White Patches – When to Refer + Diagnoses ORAL MED – PDP206

In this episode, we focus on the link between periodontal disease and the systemic effects on the human body. There’s more to oral hygiene than just saving our teeth, so let’s dive into this fascinating episode with Dr Reena Wadia to learn more about the importance of perio and how it is associated with the rest of our health. https://youtu.be/fldpB_8h2Dc Watch GF024 on Youtube Key Takeaways: There is a strong link between gum health and systemic health. Diabetes and cardiovascular disease are key conditions linked to gum health. Understanding correlation vs. causation is crucial in dental practice. Effective communication with patients can improve treatment outcomes. Treating pregnant patients for periodontal health is safe and beneficial. Proper diagnosis is essential for effective dental treatment. Patients are often unaware of the links between gum health and overall wellness. Motivating patients with health benefits can enhance compliance. Evidence-based dentistry is vital for accurate patient information. Add the word diagnosis to templates for clarity. Team collaboration (dental and medical practices) enhances patient care effectiveness. Screening for conditions like diabetes can save lives. Holistic care in dentistry is becoming increasingly important. A periodontal protocol is crucial for consistent care. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode:  3:50 Introduction to Dr Reena Wadia 7:14 Systemic Link 12:24 Under Investigation 13:54 Using this with our Patients 17:04 Birthweight-related Studies and Pregnancy 20:14 Make a Periodontal Diagnosis 23:34 Medicine and Dentistry Collaboration 26:29 Understanding the Patient 29:14 HbA1c Machine 32:19 The Perio Handbook This episode is eligible for 0.5 CE credits via the quiz on Protrusive Guidance.  This episode meets GDC Outcome A, B and D. AGD Code: 490 PERIODONTICS (Pathophysiology of periodontal disease)  Aim: To enhance dentists' understanding of the link between periodontal health and systemic diseases, enabling them to integrate evidence-based periodontal care into their clinical practice. Learning Outcomes: Knowledge and Application: Dentists will gain a thorough understanding of the bi-directional relationship between periodontal disease and systemic conditions such as diabetes and cardiovascular disease, and learn how to apply this knowledge in clinical practice to improve patient outcomes. Patient Education: Dentists will acquire practical strategies for effectively educating patients about the systemic implications of periodontal health, using analogies, visual aids, and evidence-based communication methods. Holistic Treatment Planning: Dentists will learn how to incorporate systemic health considerations, such as screening for diabetes or collaborating with medical professionals, into their periodontal treatment plans to deliver comprehensive care. Enhance your knowledge with Dr. Reena Wadia's Perio School and establish a habit of implementing Perio protocols in your practice. Don't forget to grab a copy of the Perio Handbook by Dr. Reena for valuable insights! If you enjoyed this episode, check out: Communication Masterclass for Periodontal Disease [B2B] – PDP086 Click below for full episode transcript: Teaser: When you hear stories like that, it's like, could that have been undiagnosed diabetes, heart attack, et cetera, et cetera. So I feel so privileged being able to have that ability to do that test on our patients. And yeah, it's not the nicest thing to say to someone, you might have diabetes, but actually like that could save someone's life. Teaser:The guidelines now are, for example, for diabetics, once they've been diagnosed with diabetes, they're supposed to see their dentist, but they need to push it more, because they definitely push the eye appointments,

What are the steps involved in Functional Crown Lengthening? Which scenarios/teeth are best for this type of surgery? What is biologic width and why should we care? Is Bone sounding a diagnostic test, or just a genre of music? The answer to these questions and a lot more can be found in this packed episode with Dr Hiten Halai. We cover the right protocols when crown lengthening and understand the difference between aesthetic and functional crown lengthening.  https://youtu.be/KRlEtz16I8c Watch PDP207 on Youtube Protrusive Dental Pearl - Bone Sounding Using a periodontal probe, go into the depth of the sulcus, pushing deeply until you hit bone, all while recording the measurement with the probe. This measurement will then guide you on how to carry out your crown lengthening procedure. Push hard to pass the connective tissue and ensure you are touching the bone. Not using AI to write your notes and letters for you yet? Save hours every day and save money using this affiliate link for DigitalTCO: Click Here  Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode:03:19 Protrusive Dental Pearl06:10 Introduction - Dr Hiten Halai12:56 Functional Crown Lengthening15:41 Understanding Crown Lengthening Types18:42 University of Dental Instagram22:38 Biologic Width aka Supra-crestal Tissue Attachment25:51 Functional Crown Lengthening: Practical Considerations31:09 Assessments & Keratinised Tissue35:47 Understanding Tissue Phenotypes39:16 Case Study: Premolar Treatment43:17 Bone Sounding and Biologic Width46:58 Shape of Gingivectomy50:31 Flap Designs52:37 Burs for Crown Lengthening56:13 Healing and Restoration Timelines58:31 Learning and Training Opportunities Key Takeaways: Hiten's journey began with a passion for periodontics during dental school. Managing time effectively is crucial for specialists with busy schedules. Functional crown lengthening is often underutilized in practice. Aesthetic crown lengthening can lead to complications if not done correctly. Understanding biologic width is essential for successful crown lengthening procedures. Preoperative assessments are critical for determining candidacy for crown lengthening. The type of gingival tissue affects surgical outcomes and healing. Proper surgical techniques can prevent complications and ensure better healing. Postoperative care is vital for achieving desired aesthetic results. Continuous education and mentorship are important for dental professionals. This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcome C. ADG Code: 490 PERIODONTICS (Mucogingival management)  Aim: To enhance knowledge and practical understanding of crown lengthening procedures, with a focus on distinguishing between aesthetic and functional crown lengthening, and the importance of biologic width in achieving predictable clinical outcomes. Learning Outcomes: Identify the key differences between aesthetic and functional crown lengthening and the clinical scenarios in which each is most appropriate. Demonstrate an understanding of biologic width and its significance in the success of crown lengthening procedures, including the impact on long-term periodontal health. Apply the principles of bone sounding to accurately assess the need for crown lengthening and ensure optimal restoration outcomes, minimising risks such as gingival recession and bone loss. If you liked this episode, check out: PDP079 - Crown Lengthening Click below for full episode transcript: Teaser: Despite what the University of Instagram tells you, all cases cannot be treated by laser gingivectomy. And that is the truth. Four or five years down the line, when there has been enough time for that tissue to relapse, what happens is they'll come back with that persistent inflammation. And actually the management of it is much more complex now.

Application points, luxation vs elevation, avoiding common mistakes - this one's an episode that I wish I had when I was at dental school! How do you know when you've found the application point during extractions? What are the key protocols that can help make your extractions more efficient? https://youtu.be/rOBPnCTyAwM Watch PS012 on Youtube This week's Protrusive Student episode is all about exodontia - and again I'm joined by Emma Hutchison, our Protrusive Student Ambassador, to discuss some tips and tricks on how to make extractions that little bit easier. Jaz also shares a memorable analogy—could removing a stone from an avocado be the perfect way to describe an extraction?! Key Takeaways Tactile feedback is crucial during tooth extractions. Understanding application points can improve extraction techniques. Using the right amount of pressure is essential to avoid breaking teeth during extraction. Luxators are typically used to sever the PDL before extraction. Atraumatic extraction techniques are important for preserving bone for future implants. Luxators should not be used as elevators. Understanding the mechanics of elevators is crucial for effective extractions. The ‘six second rule’ helps in assessing extraction progress. Having a plan for extractions can prevent complications. Communicating with patients about the extraction process is essential. Avoid tunnel vision; consider the surrounding teeth during extractions. Breaking interproximal contacts can simplify extractions. Always check the patient's medical history before procedures. An audible checklist can prevent mistakes during extractions. Need to Read it? Check out the Full Episode Transcript below! Highlight of this episode: 00:00 Introduction 02:07 Catching Up with Emma 05:58 Teeth are like avocados! 11:13 Understanding Application Points in Extractions 17:01 Luxators vs. Elevators: Techniques and Safety 24:10 Extraction Technique 25:08 The Six-Second Rule 28:04 Having a plan 29:58 Common Mistakes and  How to Avoid Them 38:17 Conclusion and CE Certification This episode is eligible for 0.75 CE credit via the quiz on below.  This episode meets GDC Outcomes B and C. AGD Subject Code: 310 Oral and Maxillofacial Surgery (Exodontia) Dentists will be able to - 1. Recognise essential steps to establish secure application points 2. Develop approaches for patient communication around extraction procedures, potential risks, and expected outcomes 3. Implement the “6-second rule” and other practical techniques to streamline extractions and troubleshoot common challenges If you loved this episode, make sure to watch Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth [B2B] – PDP085 Click below for full episode transcript: Jaz's Introduction: This episode on basics of extractions is the episode I wish I had when I was learning extractions when I was a student. But also what I've found from this Protrusive Student series is that so many dentists are listening to them and they're commenting and they're enjoying and they're liking it. Jaz's Introduction:What I've discovered is that it's so good to just reconnect with basics and actually by listening to these kind of episodes you do sometimes pick a few things up or it's validation. It helps to validate some techniques, some ideas, some protocols that you're already using. It's also a wonderful way to see how far you've come. Sometimes we move so far in our career that we forget what it's like to have those struggles like we did when we were a student. So the reason I gave you that little preamble is because now from this episode, most Protrusive Student episodes, I think, will be eligible for CPD or CE credits. And so this one is eligible for 0. 75 CE credits or 45 minutes, if you're in the UK. Protrusive Education is a PACE approved education pro...

Are you confident in diagnosing white patches? Which white patches need an URGENT referral? How do you tell the difference between lichen planus, lichenoid reactions, and other common lesions? Dr. Amanda Phoon Nguyen is back with another amazing episode, this time diving deep into the world of oral white patches. Jaz and Amanda explore the most common lesions you’ll encounter, breaking down their appearance, diagnosis, and management. They also discuss key strategies to help you build a strong differential diagnosis, because identifying the right lesions early can make all the difference in patient care. https://youtu.be/xlQpuQu2Hl0 Watch this full episode on YouTube Protrusive Dental Pearl: A new infographic summarizing Dr. Amanda Phoon Nguyen’s key teachings. Jaz describes it as an easy-to-follow "cheat sheet" designed to simplify complex ideas and make it easier to apply the concepts discussed in the episode. You can download the Infographic for free inside Protrusive Guidance 'Free Podcasts + Videos' section. Key Takeaways White patches in the oral cavity can be classified into normal variants, non-pathological patches, and potentially malignant disorders. It is important to identify the cause of the white patch and differentiate between different types. Referrals should be made based on the characteristics of the white patch and the urgency of the situation. Clinical photographs are valuable in referrals and can aid in triaging patients. Ongoing monitoring is important for potentially malignant disorders. Lichen planus can have different types and presentations, and a biopsy may be necessary for certain cases. Enlarged taste buds, particularly in the foliate papillae, are usually bilateral and not a cause for concern. Oral lichenoid lesions can be triggered by dental restorative materials or medications, and a change in dental material may sometimes improve the condition. Smoker's mouth can present with white patches and inflammation in areas where smoke gathers, and counseling patients to reduce smoking is important. Oral submucous fibrosis, often caused by areca nut chewing, requires regular review and counseling patients to stop chewing the nut.  Need to Read it? Check out the Full Episode Transcript below! Highlights for this episode: 01:22 Protrusive Dental Pearl 05:13 Dr. Amanda Phoon Nguyen Introduction 07:39 White Patches Introduction 09:16 Understanding Geographic Tongue 12:44 Keratosis vs. Leukoplakia 19:02 Proliferative Verrucous Leukoplakia 22:18 Referral Tips for General Dentists 29:56 Understanding Leukoplakia 33:17 Urgent and Non-Urgent Referrals 34:37 Patient Communication 39:17  Discussing Erythroplakia  41:03 Oral Lichen Planus: Diagnosis and Management 47:50 Enlarged Taste Buds 49:47 Oral Lichenoid Lesions vs Oral Lichen Planus 53:43 Smoker's Mouth 55:14 Oral Submucous Fibrosis 57:23 Learning more from Dr. Amanda Phoon Nguyen  This episode is eligible for 1 CE credit via the quiz below.  This episode meets GDC Outcomes B and C. AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Diagnosis, management and treatment of oral pathologies) Dentists will be able to - Identify the cause of a white patch and differentiate between different types. Understand when and how to make referrals based on the characteristics of the white patch and the urgency of the situation. Appreciate the importance of ongoing monitoring for potentially malignant disorders, including when to consider a biopsy. For those interested in visual case studies and deeper insights into oral lesions and conditions, follow Dr. Amanda on Instagram and Facebook! If you loved this episode, be sure to check out another epic episode with Dr. Amanda - Prescribing Antifungals as a GDP – Diagnosis and Management – PDP151 Click below for full episode transcript:

What are the key steps and nuances to make awesome Dentures that your patients will love? In this episode, Jaz probes Removable Pros legend Dr Mike Gregory to break down the process. From border molding to primary impressions and the teamwork between dentists and technicians, Mike reveals the key steps to making great dentures. https://youtu.be/snM3PerQ1ko For example, be sure to include a note on the lab sheet for the technician: "Preserve full peripheral depth and width of the sulcus on this impression, to about 2-3mm." This ensures the correct functional width is maintained when the final tray or denture is created. Protrusive Dental Pearl: When checking denture occlusion, it's crucial to keep the patient relaxed. Mike suggests one simple trick: ask the patient to close their EYES before closing their teeth. This can sharpen their senses, helping to improve the bite assessment. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode: 02:07 Protrusive Dental Pearl 03:31 Mike Gregory's Journey into Dental Technology 10:09 Understanding Border Moulding 13:19 Technician's Role in Denture Creation 15:45 Improving Communication with Technicians 18:34 Special Trays and Custom Trays 25:58 The Role of Green Stick 29:04 Denture Impressions 31:35 Boxing and Beading Techniques 35:08 Additive vs. Reductive Rest Seats 40:46 Guide Planes 42:43  Creating Undercuts for Dentures 45:10 Final Tips and Best Practices 48:54 Learn More with Mike Gregory This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject code: 670 REMOVABLE PROSTHODONTICS    Aim: To explore the intricate process of denture creation and provide practical insights on improving denture fit, occlusion, and collaboration between dentists and technicians. Dentists will be able to:  1. Understand the key elements of denture creation, including border molding and primary impressions. 2. Learn the significance of maintaining peripheral sulcus depth and width in denture impressions for functional accuracy. 3. Gain insight into the role of special trays, custom trays, and impression materials in denture fabrication. 4. Recognize the importance of clear communication between dentists and technicians in achieving optimal denture outcomes. If you liked this episode, you’ll love Suction Lower Complete Dentures – Improve your Removable Prosthodontics – PDP073 Click below for full episode transcript: Teaser: This huge misconception that if you get suction on an impression, that impression is the perfect impression to make a denture. But you know, and I know if you take an impression, you fill somebody's mouth with algae, you get suction. You have to break the seal to get it out. That doesn't mean you've got the right depth. Teaser:It doesn't mean you've got the right borders. You've just created a vacuum and that's the worry that people create suction. I think this is it. This is going to be the great denture. But if you create suction, take the impression out of the mouth and look at it. It's going to be big. You can picture this, can't you? It's going to look big, it's going to look like you've just pushed everything out the way. I used to think dentists were rubbish, which is really tough, but as a technician you've seen model after model that's garbage. And then you think, these poor guys are taking impressions, but they don't know what they're doing wrong. How do I do it better? If you were taught maybe not brilliantly as an undergraduate, or you didn't love it as an undergraduate, so you didn't really focus on it. How do you ever get better? You need to be re taught. Jaz's Introduction:Let's face it guys, dentures are a bit of a dark art. You only get so much exposure at dental school, and when you come to the real world, you're faced with flabby ridges,

Implant crowns should be out of occlusion, right? Think again!  In my experience, single tooth implant crowns when I see them are IN occlusion and holding shim - even when this was not intended by the Restorative Dentist. When this happens, should we be adjusting the implant crown? Or perhaps the adjacent tooth? *shock horror* And how often would this need to be repeated? This podcast will show you a better way to manage implant occlusion! https://youtu.be/l8WOiamk06M Watch PDP204 on Youtube In this episode, I’m thrilled to chat with Professor Riaz Yar, an occlusion expert and mentor who greatly influenced me early in my career. Together, we’ll debunk common myths and dive into practical approaches to managing implant occlusion. Even if implants aren’t part of your practice, understanding occlusion on implants is crucial for patient care. Tune in as we uncover best practices and clear up misconceptions to help you achieve better results for your patients! Protrusive Dental Pearl: Dr. Pav Khaira has created a free implant assessment form, now available to the Protrusive community. Accessible at www.protrusive.co.uk/implant - this responsive PDF includes key areas like patient goals, biotype, and occlusion, with an 8-minute video guide for easy use. Key Takeaways -Implant occlusion is a major factor in implant failure.-Understanding the biology of the implant system is crucial.-Functional loading is more important than static loading!-Chewing dynamics can reveal important insights about occlusion.-Guidelines for occlusion should be followed but adapted to individual cases.-Patient education on post-implant care is essential.-Shared loading on implants is vital for their longevity. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode: 01:34 Protrusive Dental Pearl 02:47  Introducing Professor Riaz Yar 05:07 Understanding Implant Failure Causes 08:04 Analyzing Implant Occlusion and Peri-Implantitis 10:27 The Chewing Gum Test 13:20 Guidelines and Challenges with Implant Occlusion and Lab Protocols 17:33 Bone Regeneration and Functional Guidance 19:22 Dynamic Movements and Occlusion Analysis 23:48 Practical Tips for Implant Bridges 28:19 Patient Guidelines for Implant Care Join Riaz for an innovative implant restorative program developed with top dentists (Nik Sissodia, Martin Wanendeya, Sanjay Sethi, and Nik Sethi), designed to enhance your skills in implant restoration. Check out Riaz's one-day course on implant occlusion at profriazyar.com and Elevate Dental. Sign up now and boost your implant expertise! This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject code: 690 IMPLANTS Dentists will be able to:  Recognize key factors that contribute to implant failure and how occlusion plays a role. Utilize practical approaches, such as the Chewing Gum Test, to assess and manage implant occlusion (function) effectively. Discuss guidelines for implant occlusion and understand the challenges involved in lab protocols. If you liked this episode, be sure to watch An Idiot’s Guide to Restoring Single Implant Crowns Part 1 and Part 2 Click below for full episode transcript: Teaser: If you overload it, the risk is that you're going to get bone loss around the neck of the tooth, just from a biological perspective. That then means, okay, how do you apply those forces? And so if you apply those forces to a tensile at an angle, that's definitely going to occur. But static forces, it's still going to get some transference through it. Teaser:So it's about understanding how to manage those forces. The one, the thing that I noticed, if it's an issue is screw loosening of the crown and an implant that tells me straight away, I have some of axia loading on my implant. So I need to deal with that straight away.

Why are principals and associates always at loggerheads with each other? Why can it be almost impossible to find the right associates to work at our amazing practice, but also almost impossible to find that amazing practice to work at as an associate?  Join myself and Dr Sarika Shah on this episode where we learn more about self leadership and the ways to prioritise our values to help us find the right working relationships and places of work to be a part of. Let’s figure out how to bring all members of a team together and create the zen we are all in search for while working in our day to day lives.  https://youtu.be/-ua1PAB6A90 Watch IC054 on Youtube Protrusive Dental Pearl: Be willing to accept rejection. A ‘no’ from a patient today is often a yes tomorrow. Plant seeds for high quality dentistry and you will find yourself harvesting many of these seeds at a later date. Those who fear rejection routinely offer less than their best, which cheats patients out of rightfully making their own economic decisions - inspired by Dr Lane Ochi (the ORIGINAL Dental Geek!) Check out Flourish as a Female: https://www.flourishasafemale.com/ Use discount code ‘protrusive’ (No financial interest) Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode:02:18 Protrusive Dental Pearl04:30 Introduction - Dr Sarika Shah10:10 Transition to Private Dentistry13:40 Practice Ownership17:20 Managing the Practice24:55 Internal Leadership29:40 Principals vs Associates Friction41:56 Women in Dentistry47:15 Supportive Partners55:25 Top Advice from Sarika58:28 Flourish This episode is eligible for 1 CE credit via the quiz on the Protrusive Guidance App.  This episode meets GDC LEARNING OUTCOMES A and B AGD Subject Code 550 Practice Management and Human Relations Aim:To explore the importance of self-leadership and effective communication in building successful relationships between dental associates and principals, enhancing teamwork, and optimising practice performance. Dentists will be able to:  Identify key principles of self-leadership and apply them to improve personal and professional development within their practice. Understand the impact of effective communication and aligned values on maintaining strong, respectful relationships between associates and principals in a dental setting. Develop strategies to enhance emotional intelligence, ensuring improved patient care and better collaborative relationships in their practice environment. If you liked this episode, be sure to check out IC025 - Parenthood and Dentistry Click below for full episode transcript: Teaser: And when this respect is gradually lost, that relationship is most likely going to break down within three years. Okay, there's research behind this. I've read a lot around this. So what it there is, is there's three phases to this. The first phase is like- because even when I went out there to approach women, to approach some of these women are still around. And I think they're awesome. They're powerhouses. But when I went to them to ask for help, I got nothing. And it's not like I just asked once. I asked a few times. I asked several women and I got nothing. So the majority of my mentors and coaches have now been male. Jaz's Introduction:Principals versus associates. Why is there so much beef? I'm constantly seeing on the dental social media groups that principals are bashing associates. They're saying like, where are all the good associates gone? I'm really struggling to find a decent, honest, hardworking associate. On the flip side, the associates are searching for trustworthy, kind, caring principals that are willing to mentor and provide an environment where you can flourish. That seems to be a bit of a pipe dream. So who's right? Are they both right? Or maybe all the associates and principals that are happy, that are in very, very happy teams.

Is Sodium Hypochlorite still the best irrigant for endodontics? Or do we have something novel and superior? How can we improve the efficacy of our endodontic irrigation? What % of NaOCl should we be using? https://youtu.be/z5h2FzHpG68 Watch PDP203 on Youtube Dr. Brett Gilbert rejoins Jaz Gulati to tackle all things endodontic irrigation after a brilliant episode on pre-emptive endodontics. Advanced activation and delivery systems could change the game—are we on the brink of a major shift in endodontics? Protrusive Dental Pearl: Before performing a molar extraction, challenge yourself to first complete an endodontic access on the tooth. This will enhance your understanding of the canal anatomy and improve your precision in sectioning the tooth. By visualizing the canals and the pulpal floor, you'll refine your angulation for more accurate sectioning. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode: 02:09 Protrusive Dental Pearl 04:23 Is Sodium Hypochlorite Still The Gold Standard? 06:54 The Role of Surfactants in Irrigation 07:58 Concentration of Sodium Hypochlorite 09:47 Chlorhexidine: Is There Still a Place? 11:32 Advanced Disinfection Technologies 21:31 Evidence-Based Techniques in Endodontics 25:22 GP Pumping This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject code: 070 Endodontics (Endodontic infections, microbiology and treatment) Dentists will be able to:  1. Gain insight into the role of sodium hypochlorite in endodontic disinfection and assess its effectiveness compared to new innovations.2. Discover the cutting-edge irrigation methods, including surfactants, ultrasonic activation, and laser-assisted irrigation, and their impact on endodontic outcomes.3. Explore emerging technologies and innovations that could revolutionize endodontic irrigation. If you liked this episode, be sure to watch the 1st Part - ‘PDP202 - Elective Endodontics? It's all about Communication’ Click below for full episode transcript: Teaser: When you use a lower percentage, you really aren't reducing or eliminating the risk of sodium hypochlorite accident. If you get 3% sodium hypochlorite out the end of the root, it's going to cause a sodium hypochlorite accident, as will 6%. If you're trying to eliminate risk using a lower concentration, I don't think it's as effective as you think, but you are taking away some of the strength that you're looking for to kill the bacteria and dissolve the tissue. So my advice would be go full. Teaser:We recognize that training our general dental colleagues on endo is paramount because we don't want the option of implant to come in place of saving the natural tooth simply because of fear or the fact that they just don't feel well enough trained to do the endo. So I believe as a dental community, the more we feel comfortable and proficient in endo, the more teeth we save and the better our patients are. Jaz's Introduction:Is sodium hypochlorite still the best thing in irrigation? If it is, what percentage should we be using? This one might actually surprise you. Is there ever a time when to use chlorhexidine. Whatever irrigant we're using, how can we improve its effectiveness? Hello, I'm Jaz Gulati and welcome to the part two with Dr. Brett Gilbert. How awesome was he? Please do check it out if you haven't already. We talked about elective endodontics or preemptive endodontics. I love the clarity and the passion in which he speaks with. And he definitely continues it on into this episode. He's so knowledgeable, he's so passionate about endodontics in general, but especially the innovation in irrigation. Because after all, endodontic success is all about killing those bugs. And Brett has so much experience in trying all the different things out there. And towards the second half of this episode,

What's the difference between radiolucency and burnout?  When's the best time to use a bitewing vs a periapical radiograph?  When should we pick up the bur for interproximal caries? Have you heard about the 4 white lines an OPG radiograph?  https://youtu.be/wCV3U8-OAvI Watch PS011 on Youtube This episode is packed full of great tips and techniques that will help you understand how to produce great radiographs as well as being able to properly figure out what they are trying to tell us. Radiographs can be tricky, whether that's due to them being flipped, upside down or due to cone cut, that's why this will help shine some light on how to get comfortable with radiographs as well as how to manage our patients after we know what we are dealing with. Need to Read it? Check out the Full Episode Transcript below! Don’t miss the special notes on Radiology and Radiography for Students available exclusively in the Protrusive Guidance app! (Join the free Students Section) This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD for Dentists waiting for you on the Protrusive App! For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. If you love this episode, check out PS003 - Routine Checkup Click below for full episode transcript: Teaser: This episode is the bare basics of radiography and radiology, i.e. the taking of the radiograph and the interpretation. How do you really know if that radiolucency you see is cervical burnout or is it actually caries? What are the four white lines on an OPG radiograph and why are they important? And why you should be really careful with radiographic interpretation? And it's really important to marry the clinical picture, because that's how you come up with a clinical diagnosis. [Jaz]Hello Protruserati, I'm Jaz Gulati and welcome back to your favorite dental podcast. This is for young dentists, students, but a lot of qualified dentists have been really enjoying this basic series, this Protrusive Student series. And so what we're going to do from the next episode is we're going to make it CE eligible. The next episode is actually on basics of extraction, but before we do that extraction, we need a radiograph. And it's a topic that you guys asked for on the YouTube comments. So there we have it. And remember, if you are a dental student, make a free Protrusive account. Go to protrusive.app and then email your username or your name on the platform to [email protected]. And you're going to get access to a secret area, which has a bit more of the premium goodies inside. Every PS episode, we have some student notes to provide you as well, made by Emma Hutchison, our Protrusive student. And the ones today are all about radiography and radiology. Hope you enjoyed the main episode, I'll catch you in the outro. Main Episode:Emma Hutchison, our Protrusive Student. Welcome back to the student's edition of the podcast. I know you've got exam results coming up and you're going on your elective soon. How exciting. [Emma]Yes, very exciting. So I'm just finishing up the last bits and bobs of my elective project and then I'm going traveling for two months. So, I should also get my exam results next week sometime when I'll be away. So, hopefully everything's good. [Jaz]We're all rooting for you. We know, you know, fingers crossed you'll do well and you'll report back to us. If anyone in Asia is a dental student or a dentist, and you happen to see Emma walking in a mall, an air conditioned mall, take a selfie with her and tag us on Protrusive. Let's see if this social experiment works. Let's see how much we're spending. That'd be cool, right? [Emma]Yeah, it would have to be an air-conditioned place because I'm from Scotland, so I'm not going to do well with the heat over there at all. [Jaz]Excellent. Well,

Does ‘elective’ or ‘pre-emptive’ endodontics have a role in Restorative Dentistry? It almost feels dirty to me as I try my best to PRESERVE pulp vitality! But sometimes this bites you, and you wish you had carried out root canal treatment before cementing that crown. At what point can pre-emptive root canal be justified in a world where MTA and biodentine exist? https://youtu.be/9Gc_yik9fDU Watch PDP202 on Youtube In this episode, Jaz sits down with renowned endodontist Dr. Brett Gilbert to delve into the intriguing world of elective or pre-emptive endodontics. Together, they explore challenging cases where teeth with uncertain pulpal health may require root canal treatment, whether due to caries or crown prep. Dr. Gilbert sheds light on patient communication strategies, the role of bioactive materials like biodentine and bioceramic sealers, and how to make crucial decisions about preserving pulp vitality. Protrusive Dental Pearl: Dr. Pav Khaira suggests using Alvogyl, commonly used for dry sockets, to treat pericoronitis! After cleaning and disinfecting the area, place a small amount under the operculum for immediate relief and to soothe inflammation. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode: 3:01 Protrusive Dental Pearl 03:55 Dr. Brett Gilbert's Journey and Philosophy 07:17 Elective or Pre-emptive Endodontics 11:06 Radiographic Measurement 11:40 Real-Life Encounters  15:29 Discussing Treatment Options and Patient Communication 20:28 Can Biodentine Prevent Root Canal? 22:45 Materials and Techniques in Endodontics 26:16 Death of Gutta-percha? This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject code: 070 Endodontics (Endodontic infections, microbiology and treatment) Dentists will be able to:  1. Learn what elective or preemptive endodontics entails and recognize scenarios where root canal treatment may be required due to caries or crown preparation, and how to approach them.2. Discover effective strategies for explaining treatment options to patients, improving trust and decision-making.3. Gain insights into the use of bioactive materials like biodentine and bioceramic sealers, and their benefits in preserving pulp vitality. If you liked this episode, you’ll love Post Operative Pain after Endodontics – Prevention and Management – GF017 Click below for full episode transcript: Teaser: I do believe in these instances, you are justified to recommend the treatment. You're not demanding it. You're not saying it's dogma, but you're having a conversation so the patient understands. Because what happens if you don't is you do your work, you're doing it in best faith. Patient winds up in pain, and they become very angry. Teaser:They become agitated, and they want to blame the dentist. And without a conversation, without a dialogue, they're clueless, and all of a sudden, they just think you did something wrong. You are a human, and you are the doctor. Speak to yourself. Let the words flow out so that you can explain all the different possibilities in a way that the patient feels heard, understood, but also nurtured, and at the same time you realize this is biology. We are not in control. Jaz's Introduction:In a world where we want to do everything to preserve pulp vitality, is it ever appropriate to carry out elective endodontics? Another terminology that our guest today, Dr. Brett Gilbert shared with me is preemptive endodontics. For example, you have a tooth with dubious pulpal prognosis. And you know that by prepping it for a crown or by removing the caries, this tooth may need root canal treatment. Is it okay to just go ahead and do the root canal so it doesn't bite you in the behind in the future? You see, I was always taught to do everything possible to preserve pulp vitality.