‘The Routine Check-Up’ – The Breakdown – PS003

I remember being a dental student and a simple 'check up' could take HOURS! Then the tutor would come along and complete the observation in 30 seconds... ‘How does a routine general dental examination work in the real world?’, asks Emma, our Protrusive student. The humble ‘check-up’ - as far as you can get from sexy before and after cases. The stuff no one is posting about on socials…until now! https://youtu.be/AutQvQBlg4o Watch PS003 on Youtube Jaz and Emma dissect a ‘routine oral health exam’ and Jaz even includes a full video of a standard check-up, complete with the banter, bitewings and bad explanations! ;) Be sure to check out this additional video freely accessible on our platform, Protrusive Guidance! Need to Read it? Check out the Full Episode Transcript below! HIGHLIGHTS OF THIS EPISODE:04:28 - Emma's Dive into Dentures05:45 - Pop Quiz Time: Testing Dental Composite Knowledge06:30 - Success in Dentistry: It's in the Details 08:13 - What Does a Check-Up Look Like?09:20 - Personal Touch: Jaz's Check-up Style10:50 - Defining a Healthy Mouth14:55 - Neck Lumps Discovery16:33 - Masseter Muscle Insights18:29 - TMJ Movement Evaluation21:21 - Temporalis Muscle Assessment38:27 - Patient History39:10 - Soft Tissue Evaluation39:28 - Basic Periodontal Exam40:25 - Magnification Importance51:10 - Confidence Access the CPD quiz through our app on https://www.protrusive.app, either on your browser or by downloading our mobile app. For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. Join us on Protrusive Guidance, our own platform for dental professionals. No need for Facebook anymore! 😉 If you liked this episode, you will also like PS002 -  Adhesive Dentistry for Beginners Click below for full episode transcript: Jaz's Introduction: When I was a dental student, I remember being on clinic and doing an examination, and it would just take me so long. And it's overwhelming when you're learning and you realize, oh my goodness, there's so much to check. You try and remember the oral medicine lectures. They tell you to check every single lymph node under the sun. Jaz's Introduction:And then of course, you remember the occlusion, the very few occlusion lectures you had, and you get the patient to bite together and you don't know what you're doing. You don't know what you're checking for, but you're just checking that the bite exists. And then to try and compute all the things you're seeing and try and put it in some sort of diagnosis and explanation, when you're a student, it's tricky. Which is why I've got Emma, our Protrusive Student on today to talk about routine, just routine, gold standard, daily examinations, something that you will see in general practice in the future. Whilst I am recording with Emma Hutchinson, the student, this is suitable for anyone who wants to learn, any dentist at any stage of career, who just wants to get back to basics, back to foundations. For a, what I call a Real World Examination. The reason I call it a real world examination is because the things that I'll be discussing today and what I'll be sharing video form on the Protrusive app under the student scholarship section is a real world exam. So, for example, a comprehensive exam evaluation could take an hour, 90 minutes. You ask different people. Some people do two hour full examinations. And they have my highest respect, and that's amazing. But that level of service is not for the masses. It's not for the general public. Look, some of my colleagues just get 10 minutes to do an entire examination. So I've had to find somewhat of a halfway house. I've just kind of assessed, okay, well, these are essential and these are desirable. Actually, these guidelines already exist. In the practice at the moment, we're doing these audits. We're auditing each other's notes. It was actually been a really great exercise to do this because the guidelines, there's a tick box for, hmm, did you discuss the diet? And did you grade the level of tooth wear? And the biggest one, which a lot of colleagues miss is, was there a clear written diagnosis? Was there a discussion? There's so many different checkpoints. And what I'll do actually is I'll share the parameters of this audit. So this is more like an aspirational thing. Like what is the gold standard checkup according to regulators up? I'll put that on there, but please don't listen to today's episode or watch today's episode and think, ah, this is what I'm going to do cause that's how Jaz does it. Today is very much foundational stuff that any question that Emma had, I just answered. And I hope that it gives you a dose of reality, like a real world examination. And there's different levels that you could do a bit more basic than what we discussed and you could do a lot more advanced than what I discussed as well. And really, you have to just find your feet, get the basics right, and grow and skill up even your examinations from there. I really believe the examination you do has to be suited to the level of the population you're treating. i. e. if you are in a public health setting and you've got five, ten minute examinations, not that I condone that or I like that, but I'm just saying, you're probably not going to check every single lymph node under the sun. You're probably not going to have an in depth discussion about diet with your patient if all you have is ten minutes. So I hope this gives you some sort of inspiration to really critically evaluate what you are checking and what you are actually omitting due to either time constraints or maybe a lack of knowledge or experience in that area. So before we join Emma, our Protrusive Student, to just geek out on the basic examination, bread and butter, please do check out Protrusive Guidance, the home of the geekiest and nicest dentists in the world. And now we have a student space for you as well. It's called a Student Scholarship. Remember, if you want to join as a student, and get access to a secret space with some goodies, just for you students. Make sure you email [email protected] with your proof. And so when Mari accepts you to network, she'll also invite you to the secret space. And remember, don't hoard this stuff. People are going to find out anyway, share it with your student colleagues, let them learn, let us grow together. That's what the ethos of Protrusive is all about. I'll catch you in the outro. Emma Hutcheson, welcome back again for the student edition, our monthly update. And today we're going to be obviously releasing some new revision notes. So we'll come to that at the end. But before we do, just tell us how is life at dental school right now? What have you been up to recently? What have you been learning? [Emma]So recently I was actually off last week because I had COVID. A wee bit embarrassing to have it in 2024, but it's fine. We're all good now. So yeah, it's been good. Really getting stuck into the clinical side of it. I've got a few patients on rotation, so I'm only seeing about two patients a week at the moment. First on, like, I'm in on a Thursday afternoon, I'm making dentures and things like that, which is really tricky. Actually really, really tricky. Just the sort to understand it all and really understand what's going on. [Jaz]I remember having a chat with you before, Emma, and you mentioned that, it's so difficult and then therefore, I think you told me that it was such a tricky topic that you really went all in on it. And I feel like we're promised when it's prosthetic month, some really epic notes for that. [Emma]Yeah, yeah, definitely. I think it's so theory heavy for prosthodontists, especially that it's good to know all the information, all the things you need to tick off and everything. But actually doing it and maybe watching someone else do it, it's just a whole other ballgame. I think you don't really understand it. I mean, I've heard dentistry, you really don't understand profs until after you've graduated. So that's definitely something. [Jaz]I think you don't understand dentistry until you've actually graduated. It's like, same like driving a car, right? You don't understand how to drive truly until you pass your test. [Emma]Absolutely. [Jaz]So it's the same no matter what discipline it is, Emma. Whoever said that to you, it should apply to all aspects of dentistry. Let's not be shy about that. [Emma]Yeah, definitely. So I'm going through that whole process and I say I'm making a set of dentures. I'm playing dentist and someone is there with me the whole time telling me what to do. And so it's still very much at the being spoon fed kind of stage, but it's good. It's going well. And I'm in restorative on a Friday, I got a big composite to do last week. So, no, it's good. That's going well. Really starting to feel like- [Jaz]So test time, in the last month's edition, we discussed about longevity of composites. Do you remember the success rates and what were the determinants of the success rates? This is just like revision for the Protruserati listening right now from last month's episode, testing you, putting you on the spot, off script. [Emma]So after 10 years, was it about 80%? [Jaz]I think it was, it was a lot better than that. If you think about the annual failure rate, right. Like in the low risk group, it was like one to three percent in general, but let's see. I know you're right. It's 82%. [Emma]Oh, okay. [Jaz]You actually nailed it. But it was higher in the low risk group and it was lower in the high risk group. But it does, you're completely right. It does average out to 80%, which is amazing. So well done. So that's a 10 years, right? Do you remember the two most important factors that determine the longevity of your composite restoration?