Protrusive Dental Podcast

What is the number 1 communication advice for Dentists? Are you confident in discussing treatment fees with your patients? Do you struggle with communicating your worth without feeling awkward? How do you shift your mindset to charge what you're truly worth without feeling guilty (a money mindset issue)? https://youtu.be/vapDrnVqHRw In this enlightening conversation, Jaz opens up about his own struggles with money mindset and how he overcame them to confidently charge for his dental services. Joined by dental student Naveed Bhatti, they explore the challenges of pricing treatments, offering empathetic solutions to patients, and using the power of visualization to boost confidence in fee discussions. They also dive into the importance of being transparent with fees, managing discounts, and recognizing your true value as a dental professional. Whether you're new to the field or have years of experience, these strategies will help you navigate the financial side of dentistry with ease and confidence. Key Takeaways Communication is crucial in dentistry, often more than clinical skills. Active listening is essential; avoid interrupting patients. Nervous patients may talk excessively; guide the conversation gently. Patients may withhold information due to fear or anxiety. It's important to make treatment recommendations based on patient needs. Asking open-ended questions can help gather more information. Experience builds confidence in patient interactions. Being authentic while adapting to patients is key. Patients can sense when a dentist is confident or insincere. Building rapport leads to better patient relationships. Kindness is essential in patient interactions. Patients often reflect the values of their dentists. Effective communication can bridge the gap between jargon and patient understanding. Long-term relationships with patients enhance trust and satisfaction. Discussing fees requires confidence and transparency. Visualization techniques can improve communication skills. Empathy is important, but it should not compromise business integrity. Highlights of this episode: 01:46 Introducing Naveed Bhatti and His Journey 02:53 The Importance of Communication in Dentistry (Do’s and Don’ts) 08:13 Handling Nervous and Quiet Patients 10:51 Dealing with Patients Who Don't Tell the Whole Truth 14:35 Making Treatment Recommendations 17:56 Asking the Right Questions 21:36 Balancing Professionalism and Personal Connection 25:49 Handling Difficult Patients  31:38 Effective Communication with Patients 35:05 Discussing Treatment Fees with Confidence 40:25 The Power of Visualization in Dentistry 48:56 Concluding Thoughts and Future Plans Support Nav’s YouTube channel, The StuDent If you enjoyed this episode, don't miss out on Think Comprehensive – Communication Gems with Zak Kara – PDP010! This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcome B. AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS Aim: To enhance dental professionals' communication skills by exploring effective strategies for patient interaction, treatment planning, and fee discussions—ultimately building trust, improving patient outcomes, and boosting confidence in everyday clinical practice. Dentists will be able to - 1. Recognize the importance of active listening and body language in patient communication. 2. Explain treatment options using patient-centered language and analogies that promote understanding and buy-in. 3. Discuss treatment fees with clarity and conviction, addressing money mindset barriers and building perceived value.

Are ergonomic loupes and fancy chairs really worth the investment? Is back pain an inevitable part of being a dentist—or can it be prevented? Are you setting yourself up for a long, pain-free career in dentistry? What’s the number one thing you should be doing right now to protect your body for the long haul? Dr. Sam Cope is back, and he’s not just any dentist—he started as a physiotherapist before training in dentistry. That means when it comes to musculoskeletal health, posture, and career longevity, Sam knows his stuff. In this episode, Jaz and Sam revisit the crucial topic of back pain in dentistry and dive even deeper into what actually works to keep you practicing pain-free. So, if you clicked on this because you’re worried about back pain, take this as your sign—your future self will thank you. https://youtu.be/lUC45aLXZKk Watch PDP220 on Youtube Protrusive Dental Pearl:  Motion is lotion. Staying active prevents back pain and keeps your career strong. If you’re not making time for exercise, it’s time to rethink your habits. Knowing isn’t enough—action is what matters. Prioritize your health now. Key Take-Away: Posture and back pain have no direct correlation. Apprenticeships provide invaluable experience and learning opportunities. Investing time in learning and shadowing can accelerate career growth. Ergonomic tools can enhance comfort but should be tailored to individual needs. Mental health is crucial for dentists, and seeking help is a sign of strength. The human body can adapt to various postures with training. Choosing a specialization should align with personal interests and strengths. Preventative measures in ergonomics can improve career longevity. Continuous learning and adaptation are essential in the dental field. Choosing the right dental chair is crucial for comfort. Preventative strategies for back pain include regular exercise. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 02:05  Protrusive Dental Pearl 04:26 Sam's Journey from Physio to Dentist 10:33 The Value of Apprenticeships and Mentorship 16:24 Niching in Dentistry 22:30 Ergonomics in Dentistry: Loupes and Chairs 27:03 Choosing the Right Chair for Your Comfort 29:54 Top Tips for Dentists to Prevent Back Pain  This episode is eligible for 1 CE credit via the quiz below.  This episode meets GDC Outcomes A and C. AGD Subject Code: 130 ELECTIVES (149 Multi-disciplinary topics) Aim: To highlight the importance of ergonomics and physical well-being in dentistry. To share strategies for preventing occupational strain and burnout. Dentists will be able to - 1. Assess the role of ergonomic loupes, chairs, and posture in reducing strain and improving long-term musculoskeletal health. 2. Understand the significance of muscle conditioning over posture correction. 3. Incorporate exercise routines to manage physical strain during long procedures. If you enjoyed this episode, you won’t want to miss Got Your Back – Physios and Dentists – PDP025! #PDPMainEpisodes #BeyondDentistry #CareerDevelopment Click below for full episode transcript: Jaz's Introduction: Over 270 episodes ago, I had on Dr. Sam Cope when he was a a baby dentist, and he's unique because he's a physio who trained to then become a dentist. Back then, we discussed about back pain and dentistry and how to prevent it, and we talk a bit more about those themes today. Are ergo loops worth it? Jaz's Introduction:Are those posh Bambach kind of chairs. Are they worth it? What's the number one advice to have a career with longevity and good health from a back pain perspective and as a physio come dentist, what does Sam do? What are the things that he practices? Because he's a bit like when Christiano Ronaldo rejoined Manchester United. He was like a, he was a big deal, right? He is the goat. He's the greatest of all time.

Are “contact lens veneers” just fake news? Why is the traditional 0.7mm prep approach outdated? Are you truly preserving enamel in your veneer preparations? Should you ever bond veneers to root dentin or cementum after crown lengthening? Why is the Galip Gürel technique the gold standard for minimal prep veneers? https://youtu.be/5BEFD1XaZtE Watch PDP219 on Youtube Dr. David Bloom joins Jaz for an insightful episode, sharing his 36 years of experience in cosmetic and restorative dentistry. With over two decades in the same practice, he’s seen what works—and what leads to failure—when it comes to veneers. We also cover the key steps in mock-ups, planning, and veneer preparation. Protrusive Dental Pearl:  Always Wax Up for 10: When planning veneers, start with a 10-unit wax-up (even if the patient initially wants 4 or 6). This allows them to visualize their full smile with a mock-up, compare different options, and make an informed decision. It’s not about upselling - most patients will appreciate the fuller look. Key Take-aways: Health and diagnosis are foundational in cosmetic dentistry. Visual try-ins are crucial for patient engagement and satisfaction. Minimally invasive techniques are preferred for cosmetic procedures. Communication with patients about their options is essential. Bonding to enamel is more reliable than bonding to dentin. Permission statements help in guiding patient expectations. The transition from veneers to crowns should be carefully considered. Staining is not the primary concern when bonding to dentin. A change in surface texture is key in modern dental preparations. Visual aids are crucial in helping patients understand their treatment options. The Gurel technique emphasizes minimal preparation for veneers. Effective communication with patients can enhance their treatment experience. Understanding occlusion is fundamental in aesthetic dentistry. Veneer thickness should be as minimal as possible for aesthetic results. Patient involvement in the design process is essential. Cementation techniques can vary based on gingival health. Maintaining a facial path of insertion is important for aesthetic outcomes. Building a good relationship with lab technicians is key to successful restorations. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 02:56  Protrusive Dental Pearl 04:15 Interview with Dr. David Bloom: Journey and Expertise 11:54 The Importance of Enamel in Veneer Longevity 13:46 Prepless Cases and Visual Try-Ins 18:54  Permission Statement 22:24 Visual Try-Ins Protocol 25:13 Decision-Making: Veneers vs. Crowns 28:35 Bonding to Root Dentine and Long-Term Outcomes 33:34 Opening Embrasures: Techniques and Tips 35:19 Visual Try-Ins and Patient Communication 38:50 Wax-up in Occlusion 41:25 The Gurel Technique Explained 47:09 Black Triangles  49:40 Guidelines for First Veneer Case 54:10 Contact Lens Veneers 56:18 Cementation Preferences and Techniques 01:00:15 Final Thoughts and Educational Resources Need expert guidance on veneers and smile design? Join Intaglio Mentoring and connect with top mentors for real-time case support and level up your Dentistry. Dr David Bloom is also a mentor on Intaglio. Watch this space for David's new educational website coming soon - he teaches Veneers hands-on too. If you loved this episode, make sure to watch How to Temporise Veneers Step by Step FULL GUIDE – PDP214 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: 780 ESTHETICS/COSMETICDENTISTRY (Tooth colored restorations) #PDPMainEpisodes #AdhesiveDentistry Aim: To provide an in-depth understanding of minimal preparation veneers, focusing on enamel preservation, diagnostic workflows, patient communication,

CORE CPD ALERT! 🚨 How dare I veer away from our beloved clinical topics to talk about… decontamination!?! 😱 Have you ever wondered how you should be disinfecting occlusal mirrors without getting them scratched? Should we be using PTFE inside the pulp chamber if it’s not been autoclaved? What are the most common decontamination mistakes that we make day in and day out that are so easy to fix? In this episode, Jaz sits down with Decon Pete, the go-to expert for all things dental decontamination, to drive into the nitty-gritty of keeping your practice squeaky clean (and compliant!). He shares practical tips to make your decontamination process safer, smoother, and stress-free. Common decon mistakes, PPE slip-ups, distilled vs. RO water, HTM guidelines vs. manufacturer guidelines - this episode will help you feel more confident in decontamination and up your infection control game. How to reach Decon Pete: Facebook group: IPC Support by Decon Pete - a private space for dental teams to ask decontamination-related questions. Website for practice support and consulting: www.deconpete.co.uk https://youtu.be/013WuXzWE3g Watch PDP218 on Youtube The Protrusive Dental Pearl: Pete’s Expert Recommendation on Cleaning your Loupes Ideally, loupes should be disinfected between every patient, but at the very least, at the end of each clinical session Avoid submerging loupes in any liquid - instead, use distilled water and a microfiber cloth or cotton buds for frames and nose pads For lenses, use 70% isopropyl alcohol wipes - no acetone or bleach! If you’re using a visor with your loupes, you won’t need to clean them as often Need to Read it? Check out the Full Episode Transcript below! Key takeaways: Decontamination is essential for patient safety in dental practices. Using proper protective equipment is crucial for staff safety. Transporting instruments safely is a key aspect of decontamination. Manufacturer guidance should always take precedence over general guidelines. Policies must be relevant to the specific practice. Manufacturer's guidance should always be followed. Disinfecting instruments is crucial for patient safety. Water quality impacts the effectiveness of dental procedures. Distilled water should be used quickly after opening. Reverse osmosis water is more sustainable for practices. Proper storage of instruments prevents contamination. Highlights for this episode:00:00 – Intro03:52 – Protrusive Dental Pearl: Pete’s top tips for cleaning your loupes06:02 – Introducing Decon Pete: Pete’s background in dental decontamination12:40 – Manual cleaning and PPE errors17:51 – Washer Disinfector27:06 – Instrument Transportation30:08 – Guidance vs. Manufacturer Instruction36:05 – PTFE Tape: Sterilization and best practices41:06 – Occlusal Mirror Care48:18 – Distilled vs. RO Water56:37 – Water for Ceramics57:22 – Outro This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC outcomes B and C. This is a GDC Recommended CPD Topic - 5 Hours of Disinfection and Decontamination every 5 year Cycle. AGD Subject Code: 550 Practice Management and Human Relations. Dentists will be able to: Identify common decontamination errors and implement strategies to enhance infection control standards Appreciate the appropriate methods for cleaning and maintaining dental equipment Apply best practices for instrument handling, including proper PPE use, safe transportation, and effective sterilisation protocols If you loved this episode, be sure to check out this one: PDP018 (Don’t Get Sued) Click below for full episode transcript: Teaser: Manual cleaning instruments just with surgical gloves on. And I see so many practices doing that and it offers them no protection whatsoever. You don't need to use sterile gauze. Teaser:If you've got sterile gauze in, great. But yeah,

Is Work-Life Balance a Myth? How do you find the right balance between your professional responsibilities and personal life? Can you truly have it all…without sacrificing your health or family time? https://youtu.be/wkAv3noFXNk Watch PS014 on Youtube In this episode, Jaz and Emma Hutchison, ‘the Protrusive Student’, dive into the real challenges of balancing parenthood, clinical dentistry, and LIFE! Jaz shares his strategies for managing these demands, revealing that while perfect balance might not exist, navigating life’s seasons with intention can make all the difference. If you’ve ever struggled with finding your own balance, this episode is packed with key takeaways for dentists at every stage of their careers. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 03:34 Emma's New Year Reflections and Study Habits 12:20 Balancing Family, Work, and Personal Time 19:50 The Importance of Planning and Support Systems 23:16 Recognizing Opportunities and Setting Boundaries 28:15 Understanding Circle of Concern and Influence 30:24 Eat That Frog: Tackling Difficult Tasks First 31:02 Burnout in Dentistry: Real Experiences 39:51 The Importance of Mentorship 41:07 Just in Time Learning 44:03 Decision Making and Confidence 49:15 Effective Time Management Strategies 51:16 Final Thoughts and Takeaways Key Takeaways: Preparation and good mental health are crucial for success during exam periods. Internalizing knowledge helps in better understanding and retention. Finding time for hobbies and self-care is essential for well-being. Planning and prioritizing tasks can lead to more effective study habits. Support systems play a vital role in managing stress. You can achieve a lot by focusing on your big priorities. Eat That Frog: tackle difficult tasks first. Burnout is a real risk for dentists. Finding a mentor is extremely beneficial for career growth. Just-in-time learning is more effective than just-in-case learning. 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 workthroughs and Masterclasses. If you enjoyed this episode, be sure to watch Stress in Dentistry 2024 – Life Changing Decisions – IC048 Click below for full episode transcript: Jaz's Introduction: Guys, there is no such thing as work life balance. It's a myth. 'cause sometimes when I'm with my family and we're on vacation, it's all about my family. Nothing else matters, and that's really the way it should be. But there are other times where things get really busy at work and I'm not able to give my children the quality time that they deserve. Jaz’s Introduction:And sometimes that happens. Or sometimes you are sacrificing sleep or your health, which really we shouldn't be doing. But sometimes this happens. 'cause of other events and other priorities at that time. So to find this daily balance and work-life balance that slots into everyone's magic week, it just doesn't exist because there's a season of life for everyone. And so a lot of what we talk about today with Emma Hutchison, who's the Protrusive Student. So welcome to this Protrusive Student episode. About 20 or 30% of what we talk about in this episode is related to students, and about 70% is all to do with dentists in the real world. Because Emma asked me, how do I do it? How do I balance everything? How do I balance fatherhood, clinical dentistry, Protrusive? And so a lot of my tactics or the strategies that I use are revealed in this episode.  Hello Protruserati. I'm Jaz Gulati. Welcome back to your favorite Dental Podcast. It's the student series that we do, but as we've seen in the comments on YouTube, mostly dentists tune in because they find it's nice to reconnect with the basics and with a topic like work-life balance and priorities ...

When Your Size 10 File is not going to length, what is happening? Your apex locator isn’t giving you a zero reading. Your file is stuck. You’re wondering—have you ledged? Or could something else be at play? In this must-listen follow-up episode, Dr. Samuel Johnson returns to tackle the biggest endodontic dilemmas left unanswered from part one. If you haven’t checked that out yet, go back and listen—it’s packed with insights on working lengths, apex locators, and even the role of consent in endodontics. https://youtu.be/1E6pK2iOPjY Watch PDP217 on Youtube Now, in part two, we go deeper. We’re talking blockages, ledges, portals of exit, and the mysterious phenomenon of file gripping. Plus, Dr. Johnson takes on your burning questions from the Protrusive community—like how he responds to biological dentists claiming root canals should be avoided entirely. (Yep, we’re addressing that controversy head-on!) Protrusive Dental Pearl: For a more visual learning experience, dive into the Pre-Endo Build-Up on Protrusive Guidance and see Jaz and Samuel’s insights in action. Sonic Pro Ultrasonic Bath - 15% OFF before 30th April with coupon code ‘protrusive’ Improve your Bond Strengths - purchase while stocks last: Sonic Pro Discount Key Takeaway: General dentists often overlook the importance of taper. Removing too much dentin can weaken the tooth. GP cones can be unstable and affect the procedure. Reshaping GP cones can often resolve length issues. Pre-bending GP cones can help navigate tight curves. Biological dentists have controversial views on root canals. It's essential to prioritize the patient's best interest. Using endo frost can aid in manipulating GP cones. Consent should be informed and comprehensive. Communication between referring dentists and specialists is vital. Continuous learning is essential for dental professionals. Ultrasonic activation improves endodontic outcomes. Pulpotomy and root canal treatments have distinct indications. Building a supportive community can alleviate feelings of isolation in dentistry. Dentists should charge for their time and expertise. Need to Read it? Check out the Full Episode Transcript below! Highlight of this Episode: 01:03 Protrusive Dental Pearl 01:49 Common Scenarios and Tips for Young Dentists 05:30 File Gripping and Canal Anatomy 08:30 Master Apical File: The Common Dilemma 11:18 GP Cone Issues and Solutions 17:03 Addressing Root Canal Myths  23:35 Cracks in Teeth: Prognosis and Treatment 25:44 Ninja Access Cavities: Pros and Cons 28:21 Common Mistakes in Emergency Endodontic Treatments 33:51 Obturation: Overextended vs Short 34:41 UltraSonic vs Sonic Irrigants 36:15 Pulpotomy and General Dentistry 39:25 Building a Dental Community As promised, here are the ESE Guidelines on managing cracked teeth. Watch and learn from Dr. Samuel Johnson on Instagram and YouTube! Don't miss the first part of this series: PDP216 – Working Lengths and Troubleshooting Apex Locators #PDPMainEpisodes #EndoRestorative #BreadandButterDentistry This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject Code: 070 ENDODONTICS (Emerging concepts, techniques, therapies and technology) This episode aimed to provide deeper insights into troubleshooting endodontic challenges, particularly when files fail to reach working length. It explores common pitfalls, advanced techniques, and expert strategies to improve clinical outcomes in root canal treatments. Dentists will be able to - 1. Recognize common endodontic challenges and strategies to navigate them effectively. 2. Evaluate the role of master apical files and resolve common dilemmas in achieving optimal shaping. 3. Identify frequent errors in urgent cases and improve treatment approaches.

‘Mentorship is more important than courses’ - said lots of wise Dentists, and I think they’re right! Do you have a mentor guiding you in your dental career? How do you know if you're making the right clinical decisions? https://youtu.be/5N0kj2YuFtA Watch IC058 on Youtube In this episode, Jaz is joined by Damian Panchal and Shivani Sadani to discuss the power of mentorship in dentistry. They explore why having a mentor can accelerate your growth, boost your confidence, and help you navigate complex cases with ease. They also introduce Intaglio, a brand-new platform designed to connect dentists with experienced mentors—so you can get real-time guidance, solve cases faster, and elevate your practice like never before. Listen in to learn why mentorship might be the best investment you make in your career. Key Takeaways: Mentorship is essential for professional growth in dentistry. Post-course support is increasingly important for new dentists. Real-world experience is crucial for applying theoretical knowledge. Investing in mentorship can lead to long-term benefits in practice. Effective mentorship can significantly improve clinical confidence and skills.  Mentorship is accessible and affordable for all levels. The value of mentorship lies in its application of knowledge. Mentors can help navigate career challenges beyond clinical skills. Relatable mentors can provide the best guidance. Learning from others' mistakes can save time and effort. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 00:00 Introduction 00:48 Introducing Intaglio: A New Mentorship Platform 01:45 Damian Panchala and Shivani Sedani - Personal Journeys 04:46 Mentorship Crisis in Dentistry 11:51 The Role of Social Media and Forums in Mentorship 17:41 The Value of Paid Mentorship 21:03 Exploring the Intaglio Platform 23:44 The Role of Mentors Beyond Clinical Help 31:05 Intaglio's Vision and Future Plans 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 workthroughs and Masterclasses. Click below for full episode transcript: Teaser: Are people willing to pay for mentorship? Okay. And actually, I think it was very validating because this is already happening in the implant space to a very big degree. Like, okay, I don't know the details there. Maybe you guys do. [Jaz]But if you're someone who's learning to place implants, though, your first X number of implants, you're probably going to make a loss on because you're going to buy all the stuff, buy all the kit, give up your clinical time, but all the fee that your patients paying you, you're pretty much paying to your mentor. And so that's a huge investment in yourself, but the ROI is exponential. [Damian]So there's only one way to learn these cases, which is you need someone holding your hand until that confidence builds. So yes, you may lose a little bit of money, lose a bit of time in the early days. But it's all going to come back in a full circle and that confidence and that money will return. Jaz's Introduction:Protruserati, I'm going to say it how it is. Mentorship is the number one thing you need to excel and grow as a dentist. It's more important than courses. The courses are important because they give you the skills. They give you the knowledge. But you know when you get stuck? At the point of application. That's when we bounce ideas off each other, even like basic stuff, like should I extract this tooth on this patient on that medication? And thankfully with the Protrusive Guidance app and having a community of practice and like minded individuals, we can help each other. But sometimes you just need in depth help, like someone to just hold your hand and talk you through exactly how to solve a problem or a case.

What makes apex locators reliable—or completely misleading? How do you determine the true working length of a root canal? Why is relying solely on radiographs for endo success a risky move? Dr. Samuel Johnson joins Jaz for a game-changing episode that will make you rethink everything you know about endodontics. In this first part of a two-part special, they dive into the nuances of apex locators, the difference between the radiographic apex and apical constriction, and why our radiographs might be lying to us. They also explore the power of glide path files, how to improve your endodontics workflow, and an incredible way to consent patients—something that extends beyond just root canals. Because mastering endodontics isn’t just about technique—it’s about communication, precision, and making the right calls for long-term success. Stay tuned for Part 2, where we go even deeper into endo essentials! https://youtu.be/M2z8Dl_g4XY Watch PDP216 on Youtube Protrusive Dental Pearl:  Buy a small whiteboard and marker for patient communication. Draw details, highlight the treatment plans, and list pros, cons, and fees. This builds trust, improves consent, and makes treatment clearer. Snap a photo and upload it to the patient’s records. https://amzn.to/3DzUJfn Key Takeaway: Understanding the difference between radiographic and anatomical apex is crucial. Apex locators are essential tools for accurate working length measurements. The anatomy of the root canal system is complex and requires careful navigation. A well-informed patient is more likely to have realistic expectations about treatment. Glide path files can significantly reduce treatment time. Avoid forcing files into hard stops to prevent damage. Complicated anatomy can lead to unexpected challenges during treatment. Taking radiographs can help clarify uncertain situations. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode: 01:40 Protrusive Dental Pearl: Patient Communication 02:39 Welcoming Dr. Samuel Johnson 04:36 Samuel's Passion for Endodontics 07:07 Reliability of Radiographic Measurements vs. Apex Locators 11:15 Canal Anatomy 14:30 Overextension vs Overfilling 16:23 Combining Apex Locators and Radiographs 20:52 Apex Locators and Hypochlorite: The Perfect Combination? 24:00 Efficiency in NHS Dentistry 26:10 Transitioning from NHS to Private Practice 27:42 Understanding Radiographic vs Anatomical Apex 29:26 The Importance of Consent in Endodontics 33:07 Mastering Apex Locators: Tips and Tricks 37:07 The Role of Glide Path Files in Endodontics 39:19 Troubleshooting Endodontic Challenges Watch and learn from Dr. Samuel Johnson on Instagram and YouTube! If you loved this episode, be sure to watch Elective Endodontics? It’s all about Communication – PDP202 #PDPMainEpisodes #EndoRestorative #BreadandButterDentistry This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject Code: 070 ENDODONTICS (Emerging concepts, techniques, therapies and technology) This episode aimed to enhance clinicians' understanding of endodontic diagnostics and workflow, focusing on apex locators, working length determination, and effective patient communication. By refining these skills, practitioners can improve treatment accuracy, efficiency, and patient outcomes. Dentists will be able to - 1. Differentiate between the radiographic apex and the apical constriction and understand why radiographs alone can be misleading. 2. Evaluate the reliability of apex locators and recognize factors that affect their accuracy. 3. Apply the use of glide path files to improve efficiency and reduce treatment time in root canal procedures. Want More Clinical Gems? Join the Protrusive Guidance App to get access to masterclasses, premium videos,

Are you confident in managing patients on bisphosphonates or biologics? Which medications increase the risk of medication-related osteonecrosis of the jaw (MRONJ)? How do you decide when to extract a tooth and when to refer to a specialist? In this episode, Jaz is joined by oral surgery consultant Dr. Pippa Cullingham to explore the complexities of MRONJ. They break down the key risk factors, share expert advice on when to proceed with extractions, and discuss the latest guidelines for managing patients at risk. They also discuss the importance of early assessment - by identifying at-risk teeth early, you can help prevent serious complications and ensure the best outcome for your patients. https://youtu.be/KnQoI8Z-FhM Watch PDP215 on Youtube Protrusive Dental Pearl: it is so important to assess patients before they start taking high-risk medications like bisphosphonates or biologics, using radiographs to identify potential issues. Extractions should ideally be done before medication starts to avoid complications, as MRONJ risk increases once treatment begins. Key Takeaways: Medication-related osteonecrosis of the jaw concerns medications other than bisphosphonates. Risk assessment is crucial when considering dental extractions for patients on certain medications. Guidelines from the Scottish Dental Clinical Effectiveness Partnership are valuable resources for dentists. Higher-risk patients require careful management and communication with their medical teams. Denosumab has a different risk profile compared to bisphosphonates. Patients on long-term bisphosphonates may still have risks even after stopping the medication. Dentists should feel empowered to manage certain extractions in primary care with proper guidance. The decision to extract a tooth should weigh the risks and benefits for the patient. Always assess the patient's risk before extraction. Eight weeks is a critical time for assessing healing. Antibiotics are not recommended for preventing MRONJ in the UK. Radiotherapy history significantly impacts extraction risk. Referral to specialists may be necessary for high-risk patients. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 02:15 Protrusive Dental Pearl 03:52  Interview with Dr. Pippa Cullingham: Insights and Experiences 06:40 Medications and Their Risks 10:02 MRONJ: Incidence and Prevalence 13:13 Biologics and other medications 14:19 Guidelines and Best Practices 17:22 Managing High-Risk Patients 25:03 Prophylactic Antibiotics  26:55 Risk Assessment 28:47 Radiotherapy & ORN Risk 31:49 Tips and Key Takeaways 33:32 New Medications & Prevention Strategies For the best approach to managing MRONJ, check the SDCEP Guidelines and the American White Paper. This episode is eligible for 0.5 CE credits via the quiz on Protrusive Guidance.  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 - 1. Be aware of the medications that increase the risk of MRONJ. 2. Learn how to assess the risk of MRONJ in patients, particularly before starting high-risk medications. 3. Understand when to proceed with extractions and when to refer patients to specialists for management. If you liked this episode, check out PDP206 - White Patches Click below for full episode transcript: Teaser: Patients prescribed a bisphosphonate for cancer were at about a 1% risk of developing an MRONJ following a dental extraction. There's been an update. So it's closer to 5%, we think, but we're not sure if that's because there's increased follow up, increased awareness, more reporting of the condition. So closer to 5 percent on the cancer patients for an osteoporosis. It's bisphosphonate medication, it's around 0. 1, 0. 2,