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 - 10% OFF with coupon code ‘protrusive10’

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.

Click below for full episode transcript:

‘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,

Not quite happy or set with being a GDP? Have you just started as a GDP and want to streamline your learnings for a brighter future? Is an MSc the right plan of action for you? How important are mentors in all of this?

In this episode we discuss Dr Kiran Shakla’s journey from University to Australia to working as a Dentist at a Specialist Practice. She shares with us her top tips on how Dentists can make the most of their weekly schedules and reduce stress while dealing with different cases.

https://youtu.be/IiecXSpsJmc

Watch IC057 on Youtube

Key Takeaways:

Hard work and determination are key to success in dentistry.

Work-life balance is crucial for long-term satisfaction in dentistry.

The first ten years post-graduation are vital for career development.

General dentistry can be fulfilling without the need for specialization.

It's important to recognize when to refer patients to specialists.

Kiran emphasizes the value of personal growth and continuous learning..

Finding joy in everyday practice is essential for a sustainable career. Australia taught me valuable skills in private practice.

Private dentistry focuses more on patient care than money.

Communication is crucial for patient satisfaction.

Finding mentorship can be challenging but essential.

Shadowing experienced professionals enhances learning.

Balancing work and education requires sacrifices.

Need to Read it? Check out the Full Episode Transcript below!

Highlight of this episode:

02:34 Introduction to Dr Kiran Shankla

06:18 Correlation between Uni and the Real World

07:29 Selling a Dream

10:13 Going Hard Early

12:43 Taking Work Home

14:55 General Dentistry

20:48 Kiran’s Journey 

24:23 What did the experience teach Kiran?

31:33 Mentoring

34:38 Work Schedule

37:38 Bone to pick with Master's

43:33 Orthodontic Position

48:53 Working with Nurses

54:33 Networking

56:33 Wrapping Up

Connect with Dr. Kiran on Instagram!

This is a non-clinical episode without CPD. For CPD or CE credits, visit the Protrusive Guidance app—hundreds of hours and mini-courses await!

If you liked this episode, check out: Stress in Dentistry 2024 – Life Changing Decisions – IC048

Click below for full episode transcript:

Teaser: They don't have the clinical skill, but they've seen so many people do it, they know what works and what doesn't. And if you get on with them and if they can teach you something, it's like going on a course and someone, I could have paid to go on a course for someone to teach me how to do that. Well, why would I, when my nurse has seen it done a hundred times and she's like, Kiran, this is how it's done. Come on, I'll help you.

Teaser:If anyone stops saying, I don't know which course to do. This is another course you can create. And you know, often, it's a secret. It can be free. Often it can be free because there's so many lovely people out there that are willing to say, you know what, if you want to shadow me 12 times in a year on this, like, once a month, I'm happy.

You don't have to pay me anything yet. Some people will charge and that's okay. That's worth it too. But if it's free, wow. And if even if it's charged, it's still worth it because to be able to shadow you learn so much.

Jaz's Introduction:Being a general dentist is the toughest gig in dentistry. You have to literally be good and know everything. In this episode I'm joined by Dr Kiran Shakla, a general dentist just like me, and we talk about her journey. I feel there's so much we can learn when we dissect an individual's journey. And Kiran's mindset is really quite special. It's really going to inspire anyone who's in the early stages of their career.

Or even if you're established in your career but you're not quite happy, you're not quite settled, you have that itchy foot like Kiran had, then this episode will be really helpful to you. You see, Kiran takes massive action.

How do we decide whether speciality training is right for us?

Is the best time to specialise straight after Dental School? Or should we gain some experience in practice first?

Dr Beant Thandi joins us today to share his journey into specialising and shares some key experiences that will surely help guide you along the way.

We discuss the different specialities within Dentistry as well as what personality types may suit them. This episode will really help you understand what it takes to specialise and how to get there.

https://youtu.be/f8ZM8EkjSQY

Watch IC056 on Youtube

Key Takeaways:- Beant is starting his specialization in periodontics.- His journey began during COVID, leading to a desire to specialize.- Proactive learning and mentorship played a crucial role in hisdevelopment.- Financial planning is essential when considering specialization.- Choosing a specialty should align with personal interests and strengths.- Periodontics offers a breadth of practice that appeals to Beant.- The importance of community support in dental education cannot be overstated.- Reflection and documentation of cases can enhance learning and confidence.- Understanding the financial implications of specialization is vital.- It's important to stay grounded and not rush into specialization. 

Need to Read it? Check out the Full Episode Transcript below!

Highlights of this Episode:00:00 Teaser02:38 Intro to Dr Beant Thandi04:03 Dental Journey06:10 What Influenced You?12:56 Too Young to Specialise17:50 Judgement by Jaz21:00 Never too Young26:05 Cost of Specialising28:23 Why not the USA?31:30 Roasting Prostho34:45 Roasting Endo37:42 Roasting Ortho39:49 Roasting Oral Surgery45:00 Shoutout to Lucy45:30 Final Thoughts47:28 End Outro

If you liked this episode, check out a classic: Should You Specialise? PDP006

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: But one thing I learned from a nurse when I was doing a DCT job was people all progress at different rates. It should be competency based, not necessarily time based things. People learn at different rates. And this was a max fax nurse who's obviously seen regists for decades, where I'm sure like, the junior regists are better than the senior regists. Just because they soak it up more.

[Jaz]The whole pros element, right? Multiple crowns, four rehabs, lots of general dentist do four rehabs, lots of general dentists do all on fours, that kind of stuff. So, nowadays it's like blurred lines between, okay, what do they actually need a Prosth for? However, prosth, I think they're very employable. However, lots of people who do an MClinDent Prosth end up being general dentist. We're just like really good general dentists in practice and still doing checkups and stuff. I have seen that.

[Beant]The fees are 37 and a half thousand pounds a year and they're subjects-

[Jaz]For a home student.

[Beant]This is for a home student. I'm a home student.  

[Jaz]What? How much is it for an international student?

[Beant]60, 000 pounds. Jaz's Introduction:I think every dentist in the world at one stage of their career has thought about specializing. And most of us never do, right? About 90% in UK anyway are general dentists or at least non specialists. Only 7% actually enter specialist fields of dentistry like perio, prostho, endo, oral surgery, you name it.

How do we decide whether specialty training is for you? There are huge sacrifices one must make both in terms of time and finances. And how can you be sure that you really want to niche and narrow your scope of practice into that one field that you might choose? Is the best time to specialize like straight after dental school? Or is it good to gain a few years experience or many years of experience before you ...

Two weeks ago I suffered a spontaneous pneumothorax and it shook me. This episode came at the PERFECT time as such health scares remind us that our health and wellbeing are the highest form of Wealth.

Should Dentists have a therapist to manage stress and anxiety?

Did you know that a BDA survey found 1 in 5 practitioners have seriously considered taking their own lives?

Is it the intense work environment, the pressure from patients, the fear of litigation, or the added burden of business ownership?

More importantly, how can we address this issue and support dental professionals?

Dr. Simon Chard, a cosmetic and implant dentist and co-founder/CEO of Parla (as seen on Dragon's Den!), joins Jaz to discuss the often-overlooked realities of the dental profession. 

https://youtu.be/rH7PtjFTOpk

Watch IC055 on Youtube

Here are the two books Jaz recommended during the intro:

The 5 Types of Wealth by Sahil Bloom

Hold on to your Kids by Gabor Mate

Check out The Dental Growth Retreat by Dr Simon Chard

Need to Read it? Check out the Full Episode Transcript below!

Key Takeaways:

Simon emphasizes the importance of balancing personal and professional life.

Mental health issues in dentistry are alarmingly high, with many professionals considering leaving the field.

Therapy can be beneficial for everyone, including dentists, to manage stress and emotional challenges.

Building mental resilience is crucial for handling the pressures of dental practice.

Sleep quality and routine significantly impact overall health and productivity.

Mindfulness and meditation can reduce stress and improve mental health.

A structured approach to self-care can enhance resilience in the dental profession.

Exercise is a key component of maintaining mental and physical health.

Creating a supportive community among dental professionals is essential for mental well-being.

Proactive self-care strategies can prevent burnout and improve job satisfaction. You can't mess up meditation; awareness is key.

Diet significantly impacts mental health and well-being.

Interpersonal relationships are crucial for mental resilience.

Exercise is a powerful tool for physical and mental health.

Purposeful living leads to greater fulfillment.

Hydration and nutrition are foundational to health.

Loneliness can have severe health implications.

Creating time for relationships is essential.

A value-based calendar helps prioritize what matters.

Retreats can provide tools for personal growth and accountability.

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.

Highlights of this Episode:00:00 Intro04:25 Introduction to Dr Simon Chard10:10 Why is Dentistry so Stressful?14:00 Therapy for Dentists19:20 Strategies for Mental Resilience25:20 Mindfulness31:57 Intake40:32 Love45:12 Value Based Calendar48:32 Exercise51:57 Managing Everything54:34 The Retreat 

If you enjoyed this episode, check out: Mental Health in Dentistry - PDP185

Click below for full episode transcript:

Jaz: The BDA, which is the British Dental Association, it had like something like it was 18% or nearly 1 in 5, right, had thoughts about and we'll just say it taking their own life, right? And I'm sorry to everyone to go in this direction, but it's important that we address it head on.

Teaser:Incredible the number of individuals who are vitamin D deficient in this country. So I vitamin D test all of my surgical patients. We have a finger prick, point of care blood tests that we do ahead of the surgical appointment. I would probably say in my patient cohort, 75% are vitamin D deficient. The digital connection that we have with people is like a junk connection, like junk food and the real interpresonal relationship that we have with people is like whole food and whole c...

What is the best technique for fabricating temporary veneers?

How do you ensure they are retentive but not TOO retentive?

What’s the best way to shape, polish, and remove them efficiently?

In this episode, I’m joined by Aodhan Docherty—an absolute sensation in Sydney when it comes to veneers. He’s mastered the art, and today, he’s on a mission to share everything you need to know to get crisp, stable, and well-shaped temporary veneers every single time.

We break down different protocols, troubleshoot common issues, and, most importantly, make sure your temporaries stay put until it’s time for the final fit.

https://youtu.be/BI_xMlSXgvc

Watch PDP214 on Youtube

Protrusive Dental Pearl: Aodhan recommended a chlorhexidine-based mouthwash to reduce inflammation but advises using an ADS (Anti-Discoloration System) mouthwash to avoid staining. The ADS system helps maintain healthy tissue response, preventing bleeding and inflammation on the day of veneer placement while eliminating the discoloration commonly associated with standard chlorhexidine products.

Key Takeaways:

Temporary veneers serve as a blueprint for final restorations.

Facially driven smile design enhances patient satisfaction.

Patient adaptation is key to successful cosmetic procedures.

Oral hygiene is vital for maintaining temporary veneers.

Effective communication with the dental team improves outcomes.

Understanding patient biotype is essential for treatment planning.

Stress management is a critical skill for dental professionals. Patient-centric approaches are essential in modern dentistry.

The shrink wrap technique offers better control and aesthetics for temporaries.

Effective communication with patients enhances their experience and satisfaction.

Hands-on training is crucial for developing practical skills in dentistry.

The importance of assessing temporaries before finalizing restorations cannot be overstated.

Need to Read it? Check out the Full Episode Transcript below!

Highlights of this episode:

01:17  Protrusive Dental Pearl

04:42 Welcoming Dr. Aodhan Docherty 

06:30 Challenges and Rewards of Managing Practice

10:00 Facially Driven Smile Design

14:53 Temporary Veneers: Practical Tips and Techniques

20:51 Non-Staining Mouthwash

 22:27 Temporaries: Pros and Cons 

26:49 Proximal Papilla Care

31:14 The Trial Smile Approach

35:14 The Shrink Wrap Technique

39:41 Detailed Steps for Shrink Wrap Technique

40:56 Spot Etching & Bonding for Retention

43:08 Removing Temporaries Atraumatically

51:22 Porcelain Veneers Workshop: Course Overview 

56:12 Learning from Failures

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/COSMETIC DENTISTRY (Tooth colored restorations)

Aim:

Aimed to provide dental professionals with a comprehensive understanding of temporary veneers, covering techniques to improve their fit, durability, and aesthetics.

Dentists will be able to -

Implement predictable protocols for creating stable and well-shaped temporary veneers.

2. Apply the shrink wrap technique for improved aesthetics and retention.

3. Assess and adapt temporaries effectively before finalizing restorations.

Ready to take your veneer skills to the next level and create stunning, long-lasting smiles? Join the Exceptional Porcelain Veneers Workshop with Dr. Aodhan Docherty and Dr. Kamran Ashraf!

📍 2025 Course Schedule:🦷 Sydney: March 8–9🦷 Melbourne: May 3–4🦷 Perth: July 26–27🦷 Auckland: April 5–6🦷 London: May 24–25

🚀 Upcoming Course:🔹 Bulletproof Dentistry – The Foundations of Occlusion & Restorative Dentistry (April 25–26, Surrey, UK)This two-day hands-on course is the ultimate foundation before tackling full-mouth rehabs and tooth wear cases. Join Jaz and Mahmoud to strengthen your force management, longevity strategies,

A Clinician’s guide to TMD Management

Walkthrough of the latest TMD Guidelines with the authors!

What’s the right approach when a patient presents with both acute and chronic painful jaw symptoms?

How can the latest RCS guidelines simplify your diagnosis and treatment process?

In this episode, Professor Justin Durham and Mrs. Emma Beecroft join Jaz to unpack the latest Royal College of Surgeons TMD guidelines designed specifically to help GDPs navigate these tricky cases. Together, they explore practical strategies for managing TMD, breaking down the step-by-step flowchart that makes handling these cases less intimidating.

From understanding the key principles to applying them in everyday practice, this episode will help you feel more confident in delivering better patient care for TMD.

https://youtu.be/R0NaBJr5g5E

Watch PDP213 on Youtube

Protrusive Dental Pearl: Important takeaway: Download the New TMD Guidelines 

The folder includes:

A patient version of the guidelines

A dentist version of the guidelines

The full guidelines document

Video of delivering an equilibrated soft bite guard using heat technique

Key Takeaways:

The guidelines for TMD are designed to simplify diagnosis and treatment.

Self-management is crucial for TMD patients and can lead to better outcomes.

Understanding the difference between muscle and joint pain is essential in TMD management.

Early intervention in TMD can lead to significant improvements for patients.

The importance of patient-centered care in managing TMD effectively.

TMD is a common issue that requires a collaborative approach among dental professionals.

The role of pain management in TMD is about improving quality of life, not just curing the condition.

Continuous education and training are vital for dental professionals dealing with TMD. Understanding the pathogenesis of TMD is crucial for effective treatment.

Stabilization splints can provide relief but should be used judiciously.

Effective communication can significantly impact patient pain experiences.

Tailoring treatment to individual patient needs is vital.

Need to Read it? Check out the Full Episode Transcript below!

Highlights for this episode:

00:48 Protrusive Dental Pearl

05:20 Introducing the Guests: Prof. Justin Durham and Mrs. Emma Beecroft

13:05 Stigma and Complexity of TMD in Dentistry

17:01 Challenges of Navigating TMD Treatment Perspectives

22:07 Diagnosing TMD: Tools and Techniques

27:09 Simplified Approach to TMD Examination

30:54 Muscle Palpation Pressure 

32:20 Acute Limited Opening: Muscle vs. Joint Origin

40:20 Diazepam for Acute Myogenous TMD

54:58 Debating Soft vs. Stabilization Splints

57:17 Patient-Centered TMD Management

01:09:28 Conclusion and Resources

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: 200 OROFACIAL PAIN (Diagnosis and treatment)

Dentists will be able to -

Explore the varied approaches to TMD care and how to align them with evidence-based practices.

Emphasize the importance of self-management strategies and their role in improving patient outcomes.

Advocate for a patient-centered approach, focusing on listening, communication, and individualized care plans.

If you loved this episode, be sure to check out this episode: TMD Full Exam with ‘The TMJ Doc’ Dr Priya Mistry – PDP064

Click below for full episode transcript:

Teaser: A standard extroral exam involves, the examination of temporalis and masseter, which are the only two muscles that international recommendations would suggest.

Teaser:So you don't need to bother with that lateral pterygoid because you've got to be, have a bit of a strange finger to reach it, firstly up and around the back of the tuberosity and not evoke kind of vomit on your shoes.

And a medial pterygoid similarly,

In this episode, Jaz dives into the complexities of Temporomandibular Disorders (TMD) management with Dr. Suzie Bergman, a US-based dentist and TMD sufferer. They discuss why treatments for TMD vary so much and examine the current state of evidence-based approaches.

https://youtu.be/r3QpkMYeTWk

Watch PDP212 on Youtube

Dr. Bergman shares her personal journey, highlighting conservative treatments, the role of occlusal appliances, and the power of multidisciplinary care. But just when you think you’ve got it all figured out—Dr. Bergman reveals a game-changing insight that could completely shift your approach to TMD management. Ready to find out what it is?

Need to Read it? Check out the Full Episode Transcript below!

Highlights of this episode:

02:40 Protrusive Dental Pearl

04:32 Meet Dr. Susie Bergman: A Personal Journey with TMD

7:27 The Wild West of TMD Treatments

10:32 Challenges in TMD Research and Treatment

13:34 Suzie’s TMD Journey: From Trauma to Advocacy

21:42 Evidence-based Therapies and Occlusal Appliances

27:11 Orthodontics and TMD: A Complex Relationship

33:40 The Role of Occlusal Appliances

35:05 Debating Disc Displacement

39:17 Comprehensive TMD Diagnosis

44:09 Orthopedic Stability in Dentistry

51:04 Splints and TMD

53:52 Managing Bruxism Effectively

58:16 Suzie’s TMD Course and Final Thoughts

Listen to Dr. Suzie Bergman’s "Why is healthcare disjointed?" | TEDxStrathcona Women

Check out Dr. Suzie’s Course “21st Century TMD Protocols"

Looking for an Online course to allow General Dentists to treat 80% of TMD cases and 100% of Bruxists? Check out SplintCourse Online by Jaz Gulati 

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: 200 Orofacial Pain (Diagnosis and treatment)

Dentists will be able to: 

1. Recognize the multifaceted nature of Temporomandibular Disorders (TMD) and the various factors influencing treatment variability.

2. Evaluate current evidence-based treatments for TMD and their effectiveness, including conservative methods and occlusal appliances.

3. Discuss the importance of a collaborative approach in TMD management, integrating different specialties for optimal patient outcomes.

If you loved this episode, be sure to check out Deep in to TMD – An Orthopaedic Perspective – PDP172

Click below for full episode transcript:

Teaser: I tell them T. A. T. U., which stands for Teeth Apart, Tongue Up, so during the day as much as possible, try to keep your teeth away from each other so that you're not clenching. I tell them, we want you to do the three S's, which are-

Teaser:I always tell people it's unrealistic with chronic pain patients to think that there will be a day that you go to zero in pain. I don't know what it's like to not be in pain. Some days might be a little bit better, but there's never a time that I'm not in pain. And part of that is because- When we have pain for so long, it can become a central nervous system issue. So when we have that central sensitization, our brain interprets non painful stimuli as painful.

We have patients who have discs that are either anteriorly and medially displaced, which is most common. It's very uncommon for there to be a posterior displacement of the disc. We have to think about how that patient's body has responded to the changes if the disc has been displayed. Some people will adapt beautifully and some people will not. And so, it's really about the individual patient.

Jaz's Introduction:The management of Temporomandibular Disorders is like the Wild West. I know for a fact that for the same issue you can go to one dentist who will suggest orthodontics, you can go to a surgeon who may suggest some form of surgery, even if it's like an arthrocentesis, you can go to another person they might suggest some botox to calm those muscles,