Surgical Extrusion Technique Update – Alternative to Ortho Extrusion or CLS – PDP249

Thinking of moving to the USA as a dentist? Wondering what exams, applications, and documents you’ll need to practice or specialize there? Curious about how much it costs — and what life as a dentist in the States is really like? Dr. Hazel Kerr and Dr. Dorrin Reyhani join Jaz for a deep dive into everything you need to know about moving to America as a dentist. Both UK-trained and now faculty at UPenn, they share their personal journeys and break down the full pathway — from exams like the INBDE and TOEFL, to transcripts, personal statements, and application timelines. They also discuss what it’s like working in the US compared to the UK, including earning potential, patient culture, and training opportunities. Whether you want to complete an advanced standing program, pursue a specialty, or bring your skills back home, this episode gives you a clear roadmap to make it happen. https://youtu.be/Ro9dljETKpc Watch IC065 on YouTube Key Takeaways The journey to becoming a dentist varies significantly by country. Specializing in dentistry can open more opportunities than general practice. Board certification enhances professional status and may offer insurance benefits. International dentists have specific routes to practice in the US. Scholarships can significantly reduce the financial burden of dental education. Teaching positions can provide pathways to practice without additional costs. Faculty primarily teach and supervise dental students in clinics. Early preparation for the INBD exam is crucial for success. Clinical experience and a strong portfolio are essential for applications. Networking and externships can enhance application prospects. Understanding the application process can alleviate stress for international students. Cultural differences impact how dental care is valued and perceived. Highlights of this episode: 00:00 Teaser 00:55 Introduction 04:15 Journey to Specialization 12:49 Understanding the Certification and Board Process 15:35 Exploring Different Routes for International Dentists 18:17 Financial Considerations and Scholarships 25:48 US Difficulty and Competitiveness 29:35 Choosing Between General and Specialty Routes 31:11 Navigating State-Specific Licensing 33:28 Teaching and Clinical Responsibilities 35:03 Midroll 38:24 Teaching and Clinical Responsibilities 43:01 Application Process and Exams 52:07 Residency and Career Pathways 57:39 Application Portals 01:00:35 Work Experience Before Specialization 01:03:22 Why Dentists Choose to Work in the US 01:09:36 Finishing the Program and Looking Ahead 01:12:01 Outro If you enjoyed this episode, you’ll definitely be inspired by The American Dental Dream – PDP002. #InterferenceCast #CareerDevelopmentThis episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan.

You’re doing a routine exam when you spot it – a stained hairline crack snaking across the marginal ridge of a molar. Your patient hasn’t mentioned any symptoms… Yet. Should you sound the alarm? Monitor and wait? Jump straight to treatment? Cracked teeth are one of dentistry’s most misunderstood diagnoses. Colleagues debate whether to crown or monitor. And that crack you’re staring at? It could stay dormant for years—or spiral into an extraction by next month. So what separates the teeth that crack catastrophically from those that quietly hold together? In this episode, I am joined by final-year dental student Emma to crack the code (pun intended) on cracked tooth syndrome.  We break down the easy-to-remember “position, force, time” framework to help you spot risk factors before disaster strikes, and share a real-world case of a 19-year-old bruxist whose molar was saved by smart occlusal thinking. If you’ve ever felt uncertain about diagnosing, explaining, or managing cracked teeth, this episode will change how you think about every suspicious line you see. https://youtu.be/mU8mM8ZNIVU Watch PS019 on YouTube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Risk factors include large restorations and bruxism. Occlusion plays a significant role in tooth health. Diet can impact the integrity of teeth. Every patient presents unique challenges in treatment. Communication about dental issues is key for patient care. Certain teeth are more prone to fractures due to their anatomy. The weakest link theory explains why some patients experience more dental issues. Patient history is crucial in predicting future dental problems. The age and dental history of a patient influence treatment decisions. Understanding occlusion is essential for diagnosing and treating cracked teeth. The location of a tooth affects the force it experiences during chewing. Bruxism increases the risk of tooth fractures. Tooth contacts and forces play a critical role in diagnosing issues. Opposing teeth can provide valuable insights into tooth health. Effective communication is essential in managing cracked teeth. Stains on teeth can indicate deeper issues with cracks. Monitoring and documenting cracks over time is crucial for patient care. Highlights of this episode: 00:00 Teaser 00:49 Intro 03:25 Emma’s Dental School Updates 07:18 What is Cracked Tooth Syndrome (CTS)? 10:02 Crack Progression and Severity 12:45 Risk Factors 14:54 Position–Force–Time Framework 21:53 Which Teeth Fracture Most Often? 25:32 Midroll 28:53 Which Teeth Fracture Most Often? 30:37 The Weakest Link Theory 34:05 Diagnostic Tools 37:56 Treatment Planning 39:42 Case Study – High Force Patient 47:27 Communication and Patient Management 51:03 Key Clinician Takeaways 53:03 Conclusion and Next Episode Preview 53:42 Outro Check out the AAE cracked teeth and root fracture guide for excellent visuals and classification details. Literature review on cracked teeth – examines evidence around risk factors, prevention, diagnosis, and treatment of cracked teeth. Want to learn more about cracked teeth? Have a listen to PDP028 and PDP098 – both packed with practical tips and case-based insights. #BreadAndButterDentistry #PDPMainEpisodes #OcclusionTMDandSplints This episode is eligible for 0.75 CE credits via the quiz on Protrusive Guidance.  This episode contributes to the following GDC development outcomes: Outcome C   AGD Subject Code: 250 – Operative (Restorative) Dentistry Aim: To help dental professionals understand the causes, diagnosis, and management of cracked teeth through a practical, evidence-based approach. It focuses on identifying risk factors using the Position–Force–Time framework and improving patient outcomes through informed communication and tailored treatment planning. Dentists will be able to: Explain the aetiology and progression of cracked tooth syndrome Identify high-risk teeth and patient factors—such as restoration design, occlusal contacts, and parafunctional habits—that predispose to cracks Communicate effectively with patients about the significance of cracks, prognosis, and monitoring options, improving patient understanding and consent.

Are you confident in spotting a child at risk of neglect? Do you know what to do if you witness abuse in your practice? How can you raise concerns safely while protecting both the child and your team? This episode with Dr. Christine Park provides tangible actions, practical scripts, and clear guidance for managing challenging scenarios—like seeing an adult hit a child in the waiting room or recognizing neglect in the dental chair. These are situations dental school rarely prepares us for. Every practice needs clear protocols for safeguarding. This episode acts as a North Star, helping you stay compliant while ethically doing the right thing. If you treat children, you must listen to this episode and share it with every colleague who treats children. https://youtu.be/-kYs23Xa4Ls Watch PDP251 on YouTube Protrusive Dental Pearl: Find the phone number of your local child safeguarding board / social services. Verify it, then display it where you and your team can quickly access it. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Dentists are trained observers of family dynamics. Recognizing normal behavior is key in dental care. Unconscious observations can guide professionals. Feeling uncomfortable about a situation is a valid signal. Empowerment comes from trusting your instincts. Dental care professionals see many aspects of families. It’s important to act on uncomfortable feelings. Observation skills are crucial for effective care. Children’s interactions reveal much about family health. Awareness of discomfort can lead to better outcomes. Highlights of this episode: 00:00 Teaser 00:59 Intro 02:40 Pearl – Child Protection Hotline 05:23 Dr. Christine Park’s Background and Expertise 08:37 The Role of Dentists in Safeguarding Children 11:19 Practical Scenarios and Guidelines for Safeguarding 15:35 Recognizing Silent Cases of Neglect 17:29 Team Collaboration and Support in Safeguarding 21:58 Guidelines and Policies for Effective Safeguarding 22:03 Midroll 25:24 Guidelines and Policies for Effective Safeguarding 28:32 Handling a Tough Safeguarding Scenario 32:18 Dealing with Poor Oral Hygiene and Neglect 39:12 Managing Parental Reactions and Consent 43:08 The Importance of Safeguarding in Dentistry 45:34 Further Guidance and Resources 46:10 Outro 📢 Safeguard your young patients with confidence! Catch Dr. Christine Park at the Scottish Dental Show in June or via her NES webinars. Check out the BSPD guidelines on dental neglect —an essential resource for any dentist treating children ✉️ Get in Touch with Dr. Christine: General: [email protected] Patient-info: [email protected] If you loved this episode, don’t miss How to Manage Children in Dental Pain – Paediatric Emergencies – PDP159 #PDPMainEpisodes #Communication #CareerDevelopment This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and D. AGD Subject Code: 430 PEDIATRIC DENTISTRY (Identification and reporting of child abuse) Aim: To equip dental professionals with practical knowledge and skills to recognize, respond to, and appropriately escalate safeguarding concerns involving children in dental practice. Dentists will be able to – Identify key signs and red flags of child neglect, abuse, or welfare concerns in dental patients. Apply clear communication strategies to discuss concerns with parents/caregivers and involve relevant authorities. Follow practice-based and multi-agency procedures for safeguarding, including documenting observations and escalation.

Let’s be honest – the occlusion after Aligner cases can be a little ‘off’ (even after fixed appliances!) How do you know if your patient’s occlusion after aligner treatment is acceptable or risky? What practical guidelines can general dentists follow to manage occlusion when orthodontic results aren’t textbook-perfect? Jaz and Dr. Jesper Hatt explore the most common challenges dentists face, from ClinCheck errors and digital setup pitfalls to balancing aesthetics with functional occlusion. They also discuss key strategies to help you evaluate, guide, and optimize occlusion in your patients, because understanding what is acceptable and what needs intervention can make all the difference in long-term treatment stability and patient satisfaction. https://youtu.be/e74lUbyTCaA Watch PDP250 on YouTube Protrusive Dental Pearl: Harmony and Occlusal Compatibility Always ensure restorative anatomy suits the patient’s natural occlusal scheme and age-related wear. If opposing teeth are flat and amalgam-filled, polished cuspal anatomy will be incompatible — flatten as needed to conform. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Common mistakes in ClinCheck planning often stem from occlusion issues. Effective communication and documentation are crucial in clinical support. Occlusion must be set correctly to ensure successful treatment outcomes. Understanding the patient’s profile is essential for effective orthodontics. Collaboration between GPs and orthodontists can enhance patient care. Retention of orthodontic results is a lifelong commitment. Aesthetic goals must align with functional occlusion in treatment planning. Informed consent is critical when discussing potential surgical interventions. The tongue plays a crucial role in orthodontic outcomes. Spacing cases should often be approached as restorative cases. Aligners can achieve precise spacing more effectively than fixed appliances. Enamel adjustments may be necessary for optimal occlusion post-treatment. Retention strategies must be tailored to individual patient needs. Case assessment is vital for determining treatment complexity. Highlights of this episode: 00:00 Teaser 00:59 Intro 02:53  Pearl – Harmony and Occlusal Compatibility 05:57 Dr. Jesper Hatt Introduction 07:34 Clinical Support Systems 10:18 Occlusion and Aligner Therapy 20:41 Bite Recording Considerations 25:32 Collaborative Approach in Orthodontics 30:31 Occlusal Goals vs. Aesthetic Goals 31:42 Midroll 35:03 Occlusal Goals vs. Aesthetic Goals 35:25 Challenges with Spacing Cases 42:19 Occlusion Checkpoints After Aligners 50:17 Considerations for Retention 54:55 Case Assessment and Treatment Planning 58:14 Key Lessons and Final Thoughts 01:00:19 Interconnectedness of Body and Teeth 01:02:48 Resources for Dentists and Case Support 01:04:40 Outro Free Aligner Case Support!Send your patient’s case number and get a full assessment in 24 hours—easy, moderate, complex, or referral. Plus, access our 52-point planning protocol and 2-min photo course. No uploads, no cost. [Get Free Access Now] Learn more at alignerservice.com If you enjoyed this episode, don’t miss: Do’s and Don’ts of Aligners [STRAIGHTPRIL] – PDP071 #PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative 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: 370 ORTHODONTICS (Functional orthodontic therapy) Aim: To provide general dentists with practical guidance for managing occlusion in aligner therapy, from bite capture to retention, including common pitfalls, functional considerations, and case selection. Dentists will be able to – Identify common errors in digital bite capture and occlusion setup. Understand the impact of anterior inclination and mandibular movement patterns on occlusal stability. Plan retention strategies appropriate for aligner and restorative cases.

Do you have a “hopeless” retained root you’re ready to extract? Think implants, dentures, or bridges are the only way forward? What if there’s a way to save that tooth — predictably and biologically? In this episode, Dr. Vala Seif shares his experience with the Surgical Extrusion Technique — a game-changing approach that lets you reposition the root coronally to regain ferrule and restore teeth once thought impossible to save. Jaz and Dr. Seif dive into case selection, atraumatic technique, stabilization, and timing, all guided by Dr. Seif’s own SAFE/SEIF Protocol, developed from over 200 successful cases. https://youtu.be/2TyodqgAP9w Watch PDP249 on YouTube Protrusive Dental Pearl: When checking a ferrule, consider height, thickness, and location of functional load. Upper teeth: prioritize palatal ferrule. Lower teeth: prioritize buccal. Tip: do a partial surgical extrusion, rotate the tooth 180°, then stabilize. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Surgical extrusion is a technique-sensitive procedure that requires careful planning. Case selection is crucial for the success of surgical extrusion. A crown-root ratio of 1:1 is ideal for surgical extrusion. Patients are often more cooperative when they see surgical extrusion as their last chance to save a tooth. Surgical extrusion can be more efficient than orthodontic extrusion in certain cases. The importance of ferrule in dental restorations cannot be overstated. Proper case selection is crucial for successful outcomes. Atraumatic techniques are essential for preserving tooth structure. The ‘Safe Protocol’ offers a structured approach to surgical extrusion. Patient communication is key to managing expectations. Flowable composite is preferred for tooth fixation post-extraction. Understanding root morphology is important for successful extractions. Highlights of this episode: 00:00 Surgical Extrusion Podcast Teaser 01:07 Introduction 02:38 Protrusive Dental Pearl 05:53 Interview with Dr. Vala Seif 08:57 Definition and Philosophy of Surgical Extrusion 15:30 Indications, Case Selection, and Root Morphology 21:37 Comparing Surgical and Orthodontic Extrusion 25:54 Crown Lengthening Drawbacks 28:39 Occlusal Considerations 33:53 Midroll 37:16 Definition and Importance of the Ferrule 43:07 Clinical Protocols and Fixation Methods 01:00:01 Post-Extrusion Care and Final Restoration 01:05:04 Learning More and Final Thoughts 01:09:29 Outro Further Learning: Instagram: @extrusionmaster — case examples, papers, and protocol updates. Online and in-person courses in development (Europe + global access). Loved this episode? Don’t miss “How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique” – PDP061 #PDPMainEpisodes #OralSurgeryandOralMedicine #OrthoRestorative This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C. AGD Subject Code: 310 ORAL AND MAXILLOFACIAL SURGERY Aim: To understand the biological and clinical principles of surgical extrusion as a conservative alternative to orthodontic extrusion or crown lengthening for managing structurally compromised teeth. Dentists will be able to – Identify suitable clinical cases for surgical extrusion, including correct root morphology and crown–root ratios. Describe the step-by-step SAFE Protocol for atraumatic surgical extrusion, fixation, and timing of endodontic treatment. Evaluate the advantages, limitations, and biomechanical considerations of surgical extrusion compared with orthodontic extrusion and crown lengthening.

Are you confident in replacing a single missing central incisor? When is a denture the right option — and when should you consider a bridge or implant instead? Why is the single central incisor one of the hardest teeth to replace to a patient’s satisfaction? In this Back to Basics episode, Jaz and Protrusive Student Emma Hutchison explore the unique challenges of replacing a single central incisor. They break down when each option — denture, resin-bonded bridge, conventional bridge, or implant — is appropriate, and the biological and aesthetic factors that influence that decision. They also share key communication strategies to help you manage expectations, guide patients through realistic treatment choices, and avoid disappointment when dealing with this most visible and demanding tooth. https://youtu.be/czjPQxKpwPw Watch PS018 on YouTube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways:  Replacing a single central incisor isn’t just about technical skill — it’s about communication and case selection.  Success comes from helping patients understand that a restoration replaces a tooth’s function and appearance, not nature itself.  Clear conversations about expectations, limitations, and maintenance are what turn a difficult aesthetic case into a satisfying long-term result. Highlights of this episode: 00:00 Teaser 00:28 Intro 01:56 From Dental Nurse to Final-Year Student 07:38 Challenges and Considerations in Replacing Central Incisors 12:51 Patient Communication and Treatment Planning 18:33 Discussing Treatment Options and Enamel Considerations 21:16 Communicating Options and Guiding Patient Decisions 25:51 Choosing Between Fixed and Removable Options 27:10 Midroll 30:31 Choosing Between Fixed and Removable Options 31:05 Handling Old Crowns and Patient Communication 34:17 Conventional vs. Resin-Bonded Bridges 37:57 Occlusal Load, Function, and Implant Considerations 43:40 Digital Workflow in Dentistry 45:54 Managing Aesthetic Expectations 48:34 Final Thoughts and Recommendations 52:59 Outro 🎧 Want to feel confident with prosthodontics? Explore these essential follow-ups to this episode: Dentures vs Bridges with Michael Frazis Crowns vs Onlays with Alan Burgin Dentures with Finlay Sutton RBB Masterclass on the Protrusive Guidance App Quick, practical lessons to sharpen your planning, communication, and anterior aesthetics — all in your pocket. #ProsthoPerio #OcclusionTMDandSplints #Communication #BreadandButterDentistry This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C. AGD Subject Code: 610 – Fixed Prosthodontics Aim: To provide a clear, clinical overview of replacing a single missing incisor — focusing on when to choose a denture, bridge, or implant, and how to communicate realistic expectations. Dentists will be able to – Identify the key biological, functional, and aesthetic challenges in replacing a central incisor. Compare the indications, advantages, and limitations of dentures, resin-bonded bridges, conventional bridges, and implants. Communicate realistic outcomes, limitations, and maintenance expectations effectively to patients.

What if one bad decision completely changed the course of your career? In this exclusive, members-only episode, Jaz sits down with a fellow dentist from our community who shares his raw, honest story about a moment of misjudgment — committing fraud — and the painful lessons that followed. This isn’t about blame. It’s about insight, accountability, and redemption. From the shock of investigation and court hearings, to the struggle of rebuilding trust and identity, this conversation shines a light on what really happens behind closed doors when things go wrong. The aim of this podcast was to hopefully deter colleagues from temptation which can affect anyone at any time. https://youtu.be/QF-UNrlYjcw Watch PDP248 on YouTube How to Watch the Full Episode This is a members-only podcast episode due to its sensitive nature. You can access it by creating a free Community account at: https://www.protrusive.app Highlights of this episode: 00:00 Teaser 00:49 Introduction 05:49 End Screen Love this episode? Don’t miss Divorce, Alcohol and Rough Patches – Overcoming Adversities (IC040) #PDPMainEpisodes #BeyondDentistry This episode is eligible for 0.5 CE credits via the Quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and D AGD Subject Code: 555 Ethics in Dentistry Aim: To reflect on the ethical, professional, and emotional lessons learned from a real-life case of dental fraud, highlighting accountability, insight, and rehabilitation while identifying practical steps to prevent similar incidents. Dentists will be able to – Recognise how workplace pressures, lack of mentorship, and poor oversight can lead to ethical lapses. Understand the legal, professional, and emotional consequences of dishonesty and poor record keeping. Identify support systems, coping strategies, and self-reflective tools to prevent burnout and maintain integrity.

Ever had a patient swear their bite feels “off” – even though the articulating paper marks look perfect and you’ve adjusted everything twice over? Or maybe you’ve placed a beautiful quadrant of onlays, only to have them return saying, “these three teeth still feel proud.” If that sounds familiar, you’re not alone. In this episode, I’m joined (in my car, no less!) by Dr. Robert Kerstein, who was back in the UK to teach about digital occlusion and the power of the T-Scan and ‘disclusion time reduction therapy’. We dig into why a patient’s bite can still feel “off” even when everything looks right, how timing is just as important as force, and why splints and Botox don’t always solve TMD. Robert explains why micro-occlusion is the real game-changer, how scanners could mislead you, and why dentistry still clings to articulating paper. So if you’ve ever wondered why “perfect” cases still come back with bite complaints, or whether timing data can actually prevent fractures and headaches, this episode will give you plenty to chew on – pun intended. https://youtu.be/0lCAsjFhsXI Watch PDP247 on YouTube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Micro-occlusion, not just “dots and lines,” is the real driver of patient comfort and long-term tooth health. T-Scan measures both force and timing, which scanners and articulating paper cannot capture. Many patients show signs of occlusal damage without symptoms. Disclusion Time Reduction (DTR) treats TMD neurologically without splints, Botox, or TENS. Relying on occlusograms alone for guiding reduction is risky. Dentists can reduce post-treatment complaints by balancing micro-occlusion with T-Scan. Adopting T-Scan requires proper training. CR can be a convenient reference point, but MIP works well in most cases if micro-occlusion is managed. Objective, repeatable data builds patient trust and provides medico-legal reassurance. Highlights of this episode: 00:00 Teaser 01:13 Intro 4:41 Protrusive Dental Pearl –  Removing a Temporarily Cemented Crown 06:39 Introduction 08:48 Global Training Footprint 09:32 What Robert Teaches (DTR & T-Scan) 09:55 Occlusion as Neurologic 10:33 Macro vs Micro-Occlusion 11:33 Neural Pathway 15:00 MIP vs CR Framing 16:48 Signs Without Symptoms 19:16 Silent Majority 20:08 Why Treat Asymptomatic Signs 20:50 Disclusion and MIP 22:28 Occlusogram Caveats 24:53 Midroll 28:14 Occlusogram Caveats 28:29 Why Occlusograms Mislead 29:21 Don’t Adjust From Color Alone 31:47 What Pressure/Timing Enable Clinically 33:02 Prosthetic Reality Check 34:46 Patient-Perceived Comfort 35:29 Why Isn’t T-Scan Everywhere? 36:29 Political Resistance 37:42 CR as Utility 38:18 MIP and Vertical Dimension. 39:48 Macro ≠ Micro 41:00 Material Longevity Benefits 41:57 T-Scan Training 42:58 Three Competencies to Master 44:20 Micro-Occlusion Rules 44:46 Outro If you want to get more clued up on TMD, tune into this episode for the latest insights and guidelines! PDP213 – TMD New Guidelines –  however be warned that the guidelines are contradictory to what Dr. Kerstein advises….ah the wonderful world of TMD!  #OcclusionTMDandSplints #OrthoRestorative This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A, C. AGD Subject Code: 250 – Clinical Dentistry (Occlusion/Restorative) Aim: to explore the role of micro-occlusion and timing in TMD and restorative success, highlighting how tools like T-Scan provide data that other tools cannot. This episode seeks to give dentists practical insights into diagnosing, preventing, and treating occlusal problems with greater accuracy. Dentists will be able to: Describe the role of micro-occlusion and disclusion time in TMD symptoms and tooth wear. Recognising the limitations of traditional methods of occlusion adjustment. Understand how objective occlusion data supports comfort, longevity of restorations, and preventive care.

Is social media killing professionalism in dentistry? Are young dentists really “clowns” online—or is lightheartedness perfectly fine? Is social media a disease? Where’s the line between humor, banter, and outright disrespect? In this episode, Jaz is joined by Joseph Lucido from the States to tackle these tough questions head-on. Sparked by a fiery Facebook rant, they dive into whether social media is harming our profession, how dentists should present themselves online, and if there’s still room for fun without crossing the line. Whether you love or hate dental content on social media, this conversation will make you rethink how we represent our profession to the world. Shout-out to two US doctors creating excellent, entertaining content on social media Dr Brady Smith Dr. Nicholas J Ciardiello Check out the 3-Step Modern Dental Marketing Plan from Clear to Launch Dental — designed to help you simplify your marketing and grow your practice without the overwhelm. https://youtu.be/W7Uh-ML9dZg Watch IC063 on YouTube Need to Read it? Check out the Full Episode Transcript below! Takeaways Social media etiquette is crucial for healthcare professionals. Avoid controversial topics to maintain professionalism. A social media presence is essential for modern dental practices. Patients often check social media to verify a practice’s credibility. Content should reflect the personality of the dentist and practice. Highlight satisfied patients to build social proof. Consistency in posting is key to maintaining engagement. Separate personal and professional social media accounts. Batch content creation to save time and effort. Engaging content can lead to more patient inquiries. Highlights of this episode: 00:00 Teaser 00:31 Intro 01:47 Introducing Joseph Lucido: Social Media Expert 03:21 Social Media Etiquette for Dentists 06:14 The Importance of Social Media Presence 12:04 Balancing Professionalism and Humor Online 17:39 Authenticity in Social Media 19:51 Balancing Personal and Professional Content 21:51 Effective Social Media Strategies 25:27 Time Management for Social Media 27:26 Do’s and Don’ts of Social Media 29:43 The Power of Social Proof 30:49 Conclusion and Resources 32:47 Outro Love this episode? Don’t miss Best Practices in Social Media for Dentists – How to Stay Out of Trouble Yet Be Impactful (IC035) #InterferenceCast #Communication #BreadandButterDentistry This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan, including Premium clinical walkthroughs and Masterclasses.

Cracked teeth — the diagnosis we all hate as Dentists! How do you decide when to monitor and when to intervene? What is the recommended intervention at different scenarios of cracks? Should we be chasing cracks and reinforcing with fibers; is there actually enough long-term data to support that approach? Over the years, we’ve had some epic episodes on this topic — from Kreena Patel’s “I Hate Cracked Teeth” (PDP028) to Dr. Lane Ochi’s Masterclass on Diagnosis and Management (PDP175). But in this brand-new episode, Jaz is joined by Dr. Masoud Hassanzadeh to bring it all together — not just the diagnosis of cracks, but their management. They explore when to intervene, the role of fibers in preventing propagation, and even the fascinating possibility that cracks in teeth may have some ability to heal, just like bone! This one’s a deep dive that will change how you talk to patients — and how you approach cracked teeth in your own practice. https://youtu.be/VHYRBnfJS3I Watch PDP246 on YouTube  Protrusive Dental Pearl Your patient’s history predicts the future! Ask if past extractions were difficult → clues you into anatomical challenges. Ask how they lost other teeth → if cracks, be proactive with today’s cracks. History isn’t just background—it’s a clinical tool. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Cracks in teeth can be diagnosed using magnification and high-quality imaging. Patient factors such as age and muscle strength play a significant role in crack prognosis. Symptomatic cracks should be treated to prevent further propagation. Understanding the anatomy of the tooth is crucial for effective treatment. The healing mechanism of cracks in teeth is possible but varies between enamel and dentin. Fibers can be used to strengthen restorations and manage cracks effectively. Long-term studies are needed to assess the effectiveness of current crack management protocols. The use of fluorescence filters can help identify bacteria in cracks. Chasing cracks should be done cautiously to avoid pulp exposure. A comprehensive understanding of crack mechanics can improve treatment outcomes. Highlights of this episode: 00:00 Teaser 00:47 Intro 03:08 Protrusive Dental Pearl - The Importance of Dental History 07:18 Interview with Masoud Hassanzadeh 08:22 Diagnosing and Managing Cracks 21:13 When to Intervene on Cracks 25:50 Restoration Techniques and Materials 28:30 Chasing Cracks: Guidelines and Techniques 36:50 Mechanisms of Crack Healing in Teeth 45:11 Exploring the Use of Fibers in Dentistry 52:43 Introducing the Book on Cracked Teeth 54:57 Percussion-Based Diagnostics (QPD) 56:44 Key Takeaways 57:21 Conclusion and Final Thoughts 01:00:07 Outro As promised, here are the studies mentioned during the discussion: Why cracks do not propagate as quickly in root dentin: Study 1a & 1b Root dentin has significantly higher fracture toughness compared to coronal dentin—nearly twice as tough, as demonstrated in multiple studies. The key difference lies in their structure and toughness. Root dentin’s unique collagen orientation adds strength, while its fewer lumens and thinner peritubular cuffs make it less brittle. In contrast, coronal dentin has thicker cuffs, which increase brittleness. Unlike coronal dentin, which fractures uniformly, radicular dentin is anisotropic—its fracture behavior varies depending on direction. These structural features give root dentin greater resistance to cracking, making it more durable under stress. Studies on decreasing crack length due to crack repair in enamel. Study 2 The importance of the modulus of elasticity of the final restoration in arresting crack propagation. Study 3 The role of fiber in restoring cracked teeth and how it can increase fracture strength—even surpassing that of natural teeth. Study 4 Decision Making for Retention of Endodontically Treated Posterior Cracked Teeth - A 5-year Follow-up Study The Cracked Tooth: Histopathologic and Histobacteriologic Aspects Historical Studies on Enamel Crack Healing– 1949 (Sognnaes): The Organic Elements of the Enamel: III. The Pattern of the Organic Framework in the Region of the Neonatal and other Incremental Lines of the Enamel – 1994 (Hayashi): High Resolution Electron Microscopy of a Small Crack at the Superficial Layer of Enamel – 2009 (S. Myoung): Morphology and fracture of enamel Don’t miss out — get instant access to all the research papers discussed here at protrusive.co.uk/cracks! Dr. Masoud Hassanzadeh has written two essential books every dentist should own: 📘 Glossary of Biomimetic Restorative Dentistry🔑 Your quick-reference guide to the language and principles of biomimetics — explained in a way you can actually use chairside. 📕 The Cracked Tooth: A Comprehensive Guide to Cracked Teeth🦷 Everything you need to know about diagnosis, management, and the science behind one of dentistry’s biggest headaches. 🌴✨ Dubai 2026: Occlusion + Family Fun ✨🌴 This Easter, join Dr. Jaz Gulati and Dr. Mahmoud Ibrahim for something truly special — a tax-efficient holiday that mixes world-class occlusion training with plenty of family time in Dubai. 🦷 What’s included? ⏰ 20 hours of hands-on occlusion (mornings only: 9 am–1 pm) 🏖️ Afternoons & evenings free to enjoy Dubai with your family 📚 Pre-learning + online content to deepen your understanding 🥂 A not-for-profit event — just dentists, families, and fun! 👉 Learn more & get your quote at: globaldentalevents.co.uk 💡 Make memories with your loved ones while making your CPD hours tax-deductible Want to level up your knowledge on cracked teeth? 🎧 Don’t miss PDP098: Cracked Teeth Management with the Direct Composite Splint Technique #PDPMainEpisodes #EndoRestorative #BreadandButterDentistry 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 Aim: To provide clinicians with practical, evidence-based guidance for diagnosing, monitoring, and restoring cracked teeth, with emphasis on prognosis, risk factors, and restorative decision-making. Dentists will be able to - Differentiate between enamel and dentine cracks, and recognize when prognosis is hopeless. Apply appropriate diagnostic tools and clinical criteria to decide when to monitor versus intervene. Select suitable restorative strategies and materials to manage cracked teeth effectively. Click below for full episode transcript: Teaser: After 48 hours, they started to see that the crack is just decreasing, like it's just healing. Is it really possible? But it is possible. Like how there is a crack healing mechanism in the bone, there is also crack healing mechanism in the tooth. When I started to learn about cracks, actually the studies were not from dentists. Teaser: They were fracture mechanic engineering that they just studied about the crack, and nowadays there is a new system, it is called quantitative percussion diagnostic, QPD. There is a stress concentration in that point where the crack is started, so we have to distribute the stress in that place, in that plane. That is the important one. If we are just going to remove the crack and put the restoration on it, I'm afraid it's just going to happen again. Jaz's Introduction: Over the years, we've had some awesome episodes on cracked teeth. If you go all the way back to PDP028 with Krina Patel, the episode was titled, I Hate Cracked Teeth, and you know what? I still hate cracked teeth. They're a damn nuisance. They're everywhere, and it creates major consent and if the tooth goes non-vital, that kind of conversation, which no one likes. Now, years later, we did this epic episode with Dr. Lane Ochi, PDP175. You need to check these two episodes out if you want to geek out on cracks. But you know what? This episode really does a wonderful summary of cracks. Not just the diagnosis, but the actual management. Should we be chasing cracks? Are fibers actually indicated? Is there enough long-term clinical data to support the use of fibers in crack propagation? And the question of, okay, when should you actually intervene? And you know what? The most important one I haven't even mentioned yet. So, Dr. Masoud, the way I got acquainted with him is on social media. I posted this image of a crack, a really nasty crack, and he said something absolutely ridiculous. He said that cracks have an ability to heal a bit like cracks heal in bone. Now, you said that because in this image I posted on social media, it was all about how I communicate cracks to my patients. I say to them, look, when you have a crack in a bone, the bone can heal, it can regenerate, but a crack in a tooth can never heal. Patients seem to resonate and they understand that. But he was suggesting that actually cracks can heal naturally a bit like bone. And so if you listen to the end of the podcast, you will see how that is actually possible. Hello, Protruserati. I'm Jaz Gulati and welcome back to your favorite dental podcast. I've had a month in August which was pretty crazy. I didn't do much recording of new podcasts. We were working on some of the older recordings I had done. We've got a huge backlog as a team, which is a wonderful position to be. We are having so much fun creating these episodes. Thank you to everyone who returns to our podcast, and of course all the new people that find us. If you're not already, you need to join 5,000 of the nicest and geekiest dentists in the world on the Protrusive Guidance app. Go on protrusive.app, make an account. Your only requirement is you must be nice and you must be geeky. If you are those two things, you should come and join us to geek out, discuss, share challenges, share wins.