on’!? The surprising origins of Bonwill’s Triangle What is a functional occlusion? Realising that the the quality of the evidence in Occlusion is poor Link to Dr Andy Toy’s eBook on PGO All the other downloads from every past episode is on the Protrusive Dental Community

Yes, you have read the title correct. I DID get Chris Orr on the Podcast…the silver lining of lockdown?! I am very excited to share this episode with you – Composite vs Ceramic, Direct vs Indirect. I have placed hundreds of humongous composites in my career that in hindsight should have been indirect restorations – I share the challenges that I faced in my journey and I am sure many of you will be able to resonate with it. https://www.youtube.com/watch?v=SGWcwkZD-kk We discuss: An extremely insightful episode with Dr Chris Orr (whom I refer to as ‘the Rockstar Dentist’ and I share the story WHY I give him this name) Is there a place for inlays? At what point does a composite become a ceramic (or read: direct becomes indirect) Is there a place for composite onlays? Does the parafunctional status of a patient influence the choice of restoration? Is eMax acceptable for 2nd molars? Dual cure cement vs light cure cement for onlays? How do you decide which cusps to cover? What kind of join is best to the tooth? Pressed eMax vs CAD/CAM eMax? What does Chris Orr think about BOPT/Vertipreps? As promised in the episode, if you are waiting for announcements of Advanced Dental Seminar courses by Dr Chris Orr – check out their ADS Facebook page

With ‘The Denture Guy’ Mark Bishop who was also my first ever clinical tutor 11 years ago! https://www.youtube.com/watch?v=4BkBEK01P0o We discussed: 🎤 Occlusion with Dentures 🎤 Identifying red flags 🎤 At what point do you need to accept that the patient NEEDS to have implants to have success with dentures 🎤 What’s more important? A technically excellent denture, or a patient with good adaptation 🎤 Why do patients who wear ‘rubbish’ dentures struggle with ‘good’ dentures 🎤 Which is the best impression material? 🎤 Which are the red flags patients for Complete Dentures? 🎤 How do you handle a patient who tells you how to do your job? 🎤 Communication Pearls via analogies 🎤 How can you achieve suction lower dentures? 🎤 Do all you dentures need to be in Class I ? 🎤 How can we improve our registration phase of complete dentures? 🎤 Why most Dentists trip up at the diagnosis stage of Complete Dentures, and how to overcome this 🎤 The importance of writing a letter to your complete denture patient The Atwoods classification and the Registration technique have been posted Protrusive Dental Community

I love Dentistry…but I FREAKING HATE CRACKS. CRACKS = DIFFICULT CONVERSATIONS with our patients. https://www.youtube.com/watch?v=IIsjE2Km-po Protrusive Dental Pearl: When checking for cracked cusp syndrome using a tooth slooth, make sure to jiggle it a little bit because it can help to get a more accurate result! I am joined by Endo Queen Dr. Kreena Patel – @kreenaspecialistendodontics to discuss all things cracks to make our decision making process clearer in General Practice! We discuss: How do you manage situations where pain is difficult to localise and you’re in a diagnostic dilemma? What if you just CANNOT find out which tooth it is? What should you say to the patient? 🤔 What % chance of success should you give to the patient based on clinical findings? Can you use a cotton wool roll as an alternative to a tooth slooth? SHOULD YOU CHASE A CRACK??? When you open a molar access cavity and trace a crack – where is the cut off for the extent of the crack before it is deemed not worth saving? Any advice for GDPs dealing with CTS? What is the evidence for RCT in patients with cracks? What is the consent conversation you have regarding cracks? And right at the start we touch on: Impact of CBCT in Endodontics Can you spot a crack on a CBCT?

This episode aims to navigate the Dentist around the complicated world of Respiratory Protective Equipment (RPE). I literally start from the basics and we build up – hope this helps! https://www.youtube.com/watch?v=30dNlplwdoI What is a Fit test vs Fit check Who should be paying for the FFP masks?! Associates?! Oops I failed my fit test – what now? Should we just drop FFP2/FFP3 and just use re-usable RPE that is way more cost effective? UDCs are reportedly keeping the same FFP3 mask on for several patients (1 per session) with a surgical mask on top – if they are getting away with it, can we do it in practice to save money? Does FFP2 NEED to be fit tested? Can you get away without one if you compensate with a face shield? What’s the difference between FFP2 and FFP3? What does a FFP even mean? Should you be stocking up now? Watch out for the fakes! Will there be a phased return or ‘chaotic return’? If I am antibody positive, do I need to bother with all this? DO we need more fit testers? How to get involved? How are we going to meet the healthcare demand of fit testing? When do you think I’ll get to place composites again?!

Many Dentists still believe that caries in to dentine on a radiograph automatically means they need to start drilling – why might they be wrong? https://www.facebook.com/watch/?v=564343240902780 Remember that case I posted on my FB and IG page some months ago? It had SPLIT our profession down the middle as to whether you should drill those carious lesions or not. https://www.facebook.com/protrusive/posts/670960430338941 Well, I asked Louis McKenzie about this case, as well as about caries detections systems and WHEN we should be picking up the drill? Why should use a caries detection system (such as ICDAS)? Which is the best system? We share THAT case – the one that split the opinions of THOUSANDS of Dentists – find out what Louis would have done! Find out what I DID end up doing! What about cracks? Does that count as a ‘cavitation’ and therefore warrant restoration? We discuss a classification to describe radiographic caries. Pearl: when you place immediate resin bonded bridges, consider a split pontic technique! www.rbbmasterclass.com for the full online course – use MAY2020 before 31st May 2020 to get a discount!

I was so happy to get feedback from ‘Finding An Associate Position‘ interference cast episode. What you asked for was some more direction on Portfolios, and that’s exactly what this episode sets out to do! https://www.youtube.com/watch?v=1URCtgQdczo As well as showing my own CV (it does not need to be too fancy!) and Portfolio, I tap in to Barry Oulton’s experience of hiring – what does he look for in an applicant? Alan Burgin (@the.cornish.dentist) and I also chat about our journey and the gradual process of organically building your portfolio (it was a snippet from an episode yet to be released). I echo in the episode that all these things are just to secure your interview – really what matters most is your emotional intelligence and your attitude. If you know a DF1 that would benefit form this advice, help them out by sharing this podcast with them!