Endodontics Basics – PS017

How can you tell if a root canal treatment is truly successful? Do you always need cuspal coverage after a root canal? Are hand files still relevant, or has rotary completely taken over? And does GP pumping really improve the effectiveness of irrigants like hypochlorite? Emma returns for another Protrusive Student Series episode as she heads into her final year of dental school. Together, we explore the fundamentals of endodontics - covering restoration choices, success criteria, instrumentation, and irrigation protocols. This episode breaks down the basics every student and young dentist should understand, while also tackling the common debates and real-world challenges of endo. https://youtu.be/DK1ZAEPE_E4 Watch PS017 on YouTube Key Takeaways Understanding the 'why' behind dental procedures is crucial for effective practice. Both hand files and rotary files have their place in endodontics, especially for beginners. Good irrigation techniques are essential for effective endodontic treatment. Rubber dam isolation is critical for safe and effective endodontic procedures. Learning to determine the master apical file size is a key skill in endodontics. The use of EDTA helps in removing the smear layer during root canal treatment. Endodontic specialists often use advanced techniques and tools for more efficient treatments. Success in endodontics is not just about radiographs, it is sometimes defined by patient comfort and healing. Cuspal coverage is often necessary after root canal treatment. Patient communication is key to managing expectations. Consent forms should be tailored to individual cases. Understanding proprioception is important for tooth preservation. Highlights of this episode: 00:00 Teaser 00:51 Intro 02:50 Emma's Final Year Reflections 04:34 Exploring Specialties 07:02 Endodontics: A Student's Perspective 08:15 Rotary vs Hand Files 11:45 Step-by-Step Notes for Students 14:24 Patency and Recapitulation 14:55 Determining Master Apical File Size 16:58 Irrigation Protocols and Techniques 21:22 Typical Irrigation Protocol 23:51 Rubber Dam Importance 27:25 Rubber Dam Importance 28:21 Role of 17% EDTA 28:59 Success Factors in Endodontics 29:46 Success Factors in Endodontics 30:46 Real-World Endodontic Practices and Challenges 32:11 Understanding Success and Survival in Root Canal 34:26 Successful Outcomes 36:24 Success vs Survival 38:12 The Debate on Cuspal Coverage and Timing 40:48 Proprioception 41:54 Pre-Endodontic Build-Up 42:29 Direct Cuspal Coverage 44:03 Consent and Communication in Endodontic 47:25 Conclusion and Future Topics 49:02 Outro Resources mentioned: Outcome of primary root canal treatment: systematic review of the literature – Part 1  Outcome of primary root canal treatment: systematic review of the literature – Part 2. Influence of clinical factors  Radiographic Assessment of the Quality of Root Canal Fillings Check out Simple Re-RCT Cases – ‘How To’ Guide – PDP233 for more Endodontic insights #BreadandButterDentistry #EndoRestorative This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcome C. AGD Subject Code: 070 – Endodontics (Endodontic infections, microbiology, and treatment) Aim: To provide dental students and early-career dentists with a structured understanding of endodontic fundamentals, including instrumentation, irrigation protocols, success factors, and restorative considerations. Dentists will be able to: Differentiate between hand and rotary file systems and identify their advantages and risks. Evaluate the factors influencing the success and survival of root canal treatment. Recognize when cuspal coverage or pre-endodontic build-ups are required.

How should you  gain consent for ELECTIVE treatments? Is selling in dentistry something to avoid, or an essential part of patient care? How much does emotional intelligence really matter for your success and happiness? Dr. Colin Campbell joins for a powerful episode that dives into consent, sales, and the balance between profit and ethics in dentistry. He also unpacks the huge role of emotional intelligence—not just in clinical practice, but in life. Expect real talk, strong opinions, and communication gems that can reshape the way you connect with patients and approach your career. https://youtu.be/Wtugp1t-IrM Watch PDP244 on Youtube Protrusive Dental Pearl: Read (or listen to) the book Let Them by Mel Robbins — a powerful reminder to take control of your own life and emotions instead of letting outside events dictate them. Need to Read it? Check out the Full Episode Transcript below! Takeaways Building trust with patients is crucial for effective consent. Consent should be a relationship management exercise, not just a legal formality. Understanding the patient's perspective is key to effective communication. Elective treatments should be approached with caution and ethical considerations. Sales in dentistry is not a dirty word; it's about providing solutions to patients. Emotional intelligence is a vital skill for dentists to develop. Good dentistry is about doing what is best for the patient, not just for profit. Continuous education and self-improvement are essential for success in dentistry. HIghlights of this episode: 00:00 Teaser 00:44 INTRO 01:44  Protrusive Dental Pearl 02:58 Welcoming Dr. Colin Campbell 04:55 Colin’s Background and Philosophy 05:36 The Importance of General Dentistry 08:40 Finding a Niche vs. Being a Generalist 11:14 Understanding Consent in Dentistry 17:42 Fear of Losing the “Sale” 18:50 Building Trust with Patients 22:09 Consent Process Overview 22:49 Patient Consultation Process – Building the Bridge to Trust 29:00 Developing Emotional Intelligence (EQ) 30:00 Patient Consultation Process – The Mechanics 30:58 Patient Consultation Process – Exploring Options 31:13 Join Protrusive Guidance 34:34 Patient Consultation Process – Exploring Options 34:36 Patient Consultation Process – Follow-Up and Consent Pathway 35:54 Patient Pathways After Consultation 36:48 Treatment Plan Letters & Legal Angle 38:45 Approach to Consent Letters 40:21 Personality Types in Consultations 42:21 Systematizing Your Process 43:37 Ethics in Elective Treatments 53:15 Guidance for New Dentists on Elective Treatments 56:33 Interjection 57:48 Guidance for New Dentists on Elective Treatments 57:56 Sales in Dentistry  01:03:05 Conclusion and Final Thoughts 01:05:20 OUTRO ✨ Transform Your Dentistry ✨ 🦷 Campbell Clinic – world-class private care in Nottingham. 📚 Campbell Academy – ethical implant training from beginner to expert. ✍️ Colin Campbell Blog – daily insights to challenge & inspire. If you liked this episode, check out ‘How to Win at Life and Succeed in Dentistry’ with Richard Porter #PDPMainEpisodes #CareerDevelopment #Communication #BestofProtrusive This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and D AGD Subject Code: 550 – Practice Management and Human Relations Aim: To explore the ethical, emotional, and practical aspects of private dentistry, with a focus on gaining valid consent, balancing profit with ethics. Dentists will be able to - Explain the importance of trust and rapport in the consent process. 2. Recognize the ethical challenges of elective treatments. 3. Outline strategies for building long-term career satisfaction and avoiding burnout. Click below for full episode transcript: Teaser: When you think about the number they have per hour,

Can and should Dentists carry out home sleep testing? It’s actually super easy and I have been doing it for 18 months! What happens after you screen them—do you know what to do next? This episode will teach you! Dr. Jaz Gulati shares his personal journey into incorporating sleep testing in practice—after 1.5 years of doing it, the impact has been nothing short of game-changing. https://youtu.be/H4rTkIuOHWI Watch PDP243 on Youtube Joined by clinical sleep scientist Max Thomas in this jam-packed episode, they deep dive into what it really means to go beyond awareness of sleep-disordered breathing. He breaks down the practical steps for dentists who want to do more than just refer—and start making a difference in their patients’ lives. You’ll learn how to bridge the gap between theory and action, how to screen effectively, and why you play a pivotal role in the patient’s journey to better sleep, more energy, and a healthier life. Protrusive Dental Pearl: If a patient has been seen gasping, choking, or stopping breathing during sleep — that’s pathognomonic for sleep-disordered breathing. 🛑 Don’t ignore it — they likely need a sleep study. Ask this in every history! Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Understanding obstructive sleep apnea is crucial for dentists. Dentists are in a unique position to screen for sleep disorders. The Malampati score is an easy tool for assessing airway obstruction. Sleep disorder breathing can significantly affect quality of life. Patient history is vital in diagnosing sleep apnea. Quality of sleep is more important than quantity. Dentists should ask specific questions to identify sleep issues. Sleep position can significantly affect sleep quality. Screening tools like Stop Bang and Epworth are essential for identifying sleep disorders. NHS sleep testing can vary greatly in wait times depending on location. Snoring is often a precursor to more serious sleep disorders. Dentists can play a crucial role in sleep disorder management. CPAP is the gold standard for treating sleep apnea. Understanding the legalities of sleep screening is vital for dental professionals. Remote monitoring became essential during COVID-19, shifting paradigms in sleep medicine.. Remote monitoring helps ensure patients are truthful about their usage of devices. Mandibular advancement devices may be more effective for certain patient profiles. Patient compliance is crucial, with many struggling to adapt to CPAP. Highlights of this episode: 00:00 Teaser 01:15 Intro 04:51  Protrusive Dental Pearl 05:52 Introducing the Expert: Max Thomas 09:39 Importance of Screening and Diagnosis 13:41 “Crowding” at the Back of the Mouth 14:46 Mallampati Score 18:54 Understanding Sleep-Disordered Breathing 25:35 Screening Tools and Techniques 32:09 Screening Questionnaires 37:24 Midroll 40:44 Screening Questionnaires 40:53 Athlete Sleep Screening and Marginal Gains 44: 20 Identifying Patients for Sleep Testing 46:15 Snoring: Risk Factor for OSA 51:44 Mandibular Advancement Devices and Legalities 55:33 Diagnostic and Treatment Options 56:57 CPAP: The Gold Standard for Sleep Apnea 01:08:33 Retesting Before MAD 01:14:41 Dentists Warning about DVLA Implications 01:17:18 Final Thoughts and Recommendations 01:19:19 Outro Resources for Screening Sleep Apnea S4S Pre-Screening Questionnaire Mallampati Score Epworth Sleepiness Scale STOP BANG Questionnaire Screening Tools The Acupebble Device  WatchPAT as an alternative Send your sleep test for reporting to Max Thomas - excellent service and affordable Max Thomas’ LinkedIn If you loved this episode, don’t miss Sleep Disordered Breathing and Dentistry – PDP139 #PDPMainEpisodes This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.

Imagine your patient is choking on a rubber dam clamp...what’s the safest way to manage choking when the patient is lying flat? Your patient's hands are shaking and they're drenched in sweat - is it low blood sugar, anxiety, or a cardiac event? ​​Do you know exactly what to do if your patient has a seizure in the chair? This second part of the Medical Emergencies series with  Rachel King Harris dives even deeper into real-life scenarios that dental teams may face. From seizures and how (and when) to give buccal midazolam, to managing choking in a dental chair, this episode is packed with practical, clear guidance. We also explore key steps in treating diabetic hypoglycaemia, understanding glucagon vs glucose, and how to confidently manage patients with angina or previous heart attacks—when to use GTN, when to give aspirin, and when to simply wait for the ambulance. It’s all about staying calm, being prepared, and delivering safe, effective care when it matters most. https://youtu.be/fyIIsT0dlIc Watch PDP242 on Youtube Protrusive Dental Pearl: Assign a clear lead to regularly check the expiry dates and supplies of emergency medications and equipment. This isn’t just about ticking regulatory boxes — it’s about saving lives. Little checks like this can make a big difference in a true emergency. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 00:00 Teaser 00:44 Intro 03:09 Protrusive dental pearl 04:14 Recap from Part 1 06:58 Seizures: Personal Experiences and Practical Tips 13:45 Seizure Emergency Kit: Buccal Midazolam 21:29 Emergency Drug Kit Overview 22:10 Choking: Techniques and Guidelines 29:19 Midroll 32:40 Choking: Techniques and Guidelines 34:05 Handling Infant Choking Emergencies 36:11 Recognizing and Managing Hypoglycemia 41:11 Emergency Protocols for Hypoglycemia 47:35 Managing Cardiac Emergencies in Dental Practice 58:59 Final Thoughts and Training Recommendations 01:00:39 Outro Stay up to date by reviewing the latest guidelines from the Resuscitation Council UK. Grab your Anaphylaxis Summary + Medical Emergency Cheatsheets from https://protrusive.co.uk/me. And make sure you’ve listened to Part 1 of Medical Emergencies so you don’t miss any crucial information. #PDPMainEpisodes #CareerDevelopment #BeyondDentistry ​​This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C and D. AGD Subject Code: 142 Medical emergency training and CPR Aim: To equip dental professionals with the knowledge, confidence, and practical skills to recognize and effectively manage common medical emergencies in the dental setting, ensuring patient safety and optimal outcomes. Dentists will be able to: Identify signs and symptoms of common medical emergencies in dental practice, including anaphylaxis, asthma attacks, seizures, angina, hypoglycemia, and stroke. Describe the immediate management protocols for each emergency, including correct drug doses, routes, and timings. Demonstrate appropriate use of emergency equipment and drugs available in the dental setting. Click below for full episode transcript: Teaser: And you're saying that you deal with one hole only and it's the mouth and not anywhere else. Teaser:When you're becoming a dentist and you have to choose between medical and dental school, you either look up one and you look down the other, and so I said, let me look down, not up. So here we are. That made me realize, and the advice on that Facebook post was, anyone age five or under choke on grapes. And so you totally agree with that? I do. I do. I just think it's not worth it. Sweaty. Sweaty. Very, very clammy. You know, there's pools of sweat that I mentioned with hypose. You can get exactly the same with an MI. Yeah. Nausea, vomiting, sweaty, clammy, impending doom. So again,

HIGHLY RECOMMENDED CPD for all Dental professionals - without getting bored! Do you know exactly what to do if a patient faints in your chair? Could you spot the early signs of anaphylaxis—before it’s too late? How quickly could you find and deliver adrenaline if it really mattered? https://youtu.be/7b2oG4g12q0 Watch PDP241 on Youtube After six years of podcasting and creating CPD, we’re finally tackling medical emergencies the Protrusive way. In this two-part series, Jaz is joined by lead nurse and medical emergencies educator Rachel King Harris, who breaks down the real-life scenarios every dental team needs to prepare for—without the fluff or generic lecture feel. From vasovagal syncope to adrenaline protocols, you’ll learn how to stay calm, think clearly, and take action when it matters most. By the end of this episode (and the next), you’ll not only tick the box for your GDC-required CPD—you’ll actually feel ready. Because when emergencies happen in the chair, panic isn’t a plan. Let’s get you prepared. Protrusive Dental Pearl: Be emergency-ready! Download a free medical emergencies cheat sheet — a quick guide for symptoms, drugs, and actions during a crisis. You can download this ready-made cheat sheet for free at protrusive.co.uk/me. Print it, laminate it, and pop it into your medical kit. Your whole team will thank you! Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Medical emergencies in dentistry are rare but high-stakes — being prepared is essential. Guidelines change often — regular refreshers are vital. You don’t need to memorise everything — use validated resources and calm judgment. Vasovagal Syncope is the most common emergency in dental settings. If unconsciousness persists → consider other causes: meds, blood sugar, cardiac issues. Anaphylaxis can occur even without rash — don’t wait for it. Key signs: stridor, lip/tongue swelling, wheeze, “impending doom,” difficulty breathing. Keep emergency drug guides visible and updated (e.g., BDA laminated sheets). Ampules = longer shelf life, more doses than EpiPens, and more cost-effective. Don’t wait for the rash — airway signs matter most in anaphylaxis. Always carry two adrenaline auto-injectors — even for mild allergy patients. Highlights of this episode: 00:00 TEASER 00:53 INTRO 04:50  Protrusive Dental Pearl 06:01 Meet Rachel King Harris: Expert in Medical emergencies 09:42 Practical Tips for Emergencies 12:05 Understanding Vasavagal Syncope 17:01 GTN Spray 20:09 Recognizing and managing Anaphylaxis 30:05 Midroll 33:26 Recognizing and managing Anaphylaxis 34:41 Allergic Reaction to Chlorhexidine Gel 37:27 What’s Inside Emergency Bag? 41:51 Adrenaline Ampules vs Auto-Injectors 52:04 Oxygen Administration In Dental Practices 57:13 Oxygen and Emergency tools 59:05 Oxygen Contraindication 1:06:37 Outro Stay up to date by reviewing the latest guidelines from the Resuscitation Council UK. Check out this Anaphylaxis Summary Document Enjoyed this one? Make sure to check out PDP159 – How to Manage Children in Dental Pain, where we dive into real-life paediatric emergencies in dentistry. ​​This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C and D. AGD Subject Code: 142 Medical emergency training and CPR Aim:To improve the preparedness and confidence of dental professionals in recognising and managing common medical emergencies in the dental setting, with an emphasis on vasovagal syncope, anaphylaxis, and appropriate use of emergency medications and equipment. Dentists will be able to - Identify early signs and symptoms of vasovagal syncope and anaphylaxis in a dental setting. Apply appropriate first-aid management protocols, including patient positioning, airway support, and oxygen delivery.

How on earth can a neck injection eliminate teeth sensitivity? Can a patient’s tooth sensitivity really be linked to their occlusion? Is occlusal adjustment ever indicated for sensitivity? And what’s the actual mechanism behind those cases where everything looks fine — no cracks, no significant wear, no exposed dentine — yet the patient still complains their teeth are sensitive? In this episode, Dr. Nick Yiannios shares the concept of Sympathetic Dental Hypersensitivity (SDH), a groundbreaking way of understanding sensitivity that goes beyond the usual suspects like caries, erosion, or leakage. We dive into how the sympathetic nervous system in the pulp can drive unexplained pain, why traditional approaches often fail, and how objective tools like T-Scan and EMG can reveal what articulating paper misses. This could completely change the way you diagnose and manage those “mystery” sensitivity cases that just don’t add up. https://youtu.be/a2Mg72Y_zkw Watch PDP240 on Youtube Protrusive Dental Pearl: When fitting a resin-bonded bridge (RBB), if you’re unsure about the fit and cement gap, use light-bodied PVS on the intaglio surface of the wing. After setting and peeling it away, the thickness of the PVS shows you the expected cement layer. Ideally, it should be thin and even; a thicker area highlights where your gap is excessive. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: The T-scan technology revolutionizes occlusal analysis. Sensitive teeth can be linked to occlusion and bite adjustments. Frictional dental hypersensitivity (FDH) is a key concept in understanding sensitivity. Sympathetic responses may contribute to dental hypersensitivity. Innovative treatments include laser therapy and ozone application. Addressing root causes is essential for long-term solutions. Dentists should explore literature for new insights and techniques. Critical thinking is vital in dental practice. Advanced technology can enhance patient care and outcomes. Objective data is essential for effective occlusal adjustments. Understanding joint function is crucial for dental health. Differentiating between types of dental hypersensitivity is important. The sympathetic nervous system plays a significant role in dental pain. Educating patients about their conditions fosters better outcomes. The beaker of pain concept helps in understanding patient symptoms. Continuous learning is vital for dental professionals. Objective metrics are necessary for accurate diagnosis and treatment. Highlights of this episode: 00:00 Teaser 00:39 Intro 03:51 Protrusive Dental Pearl 05:42: Dr. Nick Yiannios’ Journey and Innovations 07:46 T-Scan and Digital Occlusal Analysis 08:29 FIRST INTERJECTION 13:46 T-Scan and Digital Occlusal Analysis 14:07 Discovery of Occlusion–Sensitivity Link 20:44 Second interjection 24:25 Student Case – Sensitivity from a Bridge 26:04  Dentine Hypersensitivity 28:39 Cervical Dentine Hypersensitivity 30:44 The Role of Lasers and Ozone in Dental Treatment 35:24 Alternatives for Dentists Without Lasers 43:12 Alternatives for Dentists Without Lasers 44:00 Frictional Dental Hypersensitivity Explained 47:15 The Importance of T-Scan in Dentistry 50:57 Neck Blocks and Sympathetic Responses. 58:24 Third interjection 01:00:01 Neck Block Mechanism 01:12:34 The Beaker of Pain Concept 01:14:38 Fourth interjection 01:16:23 The Beaker of Pain Concept 01:16:59 Community and Collaboration 1:20:57 Outro Curious to dive deeper?You can explore more of Dr. Nick’s work and insights through these resources: Upcoming course: CNO6 – Sympathetics in Dentistry: The Missing Link in General & Specialty Practice AES (American Equilibration Society) – check out their upcoming conference for world-class learning in occlusion and TMD. CNO – Center for Neural Occlusion

Is it time to say goodbye to your DSLR? Are mirrorless cameras really the future of dental photography? If your DSLR is still working perfectly, should you upgrade now or wait for the right time? Jaz is joined by Dr. Ashish Soneji in this game-changing episode to discuss the death of the DSLR and why the shift to mirrorless cameras is inevitable. They break down whether you should proactively switch or strategically hold off, plus what this means for your existing lenses. You'll also learn the rules of mix and match—can you use your current DSLR lens on a mirrorless body? And most importantly, which mirrorless lenses are worth buying and which ones to avoid (hint: if they don’t have markings, you might be in trouble!). If you care about consistent, high-quality dental photography, this episode is a must-listen! https://youtu.be/Y29Mnz26ZIU Watch PDP239 on Youtube Protrusive Dental Pearl: Jaz introduces the 21-Day Photography Challenge for beginners, featuring 21 short videos to help dentists take clear, well-framed photos. In just three weeks, participants will master essential shots, including tricky occlusal views, at their own pace. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Investing in quality equipment pays off in the long run. Mirrorless cameras offer significant advantages over DSLRs. Lighting is crucial for capturing quality images. Standardized images require barrel markings on lenses. Second-hand DSLRs can be a cost-effective option for beginners. The evolution of camera technology impacts photography practices. Choosing the right lens is essential for dental photography. Flash consistency is vital for accurate representation in images. Upgrading to mirrorless is a smart move for future-proofing photography. Upgrading your camera setup should align with your clinical progression. Mirrorless cameras are lighter and offer better image quality. Consider the size and transportability of your camera kit. Timing for upgrades can be linked to job changes or equipment failures. Image quality is influenced by megapixels, especially for presentations and printing. Using the right tools, like smaller mirrors and retractors, can improve photography outcomes. Testing second-hand cameras before purchase is crucial to avoid issues. Mobile photography is improving, but may not match the quality of dedicated cameras. Investing in good photographic equipment is essential for quality results. Highlights of this episode: 00:00 Teaser 00:47 Intro 01:41 Protrusive Dental Pearl 03:30 Ashish's Journey into Photography 09:06 The Shift from DSLR to Mirrorless Cameras 13:33 Choosing the Right Camera Setup 15:32 Upgrading to Mirrorless Cameras 19:22 Camera Recommendations for Beginners 27:23 Investing in Reliable Flash Equipment 32:20 Investing in Reliable Flash Equipment 33:48 When to Upgrade Your Camera Setup 38:08 Getting HQ Images: Mirrorless vs DSLR 42:03 Avoiding Newer Lenses 43:23 Posterior Quadrant Photography 47:50 Tips for Buying Second-Hand Cameras 49:54 Mobile Dental Photography: Are We There Yet? 53:20 Getting Your First Mirrorless Camera 55:40 Course Information 57:53 Outro 💡Catch Dr. Ashish Soneji’s upcoming course The Magic of Dental Photography this November 2025! 📅 Friday 14th November 2025 – Exclusively for BUPA dental care professionals at Bupa Head Office in Staines📅 Saturday 15th November 2025 – Open to all dental care professionals at the A-dec Showroom in Bracknell You can head over to https://www.magicofdentistry.com/ and add yourself to the waitlist. Further details on how to book will be sent directly to your email. Course overview: Understanding an SLR camera it's features Understanding a mirrorless camera and its features Discussing the process of recording an image

Should we be doing more to save questionable teeth? What if you could buy more time — without compromising patient care? Dr. Omar Ikram returns for a powerful episode diving into the real-world decision-making between endodontics and implants. Together with Jaz, they explore tough scenarios — like teeth with nasty cracks or minimal remaining structure — and ask the critical question: when is it truly time to extract? They break down concepts like retained roots, root burial, amputation, and a new term Jaz introduces — palliative endodontics. Because sometimes the best outcome isn't immediate replacement, but smart, strategic delay. https://youtu.be/5msP908JvuI Watch PDP238 on Youtube Protrusive Dental Pearl: When discussing treatment longevity with older patients, tailor your language to be more relatable. Instead of saying, “I plan my dentistry to age 100,” say, “I want this to last well into your eighties or nineties.” This makes the conversation more personal and realistic, helping patients better connect with the concept of long-term outcomes. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Understanding the limitations of implants compared to natural teeth is vital. Medical history significantly impacts dental treatment decisions. Managing patient expectations is crucial for satisfaction. Palliative endodontics can provide temporary relief and management. Reading and interpreting CBCT scans requires skill and experience. If it's not that five millimeter defect, it's up to you. The second molar is a good one because often second molars can't be replaced with an implant. Retaining roots is definitely a good way to go. You need to risk assess the patient before extraction. Palliative endo is technically always an option. Success in endo can be often difficult to achieve. Asymptomatic and functional is a good criteria. If endo is on the table, it's feasible. Highlights of this episode: 00:00 Teaser 00:35 Introduction 01:48 Protrusive Dental Pearl 04:15 Interview with Dr. Omar Ikram: Philosophy and Growth 10:17 Endodontics vs. Implants: Treatment Planning 16:35 Antidepressants and Dental Implant Failure 19:37 Managing External Cervical Resorption (ECR) 22:30 Patient Communication 24:16 Cracks and Complications in Endodontics 29:12 Endodontic Protocol 30:50 Challenges with CBCT and Cracks 32:07 Second Molars: Retain or Extract? 35:05 Retaining Roots for Future Implants 36:21 Root Burial and Special Cases 40:08 Root Amputation: A Niche Solution 40:57 Key Signs to Rethink Root Canal Treatment 43:17 Cracked Teeth: Poor Prognosis 47:08 Stained Crack Tooth 50:19 Success vs. Survival in Endodontics 56:02 Final Thoughts and Upcoming Events Want to sharpen your endo game even further? Watch Stop Being Slow at Root Canals! Efficient RCTs with Dr Omar Ikram – PDP163 Check out Specialist Endo Crows Nest — led by Dr. Omar Ikram, offering expert care, hands-on courses, and practical tips for real-world endodontics. This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and C. AGD Subject Code: 070 ENDODONTICS (Endodontic diagnosis) Aim: To help clinicians develop a deeper understanding of when to preserve a tooth through endodontic treatment versus when to consider extraction and implant placement. Dentists will be able to - Identify key red flags that may contraindicate definitive root canal treatment. Understand the concept of palliative endodontics and how it can be used to delay or defer implant placement responsibly. Recognize the value of retained roots in maintaining alveolar bone, particularly in medically compromised or high-risk patients. #PDPMainEpisodes #EndoRestorative #BreadandButterDentistry Click below for full episode transcript:

Is Practice Ownership worth the stress?  What's the most difficult thing you have to do as a practice owner?  Thinking about starting your own squat practice? How long does it really take before you see profit, and what sacrifices do you need to make along the way? In this episode, Jaz is joined by Dr. Shabnam Zai to unpack the real highs and lows of running a dental practice. From the loss of control as an associate, to the resilience needed during COVID, to the challenges of leadership and managing a team—nothing is sugar-coated here. They also tackle the big money question: when does a squat practice finally become profitable, and is it worth the grind in those first few years? If you’ve ever wondered whether practice ownership is for you—or why it might not be—this episode will give you the clarity (and reality check) you need. https://youtu.be/Tf1bgOWMA2A Watch PDP237 on Youtube Protrusive Dental Pearl: “DO NOT COMPARE YOUR WORK TO WHAT YOU SEE ON SOCIAL MEDIA” Most cases shown online are the very best results, done under perfect conditions by clinicians with thousands of hours of experience.  Instead of letting that trigger self-doubt or imposter syndrome, use it as inspiration: respect it, aspire toward it, and occasionally achieve it — but remember that real-world dentistry is different. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Engagement in work is crucial for job satisfaction. Time management is essential for balancing work and family. Marketing and patient relationships are vital for practice growth. Quality time with family is more important than quantity. Coaching can help surface potential and provide accountability. Delegation is essential for effective practice management. Vulnerability can arise unexpectedly in practice ownership. Managing people requires empathy and clear communication. Being an associate can be fulfilling and offers flexibility. It's important to have projects outside of dentistry. Balancing family life with practice ownership is challenging but possible. Financial planning is crucial before starting a practice. Understanding your priorities helps in making career decisions. Documenting staff performance is key to effective management. Continuous learning and self-improvement are vital for success. Highlights of this episode: 0000 Teaser 00:25 Intro 06:10: Guest Introduction – Dr. Shabnam Zai 08:38 Journey into Dentistry and Practice Ownership 15:08 Practice Philosophy and Security 16:33 Decision Making and Growth 19:10 Hardest Part of Being a Practice Owner 24:30 Balancing Parenthood and Dentistry 26:10 Coaching and Supporting Others 30:44 Compliance and Personality Types 34:15 Compliance and Personality Types 35:55 Navigating Career Vulnerability During COVID-19 37:06 The Importance of Self-Awareness and Managing People 40:07 The Forever Associate Trend 43:01 Projects vs Goals 48:33 Balancing Parenthood and Professional Growth 50:47 Financial Considerations for Starting a Practice 59:05 Final Thoughts and Mentorship Opportunities 59:42 Outro Enjoyed this episode? You might also like Treatment Co-Ordinators – Are They Right For Your Practice? – IC043 #PDPMainEpisodes #CareerDevelopment #BeyondDentistry Connect with Dr. Shabnam:Website → shabnamzai.comInstagram → @drshabnamzai This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes: B: Effective management of self and working with others in the dental team. AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS Aim: To provide dentists with an honest, practical insight into practice ownership—particularly squat practices—covering the challenges, rewards, financial realities, and mindset shifts needed for success. Dentists will be able to -

Are you living your career by design—or just letting it happen to you? Do you know what your ideal day as a dentist looks like? What about your ideal week? In this episode, Jaz is joined by Dr. Andrea Ogden to explore how you can design a career—and a life—in dentistry that feels purposeful and fulfilling. They dive into why many of us get stuck on autopilot, chasing goals we’ve never truly chosen, and how to break free by aligning work with your values.  Andrea also shares practical techniques to help you fall back in love with dentistry, so you can build a career that energises you—inside and outside the surgery. https://youtu.be/XDxlUFeEpbw Watch IC060 on Youtube Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 00:00 Teaser 00:21 Introduction 04:49 Guest Introduction – Dr. Andrea Ogden 06:05  Andrea's Journey in Dentistry 08:51 Pivotal Moments in Dentistry 14:51 Trial and Error in Career Development 15:51 Current Role 16:59 Identifying Strengths vs. Enjoyment in Dentistry 18:18 Challenges for Young Dentists 21:51 The Importance of Career Awareness 24:05 Impact of Social Media 26:57 Understanding the Decline in Dentist Morale 31:51 External Factors Contributing to Stress 35:09 Internal Factors and Cognitive Dissonance 41:17 Practical Steps to Reignite Passion for Dentistry 47:32 Resilience Through Adaptation 48:59 Community and Support Networks 51:46 Enjoying the Journey 56:30 Outro Key Takeaways:  Dentistry is more than fillings and crown preps—it’s a career you can shape to truly excite you. Choose Variety & Joy – Build a mix of roles that energise you, not just ones you’re good at. Ditch the Comparison Game – Your journey is unique; stop measuring it against 15-year veterans on Instagram. Guard Your Values – Burnout often comes from a mismatch between what you believe in and where you work. Align the two. Create Space to Reflect – Slow down, think, and use SMART goals to plan your next step.  Find Your Tribe – Mentors, colleagues, and community will keep you inspired and resilient. Celebrate the Wins – Small or big, they’re proof you’re moving forward. Loved this conversation? You’ll also enjoy Passion and Values in Dentistry – PDP014 #CareerDevelopment #InterferenceCast #BreadandButterDentistry This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes  B: Effective management of self and working with others in the dental team. C: Maintenance and development of knowledge and skills within your field of practice. D: Maintenance of skills, behaviours and attitudes which maintain patient confidence in you and the dental profession, and put patients’ interests first.  AGD Subject Code: 770 – Practice Management and Human Relations Aim: To provide dentists with strategies, insights, and practical steps to rekindle passion for dentistry, align their work with personal values, and develop sustainable career satisfaction. Dentists will be able to - 1. Identify personal values and career drivers that contribute to long-term job satisfaction. 2. Recognise common stressors affecting dental morale and their underlying causes. 3. Apply structured decision-making frameworks (e.g., SMART goals) to career planning. Click below for full episode transcript: Teaser: There's a definite difference between doing more of something or because you are good at it and doing more of something because you enjoy it. You know your values are a compass. As to, you know, where you are gonna go in, in, in life. I think if you are listening to this conversation and you are really struggling, is that the first thing you need to do is you- Jaz's Introduction:Hello Protruserati. I'm Jaz Gulati and welcome back to your favorite Dental podcast. This is the interference cast, like the nonclinical arm,