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Protrusive Dental Podcast

Jaz Gulati

The Forward Thinking Dental Podcast

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  • 52 episodes
  • weekly
  • Avg 54 min
  • English

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  • Yesterday · 1 hr 10 min

    You’re Probably Using Your Ultrasonic Wrong - PDP288

    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.

  • October 7 · 44 min

    Painless Local Anaesthetic with "No-Pain Nigel" - PDP287

    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.

  • October 2 · 48 min

    Thoughts Become Things - How to Be Happier in Dentistry - IC079

    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.

  • September 30 · 1 hr 21 min

    How to Explain Treatment Risks and Fees Without Scaring Patients - PDP286

    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.

  • September 23 · 1 hr 21 min

    How to Talk to Patients Who Only Want One Tooth Fixed - PDP285

    NEW: 15% OFF FIGS Worldwide 🌍 - use code FIGSPD15 at wearfigs.com 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...

  • September 18 · 55 min

    Studying Dentistry in Bulgaria / Spain / Hungary and Beyond - IC078

    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

  • September 16 · 59 min

    No More Air Polishing or Prophy Paste! Revolutionary New Technique for Non Mechanical Prophylaxis - PDP284

    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 Start offering Magic3 Where to get Magic3: UK: directoralcare.com Register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses. Use promo code PROMAGIC10 at checkout to receive 10% off Magic3. Outside UK: Please enquire from Dr Wyman Chan's website. Orders are invoiced rather than purchased directly through the website. Quote promo code PROMAGIC10 when enquiring to receive 10% off your Magic3 order. FREE Wyman Dental Retractors With your first Magic3 order, you’ll also receive 1 Wyman Dental Retractor free. The Wyman Dental Retractor is a multi-use, autoclavable retractor (up to 100 uses) designed for comfortable and effective soft-tissue retraction. Order 1–2 Magic3: Get 1 free Wyman Dental Retractor Order 3+ Magic3: Get 3 free Wyman Dental Retractors 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: Describe how the abrasivity of prophylaxis pastes and air-polishing powders interacts with sound versus demineralised enamel. 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. 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.

  • September 9 · 1 hr 29 min

    Full Mouth Reconstruction with Lukasz Lassmann and Riaz Yar - PDP283

    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.

  • September 2 · 58 min

    Daddy Dentist: Balancing Fatherhood and Dentistry - IC077

    When you walk through the door after work, are you actually present or are you still running the day’s to-do list in your head? Is there ever a “good” time to have a baby in the middle of specialist training and how do you fund it? How do the best dentist-parents you know protect time with their kids without their careers stalling? And can technology actually give you hours back — or is that just another thing to feel guilty about? This is one for the dads. In this Interference Cast episode, Jaz sits down with Dr Sunny Marwaha — a dentist completing part-time specialist training in prosthodontics at Guy’s, who became a father right in the middle of it. It’s not a clinical episode. It’s an honest conversation about doing the hardest career stretch (training, buying practices, building a name) at the exact same time you’re raising young children — the sleep, the money, the guilt, and the strategies that actually help. Two dentist dads, comparing notes. What You’ll Take From This Episode Priority management, not time management — Decide what this season of life is for, and protect it; priorities shift as the kids grow. Leave the day at the door — both directions — The driveway is dad mode, the clinic is showtime; you can’t take work home or home to work. Run the family like a small business — Regular family meetings and a “mind like water” system can help carry the load without living in your head. Use AI to buy back time — Make use of dictated notes, auto-drafted letters, and turning papers into audio for the commute. This is leverage, not cheating. Specialise or self-direct? — An honest filter for whether a structured training pathway or private courses and mentorship suits you better. Highlights of This Episode 00:00 Teaser 00:42 Daddy Dentist: Balancing Fatherhood and Dentistry 03:42 Should You Specialise or Learn Through Private Courses? 10:12 How to Time Having Kids Around Specialist Training 13:32 Paternity Leave for Dentists: What's Realistic? 16:42 Funding Specialist Training With a Young Family 20:02 Why Family Support Is a Privilege, Not a Given 22:57 Time Management vs Priority Management 23:42 The Two Moments With Your Kids That Matter Most 29:12 Protecting Sleep, Fitness and Your Mental Health 30:13 Midroll 39:03 Top Tips for Dentist Dads 41:53 Using AI to Buy Back Time for Your Family 45:53 Run Your Family Like a Small Business 53:33 How to Cut Kids' Screen Time (and Make It Stick) 59:23 Life After Specialist Training: A Shorter Week 59:57 Outro From the Guest Dr Sunny Marwaha is a dentist completing part-time specialist training in prosthodontics at Guy’s (King’s College London). He’s passed the MProst (Royal College of Surgeons), with his final MClinDent and GDC specialist listing still ahead. He became a dad to son Kabir midway through training; his wife Amrit is also a dentist. 👉 Follow Sunny on Instagram: @dr_marwaha References & Further Reading Listed for reference (mentions, not endorsements): NotebookLM — Google’s AI research tool; can turn a source document (e.g. a paper) into an audio, podcast-style discussion for the commute. Trello, Inkpad Notepad, and Google Calendar — The “mind like water” offload system. Loom — screen/video-message tool, mentioned as an alternative to written tooth-by-tooth reports. Want more? If you enjoyed this episode, check out: [Screen Times and SmartPhones for Children – Best Practices – IC061]. The screen-time reset comes up near the end of this chat; that episode goes deeper. Tags #InterferenceCast #CareerDevelopment #BeyondDentistry Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcome B. AGD Subject Code: 770 Self-Improvement.

  • August 28 · 55 min

    The Art and Science of Complete Denture Success - PDP282

    Complete Dentures That Actually Work: Impressions, CR & Adaptation You don’t have to suck at complete dentures — there’s a science to them, and an art you gather with experience. Why do complete dentures feel so unpredictable — when a crown prep or an endo doesn’t? What’s the number-one impression mistake dentists make — and the tissue-conditioning step most of us skip? And when a new denture comes back painful — is it the extension, or the occlusion? This one is a whistle-stop tour of complete dentures with Dr Leif Stromberg — a Dallas general dentist who learned removable prosthodontics directly from the legendary Earl Pound and has taught it for decades. Recently nominated for the Texas AGD’s 2026 Texas Dentist of the Year™ Award, Dr. Stromberg brings a wealth of clinical experience, leadership and mentorship to the profession. Rather than drilling into a single appointment, Jaz put a stack of Protrusive Guidance community questions to him and covered the whole arc, from choosing the right patient to troubleshooting a painful denture at delivery. Expect breadth over depth — a lot of ground, a little from each stage — with plenty of technique, nuance and communication tips to take back to the chair. Protrusive Dental Pearl: Pick the Patient Before the Denture You don’t have to treat everyone. Before promising anything, work out whether you can meet the patient’s expectations — because you can build the world’s best denture and they still may not adapt to it. The single strongest predictor of success is the patient’s own adaptation, not the technical quality of the prosthesis. So read the markers of adaptation. The patient who has worn a technically poor, flimsy denture happily for years — and only needs a new one because the old one is worn out — is a home run: improve the retention and stability and they’ll do brilliantly, because their neuromuscular adaptation is already proven. The patient who has hated every set they’ve owned is the warning sign. Assess adaptation right from the first appointment; it matters more than the articulator you own. What You’ll Take From This Episode Pick the patient, not just the denture — the markers of adaptation that predict success before you start. Where the teeth actually go — Pound’s lingual control lines, and why “lingual” means stable. The number-one impression mistake — coverage versus overextension, plus pre-impression tissue conditioning. Records without the wobble — recording centric relation with a gothic arch tracer, and why the facebow ranks low. A painful denture at delivery — how to tell overextension from occlusal overload, and what to do about each. Highlights of This Episode From the Guest Dr. Stromberg teaches the fundamentals of predictable complete dentures through a run of CE courses on Dentaltown — a five-part written series and a video series that walk through the exam, impressions, records, try-in and delivery. 👉 Stromberg’s “Keys to Complete Denture Success” CE courses on Dentaltown Learn more at: https://www.strombergdentistry.com/articles Want more? If you enjoyed this episode, check out: Occlusion for Complete Dentures – PDP162 Tags #PDPMainEpisodes #ProsthoPerio #Communication 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 C AGD Subject Code: 670 Removable Prosthodontics. Aim & Learning Outcomes Aim: To give clinicians a predictable, appointment-by-appointment approach to complete dentures — patient selection and adaptation, accurate records, functional tooth position, and troubleshooting at delivery. Learning Outcomes — by the end of this episode, dentists will be able to: 1. Assess a patient’s suitability for complete dentures and their likely adaptation, and manage expectations before treatment begins. 2. Describe the sequence of clinical appointments for complete dentures and the key objective of each — impression coverage, recording centric relation and vertical dimension, and functional tooth position. 3. Differentiate the common causes of pain at denture delivery (overextension versus occlusal overload) and apply an appropriate method to identify and correct each.

  • August 26 · 57 min

    Biological Dentistry vs Holistic - Trend or Future? Implementing Nutrition and Testing - PDP281

    Holistic, biological, functional — is there actually a difference, or is it all just marketing? Are root canals really dangerous — or is that just what the algorithm keeps showing your patients? When a patient wants their sound fillings out, do you test, reassure, or drill? And how do you bring sleep, diet and blood tests into a dental appointment without it stopping being dentistry? This episode sits down with Dr James Goolnik (https://uk.linkedin.com/in/james-goolnik)— clinical dentist, founder of the London holistic practice Optimal Dental Health, past President of the British Academy of Cosmetic Dentistry, and one of Jaz’s earliest mentors. James openly calls himself a holistic and biological dentist, which makes him the ideal person to separate the thoughtful, evidence-aware end of this world from the online extremism that gives it a bad name. Expect a balanced, honest conversation: some of it you’ll adopt tomorrow, some of it you’ll want to pressure-test — which is exactly the point. Protrusive Dental Pearl: Dentistry Isn’t Just About Fixing Teeth This one isn’t a clinical tip — it’s a sentiment that frames the whole episode. Dentistry isn’t just about fixing teeth; it’s about improving health. You don’t have to agree with every claim made in biological dentistry — but you will struggle to disagree that a patient’s diet, sleep, breathing, stress and inflammation all influence oral health. So the pearl is simple: stay curious, stay open-minded — but stay critical, and never stop asking better questions. What You’ll Take From This Episode The holistic–biological spectrum — what each word actually means, and where thoughtful practice tips into online extremism. Test or reassure? — the three-question filter for deciding whether any test earns its place before you order it. Safe amalgam removal — the SMART protocol, and when a worried patient’s sound filling should be left well alone. The mouth-body connection — how sleep, glucose control and systemic inflammation affect the mouth, and where to refer. The balanced take on root canals and implants — whether root canals are dangerous, and titanium versus ceramic with metal-allergy testing. Highlights of This Episode 00:00 Teaser 00:59 Holistic vs Biological Dentistry: What's the Difference? 05:49 Why Listening Beats Perfect Margins in Dentistry 10:29 Why Patients Started to Doubt Root Canal Treatment 12:09 Mercury Fillings: Should You Remove Amalgam? 14:09 The SMART Protocol for Safe Amalgam Removal 19:59 The Mouth-Body Connection: Sleep, Diabetes & Alzheimer's 24:59 How to Build Nutrition Into a Dental Practice 26:25 Midroll 34:01 Sleep Tests, Glucose Monitors and Blood Tests in Practice 38:21 Is Biological Dentistry Dangerous? The Extremist Problem 39:21 Are Root Canals Dangerous? A Balanced Take 41:51 Titanium vs Zirconia Implants and Metal Allergy Testing 46:51 When Removing a Healthy Tooth Becomes Negligent 50:56 What Diet Should Dentists Actually Follow? 53:41 How to Get Started in Holistic Dentistry 56:30 Outro From the Guest Dr James Goolnik is a clinical dentist and founder of Optimal Dental Health, a holistic practice in London built around integrating nutrition, sleep and whole-health screening into everyday dentistry. He is a past President of the British Academy of Cosmetic Dentistry, a member of the International Academy of Oral Medicine and Toxicology, and the author of “Brush” (profits to Dentaid) and the “Kick Sugar” cookbook (profits to his Rewards Project charity). 👉 Optimal Dental Health — monthly practitioner newsletter, and connect with James on LinkedIn Want the Toolkit? We’ve turned this episode into a practical Holistic Dentistry Clinical Toolkit — with quick-reference guides for whole-body assessment, testing, patient conversations, and navigating the holistic–biological spectrum. Download the free toolkit at www.protrusive.co.uk/biological References & Further Reading Sources and further reading from this episode: IAOMT — Safe Mercury Amalgam Removal Technique (SMART). The protocol for safely removing amalgam (rubber-dam isolation, adsorbent rinse, sectioning, high-volume evacuation) to minimise mercury exposure for patient and team. MELISA test. A validated blood lymphocyte-transformation test for type-IV hypersensitivity to metals including titanium and mercury — used to guide titanium-vs-ceramic implant decisions. Tests, devices & materials referenced — a home overnight sleep test, a phase-contrast microscope, a national blood-testing partner, point-of-care fingerprick analysers (CRP / HbA1c), a blood/hair/urine mercury panel, continuous glucose monitors, and Biodentine for vital-pulp therapy. Want more? If you enjoyed this episode, check out: Implementing Sleep, Airway and Myo to Restorative Dentistry Part 1 — PDP262 Tags #PDPMainEpisodes #Communication #BeyondDentistry Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C. AGD Subject Code: 150 Health, medicine and nutrition. Aim & Learning Outcomes Aim: To give dentists a balanced, evidence-aware understanding of holistic and biological dentistry — what the terms mean, how to integrate whole-health thinking and appropriate testing into practice, and how to navigate patient beliefs about root canals, mercury and metal-free dentistry without abandoning the evidence base. Learning Outcomes — by the end of this episode, dentists will be able to: 1. Differentiate between holistic and biological approaches to dentistry, and articulate where evidence-based, minimally invasive care ends and unsupported claims begin. 2. Apply a structured decision filter to judge whether an additional test or intervention is justified — whether it will change treatment, provide a benchmark, or motivate the patient — while working within scope and referring appropriately. 3. Describe t...

  • August 19 · 48 min

    How Not to Cry Whilst Injection Moulding - Secrets to Reduce Excess and Clean Up - PDP280

    Injection moulding is meant to save you time. Too often it hands you a mouthful of flash and a cleanup that swallows the chair time you thought you were saving. Dr Sandra Hulac is a Clinical Instructor at the Kois Center in Seattle and an Accredited Fellow of the American Academy of Cosmetic Dentistry. She uses full-mouth injection moulding to road-test occlusions and stabilise breaking-down dentitions, and she teaches the technique hands-on. In this episode she works through where the mess actually comes from, and how design, matrix strategy, careful PTFE and a simple cleanup protocol keep a case clean from the first injection. This episode comes with an infographic: the whole no-mess workflow on one visual guide to keep beside you during design and cleanup. Download it at protrusive.co.uk/nomess. It is the fastest way to turn this episode into something you actually use at the chair. What You’ll Take From This Episode Most injection-moulding mess is prevented at the design stage, through thickness targets and clear lab communication, long before any cleanup. The alternating matrix technique, injecting every other tooth, is the biggest single cleanup saver and cuts the PTFE you need. Matrices cured in a pressure pot, with a spacer protocol, give even thickness and far fewer bubbles. Thin, careful PTFE prevents distortion; bunching it interproximally creates the very excess you are trying to avoid. An S-shaped motion with a Ceri-saw and several 12-plate blades clears resin while protecting the contact. Good pre-treatment hygiene, using diluted hypochlorite or povidone-iodine rather than chlorhexidine, cuts bleeding and contamination. Highlights of this episode: 00:00 Teaser 00:54 Introduction 02:17 Dental Pearl: Free Injection Moulding Infographic 03:17 Main Interview with Dr. Sandra Hulac 4:49 Innovations in Dental Education 07:26 The Mess Problem in Injection Moulding 15:38 Alternating Matrix Technique 18:18 Every-Other-Tooth Technique 27:54 Cleanup Instruments and Techniques 31:35 Handling Teflon and PTFE 36:41 Patient Oral Hygiene Tips 37:27 Dilution protocol: 39:24 Key Principles for Minimizing Mess 40:42 Matrix Fabrication and Spacer Protocol 43:55 Course Information and Conclusion 46:19 Outro From the Guest Master Full Mouth Injection Moulding in this exclusive two-day hands-on course! 📅 Dates: Feb. 26-27, 2027 📍 Location: Central London Venue (TBC) 🌐 Learn more & secure your spot: protrusive.co.uk/FMIM Want more? Learn to treat tooth wear with injectable composite in Injectable Composites in PDP081 Tags #PDPMainEpisodes, #BreadandButterDentistry, #AdhesiveDentistry Listen, subscribe, and earn CPD Listen: Spotify, Apple Podcasts, YouTube, and inside Protrusive Guidance. Earn CPD: This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. Compliance: GDC Development Outcome C. AGD Subject Code 250 Operative (Restorative) Dentistry. Aim & Learning Outcomes Aim: To enable dental professionals to minimise cleanup during injection moulding by optimising design, matrix use, PTFE application, and interproximal finishing techniques. By the end of this episode, dentists will be able to: Explain how proper design and lab communication can reduce composite flash and cleanup in injection moulding. Demonstrate the alternating matrix technique and the correct use of PTFE in minimising mess. Identify and use appropriate instruments and techniques for efficient interproximal cleanup after injection moulding.

  • August 12 · 53 min

    Maintain or Extract? First Permanent Molars of Poor Prognosis - PDP279

    Your patient is nine years old. One first permanent molar is crumbling — the others look fine. Does it stay, or does it go? Is that broken-down first permanent molar really down to poor brushing — or is it Molar Incisor Hypomineralisation? When is the right time to take a first permanent molar out — and how do you read it off the X-ray? And how do you tell a parent their child needs an adult tooth removed — without losing them? First permanent molars of poor prognosis are one of the genuine head-scratchers of general practice — full of ifs, buts and timing. In this episode Jaz sits down with Dr Nicole Sturzenbaum, a paediatric dentist and the owner and clinical director of Toothbeary in Richmond, London, to work through the whole decision: getting the diagnosis right (molar-incisor hypomineralisation versus caries), reading the extraction window off an OPG, the restorative ladder from sealant to stainless steel crown, when to bring in the orthodontist, and how to handle the conversation with anxious parents. There’s no one-size-fits-all answer — but there is a clear way to think about it. Protrusive Dental Pearl: Painless Polishing for Anxious Kids The mechanical clean is what frightens children (and plenty of adults) — the scaler, the bristle brush, the gritty prophy paste. For the polishing part, a colourless plaque-dissolving foam gel does the job without any of it. It fizzes wherever there is plaque, so you can hand the child a mirror and show them exactly where to brush; it leaves the teeth satin-smooth, reduces gingival inflammation, and is painless and non-invasive. Two caveats: it does not remove calculus — you still need a hand or ultrasonic scaler for that — and you should agitate the gel gently at the gingival margin for the full effect. It is especially useful for orthodontic and adolescent patients because it reaches the nooks around brackets, which is where post-orthodontic white-spot lesions start. Product: Magic3 (3% hydrogen peroxide, colourless plaque indicator), by Dr Wyman Chan — protrusive.co.uk/magic3. What You’ll Take From This Episode Diagnosis first — MIH or caries? The distinction changes the plan, the prognosis and the whole conversation with the family. Reading the extraction window off an OPG — why chronological age tells you nothing, and what the second molar’s bifurcation tells you instead. The restorative ladder — seal, composite, preformed metal crown, or plan the extraction: matching the least invasive option that will actually hold. When to involve the orthodontist — essential or desirable, which teeth come out, and managing the space afterwards. Getting sensitive molars numb — why MIH teeth are so hard to anaesthetise, and the comfort stack that helps. Highlights of This Episode 00:00 TEASER 00:59 First Permanent Molars of Poor Prognosis in Children 02:51 Painless Chemical Polishing for Kids (Protrusive Dental Pearl) 04:53 Meet Dr Nicole Sturzenbaum, Paediatric Dentist 11:49 MIH or Caries? Getting the Diagnosis Right 15:14 What Is MIH? Causes, Grades and 'Cheese Molars' 17:23 When to Extract a First Molar: Reading the OPG 20:08 Sealant, Composite or Crown for MIH Molars 22:32 Stainless Steel Crowns for Hypomineralised Molars 25:52 Do You Need an Orthodontic Opinion Before Extraction? 29:15 Talking to Parents About Removing an Adult Tooth 31:56 Anaesthesia Tips for Sensitive MIH Molars 36:14 Managing the Space After First Molar Extraction 41:15 Balancing and Compensating Extractions Explained 47:53 Early Orthodontics and Prevention at Toothbeary 51:15 OUTRO From the Guest Dr Nicole Sturzenbaum is a paediatric dentist and the owner and clinical director of Toothbeary, a paediatric dental practice in Richmond, London. 👉 Toothbeary — paediatric dentistry, sedation & early orthodontics, Richmond, London References & Further Reading EAPD guidance (cited on the episode). European Academy of Paediatric Dentistry policy documents on MIH (Lygidakis et al., best clinical practice guidance for clinicians dealing with children presenting with MIH) and on paediatric local analgesia (Kühnisch et al., 2017). Preoperative analgesia for MIH (further reading). Vicioni-Marques, F., Paula-Silva, F. W. G., Carvalho, M. R., Queiroz, A. M., Freitas, O., Duarte, M. P. F., Manton, D. J., & Carvalho, F. K. (2022). Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar: a triple-blind randomized clinical trial. Journal of applied oral science : revista FOB, 30, e20210538. https://doi.org/10.1590/1678-7757-2021-0538 Want more? If you enjoyed this episode, check out: Zirconia vs Metal Hall Crowns vs Conventional with Dr Tim Keys – PDP227 Tags #PDPMainEpisodes #OrthoRestorative Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C. AGD Subject Code: 430 Pediatric Dentistry. Aim & Learning Outcomes Aim: To help general dentists diagnose, assess and manage first permanent molars of poor prognosis in children — recognising molar-incisor hypomineralisation, timing extraction from radiographic development, and choosing between restoration and extraction with the wider team. Learning Outcomes — by the end of this episode, dentists will be able to: Differentiate molar-incisor hypomineralisation from caries of hygiene origin, and explain how that distinction changes management and communication. Apply radiographic developmental assessment — the second molar’s bifurcation and the presence of third molars — to judge the timing of first permanent molar extraction. Select an appropriate management pathway, from sealant and composite through preformed metal crown...

  • August 5 · 1 hr 2 min

    TRAYLESS Whitening Technique Part 2 - Tetracycline Staining and Non Vital Bleaching Scenario! - PDP278

    Patient has patchy white spots after braces — do you really whiten, or will that just make the spots stand out more? Tetracycline staining darker than your darkest shade tab — is bleaching even worth attempting, or is it veneers by default? A single dark, root-filled central incisor — can you fix it without picking up a drill at all? And how do you talk a patient through weeks, shades and cost so they actually consent to the slow, non-invasive route? This is Part 2 of the trayless whitening series with Dr Wyman Chan — inventor of trayless teeth whitening and the Get2Smile system — and Dr Elvis Law, who now runs around 90% of his whitening trayless. Part 1 covered the science and the everyday protocol; this part applies it to the three cases dentists find hardest, with the costing and consent conversations that make them work. Protrusive Dental Pearl: Treating Family and Friends Almost every clinician has a story about a case that went wrong on a family member, a friend, or a loved one. It’s not a random fluke. When we treat someone we love, we put our guard down — we relax the checklist, skip a step, get driven by emotion, and lose our judgement. So if you must treat family and friends, stay razor-sharp and treat them exactly as you would a stranger. Be extra vigilant, extra hot on your protocols, and take the emotion out of it. If that tooth needs a root canal, it needs a root canal — don’t bend the plan to preserve pulp vitality that was never the right call. The best pearl is not to treat loved ones at all; the real-world one is to not lose your judgement when you do. What You’ll Take From This Episode The frosted glass model — a patient-ready way to explain white spots: enamel is clear glass, dentine is a yellow sponge, and acid has turned the glass frosty. A two-stage white spot protocol — remineralise and condition the gums first, then whiten trayless, and why a dirty tray would have sabotaged the result. Whitening tetracycline staining — realistic timelines, why darker teeth lift faster, and how to frame it honestly against veneers. The non-vital tooth without a drill — whiten every tooth to target, then paint the single dark tooth to match, and why leakage (not the bleach) causes rebound. Costing and consent — charging “almost by time,” staged reviews, and matching invasiveness to the mouth in front of you. Highlights of This Episode 00:00 Teaser 01:05 Trayless Whitening Part 2: Recap of Part 1 03:55 Protrusive Dental Pearl: Treating Family and Friends 06:55 Whitening White Spot Lesions After Orthodontics 11:55 Whiten First or Restore First? Cavitated Anterior Caries 18:35 The Frosted Glass Analogy: Explaining White Spots to Patients 21:05 A Two-Stage White Spot Protocol: Remineralise, Then Whiten 32:57 Midroll 36:23 Whitening Tetracycline-Stained Teeth 40:03 Costing and Consent: Bleaching vs Veneers 46:23 Whitening a Non-Vital Yellow Central Incisor 47:43 Why Root-Filled Teeth Rebound After Bleaching 53:13 Trayless Single-Tooth Whitening Without a Drill 1:00:43 How to Access Trayless Whitening and Training 1:03:40 Outro From the Guest Dr Wyman Chan is the inventor of trayless teeth whitening and the Get2Smile system, with a PhD in the efficacy and safety of teeth whitening and a whitening clinic in London’s West End. Dr Elvis Law trained in safe dental bleaching under Dr Wyman Chan and now runs the majority of his whitening trayless. Start Offering Trayless Whitening for Your Office UK Dentists: In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes. Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses. At checkout, use code: DOCSUMMER20 International Dentists wishing to offer Get2Smile, please enquire from Dr Chan's website. The international version uses 10% formulation applied for 15 minutes, twice daily. 📌 Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026. Saturday 5th September London, UK CPD EVENT: 👉Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases. 📍 Royal Asiatic Society, London NW1 2HD The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases. Want more? If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all.. Tags #PDPMainEpisodes 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: 780 Esthetics/Cosmetic Dentistry. Aim & Learning Outcomes Aim: To give dental practitioners a practical, non-invasive approach to three difficult whitening presentations — post-orthodontic white spot lesions, tetracycline staining, and a discoloured non-vital tooth — together with the expectation-setting and consent conversations that make treatment succeed. Learning Outcomes — by the end of this episode, dentists will be able to: Describe how enamel demineralisation produces white spot lesions and explain, in patient-friendly terms, why a repair-then-whiten sequence addresses both the surface and the underlying tooth colour. Apply a staged, non-invasive protocol to manage white spot, tetracycline and non-vital discolouration cases, selecting an appropriate route by matching invasiveness to the individual patient. Articulate realistic expectations on shade, timeline and cost, and use them to obtain informed consent for an extended, reviewable whitening course.

  • August 5 · 1 hr 2 min

    TRAYLESS Whitening Technique Part 2 – Tetracycline Staining and Non Vital Bleaching Scenario! – PDP278

    Patient has patchy white spots after braces — do you really whiten, or will that just make the spots stand out more? Tetracycline staining darker than your darkest shade tab — is bleaching even worth attempting, or is it veneers by default? A single dark, root-filled central incisor — can you fix it without picking up a drill at all? And how do you talk a patient through weeks, shades and cost so they actually consent to the slow, non-invasive route? This is Part 2 of the trayless whitening series with Dr Wyman Chan — inventor of trayless teeth whitening and the Get2Smile system — and Dr Elvis Law, who now runs around 90% of his whitening trayless. Part 1 covered the science and the everyday protocol; this part applies it to the three cases dentists find hardest, with the costing and consent conversations that make them work. https://youtu.be/1PyL-dXRVHo Watch PDP278 on YouTube Protrusive Dental Pearl: Treating Family and Friends Almost every clinician has a story about a case that went wrong on a family member, a friend, or a loved one. It’s not a random fluke. When we treat someone we love, we put our guard down — we relax the checklist, skip a step, get driven by emotion, and lose our judgement. So if you must treat family and friends, stay razor-sharp and treat them exactly as you would a stranger. Be extra vigilant, extra hot on your protocols, and take the emotion out of it. If that tooth needs a root canal, it needs a root canal — don’t bend the plan to preserve pulp vitality that was never the right call. The best pearl is not to treat loved ones at all; the real-world one is to not lose your judgement when you do. What You’ll Take From This Episode The frosted glass model — a patient-ready way to explain white spots: enamel is clear glass, dentine is a yellow sponge, and acid has turned the glass frosty. A two-stage white spot protocol — remineralise and condition the gums first, then whiten trayless, and why a dirty tray would have sabotaged the result. Whitening tetracycline staining — realistic timelines, why darker teeth lift faster, and how to frame it honestly against veneers. The non-vital tooth without a drill — whiten every tooth to target, then paint the single dark tooth to match, and why leakage (not the bleach) causes rebound. Costing and consent — charging “almost by time,” staged reviews, and matching invasiveness to the mouth in front of you. Highlights of This Episode 00:00 Teaser 01:05 Trayless Whitening Part 2: Recap of Part 1 03:55 Protrusive Dental Pearl: Treating Family and Friends 06:55 Whitening White Spot Lesions After Orthodontics 11:55 Whiten First or Restore First? Cavitated Anterior Caries 18:35 The Frosted Glass Analogy: Explaining White Spots to Patients 21:05 A Two-Stage White Spot Protocol: Remineralise, Then Whiten 32:57 Midroll 36:23 Whitening Tetracycline-Stained Teeth 40:03 Costing and Consent: Bleaching vs Veneers 46:23 Whitening a Non-Vital Yellow Central Incisor 47:43 Why Root-Filled Teeth Rebound After Bleaching 53:13 Trayless Single-Tooth Whitening Without a Drill 1:00:43 How to Access Trayless Whitening and Training 1:03:40 Outro From the Guest Dr Wyman Chan is the inventor of trayless teeth whitening and the Get2Smile system, with a PhD in the efficacy and safety of teeth whitening and a whitening clinic in London’s West End. Dr Elvis Law trained in safe dental bleaching under Dr Wyman Chan and now runs the majority of his whitening trayless. Start Offering Trayless Whitening for Your Office UK Dentists: In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes. Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses. At checkout, use code: DOCSUMMER20 The Trayless whitening system is called Get2Smile. International Dentists wishing to offer Get2Smile, please enquire from Dr Chan’s website. The international version uses 10% formulation applied for 15 minutes, twice daily. 📌 Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026. Saturday 5th September London, UK CPD EVENT: 👉Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases. 📍 Royal Asiatic Society, London NW1 2HD The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases. Want more? If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all.. Tags #PDPMainEpisodes 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: 780 Esthetics/Cosmetic Dentistry. Aim & Learning Outcomes Aim: To give dental practitioners a practical, non-invasive approach to three difficult whitening presentations — post-orthodontic white spot lesions, tetracycline staining, and a discoloured non-vital tooth — together with the expectation-setting and consent conversations that make treatment succeed. Learning Outcomes — by the end of this episode, dentists will be able to: Describe how enamel demineralisation produces white spot lesions and explain, in patient-friendly terms, why a repair-then-whiten sequence addresses both the surface and the underlying tooth colour. Apply a staged, non-invasive protocol to manage white spot, tetracycline and non-vital discolouration cases, selecting an appropriate route by matching invasiveness to the individual patient. Articulate realistic expectations on shade, timeline and cost, and use them to obtain informed consent for an extended, reviewable whitening course.

  • #1
    July 30 · 1 hr 6 min

    TRAYLESS Whitening Technique Part 1 - with Dr Wyman Chan - PDP277

    What if the tray is the reason your whitening results are inconsistent? Why would a dentist who owns a whitening lab — and holds four patents on making bleaching trays — tell you to skip the tray? Trayless whitening does not mean strips. It means the patient puts in a retractor and paints the gel directly onto the teeth, twice a day, for half an hour. No impression, no lab bill, no two-week wait, and no soft plastic reservoir quietly absorbing your peroxide. This is Part 1 of a two-part conversation with Dr Wyman Chanand Dr Elvis Law, recorded live in their central London whitening practice. Wyman has done nothing but whitening since 2002, has a PhD on the efficacy and safety of whitening processes, and — despite owning the lab that makes the trays — now does most of his cases without one. Elvis trained under him and reckons around 90% of his own cases are now trayless. Part 1 is the mechanism, the protocol and an honest list of who it doesn’t suit. Part 2 takes it into the hard cases. Protrusive Dental Pearl: Let the Patient Pick the Shade Most of us ask “how white do you want to go?”, get a laugh about Hollywood white or Simon Cowell white, then hold a B1 tab against the canine and call that the destination. Try flipping it. Under corrected light, record where the patient is now. Then hand over the whole shade guide, arranged by value, and let them choose the tab they want to reach. Photograph both. This is the VITA Shade guide arranged by value: B1 → A1 → B2 → D2 → A2 → C1 → C2 → D4 → A3 → D3 → B3 → A3.5 → B4 → C3 → A4 → C4 Two things change. You now know the target precisely instead of inferring it, and you can track progress against a fixed reference. Most patients land on B1 — it’s the last shade before the bleach range, and it reads natural rather than veneered. Some will point at 0M1 and that’s a different conversation, which is exactly the point. Because whatever they choose dictates how many weeks, how much gel and how many reviews the case needs — and therefore what it should cost. A single flat whitening fee assumes every case takes the same work. They don’t. Someone starting at C4 who wants a bleach shade can get there, but it takes more gel, more time, more reviews and probably a protocol change along the way. Price that honestly. Only you can decide what the tiers look like in your practice. But it might be worth sitting down as a team of dentists and therapists and asking: how are we delivering whitening? Two tiers? More? Based on what? What You’ll Take From This Episode Conscious bleaching — why an awake patient with an open mouth is a completely different chemical situation to a sealed tray worn overnight, and what that does to sensitivity. The formulation constraint — peroxide needs acid to stay stable on the shelf, which is why pre-mixed products lean acidic and why two-component gels exist at all. The full trayless protocol — wear schedule, spacing, patient positioning, review intervals and what to troubleshoot first when a case is behind. Who it doesn’t suit — an honest contraindications list, including the one objection patients raise most often and the answer to it. Tray hygiene as a clinical instruction — the reason results vary so much between patients using the identical gel. An A3.5 to B1 case — start to finish in three weeks, with the review points and the maintenance plan. Highlights of This Episode 00:00 TEASER 01:05 Trayless Teeth Whitening Explained 03:40 Protrusive Dental Pearl: Let Patients Pick Their Whitening Shade 06:05 Meet the Guests: A Career Built on Teeth Whitening 10:27 What Is Trayless Whitening? (It's Not Whitening Strips) 13:44 Why Whitening Trays Waste Your Bleaching Gel 15:37 Are Whitening Strips Acidic? Gel Formulation Explained 19:17 Conscious Bleaching and Whitening Sensitivity 24:43 When NOT to Use Trayless Whitening 29:05 The Trayless Whitening Protocol: 30 Minutes Twice a Day 32:55 Midroll 42:45 How to Clean Whitening Trays Properly 50:02 A3.5 to B1 in Three Weeks: A Case Walkthrough 56:16 Tooth Porosity and the 45-Degree Recline Rule 1:02:09 Whitening Top-Ups and the Five-Year Guarantee 1:06:49 How to Price Teeth Whitening and Let Patients Pick the Shade 1:07:45 OUTRO 1:12:56 What's Coming in Part 2 Start Offering Trayless Whitening for Your Office UK Dentists: In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes. Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses. At checkout, use code: DOCSUMMER20 The Trayless whitening system is called Get2Smile. International Dentists wishing to offer Get2Smile, please enquire from Dr Chan's website. The international version uses 10% formulation applied for 15 minutes, twice daily. 📌 Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026. Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases. The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases. Want more? If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all. Tags #PDPMainEpisodes 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: 780 Esthetics/Cosmetic Dentis...

  • July 29 · 1 hr 6 min

    TRAYLESS Whitening Technique Part 1 – with Dr Wyman Chan – PDP277

    What if the tray is the reason your whitening results are inconsistent? Why would a dentist who owns a whitening lab — and holds four patents on making bleaching trays — tell you to skip the tray? Trayless whitening does not mean strips. It means the patient puts in a retractor and paints the gel directly onto the teeth, twice a day, for half an hour. No impression, no lab bill, no two-week wait, and no soft plastic reservoir quietly absorbing your peroxide. This is Part 1 of a two-part conversation with Dr Wyman Chan and Dr Elvis Law, recorded live in their central London whitening practice. Wyman has done nothing but whitening since 2002, has a PhD on the efficacy and safety of whitening processes, and — despite owning the lab that makes the trays — now does most of his cases without one. Elvis trained under him and reckons around 90% of his own cases are now trayless. Part 1 is the mechanism, the protocol and an honest list of who it doesn’t suit. Part 2 takes it into the hard cases. https://youtu.be/aAAoUxTIkxo Watch PDP277 on YouTube Protrusive Dental Pearl: Let the Patient Pick the Shade Most of us ask “how white do you want to go?”, get a laugh about Hollywood white or Simon Cowell white, then hold a B1 tab against the canine and call that the destination. Try flipping it. Under corrected light, record where the patient is now. Then hand over the whole shade guide, arranged by value, and let them choose the tab they want to reach. Photograph both. This is the VITA Shade guide arranged by value: B1 → A1 → B2 → D2 → A2 → C1 → C2 → D4 → A3 → D3 → B3 → A3.5 → B4 → C3 → A4 → C4 Two things change. You now know the target precisely instead of inferring it, and you can track progress against a fixed reference. Most patients land on B1 — it’s the last shade before the bleach range, and it reads natural rather than veneered. Some will point at 0M1 and that’s a different conversation, which is exactly the point. Because whatever they choose dictates how many weeks, how much gel and how many reviews the case needs — and therefore what it should cost. A single flat whitening fee assumes every case takes the same work. They don’t. Someone starting at C4 who wants a bleach shade can get there, but it takes more gel, more time, more reviews and probably a protocol change along the way. Price that honestly. Only you can decide what the tiers look like in your practice. But it might be worth sitting down as a team of dentists and therapists and asking: how are we delivering whitening? Two tiers? More? Based on what? What You’ll Take From This Episode Conscious bleaching — why an awake patient with an open mouth is a completely different chemical situation to a sealed tray worn overnight, and what that does to sensitivity. The formulation constraint — peroxide needs acid to stay stable on the shelf, which is why pre-mixed products lean acidic and why two-component gels exist at all. The full trayless protocol — wear schedule, spacing, patient positioning, review intervals and what to troubleshoot first when a case is behind. Who it doesn’t suit — an honest contraindications list, including the one objection patients raise most often and the answer to it. Tray hygiene as a clinical instruction — the reason results vary so much between patients using the identical gel. An A3.5 to B1 case — start to finish in three weeks, with the review points and the maintenance plan. Highlights of This Episode 00:00 TEASER 01:05 Trayless Teeth Whitening Explained 03:40 Protrusive Dental Pearl: Let Patients Pick Their Whitening Shade 06:05 Meet the Guests: A Career Built on Teeth Whitening 10:27 What Is Trayless Whitening? (It’s Not Whitening Strips) 13:44 Why Whitening Trays Waste Your Bleaching Gel 15:37 Are Whitening Strips Acidic? Gel Formulation Explained 19:17 Conscious Bleaching and Whitening Sensitivity 24:43 When NOT to Use Trayless Whitening 29:05 The Trayless Whitening Protocol: 30 Minutes Twice a Day 32:55 Midroll 42:45 How to Clean Whitening Trays Properly 50:02 A3.5 to B1 in Three Weeks: A Case Walkthrough 56:16 Tooth Porosity and the 45-Degree Recline Rule 1:02:09 Whitening Top-Ups and the Five-Year Guarantee 1:06:49 How to Price Teeth Whitening and Let Patients Pick the Shade 1:07:45 OUTRO 1:12:56 What’s Coming in Part 2 Start Offering Trayless Whitening for Your Office UK Dentists: In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes. Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses. At checkout, use code: DOCSUMMER20 The Trayless whitening system is called Get2Smile. International Dentists wishing to offer Get2Smile, please enquire from Dr Chan’s website. The international version uses 10% formulation applied for 15 minutes, twice daily. 📌 Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026. Saturday 5th September London, UK CPD EVENT: Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases. 📍 Royal Asiatic Society, London NW1 2HD The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases. Want more? If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all. Tags #PDPMainEpisodes 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: 780 Esthetics/Cosmetic Dentistry. Aim & Learning Outcomes Aim: To give dental practitioners a mechanism-led understanding of external tooth whitening delivered without a tray — how gel containment and contact time influence sensitivity and efficiency, how formulation constrains the delivery method, and how to select, sequence and price a whitening case around the patient’s chosen target shade. Learning Outcomes — by the end of this episode, dentists will be able to: Describe how containment and contact time influence bleaching sensitivity, gingival irritation and the proportion of active gel that reaches the tooth. Apply a structured protocol for tray-free external whitening, including wear scheduling, patient positioning, review intervals and technique troubleshooting. Differentiate between patients suited to tray-based and tray-free delivery, and justify a fee structure derived from the patient’s target shade rather than a flat rate.

  • #1
    July 22 · 46 min

    What Dental School Didn’t Prepare You For – PDP276

    Just qualified — so why does it feel like the learning is only just beginning? What should you actually focus on in year one: the flawless dentistry on your feed, or something far less glamorous? How do you tell a patient their nerve might die — without it sounding like YOUR fault? And when a patient says “just do whatever you think” — what do you say back? This is the conversation every new dentist needs and every experienced one recognises. Our guest is Dr Emma Hutchison — a former dental nurse who trained at the University of Glasgow, and has been the face of the Protrusive Students series across her studies. We recorded in her final weeks of dental school, right on the threshold of practice, and talked through everything the syllabus skips: the safe-beginner mindset, what to learn (and what to ignore) early on, how to protect your standards under time pressure, which cases to take on, and how to talk to patients about risk, cost and consent so the words actually land. If you’re fresh out, this one hits hard. If you’re an oldie, it’s a trip down memory lane — and a reminder of how far you’ve come. https://youtu.be/gjJiDVP4w-4 Watch PDP276 on YouTube Protrusive Dental Pearl: Predict the Complication Before It Happens A communication pearl for every deep restoration. When a filling sits close to the nerve — a big cavity, a crack — name the likely complication before it happens. Show the patient the images, then tell them what to expect: a twinge to cold or hot that can linger a few days, so keep taking painkillers and keep the area clean. And warn them what a red flag looks like: a severe throbbing ache keeping them up at night, or pain out of the blue without eating or drinking, means the nerve is struggling and they should call you. Do this and, if the complication ever arrives, you look like the expert who called it — not someone something went wrong for. Skip it and reception fields the panicked calls instead. It reassures the patient, lowers your callback rate, and quietly reduces your risk profile. Obvious, easy to forget, and worth saying out loud every single time. What You’ll Take From This Episode The safe-beginner mindset — why qualifying is the driving licence, not the destination, and how the happiest dentists keep getting 1% better. Just-in-time learning — study for the cases actually in your diary, not the obscure pathology you won’t meet for years. Get good before you get fast — master the bread and butter, protect a little extra time early, and reflect on every procedure. Clever hacks vs cutting corners — how to tell the difference, and why every shortcut quietly rewires the habit. Consent that works — getting patients to own the problem, and giving a clear recommendation instead of a fifteen-item menu. Highlights of This Episode 00:00 Teaser 01:05 The Things Dental School Doesn’t Prepare You For 03:05 Communication Pearl: Predict the Complication Before It Happens 05:35 Life as a Final-Year Dental Student on Outreach 09:55 Why You’re Only a “Safe Beginner” When You Qualify 13:45 Master Bread-and-Butter Dentistry Before the Fancy Stuff 16:05 Just-in-Time Learning: Study for the Cases in Front of You 18:05 Get Good Before You Get Fast (and Protect Your Time) 19:45 Clever Hacks vs Cutting Corners: Don’t Lose Your Standards 24:14 Midroll 27:46 The Skills to Nail in Your First Year as a Dentist 30:11 Which Cases to Take On — and Learning From Mistakes 35:46 How to Explain Risk and Get Patients to Own the Problem 41:26 When Patients Refuse the Ideal Treatment: Start With Their Goal 44:26 Treatment Planning Without the Overwhelm: Loom & “Guess Who” 47:36 Claim Your CPD & Become the Next Protrusive Student 47:38 Outro Dr Emma Hutchison came to dentistry the long way round — from a dental nursing background into dental school at the University of Glasgow, with final-year outreach on the Kintyre peninsula in Campbeltown. She has been the face of the Protrusive Students series throughout her studies, and this episode marks her crossing from student to newly qualified dentist. On behalf of the whole Protruserati: we’re proud of you, Emma. Become the next Protrusive Student: with Emma qualifying, we’re looking for the next keen student who wants part-time work, an income while studying, and to contribute to Protrusive — or a nudge if you know one. DM the team inside the Protrusive Guidance app. Resources & Mentions From This Episode Quick & slick rubber dam — the in-app video series on quadrant isolation, for building the rubber dam habit from day one. 21-Day Photography Challenge — the in-app challenge that walks you through capturing every clinical photo, including the dreaded occlusal shots, in your first three weeks. Loom School — in-app training on async, Loom-video treatment planning (roughly 90 minutes of CPD across around 15 bite-sized lessons). Access the above masterclasses and more when you subscribe to the Ultimate or Infinity plan. Want more? If you enjoyed this episode, check out: Periodontics for Beginners – PS008 #PDPMainEpisodes #CareerDevelopment #Communication Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A and D. AGD Subject Code: 770 Self-Improvement Aim & Learning Outcomes Aim: To give early-career dentists a practical framework for the transition from dental school to independent practice — how to keep developing, how to protect clinical standards under time pressure, and how to communicate risk and treatment options as part of valid consent. Learning Outcomes — by the end of this episode, dentists will be able to: Apply a “just-in-time” approach to continuing development, prioritising the competencies relevant to the cases in front of them over isolated advanced techniques. Differentiate time-saving efficiencies from quality-compromising shortcuts, and describe strategies to maintain clinical standards early in practice. Apply structured communication techniques to explain procedural risk, establish a patient’s treatment goal, and make a clear, defensible recommendation as part of va...

  • #1
    July 15 · 1 hr 2 min

    Why is Dr Tif Qureshi doing Blood Tests for his Patients? Should YOU? – PDP275

    Your patient brushes well, avoids sweets — and still keeps getting decay. What if the answer isn’t in their mouth at all? What if two inexpensive finger-prick tests told you more about a patient’s gum disease and implant prognosis than anything on the radiograph? And here’s the uncomfortable one: if the science is this clear, is not checking starting to look like a medico-legal risk? Especially for imlpant surgery! This is a conversation with Dr Tif Qureshi— the dentist who changed how the profession thinks about the lifelong patient, the envelope of function, and Align, Bleach, Bond. He’s gone down a new rabbit hole: metabolic health. In general practice he’s now doing blood tests — HbA1c and vitamin D — and making the case that the mouth isn’t connected to the body, it is the body. This isn’t about becoming a “biological dentist” (as you’ll hear, Tif is refreshingly blunt about the wilder end of that world). It’s about respecting the biology, screening sensibly, and helping patients where we’re genuinely placed to help. https://youtu.be/mt1MXLFCTp0 Watch PDP275 on YouTube Protrusive Dental Pearl: Test Yourself First Before you even think about introducing blood tests for your patients, ask whether you’re checking your own biomarkers at a sensible interval. The deepest way to understand this topic is to learn it on yourself and your family first — run your own HbA1c, vitamin D, iron, and liver and kidney markers, and see what the data tells you. Start quarterly, like hygienist visits, then stretch to six-monthly or annual once things look good. Getting invested in your own numbers is what makes better food and lifestyle choices actually stick — and it’s the honest starting point for ever offering this to a patient. What You’ll Take From This Episode The metabolic lens — why one disordered glucose-and-insulin system sits under so much chronic and dental disease, and why dentistry is well placed to act on it. Sugar, redefined — why patients who avoid sweets still get decay, and how frequency of starchy carbs drives the problem. The two biomarkers that matter most — what HbA1c and vitamin D each tell you about caries, perio and healing. How to run it in practice — finger-prick logistics, what to test, and how to raise it on the medical history form. The medico-legal case — why documenting these markers can protect you before implant, graft and perio work. Highlights of This Episode 00:00 Why Dentists Should Care About Blood Tests 06:00 Metabolic Disease: The Root Cause Dentists Miss 13:00 Why Starchy Carbs Cause Decay, Not Just Sugar 15:50 HbA1c and Caries: What the SHIP Study Shows 21:00 Insulin Resistance: The Hidden Driver of Gum Disease 26:00 How to Talk to Patients About Diet Without Scaring Them 31:00 Why Vitamin D Deserves a Place in Dentistry 34:00 Vitamin D, Implant Failure and Perio Risk 37:00 Blood Tests as Medico-Legal Defence 42:00 What Dentists Should Test: HbA1c and Vitamin D 44:00 How In-Practice Blood Testing Actually Works 50:00 The Mouth Is the Body: Screening, Not Diagnosing 51:00 Is This Biological Dentistry? An Honest Answer 57:00 How to Learn Blood Testing for Your Practice From the Guest Dr Tif Qureshi qualified from King’s College London in 1992 and is a Past President of the British Academy of Cosmetic Dentistry. He is Founder and Clinical Director of IAS Academy, best known for pioneering Align, Bleach, Bond and Progressive Smile Design, and as a teacher of the Dahl concept. His current focus is metabolic health in general practice. 👉 IAS Academy — Align, Bleach, Bond, the Dahl concept, and blood-testing / metabolic health training Coming soon: Join Dr. Tif in one-day metabolic health programme. He has spent years connecting the dots between what’s happening in the mouth and what’s happening in the body. The results are undeniable: better outcomes, stronger case acceptance, and a rock-solid medico-legal position. This one-day course will change the way you practise. For good.👉Metabolic Health in Dentistry References & Further Reading Studies and sources referenced in this episode: Song I-S, et al. Severe Periodontitis Is Associated with Insulin Resistance in Non-abdominal Obese Adults. J Clin Endocrinol Metab, 2016;101(11):4251–4259. Insulin resistance as an independent risk factor for severe perio in normal-weight adults. Botelho J, et al. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients, 2020;12(5):1471. Vitamin D across caries, periodontitis, orthodontic and surgical outcomes. Schmolinsky J, Kocher T, Rathmann W, Völzke H, Pink C, Holtfreter B. Diabetes status affects long-term changes in coronal caries – The SHIP Study. Sci Rep. 2019 Oct 30;9(1):15685. doi: 10.1038/s41598-019-51086-z. PMID: 31666549; PMCID: PMC6821733. Want more? If you enjoyed this episode, check out: Why do some Dentists find Dahl Distasteful? – PDP016. #PDPMainEpisodes #BeyondDentistry #Communication Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C and A. AGD Subject Code: 730 Oral Medicine, Oral Diagnosis, Oral Pathology Aim & Learning Outcomes Aim: To help dental practitioners understand the link between metabolic health and oral disease, and to evaluate whether simple in-practice biomarker screening has a place in their care of patients. Learning Outcomes — by the end of this episode, dentists will be able to: Describe how disordered glucose and insulin metabolism relates to caries, periodontal disease and healing outcomes, and explain what HbA1c and vitamin D each indicate. Apply a structured, non-alarmist approach to discussing diet and biomarker screening with patients, within the professional boundary of screening rather than diagnosing or prescribing. Evaluate the clinical and medico-legal case for documenting relevant biomarkers before periodontal and surgical treatment, and identify when to refer to a medical colleague.

  • July 15 · 1 hr 2 min

    Why is Dr Tif Qureshi doing Blood Tests for his Patients? Should YOU? – PDP275

    Your patient brushes well, avoids sweets — and still keeps getting decay. What if the answer isn’t in their mouth at all? What if two inexpensive finger-prick tests told you more about a patient’s gum disease and implant prognosis than anything on the radiograph? And here’s the uncomfortable one: if the science is this clear, is not checking starting to look like a medico-legal risk? Especially for imlpant surgery! This is a conversation with Dr Tif Qureshi — the dentist who changed how the profession thinks about the lifelong patient, the envelope of function, and Align, Bleach, Bond. He’s gone down a new rabbit hole: metabolic health. In general practice he’s now doing blood tests — HbA1c and vitamin D — and making the case that the mouth isn’t connected to the body, it is the body. This isn’t about becoming a “biological dentist” (as you’ll hear, Tif is refreshingly blunt about the wilder end of that world). It’s about respecting the biology, screening sensibly, and helping patients where we’re genuinely placed to help. https://youtu.be/mt1MXLFCTp0 Watch PDP275 on YouTube Protrusive Dental Pearl: Test Yourself First Before you even think about introducing blood tests for your patients, ask whether you’re checking your own biomarkers at a sensible interval. The deepest way to understand this topic is to learn it on yourself and your family first — run your own HbA1c, vitamin D, iron, and liver and kidney markers, and see what the data tells you. Start quarterly, like hygienist visits, then stretch to six-monthly or annual once things look good. Getting invested in your own numbers is what makes better food and lifestyle choices actually stick — and it’s the honest starting point for ever offering this to a patient. What You’ll Take From This Episode The metabolic lens — why one disordered glucose-and-insulin system sits under so much chronic and dental disease, and why dentistry is well placed to act on it. Sugar, redefined — why patients who avoid sweets still get decay, and how frequency of starchy carbs drives the problem. The two biomarkers that matter most — what HbA1c and vitamin D each tell you about caries, perio and healing. How to run it in practice — finger-prick logistics, what to test, and how to raise it on the medical history form. The medico-legal case — why documenting these markers can protect you before implant, graft and perio work. Highlights of This Episode 00:00 Why Dentists Should Care About Blood Tests 06:00 Metabolic Disease: The Root Cause Dentists Miss 13:00 Why Starchy Carbs Cause Decay, Not Just Sugar 15:50 HbA1c and Caries: What the SHIP Study Shows 21:00 Insulin Resistance: The Hidden Driver of Gum Disease 26:00 How to Talk to Patients About Diet Without Scaring Them 31:00 Why Vitamin D Deserves a Place in Dentistry 34:00 Vitamin D, Implant Failure and Perio Risk 37:00 Blood Tests as Medico-Legal Defence 42:00 What Dentists Should Test: HbA1c and Vitamin D 44:00 How In-Practice Blood Testing Actually Works 50:00 The Mouth Is the Body: Screening, Not Diagnosing 51:00 Is This Biological Dentistry? An Honest Answer 57:00 How to Learn Blood Testing for Your Practice From the Guest Dr Tif Qureshi qualified from King’s College London in 1992 and is a Past President of the British Academy of Cosmetic Dentistry. He is Founder and Clinical Director of IAS Academy, best known for pioneering Align, Bleach, Bond and Progressive Smile Design, and as a teacher of the Dahl concept. His current focus is metabolic health in general practice. 👉 IAS Academy — Align, Bleach, Bond, the Dahl concept, and blood-testing / metabolic health training Coming soon: Join Dr. Tif in one-day metabolic health programme. He has spent years connecting the dots between what’s happening in the mouth and what’s happening in the body. The results are undeniable: better outcomes, stronger case acceptance, and a rock-solid medico-legal position. This one-day course will change the way you practise. For good.👉Metabolic Health in Dentistry References & Further Reading Studies and sources referenced in this episode: Song I-S, et al. Severe Periodontitis Is Associated with Insulin Resistance in Non-abdominal Obese Adults. J Clin Endocrinol Metab, 2016;101(11):4251–4259. Insulin resistance as an independent risk factor for severe perio in normal-weight adults. Botelho J, et al. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients, 2020;12(5):1471. Vitamin D across caries, periodontitis, orthodontic and surgical outcomes. Schmolinsky J, Kocher T, Rathmann W, Völzke H, Pink C, Holtfreter B. Diabetes status affects long-term changes in coronal caries – The SHIP Study. Sci Rep. 2019 Oct 30;9(1):15685. doi: 10.1038/s41598-019-51086-z. PMID: 31666549; PMCID: PMC6821733. Want more? If you enjoyed this episode, check out: Why do some Dentists find Dahl Distasteful? – PDP016. #PDPMainEpisodes #BeyondDentistry #Communication Listen, Subscribe, Earn CPD Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube. This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C and A. AGD Subject Code: 730 Oral Medicine, Oral Diagnosis, Oral Pathology Aim & Learning Outcomes Aim: To help dental practitioners understand the link between metabolic health and oral disease, and to evaluate whether simple in-practice biomarker screening has a place in their care of patients. Learning Outcomes — by the end of this episode, dentists will be able to: Describe how disordered glucose and insulin metabolism relates to caries, periodontal disease and healing outcomes, and explain what HbA1c and vitamin D each indicate. Apply a structured, non-alarmist approach to discussing diet and biomarker screening with patients, within the professional boundary of screening rather than diagnosing or prescribing. Evaluate the clinical and medico-legal case for documenting relevant biomarkers before periodontal and surgical treatment, and identify when to refer to a medical colleague.

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