Isolating the Last Tooth in the Arch #RubberDamFam – PDP183

Rubber Dam isolation can be tricky enough sometimes - it is especially awkward when the TERMINAL MOLAR needs restoring. How on earth does one isolate AND matrix this tooth? In this episode, Dr. Celine Higton delves into the intricacies of rubber dam isolation, particularly focusing on the last tooth in the arch. This discussion ties into the broader theme of mental health, highlighting how mastering such techniques can lead to a more enjoyable and stress-free practice.  https://youtu.be/VeoPTNShAcs Watch PDP183 on Youtube Protrusive Dental Pearl: "Cow Mode" as a technique to improve access to the mouth's hard-to-reach areas, especially around the last molars. By instructing patients to shift their jaw to one side, akin to a cow's chewing, this approach aids in better oral hygiene practices and facilitates procedures like rubber dam isolation when clamping the terminal molar. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 02:24 Protrusive Dental Pearl 5:36 Introduction to Dr Céline Higton 7:07 The Journey from Architecture to Dentistry 9:15  Mastering Rubber Dam Isolation: Tips and Techniques 14:12 Types of Clamps Ideal for Isolating the Last Tooth (Upper) 18:01 Dental Pearl - Cow Mode 19:22 Accessing the Last Tooth 22:13 Dr. Céline’s Personal Choice of Rubber Dam 23:11 Proper Lubrication for Rubber Dam 25:00 Correct Flossing Technique 27:01 Matrixing the Last Tooth 32:09 Cavity Preparation 35:37 Isolating the Last Tooth (Lower) 37:28 Coronoid Process in Clamp Placement 38:36 How to get in touch with Dr Celine Reach out to Dr. Céline Higton via her Instagram, @drcelinehigton and via her website, #RUBBERDAMFAM Access the CPD quiz through our app on https://www.protrusive.app, either on your browser or by downloading our mobile app. For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. Join us on Protrusive Guidance, our own platform for dental professionals. No need for Facebook anymore! 😉 If you love this episode, be sure to watch 10 Commandments for Staying Out of Trouble Click below for full episode transcript: Jaz's Introduction: When you're going through the journey of learning rubber dam isolation, because you want to level up your restorative dentistry and become better at adhesive dentistry. Jaz's Introduction:And for me, I've talked about before, like for me, rubber dam is my tranquil environment. It's when I'm least stressed. I've got rubber dam on, the patient can't talk, the tongue is abolished, and I'm just falling in love with a little micro steps that makes our profession so much fun, right? But when you're isolating the last tooth, like let's say it's a wisdom tooth or whichever is the last tooth. And then that tooth also needs a restoration. Then we have some issues, i.e If you clamp that tooth, then how can you get a matrix on that tooth? And that's the problem that we're solving today with the real superstar of dentistry. Her name is Dr. Celine Higton. I know so many of you probably already have heard of her. And I think it's so fitting that April, we're focusing April on mental health. So I'm going to talk a little bit more about mental health this month. And how is isolating the last tooth rubber dam relevant to mental health? Well, I told you already, it reduces my stress. I'm in my happy place when I've got rubber dam on. I want everyone, I want all dentists to experience this level of isolation whereby they're just listening to classic FM and everything's under control and the patient's not going to lick anything. So it's a great stress reducer for me. But also because in the conversation that I had with Celine, I think it's so obvious that, look, you guys know I'm super enthusiastic about what I do in dentistry. And I think that's really important for a long career and fulfillment and enjoyment of your work. And I think the same can be said about Celine. Celine is someone who loves documenting her work. You can tell that on her Instagram, she's super enthusiastic about it. And I think that is a secret ingredient that we need to have. So if you just practice dentistry as a means to an end only, and you're constantly clock watching, that's not a great place to be. I gain great satisfaction from falling in love with those little details. And it's really mastering your craft. That journey of becoming good at something. The journey of problem solving that me and Celine will talk about a bit later in the interview. And I hope that will inspire some of you. If you're not in a great place, then sometimes an episode like this just reignites you. And then you think, you know what, I'm going to try to master Rubber Dam. And I spend the next six months to a year master rubber dam, and you'd be amazed how just focusing on your craft can really re engage you in our wonderful profession and actually help you to deliver better care. Now, of course, when you're learning a new trick or when you're trying to do more complex cases, there is a frustration associated with learning, but that's all part of the journey, it's all part of the fun. Dental PearlHello Protruserati, I'm Jaz Gulati and welcome back to your favorite dental podcast. Before we join the main episode, every PDP episode I give you a Protrusive Dental Pearl. And today's pearl is something that I've taken from the main interview and it's basically Cow Mode. Like I used to call this wiggle your jaw but I love that Celine called it Cow Mode. Now what is cow mode? So when you look in a patient's mouth and you notice that they've got fairly good oral hygiene, looking at the upper first molar, upper second molar, and when you get to the last molar you see that because their cheek and their coronoid process, remember that piece of anatomy, part of the mandible, right, the coronoid process, it is impeding access of their toothbrush, i. e. they can't actually get the toothbrush on that wisdom tooth, on the buccal surface of the wisdom tooth, because the coronoid and the cheek are in the way. So what do you do? You tell them to look like a cow. You tell them to half open, and you get them to move their jaw so they look like a cow all the way off to one side. Now I usually say, open a little bit and then wiggle your jaw all the way to one side. And then they usually ask, okay, which jaw should I move? Should I move my upper jaw or my lower jaw? And you can just smile and say, please, can you move your lower jaw today? Anyway, once they move their mandible off to one side, whether you say wiggle or whether you say cow mode, i. e. just look like a cow, then you can show the patient that, look, now you've got all this space and now you can access that wisdom tooth, that poor, neglected buccal surface of the wisdom tooth. Now, why is this even relevant to rubber dam dentistry? Well, when we're clamping the terminal tooth, this could be a second molar, this could be a wisdom tooth, we have the same issues. We're cramped for space there. So to go into cow mode can really help you to get that clamp on. And so you need to coach your patient to be able to do that to help facilitate rubber dam isolation. Listen, I hope you enjoy our conversation. There's a few laughs in there. I hope you like it. One last thing before we hit the main episode. As you know, the protrusive app has been just a great revolution. It's like our Netflix moment. You know how Blockbuster got very old and stale and Netflix came. This is kind of why we're moving away from our Facebook group and our lovely little community on Protrusive Guidance. The theme of this month is mental health. And you know a wonderful exchange happened on our private little chat group on the app. So once you get the app, you get access to our private chat group. And one of the Protruserati, she's been a Protruserati for years. It was, I think, one evening after work, she just messaged saying, do you guys sometimes feel that this is not for you, that you shouldn't be doing dentistry anymore? Do you have those days? And I tell you, the amount of support from Protruserati all over the world. From Greece, Italy, America, you name it, it was just absolutely special. You guys truly are the nicest and geekiest community in the world. And from that little chat discussion, I wish I could frame it, some wonderful ideas and suggestions came. So tune into the next episode PDP184 with Marco Maiolino. We're talking about perfection and actually imperfection. We celebrate imperfection, we're not perfect. The whole thing about ideal standard, get rid of it. What Marco will talk about next episode is the daily standard. Because sometimes that extraction that was supposed to take you half an hour will take you an hour. Sometimes with that wedge, what that was supposed to close the apical seal of your matrix band just wasn't good enough. And you know what? We beat ourselves up and it really takes a toll on our mental health. So in that message, there was too many announcements. One is check out Protrusive Guidance and thank you so much for being just a fantastic community and showing so much support to your peers.And number two, watch out for the next episode. Continuing on for Mental Health Month with Marco Maiolino. Let's catch the main episode now. Main Episode:Dr. Celine Higton, welcome to the Protrusive Dental Podcast. How are you? [Celine]I'm great. I mean, thank you for having me, Jaz. It's absolutely amazing to be on here. I've watched your podcast from afar for a very long time, so it's great to be on this side. [Jaz]Well, we've just had this little pre chat and some things that we can't reveal, which is very exciting and that stuff. But you said that you're exhausted and I'm exhausted, but just knowing that I had you on the show,