Protrusive Dental Podcast

Is your diary running you — booked weeks ahead, no white space, drowning by Thursday?

Do you really have to specialise to get referrals?

How does an associate negotiate a month off every August — and get a yes?

And what changes when you start treating yourself as your most important instrument?

This is Part 1 of a two-part conversation with Dr Ronit Patel — a Richmond GDP of 20-odd years, an associate at the White House Dental Clinic in Kew, and one of the nicest and geekiest members of the Protrusive community. He works three and a half days a week, takes Wednesdays off, and typically takes the whole of August off. This episode is how he got there: staying a generalist when specialising beckoned, buying a microscope he wasn’t allowed to see, building a referral book without social media, and — the big one — taking control of the diary.

It’s a warm, reflective conversation rather than a technique masterclass, and Ronit is refreshingly honest that it hasn’t always been smooth. Part 2 goes into fuel versus friction: what fills you, and what drains you.

Protrusive Dental Pearl: Get Good, Then Get Passionate

“Follow your passion” is actually bad career advice. What most of us call passion is really interest. When you applied to dental school, you may have said you were passionate about dentistry and oral health — but you had barely scratched the surface. That wasn’t passion; that was flirting with the idea of dentistry. Then you married it, and disillusionment arrived: is this really what I signed up for?

Passion develops once you start to get good at something and you’re helping people — and dentistry has so many avenues to do both. You don’t become passionate first, then good. You become good, then passionate. So the better advice: become good at something, help people, develop a passion, and follow it through.

What You’ll Take From This Episode

• The diary control sequence — four moves that turn a chaotic book into a business case: audit, price, zone, pitch.
• Slack, rhythm and energy — why white space isn’t waste, and what time-of-day research means for when you book your hardest work.
• The referral engine — how a handful of colleagues, not a social following, can fill a niche book.
• Specialise or invest? — the decision filter for cutting your book, and how full it should really be.
  Scripts for the principal conversation — the exact lines for asking for a zoned diary and protected time off.

Highlights of This Episode
00:00     TEASER
00:59     How to Take Control of Your Dental Career (Without Quitting)
03:33     Dental Pearl: Why "Follow Your Passion" Is Bad Career Advice
07:57     Generalist vs Specialist: Why Stay a General Dentist?
11:26     Buying a Dental Microscope as an Associate
14:50     How to Get Endo Referrals as a Non-Specialist
21:49     Why Word of Mouth Beats Social Media for Referrals
26:59     How to Audit and Zone Your Dental Diary
29:51     Morning vs Afternoon: Decision Fatigue in Dentistry
32:22     What Is Slack in Your Diary? (And Why You Need It)
37:01     How Associates Can Negotiate Diary Control
45:50     Creating Scarcity: Building a Referral Funnel
48:30     Why Every Dentist Needs a Mentor or Coach
51:49     How to Negotiate Time Off as an Associate
57:48     Going Part-Time as a Dentist: The Real Trade-Offs
1:06:27   How Far Ahead Should Your Diary Be Booked?

From the Guest

Dr Ronit Patel is a general dental practitioner and associate at the White House Dental Clinic in Kew, where his book is now largely referrals — endodontics, restorative work under the microscope, and the tricky cases other dentists have become stuck with. Before that, he was a clinical lead for a corporate group, mentoring dentists across the South of England.

In the community: members of Protrusive Guidance will already know Ronit from his short, helpful clinical videos inside the app. No courses, books or social channels were promoted on this episode — fittingly, for a referral practice built without social media.

References & Further Reading

Books and research mentioned in this episode:

• Kleitman N. Sleep and Wakefulness (rev. ed., 1963). The ~90-minute basic rest–activity cycle, proposed to continue through waking hours (daytime evidence is still debated).
• Kahneman D, Sibony O, Sunstein CR. Noise: A Flaw in Human Judgment (2021).
• Pink DH. When: The Scientific Secrets of Perfect Timing (2018).
• Danziger S, Levav J, Avnaim-Pesso L. Extraneous factors in judicial decisions. PNAS, 2011;108(17):6889–6892. The parole-decisions-and-food-breaks study.
• Newport C. Slow Productivity: The Lost Art of Accomplishment Without Burnout (2024).
• Maltz M. Psycho-Cybernetics (1960).

Want more?

If you enjoyed this episode, check out: Better Dentistry Through Compassion (Not Just Technique) – IC073

Tags

#PDPMainEpisodes #CareerDevelopment #BeyondDentistry

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes B.

AGD Subject Code: 550 Practice Management and Human Relations.

Aim & Learning Outcomes

Aim: To help dental practitioners take deliberate control of their clinical diary and career design — using audit data, scheduling principles and professional networks — so they can sustain high-quality care, develop a clinical niche and protect their own wellbeing.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe how auditing an appointment book and calculating the hourly value of each appointment type can be used to zone a clinical diary and build a business case for changes to working patterns.
• Explain how planned slack and time-of-day considerations in scheduling can protect clinician energy, decision quality and patient care.
• Identify strategies for developing a non-specialist referral niche through professional networks, incremental skill development and case audit.

Ever felt like being a good clinician is just the entry fee?

Have you got an idea you’ve been sitting on — and no one telling you to go for it?

Practice ownership, a side business, or staying a happy associate: how do you know which is right for you?

And when you tell a patient the fee… do you stay silent, or start talking?

This is an Interference Cast — a non-clinical episode designed purely to inspire. My guest, Dr Jawad Abbas, is a young associate who’s already building two ventures alongside his clinical work: an AI tool for radiographic analysis and treatment-plan communication, and a luxury oral-care brand. We start with the communication skills that turn patient trust into comprehensive care — then dig into what it really takes to build something of your own, and whether you even should.

We’re living through a moment where, if you can think it, you can increasingly build it. If there’s a big enough problem out there and you have a good solution for it, this episode might be the spark you needed.

Protrusive Dental Pearl: Say the Fee, Then Stay Silent

When you present a treatment fee, say the number clearly — then stop talking. Don’t justify it, don’t over-explain, don’t rush to fill the gap. The pause feels endless to you, but for the patient it passes in a second or two, because they’re busy doing the mental maths: what’s in savings, what the monthly commitments look like, whether they can make it work. Give them that space.

What undermines a fee is rarely the number; it’s the delivery. Closing your eyes as you say it, your voice rising in pitch, launching straight into justification, or avoiding it altogether and letting the patient discover it at reception all signal that you’re not sure of your own fee. Remember what sits behind it — your training, and what your surgery costs to run every hour — and say it like you mean it.

What You’ll Take From This Episode

• Four communication habits that build trust — from asking what matters to matching your information to the decision-maker.
• The cost of doing nothing — how to make an unconcerning problem an informed choice, without selling.
• What a fee actually covers — the one question every associate should ask their principal.
• The three hats — entrepreneur, manager or technician, and why so few people wear all three well.
• From problem to prototype — five steps to test a business idea before you sink money into it.
  The decision filter — six honest questions to tell you whether building something of your own is right for you.

Highlights of This Episode
00:00     TEASER
00:59     Entrepreneurship in Dentistry: Why Now Is Different
07:14     Patient Communication: Ask What Matters to Them
10:39     How to Explain the Cost of Doing Nothing
14:19     Short-, Medium- and Long-Term Treatment Plans
16:57     Fast-Lane vs Slow-Lane Patients: Personality Types
20:09     How to Present Your Dental Fees With Confidence
24:07     How Profitable Is a UK Dental Practice?
26:29     Why Dentists Become Entrepreneurs
31:08     Associate, Principal or Entrepreneur?
36:19     The E-Myth for Dentists: Which Hat Do You Wear?
41:09     Building an AI Treatment-Planning Tool
44:06     How to Validate a Business Idea Before You Build It
49:51     Creating a Luxury Mouthwash Brand
53:24     How to Find a Business Idea — In or Out of Dentistry
58:54     Dentistry as Your Safety Net: Starting a Side Business
1:04:58   OUTRO

From the Guest

Dr Jawad Abbas graduated from the University of Manchester and is completing a diploma in restorative and aesthetic dentistry at Smile Dental Academy, while working as an associate in Ipswich and Peterborough. Alongside clinical work, he’s developing two ventures, both at prototype stage: an AI tool that flags decay and presents tiered treatment options as a communication aid, and Jawdouré, a luxury fragrance-led mouthwash brand. During foundation training he wrote for dentistry.co.uk about the anxiety of charging for treatment.

👉  @jaw.dental on Instagram — questions and messages welcome

References & Further Reading

Books, brands and episodes mentioned in this episode:

• Gerber ME. The E-Myth Revisited. The source of the entrepreneur / manager / technician model. A dentistry edition also exists: Gerber ME, Kwong Hing A, Barrow C. The E-Myth Dentist. Michael E. Gerber Companies, 2014.
• Erikson T. Surrounded by Idiots: The Four Types of Human Behaviour. The four-colour personality model discussed in the communication section.
• Squibb S. What’s Your Dream? Penguin, 2024.
• MAISON de SABRÉ — the luxury leather-goods brand founded in Sydney in 2017 by brothers Omar and Zane Sabré, who trained as dentists.
• Previous Protrusive episodes: Dr Colin Campbell on consent and personality types (PDP265); Professor Avijit Banerjee on caries management (PDP269).

Want more?

If you enjoyed this episode, check out: How to Find a Mentor in 5 Seconds Flat! – IC058

Tags

#InterferenceCast #CareerDevelopment #BeyondDentistry #Communication

Listen & Subscribe

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is not eligible for CPD/CE — but most of our episodes are. Find them, and earn your CPD, inside Protrusive Guidance.

Beyond Scaling: How to Get More From Your Ultrasonic

Do you really need your ultrasonic on 100%? (Probably not — and it may be costing you precision.)

Which part of the tip should actually be touching the tooth — and is that why the hygienists keep complaining about blunt tips?

Could the scaler tip you already own refine your margins, find a calcified canal and cut gutta-percha like a hot knife through butter?

And if you’re in the market for a new unit, which features are actually worth paying for?

Every dentist uses an ultrasonic — but most of us use it as a perio tool and nothing more. In this episode, Dr Hussain Hassanali, a general dentist who has gone properly geeky on ultrasonics, walks through how they really remove tooth tissue and how to put them to work in restorative dentistry and endo. It’s foundational, practical, and full of things you can try at your next session. Jaz’s biggest takeaway? Stop whacking the power up to 100%.

Protrusive Dental Pearl: Trim Gutta-Percha With Your Scaler Tip

You’ve just obturated a canal and need to remove the excess gutta-percha. The old ways: heat a ball burnisher in the flame until it glows red (that smell, and the GP smearing everywhere — or lifting out entirely because the sealer hasn’t set), or sink a long-neck bur into the GP while it spins and hope you don’t gouge the dentine.

Instead, take your bog-standard ultrasonic scaler tip, turn the water off, and set the power to around 10%. Sweep it across the orifice and it cuts through gutta-percha like a hot knife through butter — the water is off because here you want the heat. Then drop the power right down (around 2%) and gently compact the coronal GP, leaving roughly 1–1.5 mm of space for your restorative material to lock into the orifice. No flame, no burn risk, and a thin tip that doesn’t block your view. Try it once and you won’t go back to heated pluggers.

What You’ll Take From This Episode

• The three rules of the ultrasonic — why it abrades rather than cuts, why the side of the tip beats the pointed end, and why power is a dial, not a switch.
• A settings guide by task — where to start for enamel margins, fissures, soft dentine, endo access and gutta-percha.
• Standard tip or specialist tip? — when the tip you already own is enough, and when diamond-coated tips earn their place.
• Water on or water off? — the two endo jobs where the water has to go off.
• Buying an ultrasonic — piezo versus magnetostrictive, and the one feature that changes patient comfort.

Highlights of This Episode
00:00     TEASER
00:59     Ultrasonic Scaler Tips Every Dentist Should Know
04:30     Why Ultrasonics Are Underused in General Dentistry
07:08     What Power Setting to Use When Cleaning Enamel Margins
09:28     Which Part of the Ultrasonic Tip Should You Use?
11:34     Ultrasonic Power Settings for Occlusal Fissures
13:47     Piezoelectric vs Magnetostrictive Scalers: Does It Matter?
21:37     Ultrasonics for PRRs, Fissure Sealants and Anxious Children
28:36     Selective Caries Removal With an Ultrasonic
30:42     Refining Crown and Onlay Margins With Ultrasonic Tips
39:02     Ultrasonics in Endo: Irrigant Activation and Finding Canals
45:35     How to Trim Gutta-Percha With an Ultrasonic
51:37     The Most Common Ultrasonic Mistake: Too Much Power
54:29     What to Look for When Buying an Ultrasonic Scaler
57:39     Are Ultrasonic Scalers Safe With Pacemakers?
1:00:55   Cementing Onlays With Heated Composite: Do Ultrasonic Tips Help?
01:09:01  OUTRO

From the Guest

Dr Hussein Hassanali is a dentist at Thorpe Dental Group and Implant Suite in York. He qualified from the University of Liverpool in 2009, completed a Postgraduate Diploma in Restorative and Aesthetic Dentistry in 2020, and is particularly passionate about preventative and minimally invasive dentistry — which is what led him down the ultrasonics rabbit hole. He is happy to answer specific questions, and he’s open to building a hands-on course if there’s demand.

👉  Dr Hussein Hassanali at Thorpe Dental Group, York

Want more?

If you enjoyed this episode, check out: No More Air Polishing or Prophy Paste! Revolutionary New Technique for Non Mechanical Prophylaxis – PDP284

Tags

#PDPMainEpisodes #EndoRestorative

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C.

AGD Subject Code: 250 Operative (Restorative) Dentistry.

Aim & Learning Outcomes

Aim: To broaden dental practitioners’ use of the ultrasonic scaler beyond periodontal debridement, by explaining how ultrasonic instruments remove tooth tissue and how to apply them precisely and safely in restorative and endodontic procedures.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe how ultrasonic instruments remove tooth tissue by abrasion, and explain what this means for selective removal, tip orientation and power setting.
• Apply appropriate power, water and tip choices to restorative uses of the ultrasonic, including margin finishing, fissure preparation for preventive resin restorations and selective caries removal.
• Use ultrasonics safely in endodontics — for irrigant activation, canal location, scouting and gutta-percha trimming — and identify precautions for patients with cardiac implantable devices.

Would you dare promise patients a refund if they felt any pain?

Why do so many of us still skip topical — and what does that say to the patient in the chair?

How do you take the sting out of an inferior alveolar nerve block, a palatal, or a screaming hot pulp?

And when the lip is numb but the patient still feels it — what went wrong before you even picked up the handpiece?

My guest is Dr Nigel Kennedy, known to his Brighton patients as “No Pain Nigel” — a dentist who backed his injections with a money-back guarantee, and who has recently retired. Fair warning: there is no revolutionary technique or new anaesthetic agent in this episode. It is the foundations of painless anaesthesia, done properly and done every time — a great reminder of the why for experienced colleagues, and an aspirational one for younger dentists. We finish on something bigger: how to stay calm, stay well, and enjoy a long career in dentistry.

Protrusive Dental Pearl: Plateaus Are Normal, Growth Compounds

Growth in dentistry is not exponential and ever-rising. Like most careers, it plateaus — and you will feel stuck, sometimes for years. That is normal. Progress comes in small increments, and one of the best things about this profession is that you learn something new every working day.

Trust the process. Keep investing in yourself and aim to be 1% better. Give each month a theme — rubber dam this month, photography the next — and the breakthroughs arrive.

A useful marker of how far you have come: early on, many of us check tomorrow’s day list so we can revise for the deep filling, the molar root canal or the denture records. Years later you walk in not knowing what is booked — even a full-mouth rehab — and think, “Okay, cool. Let’s do this.” It may not feel rapid, but it is compounding.

What You’ll Take From This Episode

• Topical done properly — the one preparation step that makes topical actually work, and why skipping it is a lack of empathy.
• Tension, pressure and distraction — how to time the needle so the patient barely registers it.
• The two-stage block — a simple sequence that takes the discomfort out of the IANB.
• Slow down — how long a cartridge should really take, and why profound beats borderline.
• When it’s hard to numb — the hot pulp, the palatal, and the last moment of an extraction.
• Phrases for patients — the exact words to use before the needle, the palatal and the final pull.

Highlights of This Episode
00:00     TEASER
01:00     Painless Local Anaesthetic: The Money-Back Guarantee
03:21     Feeling Stuck in Dentistry? Why Plateaus Are Normal
06:20     How to Market Pain-Free Dentistry to Anxious Patients
08:20     How to Build a Dental Practice Patients and Staff Stay With
11:56     Can You Promise Patients Pain-Free Dentistry?
15:29     Why Topical Anaesthetic Is Non-Negotiable
16:56     How to Give a Painless Dental Infiltration
18:49     Painless Inferior Alveolar Nerve Block: The Two-Stage Technique
20:13     How Slowly Should You Give a Dental Injection?
21:22     Midroll
25:44     Lip Numb but Still Feeling It? Testing for Profound Anaesthesia
27:44     How to Numb a Hot Pulp
29:51     Painless Palatal Injections: Two Techniques
32:31     Communication vs Technique in Pain-Free Dentistry
35:52     Pain-Free Dentistry: What to Change Tomorrow
39:19     Stress, Longevity and a Fulfilled Career in Dentistry
45:41     OUTRO

From the Guest

Dr Nigel Kennedy qualified in Manchester in 1979 and owned his own practice in Brighton from 1994, selling it in stages to his associate before retiring at 71. The “No Pain Nigel” name started with a patient who told him she never felt his injections — and grew into a practice-wide promise of pain-free dentistry, backed by patient video testimonials.

Nigel is happy to hear from dentists, especially younger colleagues, who want advice. He is on Instagram, Twitter and LinkedIn: Nigel Kennedy

References & Further Reading

Sources and further reading from this episode:

• Melzack R, Wall PD. Pain mechanisms: a new theory. Science, 1965;150(3699):971–979. The gate control theory of pain — why firm pressure beside the injection site helps.
• HurriCaine topical anaesthetic gel (Beutlich; 20% benzocaine) — the topical discussed in this episode.
• The Profitable Dentist magazine (Excellence in Dentistry, USA) and Tony Gedge of the Marketing Pirates of Dentistry — the practice-marketing influences behind the “pain-free” promise.
  Dr Mike Gow (Berkeley Clinic, Glasgow) — previous Protrusive guest on dental hypnosis and anxiety. [PDP050]

Want more?

If you enjoyed this episode, check out: What Every Dentist Should Know About Managing Dental Anxiety – PDP050

Tags

#PDPMainEpisodes #Communication #CareerDevelopment

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes A.

AGD Subject Code: 340 Anesthesia and Pain Management.

Aim & Learning Outcomes

Aim: To equip dental practitioners with practical, patient-centred techniques for delivering comfortable intraoral local anaesthesia and managing difficult anaesthetic scenarios, recognising the role of communication in the patient’s experience of pain.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe a structured approach to comfortable local anaesthetic delivery, including topical application to dried mucosa, tissue tension, pressure-based distraction and slow deposition.
  Apply strategies for difficult anaesthetic scenarios — the inferior alveolar nerve block, palatal injections and irreversible pulpitis — including staged and supplementary techniques and objective testing before treatment.
  Use rapport, honest expectation-setting and reassurance to reduce patient anxiety and perceived pain during local anaesthesia and treatment.

When a filling doesn’t go to plan, how many times do you replay it on the drive home?

Have you fallen out of love with dentistry — or just with the way you’re experiencing it right now?

Why do the habits that could help your headspace get forgotten by Wednesday?

And when did you last ask yourself: have my thoughts been serving me today?

This is an Interference Cast episode — no margins, no bonding protocols. Jaz is joined by Neo Positivity, a former Camden, New Jersey police officer turned mindset speaker, who now spends his time in dental practices in the US and the UK with one message: thoughts become things.

Neo is big energy, and not every part of his philosophy will land for everyone — it doesn’t need to. Underneath it are habits any dentist can use tomorrow: stepping back from the “what if” spiral after a treatment goes wrong, catching autopilot thinking, remembering how badly you once wanted this job, and building reminders into the day so you actually follow through. Jaz leaves with a very personal takeaway about the version of himself that shows up at home.

This episode discusses suicide in the dental profession. If you’re struggling, please talk to someone today — in the UK and Ireland, Samaritans are free and available 24/7 on 116 123; in the US, call or text 988. The Canmore Trust (thecanmoretrust.co.uk) supports dental professionals affected by suicide.

What You’ll Take From This Episode

• Step back from the thought — the press-conference technique for the “what if I get sued?” spiral.
• Watch what you water — why the thoughts you rehearse most become the easiest to repeat.
• Get home first — the step to take before you quit a job, or dentistry.
• Reach for the cookie jar — using past wins to reset a bad day and repair a strained nurse relationship.
• Lead the ripple — why a leader who walks out of the wellbeing session undoes it.

Highlights of This Episode

00:00     TEASER
00:57     Why Mental Wellbeing Belongs on a Dental Podcast
03:49     From Police Officer to Mindset Coach
09:12     Burnout in Dentistry: Facing the Problem Honestly
10:24     How to Stop Ruminating After a Treatment Goes Wrong
14:07     Your Thoughts Aren't Facts: The Press Conference Technique
16:10     Watering Seeds: How Repeated Thoughts Rewire Your Brain
20:03     Autopilot Thinking in the Dental Practice
22:31     Midroll
25:52     Energy, Vibe and the Patients You Attract
30:30     How to Fix a Difficult Relationship With Your Dental Nurse
33:14     The Cookie Jar: Using Past Wins to Reset Your Mood
33:54     Burnout or the Wrong Practice? Before You Quit Dentistry
39:57     Remember How Badly You Wanted to Be a Dentist
41:18     Leading by Example: Building a Positive Practice Culture
44:53     Accountability Partners and the Daily Mindset Check-In
46:51     Takeaways, Resources and Wrap-Up
50:31     OUTRO

From the Guest

Neo Positivity speaks to dental practices, conferences and teams, visiting practices and speaking at lunch breaks with his “Thoughts Become Things” message. His book, Your ATM (“Your Ability to Manifest”), is out in print and as an audiobook, and he produces short morning-huddle videos for practice teams.

👉  neopositivity.com — book Neo for your practice, and find Your ATM

References & Further Reading

Books mentioned in this episode:

• Eckhart Tolle — The Power of Now. On living in the present moment.
• Michael A. Singer — The Untethered Soul. On observing your thoughts rather than being carried by them.
• David Goggins — Can’t Hurt Me. Source of the “cookie jar” idea discussed in the episode.
• Rhonda Byrne — The Secret; and Napoleon Hill — Think and Grow Rich. The works that introduced Neo to the “thoughts become things” idea.

Want more?

If you enjoyed this episode, check out: Before the Breaking Point – IC071

Tags

#InterferenceCast #BeyondDentistry #CareerDevelopment

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcome B.

AGD Subject Code: 770 Self-Improvement.

Aim & Learning Outcomes

Aim: To help dental professionals recognise and interrupt negative thought patterns, and to give them simple, repeatable habits that support wellbeing for themselves and their teams.

Learning Outcomes — by the end of this episode, dental professionals will be able to:

• Describe how rumination after a clinical or workplace setback reinforces itself, and apply a step-back technique to interrupt a negative thought loop.
• Identify practical cues and peer accountability structures that help dental professionals sustain wellbeing habits during the working day.
• Differentiate dissatisfaction with a working environment from dissatisfaction with dentistry itself, and outline steps to take before a major career change.

How do you explain everything that could go wrong with a root canal — without the patient walking out?

Why does a signed consent form protect you far less than you think?

What should you say in the exact moment after you tell a patient the fee?

And which single word is quietly sabotaging every future conversation you have about maintenance?

This is Part 2 of our communication masterclass with Dr Zak Kara, principal dentist at Smile Stories in Bournemouth, who coaches and mentors dentists on exactly these conversations. We tackle two questions sent in by the community: how to explain risks without discouraging patients from treatment, and how to present fees — including future maintenance and complications — clearly and confidently. Expect two live role-plays (a molar root canal and a lower wisdom tooth), a respectful disagreement about whether to call people patients or clients, and the fee-presentation sequence I wish I’d had years ago, when I hated every part of talking about money.

Protrusive Dental Pearl: Could They Retell It at Home?

Measure a consultation by one question: was I understood? Not conversion, not uptake — understanding. The ethical approach tends to deliver the conversion anyway.

The practical test: when the patient gets home and someone asks “How was the dentist today?”, can they summarise in a few sentences exactly what the appointment was about and what they need to do next? If not, the explanation isn’t finished — however thorough it felt from your side of the chair. That clarity is a skill, and it gets built deliberately.

What You’ll Take From This Episode

• Six moves for explaining risk — how to make every risk proportionate, personal and paired with your plan to reduce it.
• A root canal consent, live — plain-English wording, an honest success rate, and the analogy that makes recovery make sense.
• Common vs rare risks — when a risk deserves a sentence and when it deserves a diagram.
• The fee presentation sequence — seven steps from the reason to the objection, and why the pause matters most.
• Words to ban — why fees beat prices and costs, and what to say instead of “permanent.”
• Maintenance without the awkwardness — setting shared responsibility up front so “redo it for free” never comes up.

Highlights of This Episode
00:00     TEASER
00:48     How to Explain Risks and Fees to Dental Patients
04:10     The Biggest Lever in Dental Communication
06:53     How to Attract the Right Patients to Your Chair
14:29     What Makes a Super Associate?
19:58     How to Explain Treatment Risks Without Scaring Patients
26:22     Root Canal Consent: A Live Role-Play
33:59     Using Analogies to Explain Occlusion and TMD Risk
36:08     Wisdom Tooth Consent: Common vs Rare Risks
41:07     Why Consent Is a Process, Not a Signature
45:45     Midroll
51:34     Patients or Clients? What to Call the People You Treat
55:12     How to Present Dental Fees With Confidence
59:08     A Simple Framework for Presenting Fees
1:12:05   When to Discuss Treatment Alternatives
1:14:45   Why You Should Never Say "Permanent Crown"
1:20:15   A Communication Course for Dentists
1:20:51   OUTRO

From the Guest

Dr Zak Kara is principal dentist at Smile Stories in Bournemouth, and coaches and mentors dentists and their teams in communication. His communication course, developed with Protrusive, teaches from real consultation videos — filmed with patients’ permission — broken down play by play: what he said, why, and why he paused where he did.

Pre-order the communication course here:

👉  protrusive.co.uk/conversations

Once the course is out, you’ll also get access to a 90-day accountability group with Zak and me, and the full course in podcast format for your commute.

Want more?

If you enjoyed this episode, check out: Presenting Treatment Plans the Comprehensive Way – PDP048

Tags

#PDPMainEpisodes #Communication

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcome A.

AGD Subject Code: 550 Practice Management and Human Relations.

Aim & Learning Outcomes

Aim: To improve how dental practitioners communicate treatment risks, fees and long-term maintenance, so that patients make informed, genuinely consensual decisions without being frightened or overwhelmed.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Explain treatment risks in proportion to the individual patient’s clinical situation, using plain language, relatable analogy and a stated plan to mitigate each risk.
• Apply a structured sequence for presenting treatment fees that links the recommendation to the patient’s own goals and responds to objections without coercion.
• Describe how consent is developed across multiple touchpoints, including discussion of alternatives, shared maintenance responsibilities and checks of patient understanding.

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What do you say when a patient comes in wanting one tooth fixed, but you can see eight more heading the same way?

How do you tell a patient who has had a scale and polish every six months for twenty years that they now need something deeper without making it sound like you’re suddenly trying to sell them more dentistry?

Is there a magic sentence that makes patients say yes to comprehensive care?

And why can the patient you’ve known and liked for six years sometimes be harder to move forward with than a complete stranger?

This is Part 1 of a two-part communication series with Dr Zak Kara — co-founder of Smile Stories in Bournemouth, and the most-returning guest on this podcast. It’s also our first-ever call-in episode: the questions came in from the community as voice notes, and this episode answers two of them. Part 2 takes on the awkward stuff — discussing fees, and communicating risk without frightening people off.

Protrusive Dental Pearl: Reactive or Proactive Associate?

When the diary goes quiet, what do you actually do? Wait for the practice to work some magic and fill it — or go and fill it yourself? The mentality of “the clinic supplies the patients, I just treat them” is worth a hard look. The strongest associates pull their weight: writing, school visits, social media, and simply having conversations out in public that bring people through the door.

The logic behind it runs straight into the rest of this episode. You never get to do the clinical dentistry unless your communication is good — and you never get to communicate at all unless there’s someone in the chair.

What You’ll Take From This Episode

• The two ladders of readiness — clinical readiness and interpersonal readiness rise separately, and a plan gets declined when they’re badly out of step.
• Why “I’ll think about it” usually isn’t distrust — and the co-diagnosis move that stops you hearing it so often.
• The conversation circle — open on goals rather than symptoms, and close the visit by tying the recommendation back to the patient’s own words.
• Words that change the meeting — inflammation score instead of bleeding score, and why one word can decide whether a patient feels blamed or informed.
• How to present a five-figure plan — when to name the number, and what to do in the silence afterwards.
• Chairside scripts you can use tomorrow — permission questions, spot-the-difference, and the line that flips a treatment plan into something the patient avoids rather than buys.

Highlights of This Episode
00:00     TEASER
00:51     How to Talk to Patients Who Only Want One Tooth Fixed
03:45     Protrusive Dental Pearl: Reactive or Proactive Associate?
09:27     The First Protrusive Call-In: Your Communication Questions
13:40     Why There Is No Magic Sentence for Case Acceptance
15:58     Co-Diagnosis: How to Make It the Patient's Own Idea
22:36     The Conversation Circle: Start With Goals, End With Goals
26:58     Why "Inflammation Score" Beats "Bleeding Score"
30:50     The Peak-End Rule: What Patients Actually Remember
34:46     How to Ask Permission Before You Educate a Patient
39:32     Scale and Polish vs Deep Clean: Explaining the Difference
39:41     Midroll
44:54     How to Introduce Full Mouth Rehab Without Overwhelming
48:39     The Ladder of Readiness: Where Is Your Patient?
55:02     Two Ladders: Clinical and Interpersonal Readiness
59:23     How to Pre-Qualify Patients Before They Reach Your Chair
1:11:32   How to Present a Five-Figure Treatment Plan
1:20:26   OUTRO

Communication course — waiting list: Zak has a communication course in preparation. Protrusive is supporting it with a 90-day accountability group inside the app for anyone who enrols, plus retained lifetime access to Loom School. 

The waiting list is at protrusive.co.uk/conversations.

Find Zak Kara in Instagram (@zakdentalkitchen) and Facebook (Zak Kara).

References & Further Reading

The behavioural science referenced in this episode:

• Norton MI, Mochon D, Ariely D. The IKEA effect: When labor leads to love. Journal of Consumer Psychology, 2012;22(3):453–460. People value what they helped build — the mechanism underneath co-diagnosis.
• Bem DJ. Self-Perception Theory. Advances in Experimental Social Psychology, 1972;6:1–62. People infer what they believe partly from observing what they themselves say and do.
• Kahneman D, Fredrickson BL, Schreiber CA, Redelmeier DA. When more pain is preferred to less: Adding a better end. Psychological Science, 1993;4(6):401–405. The healthcare application is Redelmeier DA, Kahneman D, Patients’ memories of painful medical treatments, Pain, 1996;66(1):3–8.

Want more?

If you enjoyed this episode, check out: Think Comprehensive – Communication Gems with Zak Kara – PDP010. The episode that started it all.

Tags

#PDPMainEpisodes #Communication

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes A.

AGD Subject Code: 550 Practice Management and Human Relations.

Aim & Learning Outcomes

Aim: To improve dental professionals’ ability to communicate the need for comprehensive or more extensive treatment to patients who present with single-tooth expectations, using structured, permission-based and goal-led conversation rather than persuasion.

Learning Outcomes — by the end of this episode, dentists will be able to:

• Describe how a patient’s readiness for comprehensive treatment can be assessed along two parallel dimensions — their understanding of their own clinical need, and the strength of the working relationship — and identify where an individual patient sits on each.

• Apply permission-based and question-led techniques that help a patient identify disease for themselves, so that a recommendation is understood and owned rather than imposed.

• Dif...

Ever wondered what it’s really like to study dentistry abroad?

How different is it to train in Bulgaria, Slovakia, or Valencia compared to the UK?

And what happens when it’s time to come back home — can you easily register with the GDC and start practicing?

Dr. Hugo Medd joins Jaz for an honest and insightful conversation about taking the path less traveled — studying dentistry in Bulgaria after not securing a UK dental school place.

They dive into the realities of living and learning abroad, including language barriers, different teaching styles, and how much clinical experience international students actually get. Hugo also shares how he navigated GDC registration, what it’s like finding work after graduation, and why he has no regrets about choosing this unconventional route.

Highlight of this episode:
00:00     TEASER
01:21     Introduction
02:49     Meet Dr. Hugo Medd: A Journey to Bulgaria
06:09     Financial Considerations and Support Systems
09:56     Why Bulgaria? DMD vs BDS explained
13:13     Language Barriers and Communication Skill
17:47     Tuition Fees, Cost of Living, and Financial Realities
20:47     Navigating Post-Graduation and GDC Registration
23:23     Accredited EU Universities and Recognition Rules
25:09     Social Life, Culture, and Student Experience
28:14     Midroll
34:47     Differences in Teaching Styles Abroad
40:54     Navigating the UK Dental Job Market
43:03     Advice for New Graduates
50:24     Pursuing a Master's in Oral Surgery
54:45     Final Thoughts and Contact Information
57:11     OUTRO

Inspired to study abroad? Study Medicine Europe helps you land top dentistry and medicine placements in Europe and guides you from application to graduation.

If you enjoyed this episode, check out “The American Dental Dream – PDP002”

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.

#InterferenceCast #CareerDevelopment 

Have you ever removed plaque using a scaler or ‘air-polisher’ and notice that the demineralised enamel flaked away?

Scaling and polishing is a routine part of preventive dental care — but could some of our traditional cleaning methods be doing more than we realise? A whitening specialist who works without a drill, scaler or air polisher argues that some approaches to cleaning may affect the enamel, and that hydrogen peroxide gel can remove plaque without touching the tooth surface.

Dr Wyman Chan has done nothing but tooth whitening since 2002, when he closed his general practice for a dedicated whitening centre, and he developed the chemical-polishing gel which is at the centre of this episode. He is joined by Dr Niki Shah, a UK general dentist and practice owner whose company distributes the product in the UK, and who now runs most of his hygiene this way.

In this episode, they explain which patients they believe may benefit most, walk through the full chairside protocol, and discuss the limitations of the approach and where it may not be appropriate.

Protrusive Dental Pearl: Manicuring Worn Lower Incisors

Worn lower incisors sit sharp against the upper teeth, concentrating stress. Take a Sof-Lex disc and manicure them, rounding the edges from pointed to smooth. Show the patient in the mirror first and, borrowing Dr Michael Melkers’ framing, ask if you can make their teeth look a little younger. It is surface topography, changed for force management, and the patient feels it with their tongue.

What You’ll Take From This Episode

• On sound enamel, prophy paste and air polishing are low-risk; on demineralised enamel hidden under plaque, the same abrasion can flake the surface.

• Chemical polishing does not lift calculus; where calculus is present, ultrasonic or hand scaling is still required.

• Dr. Wyman Chan offers a 3% hydrogen peroxide gel as a plaque and biofilm adjunct, not a replacement for oral hygiene instruction.

• The strongest cases for this are anxious, paediatric, orthodontic, special-needs and geriatric patients who tolerate scraping poorly.

• The chairside protocol runs about twelve minutes and still ends with manual agitation using a single-tufted brush.

• No published evidence supports the product’s clinical claims yet; Dr. Wyman Chan describes studies in progress.

Highlights of This Episode
00:00     Teaser
01:21     Rethinking How We Polish Teeth
03:36     Protrusive Dental Pearl: Manicuring Worn Lower Incisors
05:23     Meet the Guests: From Whitening to Chemical Cleaning
12:10     What Is Chemical Polishing? Prophylaxis, Not Whitening
20:05     Is Traditional Polishing Damaging Teeth?
21:54     How Abrasion Harms Demineralised Enamel
25:30     The Strongest Case: Anxious Patients
29:09     Children, Adolescents and Orthodontic White Spots
29:49     Midroll
35:22     Managing Pericoronitis and Gingival Abscess
38:15     Special Needs, Geriatric and Post-Surgery Care
40:43     Where Is the Evidence? Studies in Progress
43:59     The Cost and Business Case for Chemical Polishing
50:16     The Chemical Polishing Protocol: Step by Step using Magic3
53:14     Why Manual Agitation Still Matters
57:58     How It Changed a Working Day
1:00:35   Outro

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  • Register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses.
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Learn more about their other products: https://protrusive.co.uk/magic3

Want more?

New to Dr Chan’s work? Start with Trayless Whitening Technique Part 1 with Dr Wyman Chan - PDP277, on his whitening approach, sensitivity and how to let patients pick their target shade.

Tags

#PDPMainEpisodes

Listen, subscribe, and earn CPD

Listen: Spotify, Apple Podcasts, YouTube, and inside Protrusive Guidance.

Earn CPD: This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.

Compliance: GDC Development Outcome C. AGD Subject Code 490 Periodontics.

Aim & Learning Outcomes

Aim: To give a mechanism- and evidence-aware view of chemical polishing as an adjunct for plaque and biofilm removal: where mechanical polishing can harm demineralised enamel, which patients the approach suits, how the chairside protocol runs, and the limits of the current evidence.

By the end of this episode, dentists will be able to:

1. Describe how the abrasivity of prophylaxis pastes and air-polishing powders interacts with sound versus demineralised enamel.

2. Identify the patient groups for whom a non-mechanical approach to plaque removal is most appropriate, and the situations, such as calculus, where it is not.

3. Evaluate the current evidence base for a 3% hydrogen peroxide chemical-polishing protocol, and apply appropriate attribution and consent where the evidence is not established.

Full mouth reconstruction — is the aim really the flawless before-and-after you scroll past on Instagram, or is that a trap?

How do you actually know you’re ready to step up from single teeth to a whole mouth?

And when your comprehensive treatment plan keeps getting declined — psychologically, financially — is that the patient’s problem, or yours?

This one is a “your questions answered” episode: the community sent in far more FMR questions than we could cover, and we put the best of them to two prosthodontists who literally wrote the book on it.

This is a full-mouth reconstruction deep dive with Prof Riaz Yar and Dr Łukasz Lassmann — co-authors of the new Quintessence textbook Full-Mouth Reconstruction (foreword by Jeffrey Okeson). We cover screening before you commit, knowing when you’re ready, getting big plans accepted, choosing materials, setting the bite in centric relation, sleep apnea, and the honest truth about “perfect” versus “acceptable.”

Protrusive Dental Pearl: Always Present the Best Advice

When you present a complex case, offer three tiers. Best advice — take time and money out of the equation and describe the ideal: what would truly get this patient to the right result (gum grafting, orthodontics, the lot). A compromise — a good result without the parts the patient won’t consent to or can’t fund. And the minimum — the least that still helps, with the non-negotiables named.

The most important of the three is the best advice. It’s tempting to self-censor — to decide a plan is too elaborate or too expensive and quietly leave it out. But if you never present the best option, you’ll never get to do those cases. Present the ideal option first, then offer the compromises. Don’t limit the patient — or yourself.

What You’ll Take From This Episode

• Screen before you plan — a green / orange / red system that sorts patients before treatment planning even starts, so you know which cases are yours.
• How to get big plans accepted — why case acceptance is a confidence problem before it’s a skills problem, and how to present the best advice, compromise and minimum.
• Choosing materials — why it’s the case, not the material: repairability vs aesthetics vs durability, and why erosion changes the answer.
• Setting the bite — why centric relation is the reference position, what a night guard can do to it, and how sleep apnea changes the plan.
• Perfect vs acceptable — defining success and failure honestly, and knowing when you’re actually ready to take a full-mouth on.

Highlights of This Episode
00:00     TEASER
00:53     Full Mouth Reconstruction: Your FMR Questions Answered
05:08     What Actually Counts as a Full Mouth Reconstruction?
10:48     Screening Patients for Full Mouth Rehab: Green, Orange, Red
18:48     Is Perfect the Goal of Every FMR? Success vs Failure
26:53     How Do You Know You're Ready for Full Mouth Dentistry?
36:23     Is the Dahl Concept a Good Segue Into Full Mouth Rehab?
38:50     Midroll
42:49     How to Get Patients to Accept Full Mouth Treatment Plans
49:34     Best Advice, Compromise, Minimum: Presenting the Options
55:04     Give Yourself Permission to Fail in Big Cases
56:14     FMR or Selective Restorations? Where's the Line on Tooth Wear?
58:49     interjection 1
1:04:52   Composite, Ceramic or Zirconia? Choosing FMR Materials
1:09:53   interjection 2
1:12:40   Centric Relation, Sleep Apnea and Setting the Bite
1:17:25   Anteriors or Posteriors First in a Full Mouth?
1:26:00   Does DTR Change How You Finish an FMR?
1:27:35   The Full-Mouth Reconstruction Book & Where to Learn More
1:30:37   OUTRO

From the Guests

Prof Riaz Yar is a specialist prosthodontist and Visiting Professor in Prosthodontics, with a 25-year focus on TMD, occlusion and full-mouth dentistry. Dr Łukasz Lassmann is a prosthodontist (DDS, PhD) whose PhD is in occlusion and the temporomandibular joint; he focuses on tooth wear, TMD and full-mouth rehab and founded Lassmann Education, whose multi-day “summer camp” FMR/occlusion course runs in Poland.

Interested in Full Mouth Reconstruction? Check out their book: 

Full-Mouth Reconstruction (Lassmann & Yar, Quintessence Publishing, 2026; foreword by Jeffrey Okeson) — a general-practitioner workflow from screening through orthodontics, perio, preparation, and cementation. 

References & Further Reading

Sources and further reading from this episode:

• Lassmann Ł, Yar R. Full-Mouth Reconstruction. Quintessence Publishing, 2026 (foreword by Jeffrey P. Okeson). ISBN 978-1-78698-153-0.
• Lassmann Ł, Calamita MA, Blatz MB. The “Smile Design and Space” (SDS) concept for altering vertical dimension of occlusion and esthetic restorative material selection. J Esthet Restor Dent. 2025;37(1):56–67.
• Loomans B, Opdam N, Attin T, et al. Severe tooth wear: European consensus statement on management guidelines. J Adhes Dent. 2017;19(2):111–119.
• Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig. 2008;12(Suppl 1):S65–S68.
• Okeson JP. Management of Temporomandibular Disorders and Occlusion. Elsevier (8th edition) 

Want more?

If you enjoyed this episode, check out: https://protrusive.app/posts/free-podcast-videos-pdp225-occlusion-myths-and-red-flags-with-lukasz-lassmann

Tags

#PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1.5 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C.

AGD Subject Code: 610 Fixed Prosthodontics.