Group Function – Protrusive Dental Podcast: Recent Episodes
Jaz Gulati
Implants can fail – we all know that…but what are the medico-legal implications when they fail at 6 months after restoring them…
Is it all the restoring Dentists’ problem? ‘He who touched it last’? Or does the implant placing surgeon also need to be involved in the ‘post-mortem’?
How can we handle the upset patient (and prevent this in the first place!)
https://youtu.be/1CSE9J1w-PwWatch GF022 on YoutubeIn the latest podcast episode, we introduced Dr. Joe Bhat and Neel Jeiswal, both prominent figures in Dentistry. Neel, representing PDI, has a rich background in clinical dentistry and medico-legal matters, while Dr Joe Bhat is a dual specialist in Oral Surgery and Prosthodontics. Joe established a pioneering multi-disciplinary clinic 20 years ago, which continues to thrive with numerous referrals.
Both guests provided deep insights into implant failures, patient management, and the importance of effective communication and collaboration in dental practices.
Check out Dr Joe Bhat’s place of practice – Moor Park Specialists
Due a renewal for your indemnity/insurance? Get a quote and special discount from PDI
If you liked this episode, you will also like 4 Ways to Boost Osseointegration of Your Implants – PDP155 – Protrusive Dental Podcast
Let’s face it – CQC inspections can be scary stuff for principals and managers (and even associates!)
As per your request, I brought on a CQC Specialist Advisor, Dr Chita Davda to share her top tips to passing with flying colours.
https://youtu.be/iLkclWANzskWatch GF021 on YoutubeWe discussed the common things that CQC checks on a practice, common questions they ask, and some tips on how to pass the examination. The emphasis is on understanding that the CQC and dental professionals share the same core ethics. Inspections aren’t about catching each other out but ensuring the best possible care for patients.
Need to Read it? Check out the Full Episode Transcript below!
If you want to learn more about Dr Chita, you can check out her website https://www.trainwithchita.co.uk
In the upcoming CPD event at The Shard, attendees will get a rare opportunity to hear from a lead inspector from the CQC. This provides a chance to debunk myths and understand common errors, offering clarity to dental professionals.
If you want to be a part of this event, head over to https://protrusive.co.uk/shard
If you enjoyed this episode, you will also like Indemnity vs Insurance 2023 – Which one is best for you? – GF019
Did you know? You can get CPD from the Web App or Phone App and watch premium clinical videos, for less than a tax deductible Nando’s per month?
Click below for full episode transcript:*Episode Teaser: Do you go through the notes? Is there a sort of a protocol you follow to go through every associate, every dentist's notes? How does that work?[Ruchita]*
Yeah, so we try and keep it as fair as possible. And obviously we’ll ask permission of the dentist just to make sure they’re okay for us to go through it.
[Jaz]
And if they say no, is that a cheat code?
[Ruchita]
If they say no, then we feel like you want something to hide. Try not to say no. I’ve had it queried a couple of times, but also we have like a warrant when we go into a practice. So in theory, we are able to access what we need to. But I’d also, as a fellow dentist, I like to just keep that respect for everyone.
So even if I have to look at the drawers inside a dent, like a surgery, I’ll always just be like, do you mind if I have a look? If there’s anything you don’t want me to see, maybe just get rid of it for a few minutes and then put it back in if that’s okay.
Jaz’s IntroductionHello, Protruserati. I’m Jaz Gulati and welcome to a group function. We haven’t done one of these episodes in a long while. A GF episode is basically when we take a question from the Protruserati. And you know what? I’ve always kind of shied away from compliance, right? Compliance type things don’t excite me so much, but it’s important to cover because that’s what allows us to practice our dentistry safely.
And that’s exactly what today is about. So there’s something in the UK called the Care Quality Commission or the CQC, and every dental practice needs to have some sort of inspection at some point from the CQC to make sure that everything is safe and well for that practice to deliver patient care.
So I brought on today Dr. Ruchita Davda to talk us about what are the common pitfalls we make when it comes to these CQC inspections and how to make sure we pass with flying colors. There are no premium notes for this episode, but at the end you can get CPD for this by answering a few questions on the app. Otherwise, those of you listening, please enjoy those of you watching.
It’s not a super visual episode, but there’s so many important nuggets. If you are a UK practitioner and you have a practice, or you’re thinking about buying a practice one day, it gives you great insights into what the CQC actually does and how to make sure you are prepared for that eventuality. Please enjoy the episode and I’ll catch you in the outro.
Main Episode:Chita Davida, welcome to the Protrusive Dental Podcast. How are you?
[Ruchita]
I am good. Thank you. And how are you, Jaz?
[Jaz]
You know what? I’ve had the sniffles. I’ve been trying to shake it off for the longest time. And I emailed everyone about it, the list and stuff. It’s something in the air. Something’s going around.
[Ruchita]
Yeah. A good little tip, which I don’t know if it’s fine to share. But if you keep drinking lots of water, then make sure you’re having vitamin D for like your immune system. So you don’t slack on that, basically.
[Jaz]
I’m definitely taking my vitamin D. And also after, there’s an episode I did with Prav Solanki a while ago. And he got me into making sure that I do the three of a blood testing every three months, which I think you’re quite into as well. These kind of like it checking your body. Cause obviously when I get you into yourself, you’re so much more than a dentist. Like your whole facets about health and stuff. So let’s start with that Chita. Tell us about you, yourself.
[Ruchita]
Cool. So I’m a general dentist qualified around 12 years ago. And then three years ago, it’s actually just before COVID I wanted to kind of get into health and I kind of had a bit of a transformation where I lost a little bit of weight, but I found.
That my journey was probably longer than it could have been by working with like different personal trainers, online coaches, and I was like surely it must be easier than this, like surely I don’t just have to eat broccoli every day to lose weight and work out loads in the gym. So I did like a personal training course, I’ve worked with various mentors, and I’m also like an online coach.
So I basically mainly help women lose weight, feel like the best version of themselves, so super confident, but whilst focusing on health. So we look at like blood test analysis, and woman analysis, it just works really well. And I actually work with a lot of dentists, so it’s quite nice because I know how stressful our lifestyle can be, how sedentary it can be as well.
But I’ve always got little tips and tricks up my sleeve to help. And then also three years ago, I started working with CQC as a specialist dental advisor, which I’m really excited to kind of talk about on the podcast today.
[Jaz]
So what is that? I mean, that’s we’ll invite you back when they talk about health and stuff. I’m always into that, so that’s exciting already. But something that I want to reserve the audience is for those my listeners and watchers outside the UK, I’m so sorry. kind of skip the next episode before episode, maybe jump back 100 few episodes ago. This is more for the UK group, basically, because CQC is a UK thing.
So our mission statement, Chita, by the end of this episode is kind of like a CQC for dummies. It’s kind of like, explain CQC to me, like, I’m 12 years old, like I’m having my first inspection, like, that’s kind of like the angle we want to go, right? So what capacity do you work with in CQC? Like, what is your role?
And how and to what capacity can you help us? Like, can you spill all the beans? What are you allowed and not allowed to do?
[Ruchita]
I can spill a lot of beans, but like within reason. So I don’t know if you remember, maybe I’m showing my age, but a really, really long time ago. So when CQC first started, they used to basically have like general people coming out to inspect dental practices.
So they may have been like policemen, teachers, and they didn’t really understand what a dental practice was. So they may be like, show me a rubber dam kit for an extraction. You’d be like, well, you don’t use one for that. And that’s when they realized, actually, we need to have dentists or like therapists, hygienists, dental nurses on board.
So what happens in a CQC inspection is you have your lead inspector. So they’re like the main person. They write the report. And then they get to invite like a dentist or a therapist or a hygienist or a dental nurse, which is someone like me. And then we kind of make it realistic. So, working in practice, we know that everything cannot be perfect, but the purpose of a CQC inspection is just to make sure that patients are being looked after and that everyone is safe and we’re just following the correct guidelines.
So as a dentist, I’m going to be honest, before I worked with CQC, there were some things that I probably thought, why are they asking this? Or it’s a bit stupid, or it’s a little bit, like, why do they need to know? And then actually, since having my role with them, I’ve learned that the way I do dentistry isn’t how, like, everyone else would do dentistry.
So that, unfortunately, there are some people who don’t follow guidelines, who won’t follow DECON and things like that. And then that’s why CQC have had to kind of had a big role. So it’s just making sure, like, everyone just following the right things. We’re never there to catch anyone out. We’re actually there to help dentists as well and it’s more just patient safety. So and sometimes we can get whistleblowers and it’s actually just knowing that could be a disgruntled staff member. It may not actually be that the practice is unsafe or dirty. But we’re just kind of doing the checks before someone takes it further to like the media or something like that and we can say actually we’ve checked it. We’re happy with it. So yeah hopefully that means.
[Jaz]
The way I see CQC, like any regulator for any profession, forget dentistry, right? You will always like, have that bitterness towards your regulator. You’ll always be like, oh no, it’s them again. Like I just want to continue on my life. But the way I see it, the way I see CQC, and please correct me if my analogy is wrong here, is when you go to a restaurant or any takeaway, they’ve got that food safety like one to five, right?
And like, you will still eat out of four. People, okay, I’ll see it at a four, three I might snub at, okay, even me, okay, three I might snub at, but like they’re there for a reason to make sure that things are safe for the consumer. Is that a good analogy, good comparison to what the CQC you think does?
[Ruchita]
Not far off. I guess we can’t rate it with CQC. So it’s either you’ve been fine in an inspection or you may have to do a little bit of work or you’ve not been fine. So for us, it’s really hard to actually rate a practice because CQC can only actually inspect around 10 percent of practices a year. So say, for example, if you were a patient and you’re comparing to a practice that has never been inspected, it’s not fair because you’re not kind of comparing like to like.
So if someone was graded like a 5 out of 5 and someone else didn’t have a grade, it’s just because they’ve not had an inspection. And because we can only inspect so many in a year, that’s why we don’t grade it on that system. So it’s more just, if you’ve had one, you’ve had one, you get a report written about how the practice is.
If you haven’t had one, you’re probably going to get one. So just keep up with everything because-
[Jaz]
And listen to this all the way through because there’ll be some gems in here, right? So let’s cover it. So how often is a practice supposed to be CQC inspected? And also answer that in the realms of let’s pretend I’ve literally started a squat practice yesterday, right?
So when can I expect my first one? Or if you’re an established practice, what’s the cycle?
[Ruchita]
So with, if you’re like a squat practice, in order to have like been able to be allowed to open up, you would have had to register with CQC, so they would have done like a primary analysis, like a phone call with you just to make sure that you’re fit to run a practice, let’s just say.
But there is a big backlog because a lot of squat practices are opening up at the moment and obviously we know that can be aligned with like how the NHS is going. And then if you’re just like a normal general practice, been open for years. It’s actually, they have a list so they just try and get through every practice as much as possible.
It’s kind of a bit like luck of the draw a little bit. So if someone’s like had concerns and patients are whistleblowing, they’re going to be like being inspected. But you’ll be told on the day of the inspection that that’s why you’re having your inspection. CQC are actually really open. We never hide anything from anyone because we were actually on the dentist side because we want you guys to do well because then patients are happy.
And then everyone loves dentists and then we’re media free, if that makes sense. So it can feel like luck of the draw. Some people may say, well, I had one five years ago. I had one seven years ago. Someone may say I’ve not had one. And it doesn’t mean if someone’s had one two in ten years that they’re riskier.
It’s just to do with algorithms a little bit. In fact, so it’s really hard to-
[Jaz]
So there’s no minimum requirement that every three years, every six years you should have one. There’s no minimum requirement, right?
[Ruchita]
No, no, but they are trying to change things. So what they’re hoping to do is maybe annually, you may have to release a bit of an annual statement. So a bit like how we have to like infection control and stuff like that. But that’s all the things that they are going to be announcing. And they’ll always tell dentists like, you always get those emails from CQC. So you’ll always kind of be aware if they’re changing things and it may not be necessarily an inspection where we come out. But you may just have a phone call or like a team’s meeting or you may just get asked to submit data a bit Like how GDC asked for R. C. P. D. and stuff like that. So, that’s the realm.
[Jaz]
Once a practice get informed that they’re having an inspection, it’s like a stressful time. It’s like you’re preparing for an exam, right? It’s like everything that you do, your livelihood, your work is going to be examined and you know that there’s a benefit of the examination. You know it should happen, but it’s still, still stressful. So how much notice is typically given to a practice?
[Ruchita]So typically, on average, you do get around a two week notice period. But what’s really great, actually, with CQC is they’ll also have a call with, like, the registered manager of the practice. So they’ll actually go through what kind of things we’re going to be looking at on the day, because we never want anyone to be surprised.
But what we actually tend to find is the list can sometimes feel a bit overwhelming if someone’s not kept up with everything. So it’s all things that we know we should be doing, in all honesty. But sometimes, seeing patients, running a practice, managing patients, it can feel a bit too much, so I guess it’s just our reminder just to say, if we keep up with this, it kind of makes life a little bit easier.
So once you’ve had an inspection with us, it’s kind of having an action plan and just saying to the team, look, every few months, let’s just keep up with everything. And the way we kind of say leave an inspection is if we were to turn up unannounced, just have your practice ready to that level because you never know, it could happen and have things.
[Jaz]
You’re suggesting that an unannounced visit could happen?
[Ruchita]
Yeah, if something’s been quite massive, so if there’s been like a massive patient issue and they’ve informed CQC and we kind of deem it to be very, very unsafe that that practice may not be, shouldn’t really be seeing patients, we can sometimes turn up on the day. And it’s just literally for patient safety reasons.
[Jaz]
So it is a bit like an exam then, because if you’ve been doing your revision every day, bringing your homework every day, you got your highlighters, everything, all that, and then you’re going to be fine. Right? Cause that last minute revision is not going to really help. Whereas if you’re like me, if you’re a crammer, then yeah, you’re going to have a stressful few weeks.
It’s one of the reasons that I don’t own a practice and having said that actually as an associate, right? We still have a responsibility to our practice to make sure they’re looked after. We want them to pass with flying colors, obviously, right? What if some people nowadays, I’ve spoken to you about this before is they are renting a surgery within a practice.
Does that individual who’s renting, him or her, do they need to he or she, do they need to register as a separate entity with the CQC or are they sort of working in the license or the CQC of that practice?
[Ruchita]
So that one, I’ll be honest, I may not give the best answer to, so it could be worth maybe speaking to a lead inspector about that. Because it’s all kind of to do with what registration the practice provider has. So it can really vary from practice to practice on that side. But I guess as a clinician and when we’re like really passionate about what we do, we’ll follow all the right things, I’d like to hope anyway. So we’re going to make sure that the drawers are clean or our record keeping is going well.
And as a dental specialist advisor, I actually just look at the clinical side of things. And then it’s the lead inspector who looks at everything else around it. So I’m the person who would speak to the dentist, speak to the hygienist, actually have a look at records, make sure we’re following FGDP guidelines.
Seeing if audits are happening, are they relevant or are we just like, ticking we’re doing it and it’s the same audit that we see like four or five years in a row and we’re not doing any action plans from it. Is decon being carried out? So again, it’s one thing to say it’s being done well, but then it’s another thing if we see instruments and they’ve got GIC and stuff all over them and they’re in the cupboards.
So I’d like to hope it’s a bit like just having a fresh pair of eyes, because when we work in our own clinic every single day, there’ll be things that we may not think about, there could be a TV hanging off the wall and you just think that’s normal nowadays. And then someone fresh comes in and is like, oh, that could be like a bit of a trip hazard for someone or so it’s more I know, like dentists do get really, really worked up.
But I think one thing I like to hope is when I go to an inspection, I’ll always try and just reassure everyone. And just to say, even if something’s not right, we’re not gonna publicize it. We’re not gonna like say bad things, we’re actually just going to help you have an action plan, give you like a time frame to sort it by.
Any feedback, we’re always welcome for it. And then we just want you guys to be compliant. That’s all we want. No one wants anyone to fail or to breach or anything like that.
[Jaz]
So we’ve also just described all the things that you guys check for. So next question is. What are the common pitfalls? What kind of things? So what we can learn from is obviously, mistakes is a harsh word, but things that we can improve on. So having done so many inspections and whatnot, what are the top tips that you can pass on to the Protruserati hack here? Okay, actually a lot of practices are weak here. Focus on this to make sure that you don’t fall into the same trap these other practices have done?
[Ruchita]
So it’s a really good question, because I actually find most practices do have the same common pitfalls. So one of them, which is the most common one I see, is that CPD has never been done. And literally, the day we announced the inspection, we typically see that two weeks, the dentist, the associates, the team, are literally doing CPD, like nonstop. So that could be-
[Jaz]
But to me that’s shocking. For those who are like listening on Spotify. They didn’t see my reaction. My jaw, my eyes like went, popped out because I’m such a CPD junkie. I can’t imagine that. But you know what? I know what you mean actually. And sometimes it’s those course that coming onto it, IRMER.
[Ruchita]
Yeah.
[Jaz]
Disability awareness, all those core subjects. Mouth cancer. These are the ones that you often miss out, I think.
[Ruchita]
Yeah. And I think as well that there can be a lot of confusion out there of what we’re supposed to be doing, like the GDC guidelines and things like that, so, and I obviously appreciate it takes time to do CPD and things like that as well, but that’s like a typical one that I tend to see, and in fairness, on the day of inspection, the CPD has been done, so we’re never going to flag anyone up for it, like, it’s been ticked off, but I just know as a general dentist, the stress that would put someone through for like that two week period of trying to do like 50 hours or whatever you need to do of CPD.
So that’s like one thing that I would always just really love to encourage all the dentists, just keep up with it on a regular cycle if you can. And just pick topics that you are interested in, but also just covering, like, the main ones, because as you mentioned, like, there are some that people won’t know are now, like, mandatory, essentially, so, like, the disability and autism awareness, and so, again, a lot of practice will go to, because they can be quite isolated, they may not know about a lot of these things, so, yeah, so that tends to be one of the main ones, and audits tends to also be a little bit of a tricky one.
And again, I know they’re like not the most interesting things, but if you’re doing x rays and they’re not to a good standard and it keeps happening, again, it has an impact on the patient. So we just want to make sure that things are being completed on a regular basis. But they tend to be like the main ones and also just keeping sure like your recruitment records are in check. So that all the staff have got their DBS completed, their hep B titre levels. Not just that they’ve had the hep B, we actually want to know the titre levels, so again, safety for patients, and it’s just kind of just being organised, I’m going to be honest, is what we look out for as well.
[Jaz]
So the role here of the practice manager is instrumental, having a really organised, intelligent practice manager who’s been doing their due diligence is super important.
[Ruchita]
Yeah. And also I think having a really lovely team where like the dentists also want to get involved. Because a lot of the time I can appreciate there can be a bit of a kickback from dentists because they just want to really treat patients, they want to do really, really good quality work.
And if you’ve got someone kind of nagging you for like an infection control certificate, you’ll just be like, oh, I’ll do it later, I’ll do it later. So I tend to find when it’s like a nice team ethos and everyone understands the reason behind it. You could just see those inspections just flow really nicely, and it makes my day a lot nicer as well, I’ll be honest.
But out of interest, Jaz, have you had an inspection, like, at all when, in the last five years or so?
[Jaz]
I think so. In the last five years I’ve been across a few practices, and this one currently I’m coming into my fourth year. I’ve had a Denplan inspection, I don’t think I’ve had a CQC. So I’ve kind of escaped it. And I think at one practice where we had one, I was on holiday. It was like perfect time.
[Ruchita]
Convenient. It is always so many dentists seem to have annual leave on the day that we visit. Because it’d actually be quite interesting hearing it from like your point of view of like, if a practice that you were working at, say, for example, the practice manager goes, look, we’ve got an inspection in two weeks.
What would be like your dread or your worry? Or like, what would be your thoughts to be that? Oh, my God. What’s gonna happen?
[Jaz]
I guess as an associate, you think that, okay, all the biggest stuff is on the shoulders of the principal on the practice manager, compliance, that kind of stuff. So yeah, CPD is one to make sure all those important topics are ticked off.
And the other one would be. And then one of the question was to ask you is record keeping, make sure that you know, my record keeping is good enough to show to the people inspecting. And so my question to you, Chita is, do you go through the notes? Is there a sort of a protocol you follow to go through every associate, every dentist notes? How does that work?
[Ruchita]
Yeah. So we try and keep it as fair as possible. And so obviously we’ll ask permission of the dentist just to make sure they’re okay for us to go through it.
[Jaz]
And if they say no? Is that a cheat code?
[Ruchita]They know, then we feel like you want something to hide. Don’t try not to say no. I’ve had it queried a couple of times, but also we have like a warrant when we go into a practice. So in theory, we are able to access what we need to. But I’d also as a fellow dentist, I like to just keep that respect for everyone. So even if I have to look at the drawers inside a dent, like a surgery, I’d always just be like, do you mind if I have a look if there’s anything you don’t want me to see, maybe just get rid of it for a few minutes and then put it back in if that’s okay.
So for records, we are just looking at, we’re following the FGDP guidelines. So, I guess it’s one of them, right? To me, it seems quite obvious, but just that we’re taking off medical history form. We’re getting consent from patients and we’re actually looking at x rays and we’re analysing them.
We’re diagnosing possibly going through a treatment plan, printed if needed. And, yeah, just kind of the, I like to think obvious things, but I know, again, it depends on the generation of dentists because the older generation, like, are still quite used to maybe saying exam done, S&P done, and that’s what we’re not looking for, I’m going to be honest.
[Jaz]
Yeah, well said. And so my final question then is, because you’ve mentioned what are the things that you check for your role within that capacity, the common mistakes that people are making that we can easily fix up on. What are your top tips to pass with flying colours?
[Ruchita]
So, first of all, I’d actually just say have a really supportive team, because if a team looks a little bit sticky on the day we’re going to think there’s alarm bells, in all honesty. So if everyone flows well, everyone’s getting on. So I’m not saying you put it on just for us, but that helps us see, like, are patients really the priority of this practice? Because at the end of the day, that’s all we’re really concerned about.
And then when you have your call with the lead inspector, which they’ll do, like, a week before, a few days before your inspection, just make sure you’ve gone through that checklist. So that’s where we’ll kind of say what we’re going to be looking for on the day. And also just to collaborate with us, so remember we’re not there to catch you out, to freak you out.
If we’re asking for something, just chat to us. If you haven’t got it, just be really, really honest. And then, as I said, as long as we kind of have an action plan to get it sorted, then you’re gonna be fine. So, just making sure, like, medical emergency drugs, like, they’re checked, they’re updated regularly.
That decon is being done well. The drawers and things are looking clean. All of your staff members at work with you. They’re safe. You’ve got all their records and things like that. And just be as friendly to us as we are to you guys. I kind of like to hope as well.
And I know everyone’s always nervous. So we always do try and relax everyone as best as we can. And just to see it as a learning experience more than anything else, not to see it as like with a to get you, I know it’s a regulatory body. I know it’s really scary but well just, just be honest.
[Jaz]
Well, when you mentioned about the medical emergency drugs, the practice I work at, they’ve got, that should do a really good job. And, the kit that we have for medical emergencies is so nicely labeled. Every single thing is just asthma attack, allergic reaction, it’s all really nicely labeled.
It just shows the level of care and detail that’s gone into it. And on a higher level, I’ve been listening to a book recently, literally on the way into today. I was listening to a book called Surrounded by Idiots. Have you heard it?
[Ruchita]
Oh yeah, I’m reading that right now. I’m literally reading that right now.
[Jaz]
I’m on like chapter eight or something. I don’t know, audio version. Cause I listened to like this one. I’m listening to at 1.7 speed because I want to digest it a bit more. And so to explain to everyone who’s watching, listening at the moment, it’s like the whole disc thing, right? About your personality type.
So if you’re red, you’re like really results orientated, like wham, bam, thank you, ma’am. Let’s go. Whereas if you’re blue, you’re very analytical, you’re slow, you’re slow with a purpose to make sure everything’s quality. So I feel like when, if you’re starting a squat, practicing, looking at hiring. I want my manager to be a blue red combination and have a strong blue so they go everything through a fine tooth comb and be very meticulous, but also red so that they can get the results and actually be very forward in their communication as well. What do you think about that?
[Ruchita]
Yeah, I completely agree. So a lot of the time we can employ a member of our team just on their role. But actually, I really feel about knowing someone’s personality, knowing their strengths and weaknesses. So maybe another team member can kind of gel if someone’s a bit weaker in one point and is like ideal and in terms of like the red and the blue.
I think that’s perfect because the red person’s just going to get everything done to like your timestamps and stuff like that. And then your blue person’s actually going to analyze it, but not just doing it for the sake of doing it. They’re actually going to digest that information. So similar, actually, like in an inspection, what we’d rather have is that someone’s actually understood the reason for doing things.
So not just like as the dentist, I don’t like just seeing an audit done and then it’s done and no one’s reflected on it. There’s no action plan. Like they’ve just done it. Because we’ve asked them to do it, kind of thing. But what I’d actually love for someone to say is, do you know what? 100 percent of our x rays were all acceptable.
That’s amazing, we’re gonna keep going. Or actually one, there was a bad film, we got a new film and we replaced it. Because again, that’s like someone’s actually thinking about the process. And again, it’s more, then your patients are being looked after. So I think that’s really important. And actually quite a good exercise to do in a staff meeting sometimes, maybe seeing what personality everyone is. And then it’d be quite cool.
[Jaz]
Having a team day to do that. I think it’s totally worth it. Right. And I’ll put the link to this book in the show notes. I think it’s really, really good. If you’re a principal, if you’re a manager, I manage a team. So that’s why I got into it. I thought, okay, let me, let me think about the different personalities.
It’s been really eye opening. I’ve really enjoyed it so far, actually. So it’s just thought a random thought that came to my mind. In the interest of time, you’ve covered so many different things in terms of looking for your CQC and you made it, to me seem less daunting, thankfully. And the thing, the main lesson is do a little bit every day.
Don’t just cram it into the end because ultimately all those little things, they count towards patient safety, which is ultimately what it’s all about. Now part of what you mentioned about CPD as well and the importance of getting it done and the important bits, but also some fun bits. CPD should be made fun and appealing as well, because it’s a time, it’s a day you take out of work, right?
Take it and you want to be fulfilled and enjoy an environment that you can enjoy. So with that, please tell us about CPD at the Shard, which you’ve got going on. I saw that recently and you invited me to be a speaker there kindly, but please tell me more about that.
[Ruchita]
Yeah, so that was actually triggered from my role as working in the CQC. Because as I said, one of the common pitfalls was like CPD wasn’t being done like on time, essentially. And also a lot of dentists are really isolated out there, but there’s also a lot of misinformation that goes out. So if you think about with CQC inspections, your version of like what may happen may be different to someone else’s version.
We may look on the Facebook group and someone may share their experience. So I thought, why not do a CPD day where we’ve actually got a lead inspector from CQC who can kind of go through all the myths, all the common errors that we think about kind of thing. And then I thought, what better way to do it than to do it at the Shard.
We’re like the most amazing view over London. Because a lot of the time, I know CPD is just there to kind of tick a box off at times. I know obviously you run events and they always look really good fun, so I feel like this is in line with that. And it’s just a good way to network, to connect, because I find we’re quite, in that era, we’re good at typing behind a laptop and typing behind a screen.
But when it comes to interacting with each other and kind of gelling, I feel like it’s missing. And obviously, we’ve got an amazing lineup of speakers. So Jaz, I’ll let you kind of talk about what you’re going to be talking about. Then I’ll say who the other ones are as well.
[Jaz]
So you asked me for something clinical because I had a look and he had a lot of non clinical stuff. So one thing I’ll be asking you is, is he intended audience as dentist or is it like the team and stuff? So, treating your team in a tactical way, what might be one element of it.
But for me, I’m talking about Resin Bridges Success Protocol. So I’ve got a fair few videos I’ve collected over the last few years to add to the whole lecture based content, but actually to actually make it engaging as possible to make sure you understand the do’s and don’ts of Resin Bonded Bridges and how to actually get those fine few percentages of success.
[Ruchita]
And when I was, because without being weird, I was like looking at all of your work and stuff. And I was like, you kind of make it seem quite simple in a good way. Like, if you follow the right techniques, it shouldn’t actually be a stressful clinical procedure, I like to hope. And it should be quite predictable.
So that was why we were just so lucky to have you there. Because I know that that can stress a lot of clinicians out, especially dentists. And then a couple of the other topics I’ve picked are things that, again, like, when I go to practices, dentists don’t have the best understanding of. So, we’ve got Richard, who’s a perio specialist, who’s going to be talking about the perio guidelines, because a lot of people still call them the new guidelines, and they’ve been around for a little while now, so we just want to cement that into everyone.
Then we’ve got Dipti, who’s going to be talking about managing trauma in dental practice, because we tend to find this, this is a trickier one for general dentists to manage. And then we’ve got Len D’Cruz, who’s going to be talking about complaints handling, just because we know, like, the area that we’re in.
Complaints are kind of just going up and up and up, but actually it’s really good for like practice manager or like dentists and principals just to have a good understanding of how to be, to manage those really well.
[Jaz]
And that’s a mandatory one, right? Complaints handling is a mandatory training that we should be doing.
[Ruchita]
Yes, exactly. Yeah. So that’s why for the CPD cycle, it’s a fun way to do it versus kind of doing it on on the computer and maybe not taking as much in. Same with infection control. I’m going to be honest, I was probably guilty of that person just ticking next back in the day. And now actually, it’s really important to have that understanding.
So we’ve got Tracy, who’s going to be talking about the guidelines, because it’s not just HTM 01-05, there’s 107. There’s all these other ones that people may not be aware of. And then we’ve obviously got Amanda, who’s our CQC lead inspector. So she’s been part of CQC for 10 years. She will have some stories to share, I’m sure.
She’s amazing. She’s so approachable. So she’ll be going through like the common pitfalls that we see. And as a lead inspector, she sees it. a little bit differently to how I see it as the dentist.
[Jaz]
And that’s quite a rare thing, right? To have someone speak on that kind of topic with the CQC, right?
[Ruchita]
Yeah, it’s actually never been done before. So it’s been a lot of hard work and a lot of planning to speak to CQC to get that done. And I don’t think it’s going to be allowed again. I think we’re just lucky that we work as a team together really, really well. And we just know. Yeah, we both have the same ethics, like, we’re never there to, like, catch each other out, so it’s gonna be really good fun.
She’s also got a lot of knowledge about, like, fire safety, because that’s a lot of the time practice principals won’t be aware that actually we’ve got to have all the right checks done and things like that on that side. And same with like legionella checks and things like that. So she’ll give you a lot more inside info on that side.
And then I’ll be kind of covering a bit of information about like social media. So how to grow your practice social media following just to kind of get the right patients in a good way. And just to kind of get known out there because there are so many practices, so many squats. It’s so hard to differentiate one from the other, so I’d love to think that by the end of that CPD day, not only do you get like 7 hours of CPD, but you’ll go away with some clinical knowledge, some CQC knowledge, some social media knowledge, everything you can basically implement straight away when you go to work.
And then also lunch is included, refreshments are included, some good drinks, good view, good people. It’s just going to be amazing. I’m just so excited about it.
[Jaz]
I imagine it’s going to be a fancy lunch, obviously.
[Ruchita]
And fancy refreshments and fancy drinks.
[Jaz]
So it’s nice to add that luxury element into it sometimes because it’s something you have to do. And if you want to treat your staff and stuff, it’s a good thing to do. Friday, 10th of November, the website for it is?
[Ruchita]
So it’s to do with my online coaching address. So it just made it easier. I’ll be honest. So it’s www.trainwithchita.co.uk, but I’m sure we’ll add the link underneath the show notes, and so if you click on there, yeah, then you’ll kind of see a lot more information about it, FAQs, and yeah, it’s gonna be so much fun, and obviously, I’ve not seen you in ages, so it’s gonna be nice to actually see people, versus having chats over Zoom and stuff like that, so it’s just gonna be amazing.
[Jaz]
I’m looking forward to ticking off those mandatory CPD. So thanks for organizing that. Protruserati, if you’d like to come along to have a nice day out in central London, just by next to Guy’s Hospital at the Shard, a nice bit of food and smooths and come and have a little listen to the talks.
It’d be great to see you there. We’ll put the links in the show notes. Chita, thanks for sharing all those gems about CQC inspection, making us feel like you are actually on our side, but then also I’m looking forward to hearing what Amanda has to say on the day in terms of the stories that perhaps can’t be revealed on the World Wide Web.
[Ruchita]
Yes. Agreed. You’ll be shocked, alarmed, and there’s some good ones, basically.
[Jaz]
So very saucy. Thank you so much, Chita.
[Ruchita]
Cool. Such a pleasure. Thank you so much, Jaz.
Jaz’s Outro:Well, there we have it, guys. Thank you so much for listening all the way to the end. I’ve made it easy for you to find that link basically, for the event on the 10th of November, I’ve done it as protrusive.co.uk/shards, S-H-A-R-D, which is obviously the beautiful building where the course is happening. I’ll be speaking on RBBs, but there’s loads of other topics there, which I kind of need to tick off as well. So I’ll be there, but also to have a nice day out in the shard in central London.
So if you’ve got a team that you want to treat, if you’ve got Fridays off, or you want to be able to take a Friday off to intend important CPD, right? So these are complaints handling, these are something clinical, these are perio guidelines, some really, really hot topics. So if you want to join us, please do. And I look forward to meeting some of you there.
As always, you can get CPD by going to the app either on Android, iOS, or www.protrusive.app. The login actually works everywhere, but as long as you answer a few questions about this episode to test that you actually did listen and watch the whole way through and to test your knowledge and to give feedback, you can get your full certificate as always.
If you find this compliance topic helpful and you’ve got something else in mind for recommendation and if you are watching on YouTube, please type below, or if you’re on the Facebook group, please let us know what you’d like and we’ll try and cover it. Thank you so much and I’ll catch you same time, same place next week.
‘Easy Dentistry on Difficult Patients is still Difficult’ - Dr Lincoln Harris
Patients with small mouth opening can be a huge pain in the back for Dentists - but did you know there are ways we can significantly improve their mouth opening through physiotherapy?
https://youtu.be/v_u9sBAGliU Watch GF020 on Youtube
In this episode I’m joined by Dr. Tzvika Greenbaum, a specialist TMJ physiotherapist who's here to spill the beans on his journey from headaches to jawaches. We bring to light the jaw-dropping collaboration between dentists and physiotherapists, making dental treatment easier for both you and your patients.
Highlights of the episode:00:00 Intro01:02 Dr. Tzvika Greenbaum03:39 Dentistry meets physiotherapy09:33 Range of movement10:23 Asymmetry11:20 Prevention12:20 Advice to dentists14:34 Stretching16:17 The dental gym16:57 Sleep bruxists vs. awake bruxists19:28 Reducing sleep bruxism20:52 Obstructive sleep apnoea22:03 Statistics and diagnostic criteria25:16 At-home exercises27:20 Pain and discomfort28:39 Rehabilitation30:14 When to involve a physiotherapist31:12 Expected results32:21 Screening34:15 Dr. Greenbaum’s event39:04 Outro
Dr. Greenbaum’s upcoming course: protrusive.co.uk/greenbaum
If you liked this episode, you will also like 3 Simple TMD Exercises
Did you know? You can get CPD from the Web App or Phone App and watch premium clinical videos, for less than a tax deductible Nando’s per month?
NEW EPISODE LIVE for public access!
Do you know the difference between dental indemnity and insurance? And which one might be better for you? Today we have Dr. Neel Jaiswal, founder of Professional Dental Indemnity (PDI), to shed light on this crucial topic (as our security and sleep depends on it!)
https://youtu.be/SmLM5cr4mzo Watch GF019 on Youtube
Should you choose a 'claims occurred' or 'claims made' policy? Dr. Jaiswal's transparent advice aids in choosing what is best for you at your stage of your career.
Get a quote from PDI and save £thousands on your policy.
If you liked this episode, you will also like 10 Commandments for Staying Out of Trouble
Did you know? You can get CPD from the Web App or Phone App and watch premium clinical videos, for less than a tax deductible Nando’s per month?
One of the most common questions I get from colleagues is ‘Which Intra-Oral Scanner should I buy?’ – I don’t have the breadth of experience of testing all the scanners out there, but Dr. Gulshan Murgai does!
We discussed which scanner is best for your practice and how to choose the correct one for your needs. I hope you gain insight into the differences between the different scanners and help you move forwards a decision.
For me, one of the biggest takeaways was that it may not be so much about which scanner, but more about ‘what is the customer support and guidance like after I invest in one?’
https://youtu.be/ERvzjlQaBRcCheck out this full episode on YouTubeHighlights of this episode:
- 2:00 Dr Gulshan Murgai Introduction
- 5:43 Which intraoral scanner should I purchase?
- 8:03 The best scanner on the market today and why?
- 12:37 Aligner system available for different scanners
- 15:17 Customer support on scanner companies
- 18:11 Scanner Prices
- 19:12 Caries detection within scanner
- 20:27 Importance of scanner and what’s the best for your practice
Check out Dr. Gulshan Murgai supply company Implant Solutions Direct and also 4D Ceramix, which is a full-production crown and bridge lab
Connect with Dr Gulshan Murgai
If you liked this episode, you might enjoy the Story Of Digital Occlusion
This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Protrusive App!
From the entire Protrusive Community - we wish Sanj a speedy recovery - keep smiling Sanj and stay strong!
In the previous episode with Sanj Bhanderi on 'how to extirpate properly and efficiently', we briefly touched on postoperative pain control. In this episode, we're focusing more on postoperative pain and the dreaded severe pain after the obturation appointment (or in-between visits).
https://youtu.be/RJzQZNhBup0 Check out this full episode on YouTube
Need to Read it? Check out the Full Episode Transcript below!
Highlight of this episode:
2:27 Post-op pain after endodontic treatment7:43 Flare-ups9:46 Guidelines in antibiotic microbial management11:03 Flare up in between visits (RCT has not been finished yet) 13:40 Crown Down approach
Dr Finlay Sutton is coming down South for his one-day signature RPD Masterclass on Saturday 14th of January 2023! Limited to 12 delegates, reserve your seat now!
If you enjoyed this, you might also like my episode with another talented Endodontist, Dr Ammar Al-Hourani, on Is Single Point Obturation Acceptable?
Click below for full episode transcript:
Opening Snippet: I wanted to start this podcast with a get well soon message for our guest, Dr. Sanj Bhanderi who did such a brilliant job with our last group function on how to extirpate quickly and properly. Now, unfortunately, after we recorded that episode, and after we recorded this one, Sanj felt acutely unwell. It was actually scary hearing the news of him being ill. But I'm getting some positive updates. And so we the Protrusive Dental Community, and then all dentists around the world. We wish Sanj a speedy recovery. We hope you get well soon. We're so glad you're okay and on the mend. And we want to pass on these wishes to you. It's been quite clear on social media, what a likable guy you are, and how much we all want you to make a speedy recovery mate. So wishing you all the best and get well soon from Team protrusive.
Jaz's Introduction:I bet this scenario sounds very familiar to you imagine you're on a course you having a great time. I personally love courses, I think you all know that. You're on your fifth coffee, and everything's going great. And suddenly your pocket starts vibrating. You've got a call from the practice or text message informing receptionist saying that, 'Mrs. Smith, you know, the root canal that you saw yesterday, she's in absolute agony.' And you curse because you think wow, you know, that was a completely straightforward root canal procedure. The patient was asymptomatic before you even started. Why is this happening for me? Look, post-op pain after endodontics is an absolute bitch. It's one of those annoying things ever actually puts me off doing root canal treatment because of the one in harmony of a chance that post op pain instance is going to happen. And I'm going to discuss with Sanj Bhandari who does such a brilliant job in that GF o one six, where we talk about how to extirpate properly and efficiently. So if you haven't listened to that one, oh my goodness, you are in for a treat. Go back and listen to that one. But in this episode, we're focusing more on post op pain like how do you manage that kind of scenario? What do you say to the patient? How can you prevent this from even happening in the first place? You know, it's funny I've actually had four root canals on my own self and before you think, 'Oh, Jaz is disgusting, you got caries, etc.' No, it's actually trauma from orthodontics. Can you believe it? Orthodontics devitalize, my lower four incisors, and I've had all sorts of issues and root canals and fractures, etc, etc. And now have a resin bonded zirconia bridge, hence why I'm so passionate about those bridges. Anyway, I experienced post op pain myself, it was a nasty thing. It was lots of inflammation. And so I've been there and I totally empathize with my patients. Before we joined the main episode I want to say yesterday I released new tickets to Fin...
When you Extirpate a Hot Pulp - do you need to find ALL the canals? Do you need to file to the apex? Which is the sedative of choice?
In this episode, we've got specialist Endodontist Dr Sanj Bhanderi to talk us through the CORRECT way to extirpate teeth in acute pain WITHOUT wasting time or making things worse for future treatment. It's packed full of gems for pain relief, diagnosis and isolation.
So, what is your protocol for extirpation? This episode is all about how to get the job done right and minimize discomfort for your patient.
https://youtu.be/SjYWxr1sSDc Click Here to watch this episode on YouTube. For the full notes check out the Protrusive App on iOS and Android.
“I call it Ninja endodontics - get in and GET OUT - Stealth!” Dr. Sanj Bhanderi
Highlights of this episode:
2:38 Dr. Sanj’s journey to Endodontics6:30 Emergency extirpations8:42 Diagnosis Protocol Irreversible Pulpitis11:57 Anaesthetic for Hot Pulps15:33 Caries and Restoration Removal Before Extirpating?19:16 Vital pulp therapy21:19 Isolation Protocol25:30 Sedative Dressing for Acute Pain28:42 Temporary restoration of choice31:39 Post Op Medicaments
Tune in for the Part 2 of this episode - next week we cover post-operative pain after endodontic treatment.
If you enjoyed this, you might also like my episode with another talented Endodontist, Ammar Al-Hourani, on Is Single Point Obturation Acceptable?
Is flapless implant placement really a solid technique? What percentage of cases are amenable to flapless implant placement?
The cynic in me wondered if this is indeed a novel technique, or was it made mainstream to attract Dentists who seldom raise flaps?
I brought on straight-talking Implant genius Dr. Pav Khaira on today's Group Function to discuss flapless implant placement - 'what's the deal?!'
https://youtu.be/679HAttBQ1c Check out this full episode on YouTube
Highlights of this episode:
4:36 The Rise of Flapless Implants7:04 Indications for Flapless implants9:43 Immediate implant placement13:59 Advice to Young Dentists considering implants18:56 Implant Mentorship24:11 Dr. Pav’s Implantology Course27:46 From Course to Implementation
Check out The Dental Implant Podcast for information on dental implants and the Academy of Implant Excellence to learn how to place implants or upgrade your skills.
If you enjoyed this episode, you will also like 'Can I Probe This Implant?'
Today we pick up where we left off on the 1st part of Group Function Episode 13 “Can I Probe This Implant?” In this episode I asked Dr Pav Khaira about bone loss around implants - what is normal and when should I worry? Another very interesting and controversial issue we tackled is how to manage implant screw loosening as a GDP?
https://youtu.be/C1Y_AdDhLzU Check out this full episode on YouTube
Need to Read it? Check out the Full Episode Transcript below!
“If every single year you're losing one millimeter (of bone) that's obviously an issue and we need to intervene and do something,” Dr Pav Khaira
In this episode we discussed:
Normal bone loss for average implants 1:53Guidelines for GDPs managing loose implant screws 5:03Universal Implant Drivers? 10:45
If you liked this episode, be sure to check out the first part of this series Can I Probe This Implant?
Click below for full episode transcript:
Opening Snippet: Because screws become stressed and they become strained. That may be one of the reasons why it's come loose. And if you retighten a strange screw you can you can cause it to break, then you're in trouble because you may not be able to retrieve it from the implant head...
Jaz' Introduction:Hello, Protruserati. I'm Jaz Gulati and welcome back to this second part of the group function. So we split it into two. On the first group function, if you haven't listened to it already, it was "Can I probe that implant?" Is it cool to probe around implants? Because there was a myth that you may scratch the implant? So is there any truth to that? Should we be concerned? That's all covered in part one. In this part two, we've got Dr. Pav Khaira, we're talking about What is the normal amount of bone loss around implant? So when I am reviewing patients who had implants placed elsewhere, potentially, and I take a peri-apical radiograph, it's been five years since they had the implant and my expecting bone loss. At what point do I get concerned? And what point should I refer? So we're gonna find that out. And another very interesting controversial issue is, how do you as a GDP manage a screw loosening? So if the implant crown is loose, is it cool for us to be going in and tightening it? What about if you don't have the right equipment? Or how to even identify which system it is. You have to stop every single driver there is? The very real world question there and I think Pav does great justice. So let's hear it from Pav, and I'll catch you in the outro.
Main Interview:[Jaz] When you see a radiograph of an implant, let's say a peri-apical. And I don't know when this implant was on, I can ask the patient, the patient like a long time ago, five years ago, 10 years ago, they give me a vague answer. But anyway, am I expecting ever, is it acceptable to have threads exposed supracrestal, ie, all the threads are not in the bone, some of the threads are outside the bone, Is this acceptable? And be what amount of bone loss is normal? Because I understand that after you place an implant, after about a year, you expect to lose "some", you're probably gonna say yes, by do all this crazy voodoo magic that they don't lose any bone. But for the average implant, what is normal in terms of bone loss.
[Pav]So historically, what's been considered acceptable is as a rule of thumb, bone loss down to the first thread, then about 0.2 millimeters per year, as you quite rightly said that these is, the modern techniques, the modern concepts, were really shouldn't be seeing anything at all. But you know, I see loads of patients where they come in to see me where they've had implants placed 20 years ago, okay? And I think the issue is in the absence, in the absence of any inflammatory responses, like what we've discussed about before, there's no bleeding, there's no suppuration, the implants been there 20 years, if you've got a 15-18 millimeter long implant, you've got three millimeters of thread exposed,
"Don't probe implants with a metal probe or you'll scratch it!" - and so for years I was afraid to check the gingival health around implants. Crazy right? Dr Pav Khaira is here to bust that myth - but like with everything, it's not a simple answer - it has some interesting anatomical considerations. His answer is so eloquent, check it out!
https://youtu.be/pLDfqe8liLE Check out this full episode on YouTube
Need to Read it? Check out the Full Episode Transcript below!
“If you can get to the neck of the implant, you SHOULD be probing to the neck of the implant...but you don't want to do it too aggressively, it should just be very gentle pressure.” Dr Pav Khaira
In this group function we discussed:
Can you probe implants? 5:33Screening Periodontal Health of Implants 11:14Referring patients with Peri-implantitis 16:22
Check out The Dental Implant Podcast!
If you liked this episode, you will love revisiting Implant Assessment for GDPs: from Space Requirement to Ridge Preservation
Click below for full episode transcript:
Opening Snippet: You just got into the cuff just sweeping it backwards and forwards and you seeing whether that triggers any bleeding because that's a sign of inflammation...
Jaz' Introduction:Hello, Protruserati. I'm Jaz Gulati and welcome to this group function. Now if you're new to the podcast, welcome, great to have you. A group function is where we work together as a team to find out a solution to a common problem. And the problem I'm presenting today and I'm hoping to get a good answer from Pav today is 'Can you probe around implants?' And what I mean by that is, I was fed a lie or a semi lie at dental school, like someone told me, I don't know who it was. But if you use a metal probe, to do a periodontal probing chart of an implant, you will scratch that implant and therefore that will harbor bacteria. And therefore you should not be probing around implants. So for the longest time, I didn't check the periodontal health of implants and it sounds really bad. But as a GDP who doesn't place implants, not much to do with implants. I thought that was the right thing to do. I thought I was doing less harm by not inserting my Williams or WHO or CPITN probe in the sulcus to check for the periodontal health because I didn't want to scratch the implant. I was scared of scratching the implant if you like. So I was expecting this to be a really quick group function. And I thought Pav was saying Yeah, you totally can. It's all good. But Pav of being Pav, an amazing guy he is. The only does he give us a really good definitive answer at the end, where he talks about the rationale of what the concerns are maybe and how each actually look a little bit deeper than Can you probe? Can you not? Because there's some anatomical variation, so I'm not going to spoil it for you. Let's join this group function with Dr. Pav Khaira. That man again. Pav Khaira.
Main Interview:[Jaz] Dr. Pav Khaira, welcome back to the podcast, my friend. How are you?
[Pav]I'm very good right now. How you doing?
[Jaz]Yeah, great. So it is Pav Khaira from The Dental Implant Podcast. And I'm gonna just pick your brains. You need to teach us something today. You need to speak to me like I'm five years old. Because this, the following questions I'm gonna ask you on this group function today is very much basic things that you're probably gonna laugh at me like Jaz, why you asked me these basic questions? But I'm sure with the referring dentist that you've met and your colleagues, like when it comes to implants we come out in dental school, like a lot of other topics. And we're like, where do we even begin? So just before we dive into that, just reminder on people who perhaps didn't listen to our episode on finding your niche. I think it was episode 76 from memory. Do listen to finding your niche, it's a cool one where we discover what is like your calling in dentistry. So do check that one out.
We’ve now come to the last bit of this 3-part Oral Surgery Complication series with Dr. Chris Waith. I'm going to be honest, I have a lot of concerns about Tuberosity Fractures - they scare the bejeebers out of me! We all know that it can be a really nasty complication. Fear not! Dr Waith will teach you how to prevent and manage maxillary tuberosity fracture.
https://youtu.be/ZQuDeViQiX4 Check out this full episode on YouTube
Need to Read it? Check out the Full Episode Transcript below!
“If there's a really tight contact between those three molars, the two teeth you're extracting, just spend a minute skimming the contact points.“ - Dr Chris Waith
In this episode, we discussed about:
Risk factors of tuberosity fractures 1:40How to manage when you hear the crack of the tuberosity 3:57High risks patients 6:35Leaving a loose bone as a space filler in soft tissue 9:07
Join us in our Telegram group! Let us help each other out!
If you loved this episode, be sure to check out the first part! Dry Sockets – How to Prevent and Manage Them?
Click below for full episode transcript:
Opening Snippet: Welcome to group function, where the Protruserati worked together to find good solutions to worthy problems in dentistry with your host, Jaz Gulati...
Jaz's Introduction: Tuberosity fractures are super scary, like, you know, when we did the first group function with Chris Waith about dry sockets, dry sockets don't worry me, okay? When it comes to OACs, Yeah, a little bit concerning, but after that episode, I feel much more confident. But when it comes to Tuberosity Fractures, man, I have to tell you, I'm really worried about causing them. And I've seen on social media people posting these photos, you know, I try to take out the upper left molar, and then the whole premolars and all the molars came out with it. And that is a scary sight. So in this group function, we're going to ask Chris Waith, how to prevent and how to manage that dreaded tuberosity fracture. Let's hit it.
Main Interview: [Jaz]Then the next one is and the last one is tuberosity fractures. Like, this is scary when you see on social media, some you know, sometimes a big group of people posting their tuberosity fractures, and you see the first molar, the second molar and a third molar, come out with this massive chunk of maxilla. I do not want to ever be in that position that must be so stressful and like how do you even begin to have that conversation like you know, we always warn our patients before doing an extraction, maxillary extraction about these kinds of things. But Never Have I Ever warned a patient that look me taking out this wisdom tooth, I might also take out three other teeth while I'm doing this, for example, it's just so rare, unfortunate. So what are the risk factors? How can we manage it when you hear that crack, and so on and so forth.
[Chris]So, I've been in that scenario of having a big unit, I think, if ever, you're taking out an upper six, or upper seven. And if there's a really tight contact between those three molars, the two tooth you're extracting, just spend a minute skimming the contact points out. So drill the contact points, make a physical space in between that tooth and the two neighboring teeth. Because then when you're Elevate, you're much less likely to engage the your neighbor and hopefully less likely to put stress on a wider area of alveolus. I think if you just take in the wisdom tooth out, look for the risk factors. And you know, I sometimes go on when I'm teaching that I say I feel bad now about how we used to teach the undergraduates because there was definitely this mentality where you gave them some notes and just said take that. I'm probably didn't spend long enough saying this is how you should take that type. And I think of parades is one of those where depending where you went, somebody would have put a cryers in your hand or a coupland and would have just said just push back, actually,
After the last group function where a juicy bit of dry socket has been tackled, I was again surprised by Dr. Chris Waith that managing OACs was such a simple matter of using your existing tools - there is some super real-world GDP-friendly advice in this episode.
https://youtu.be/aHV15R0SNaw Check out this full episode on YouTube
Need to Read it? Check out the Full Episode Transcript below!
"If the OAC is bigger than 5mm, you really get into the point where I don't necessarily think we should be expecting GDPs to do something super courageous at that point." - Dr. Chris Waith
In this group function we talked about:
The Classic OAC regimen 1:31Oro-Antral Communication Management 6:37Medications for an OAC 8:55
If you loved this episode, be sure to check out the first part! Dry Sockets – How to Prevent and Manage Them?
Click below for full episode transcript:
Opening Snippet: Hello, Protruserati. I'm Jaz Gulati and welcome back to another group function again, Oral Surgery, we're doing a three part for surgery with Chris Waith, we already covered dry sockets. And his answer was very surprising to me. This one OACs was a bit more of what I expected to hear. And so we're gonna jump straight in, right? You are now very familiar with these group functions. So how do you prevent and manage an OAC? Shall we move on to now?...
Main Interview: [Jaz]OACs. Okay, so, OACs, I was taught at dental school that a lot of times when we take tooth out, we probably make an OAC without even realizing. And it's a very common thing. And actually the probably heals up, especially when it's less than x millimeters, maybe that's four millimeters or whatever it might be. I was also taught and here's why I've been a little bit naughty. So let's play Zak's stuff 'Am I naughty, I get my, if I'm really not sure if there's an OAC and then I want to start them on the regimen, which we'll talk about shortly and see if our regimens are the same. But if I'm really not sure, then am I naughty if I get them to pinch their nose and try and blow out the nose aka the Valsalva maneuver, because I was taught not to but a few times, I'm really not sure whether I'm about to start this patient on the regimen. I have done it. What do you think?
[Chris]I'd say yes, you are naughty. I mean, my logic is that I think we must close OACs all the time. But 99% plus they just heal. Some of the time will be because the membranes completely intact. And the whole, the communication is actually it's just a bony break. Sometimes the hole in the membrane will be so small that your body can heal it. If you've got a small hole, and you squeeze your nose and blow. Essentially, what we've just got them to do is what we're about to instruct them not to do for the next two weeks, because we know it might open up the OAC. So I would say if you got, if you're going to check and grab your suction off of your Nurse (so that she's not tempted to put it down to the bottom of the socket), just get your suction over the top of the socket, either get the light from your loupes or your chair light in a decent position. And just look. And I think if you can't see anything obvious, it's not to say it's not there. But if you can't see it, that's good. Because I usually teach five millimeters, I say less than five millimeters, I think you can kind of sit on that. Give them the instructions. And I try and make myself feel better - I put some collagen cubes in the coronal portion of the socket. [Jaz] So do I [Chris] If it's bigger than five millimeters, you really get into the point where I don't necessarily think we should be expecting GDPs to do something super courageous at that point. If you were thinking that that actually needs some kind of physical closure. I think if you're the GDP, the quickest, simplest thing you could do is just take an alginate, take an alginate send it to the lab, just say to the lab this needs to be kind of processed now.
When did they change the ingredients of Alvogyl?! It's the return of Oral Surgery Specialty Dentist and sensible man Dr. Chris Waith - this time to answer our Oral Surgery Complication questions starting with Dry Socket prevention and management!
https://youtu.be/QiOJAwxAZE8 Check out this full episode on YouTube
Need to Read it? Check out the Full Episode Transcript below!
“It will be better no matter what we do, whether we dress it or not, it's just whether you can live with that timeframe.” - Dr Chris Waith
In this group function we discuss:
How can we prevent dry sockets? 3:54Can suturing help in preventing dry socket? 10:43How to manage patients in pain with dry socket 15:39Does Irrigation and Alvogyl actually help in managing dry sockets? 19:09
Click for ->Chris Waith's Oral Surgery Course
If you enjoyed this episode, check out Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth
Click below for full episode transcript:
Opening Snippet: Welcome to group function, where the Protruserati worked together to find good solutions to worthy problems in dentistry with your host, Jaz Gulati...
Jaz's Introduction: Hello, Protruserati. I'm Jaz Gulati and welcome back to another group function this time with all surgeons specialists, Chris Waith. Yes from that epic episode on how to section and elevate teeth. Listen, if you haven't listened to Episode 85, it is huge, because it just gives so much. I wish I had that when I was just one or two years qualified. In fact, let me tell you a story. Kamila. Kamila, you posted on YouTube when you watch the video which got like over 1000 views now, which is awesome. Guys, I appreciate it very much. Now, Kamila posted on one of the comments saying that, 'Thanks for you know, I discovered your podcast. And thanks for this episode. I was able to on my last day in dental foundation training, I was able to section and elevate a tooth with confidence, and is only possible due to this episode.' So thanks for epic episode with Chris Waith, she was able to do that, which is just amazing. That's the kind of feedback I absolutely love. And that's the reason I keep this podcast growing. So thanks so much guys who always comment and like on the YouTube or if you listen on your commute, I really appreciate it. Now, this episode is very fundamental, right? Like dry sockets. Such a huge thing. Actually, Lucky you. I've got Chris Waith to talk about three things over three group functions. We're talking dry sockets, OACs, and those dreaded tuberosity fractures. So let's listen to what Chris Waith has say about what's the best way to prevent a dry socket. And if you are unlucky enough to have a patient's who've got dry socket, how can you manage it? And I'll be honest with you, I don't think I'll be doing what Chris says like on reflection. I don't think I'll be doing what he says because it's a very interesting approach. It surprised me and it will might surprise you. And you may or may not do what he says. So let me know, you know, reach out to me the protrusive Instagram pages @protrusivedental, so it'd be great to connect on there. But let me know what you think about Chris's advice.
Main Interview: [Jaz] Chris Waith, a man who needs no introduction after that podcast episode we did about extractions and how to section and elevate. Chris, how you doing, mate?
[Chris]I'm really good. Thanks, man.
[Jaz]I'm brilliant. And we were just chatting before I hit the record button. I asked you have had you seen the comments that we got on our YouTube video. And it's had like over you know, 1.2k views on it, which is great. But overall, over 4000 dentists over the world have listened to that episode. And I sometimes thinking why do I do this? Why do I do what I do. And when I get comments, like I saw, it was amazing. It was young lady, foundation dentist who said that, on my last day of FD, I was able to tackle a difficult molar and I had ...
Online reviews for Dentists are a big thing in 2021 and it's only really just lifting off now. A few years ago I had an appointment with an ENT consultant and the first thing I did was google his name. Most of our patients are googling us and our online reputation is critical. In this episode I am joined by the founder of Doctify, Dr Suman Saha to help you get more high quality reviews for your practice.
https://youtu.be/LiHSvoWBuPA Check out this full episode on YouTube
Need to Read it? Check out the Full Episode Transcript below!
Protrusive Dental Pearl: How to increase the success rate of capturing review: Consider text messaging and/or having a tablet in your practice so they can leave it immediately after treatment.
In this Group Function we discussed:
What is the role of patient Reviews dentistry? (07:02)Doctify vs different online review sites/apps such as Google Reviews (08:39)How can we make sure the reviews are accurate? How to overcome fake reviews (12:18)How to create a win-win scenario between Principals (the practice) and associates (that want their reviews to stick with them) (17:48)How to get dentists (who might be introverts) to have awkward conversation with patients and ask for reviews (24:20)
If you enjoyed this episode, you might also like this episode Think Comprehensive – Communication Gems with Zak Kara
Click here for Full Episode Transcription:
Opening Snippet: You know even if you're not paying for it yourself just knowing that actually this person's an expert or can deal with the condition that i know i'm going to see him for or her is like it's so powerful and i think that's what we want to try and solve...
Jaz's Introduction: Hello, Protruserati. I’m Jaz Gulati and welcome to this group function where we answer a really big and important question i get quite a lot from our colleagues. Now you guys know that I’ve been using something called Doctify to collect reviews but the number one objection or query I get from dentists is that hey Jaz, you use Doctify but my principal is being really funny about me collecting my own reviews. How did you overcome this or something related to the fact that there’s some sort of friction between principals and associates? Like even if you collect google reviews as an associate when you are doing all the hard work to gain the google reviews to uplift the goodwill and the reputation of the practice but what if you leave that practice those reviews don’t go with you. So we asked Dr. Suman, who is actually an orthopedic surgeon, who actually created Doctify to answer this very important question as well as how to harness the power of dental review so even if you don’t use Doctify you will gain something about how to use reviews in a clever way. How to collect more reviews and how to actually improve the social proof of your practice. Hope you enjoy this group function.
Main Interview:
[Jaz] Part of this podcast is journeys. Learning what motivates people learning about the different routes people take. So Suman, do you practice clinical density at the moment?
[Suman] No, so my background is so I’m not a dentist. So I’m gonna put it out there now, I’m not a dentist.
[Jaz] You know, what I totally thought you were. I totally thought you were.
[Suman] So this has been super interesting learning because I’ve been in and around dentistry for three, four years now and I’ve got a lot of dental friends. So I’m an orthopedic surgeon by background so i trained in London, myself is an orthopedic registrar when we found the Doctify and then I guess we’ve been in dentistry because we started the healthcare and medicine and surgery because that’s what I knew but we suddenly went on to our site and I think the third most searched thing was dentistry even though we had no dentist, we weren’t working with dentists about four years ago and so we basically just knew one of the things people not even patients just people care about is...
TIME SENSITIVE - 50% off Maciek's Online Contact Point Ambassador Course! Click here
Let's face it, Class IIs may be our bread and butter Restorative Dentistry but they are ANYTHING but simple. In some scenarios, achieving a perfect contact on a class II restoration seems impossible.You have likely been in a scenario where everything is going to plan and your matrix is looking like it will achieve a lovely contact area - however, as soon as you insert the wedge or tighten the band (circumferential matrices) the matrix leans away from the adjacent tooth, revealing a ghastly looking open contact. How can we overcome this? Is soft tissue removal an option? In this Group Function, I’m again joined by my boy Dr Maciek Czerwinski who answers this emphatically!
https://www.youtube.com/watch?v=V6pu7FLb9Kw The full episode! Minor video issues with Maciek
https://www.youtube.com/watch?v=cvX-oaEaqUI How to do Teflon Floss Technique - the Main Interview Podcast Video has some syncing issues, please bare with us!
Need to Read it? Check out the Full Episode Transcript below!
“If you use the stiff wedge, if the wedge is too big it will just move the matrix (and you lose your contact), but if you've got something soft, it will go under the curvature of the matrix, and then it will just self adapt.” - Dr Maciek Czerwinski
In this group function we also discuss:
Is it necessary to remove soft tissue? - Why? How? What to use? How to improve the contact areaWhy and when to place an orthodontic separator to help your future restoration
Tired of spending hours just to customise your stiff wedges and matrices? Check this gem shared by Dr Maciek - FINALLy the video on how to do the Teflon Floss technique (as promised in the episode):
Also, Dr Maciek is giving 50% off to all Protruserati up until June 30. Click here to check it out! I have done his online course and it was very comprehensive and is guaranteed to improve your contact points no matter how tricky the situation. It is an all-encompassing direct restorations online course - with play by play explanation of matricing, wedging, ring selection and isolation!
Click on the image to check out Maciek's course!
If you have any other questions that would make a good group function, please do message me on @protrusivedental Instagram page or the Facebook Page
If you enjoyed this, you might also like my other episode with Dr Maciek Czerwinski on Which is the Best Matrix System for Class II Restorations
Click here for Full Episode Transcription:
Opening Snippet: When i first saw this i was disgusted when i first saw this i was like you're removing healthy papilla, what's gonna, you're gonna destroy the biological width. The patient will die, the patient will get necrosis you know all these things...
Jaz's Introduction: Have you ever had that scenario where you're, you've got your matrix band in and you've got this lovely looking contact area and thinking great there's gonna be a home run restoration but then you put in your wedge and okay the whole contact is now open right? The matrix that was beautifully contacting the adjacent tooth before is no longer contacting that tooth. What's happened there and how can we overcome this Really simple basic but daily bread and butter issue? I've got none other than Maciek Czerwiński obviously came on to do an amazing episode all about Matrix selection which is the best Matrix and I hope you enjoyed that episode. So today we're gonna be talking about this class two woes. Do you make these class two mistakes? We're gonna be talking about the importance of recognizing how to overcome this issue that as soon as you put wedge in the contact area opens or the second scenario is the importance of soft tissue removal. Like I couldn't believe that when I spoke to Maciek, He revealed that in 70% of his class two cases he's having to remove some soft tissue. Now if you've seen some of his work on facebook you'll see w...
When it comes to direct composite restorations, shape is more important than shade. Mastering primary anatomy with well defined line angles is the difference between mimicking nature or ending up with flat white blobs with no definition. In this Group Function I'm joined by Dr Matt Parsons who answers the following question from the Protruserati:
Once you have drawn on the desired line angles, how would you suggest to really define them? When using bur or disc I tend to find I get a result which is rather flat and lacks line angle definition.Dr Devin
Firstly, if you don't already follow Dr Matt Parsons on Instagram....you will now, and therefore you're welcome. It's dental porn.
https://youtu.be/CFvmFm5FhQk Dr Matt Parsons on Nailing Line Angles
Need to Read it? Check out the Full Episode Transcript below!
If you have any other questions that would make a good group function, please do message me on @protrusivedental Instagram page or the Facebook Page
If you enjoyed this, you will like my 3 reflections on a Composite Veneer case.
Click below for full episode transcript:
Opening Snippet: Hello Protruserati. I'm Jaz Gulati and welcome to this group function all about line angles this was inspired by Dr Devin Mandalia...
Jaz's Introduction: I'm going to ask Devin's question now. So in episode 52, I gave a protrusive dental pearl about the use of a pencil on its front and on its side to reveal different things about the line angles when you're doing direct composite restorations like veneers for example and on that youtube video of the protrusion dental pearl Dr Devin Mandalia, Devin thanks so much sending your question buddy. He says once you have drawn the desired line angles, how would you suggest to really define them when using a bur or a disc? I tend to find i get a result which is rather flat and lacks the line angle definition so i got someone who's absolutely phenomenal at line angles i look at Matt Parsons cases on instagram and every single case he's absolutely nailed the line angles and i think that is really the most fundamental thing about what defines the anatomy of your in sciences is about getting those line angles crisp and perfect so they don't look like flat tic tacs. So Devin, i hope you enjoy and everyone hope you enjoy this group function with Matt Parsons all about how to redefine those line angles. Thanks so much.
Main Interview: For those listening we need to congratulate Matty Parsons i want to say your name now so you can introduce yourself in a moment but congratulations will be becoming a father to little george who's seven weeks old. Describe the last seven weeks for us. A roller coaster of nappies, no sleep, screaming kind of the the moment where you get home from work and Meg just looks like she's had hit constantly all day and just kind of like throws him at me like get him off me for half an hour at least but and he was so annoying at the same time. So he can be just crying for no reason for two hours and you're kind of saying what is wrong with you and then he just gives you one little smile and it's like oh you're so annoying because now i can't be angry with you. So it sounds like george might have what my son had like you know the whole colic term right i mean my son was pretty colic for the first three four months crying for no reason and stuff. I'll never forget that but don't worry the end is in sight eventually they will grow out of it don't worry. Well George's awesome. Hopefully sooner rather than later. We'll have to do a fatherhood podcast another day because today is about it's a group function about nailing those line angles. Matty your work that i've seen on social media is just stunning like even the full protocol cases that you post on mini smart mocova and the before and afters that we see on instagram those line angles and the anatomy is just absolutely brilliant and that's what we need your help with today.
This is THE most common question I get - 'Jaz, can you just tell me which camera to buy for dental photography, I am so confused!'
I'm no mug when it comes to Dental photography, but I wanted to get a real expert to help answer this important question. I present to you Alessandro Devigus from Switzerland who owns the @dentist.camera Instagram page (which I love).
https://youtu.be/q3VkbMLhsn8
Need to Read it? Check out the Full Episode Transcript below!
I was shocked that he recommended a Mirrorless set up - but I totally understand his rationale. Here are the links to the products he mentions:
Budget Setup
Nikon Z50 Mirrorless Camera Body - ensure the kit comes with a FTZ Nikon adaptor so it works with the lensNikon 85mm Macro Dx LensMieke Ring Flash for NikonBudget setup for excellent Dental Photography
The 'Posh' Setup
A Canon or Nikon Full Frame camera, with a 100mm macro lens and 2 x flashes mounted on a bracket - pick your favourite brand eg Nikon or Canon. It's all good!
If you enjoyed this episode, you may also enjoy the IMPORTANCE of taking photos in your Dental Journey, check it out!
Click below for full episode transcript:
Opening Snippet: Hello Protruserati. I'm Jaz Gulati and welcome to another group function.Today's mission is to help you figure out which camera to buy like i am absolutely inundated with messages and one of the messages i get is Jaz can just tell me which camera i should buy like people we don't want to do all the homework and the research and why should you right?...
Jaz's Introduction: Nowadays there's too much variety there's sonys, there's nikons, there's canons, there's a lot of variety and it can get very confusing to know which setup is for you especially when some gurus will recommend a 60 millimeter lens and others will recommend a 110 millimeter lens or something and a different ring flash and a bracket system. It can get really confusing especially if you're buying your first camera. So i got an expert Dr Alessandro Devigus who owns the instagram page dentist.camera which is just brilliant right because what he shares is every dentist who's passionate about photography they share their setup, what are they using on that instagram page. So definitely check that one out. The question i'm answering for you today guys is if you're on a budget, you're a new grad and you're going to buy your first camera, which camera does Alessandro think you should buy and then also he's answering the question if you are an established dentist in the sense that you've got a bit more money and you're maybe looking to upgrade your set which is the bells and whistles one that he would advocate. Now bear in mind that Alessandro is team Nikon and i'm team Canon, so obviously he's gonna recommend Nikon right? So it's totally cool honestly. When you get a Nikon or a Canon, it's not gonna make a world of difference at all. I would probably go with the setup that he recommends which i'll keep in as a suspense for you obviously. The thing that people will probably also want to know is what is my setup, what am I using. Well i'm using a very old model. I bought this like eight years ago right? I'm using a canon 60d if i was getting my setup all over again if i was a new grad and instead of getting the 60d which was pretty good back then i'd probably now get the canon 850d, i'd get the 100 millimeter macro lens which is still the same one i have today and i'd get a ring flash. Now i know you can get twin flashes and you get the sexy line angles and stuff but i think when you're starting out in photography you want consistency and you want to be able to take effective occlusal shots and you don't have to faff around too much. So i think start with the ring flash. It was designed for this kind of stuff, it's brilliant and it's going to get you a lot of good shots and you cannot, you can even be artistic with it. You can actually detach the ring flash part and sort of point it...
You place some veneers and your patient leaves in tears of joy. Imagine getting a letter a few weeks later to tell you that the patient now HATES her veneers and would like a full refund. That is soul destroying stuff, and it's NOT about the money!
https://youtu.be/LCAhjm9ymy8 Dr Rhode to the Rescue!
Need to Read it? Check out the Full Episode Transcript below!
Within the context of this specific scenario where 6 veneers were placed, we discuss:
A. How this could have been prevented
B. How to handle the veneers that are 'bulky at the gumline'
C. How to handle this refund request...!
I want to thank Dr Manrina Rhode for yet again adding so much value for the Protruserati
You can check out her course on Designing Smiles website
If you liked her episode and want a full hour of Veneers from preps to Temps, check out Everything Veneers with Manrina Rhode
Click below for full episode transcript:
Opening Snippet: You pour your heart and soul into a treatment. You like study extra, you go on extra courses, you want to give your patient the best they can get so when it comes to like cosmetic dentistry, veneers remember your first couple of veneer cases like you really think about it. You really go that extra mile to make sure your patient is ecstatic at the end and then you get a letter saying that i would like a refund for my veneers like that crushes you right?...
Jaz's Introduction: So this my friends is something that was experienced by one of the Protruserati. She's going to remain anonymous and i really wanted to help her. So i'm recording here on sunday as in like an emergency episode i message Manrina Rhode, veneer queen who else right about how to tackle this scenario. So the scenario is basically you do some, you place six veneers for a patient and she's really happy, she approves the try-in, she approves a mock-up even, she signs your consent form, she leaves really pleased on the day that you fit the veneers and then you get a letter and you think this letter is gonna be a thank you letter but actually it's letter say that i have gone and got a second opinion from so-and-so dentist pg, dip aesthetic dentistry and implant density blah blah and we both agree that the veneers are too bulky. So the main complaint was actually i think my, by the gum line they're too bulky and i don't like them anymore without actually telling the dentist. They just wrote in like out of the blue right and i would like a full refund of all the treatment. So this dentist wrote to me to say that she's really upset that this has happened and she followed the whole protocol and she worked so hard and she's a really awesome progressive forward-thinking dentist who has put a lot of time and money into her education so i felt really crushed for her because of one sentence she said that she she's really lost confidence in herself and we will all lose confidence in ourselves in some procedures throughout our career. It happens it's inevitable and i want to make this episode to help her out and so that we all as a group can learn because we all have patients, veneers patients in particular right because i'm happy to say that patients who come seeking veneers they're all a little bit crazy let's face it. They're a little bit crazy i think and we have to be wary of body dysmorphia. So i pitch this scenario to Manrina Rhode, how would she advise handling a scenario A) had to prevent this from happening in the first place that you don't have an unhappy patient. B) now that a patient has complained of bulk veneers, is it okay to prep them down? How do you manage that? and C) should this dentist give the money back to the patient? What does Manrina think? I actually felt bad about asking Manrina this last question because very tough question to ask. I really twisted her arm at the end so anyway i hope you enjoyed this group function and i hope you gained value from it thank you so much.
How do you obturate yours? When I have had the equipment (and training) I have used warm vertical compaction - no doubt that IS the gold standard. However, what is the humble GDP using all over the world? I would argue that not only are we using cold lateral compaction with sealer, but in many cases, we are sticking a big, fat, tapered GP cone in the canal with a splodge of sealer around it. Is that legit?
https://www.youtube.com/watch?v=GkWR7XzTHCs The million dollar endodontic question that no one asks!
Need to Read it? Check out the Full Episode Transcript below!
Obviously the landscape is changing with the popularity of bioceramic sealers in Endodontics - I use this time to ask Dr Ammar Al-Hourani about this too.
Is single point obturation cheating?
Should GDPs start using bioceramic sealers?
Does it even matter?
I hope you enjoy this group function - you can follow Dr Al-Hourani on Instagram via @theendoguys
If you enjoyed this, you might also like my episode with another talented Endodontist, Kreena Patel, on why we hate cracked teeth!
Click below for full episode transcript:
Opening Snippet: Hello, Protruserati, I'm Jaz Gulati and welcome to this group function where we answer one burning question. Today's burning question has been sent in by someone it is regarding endodontics, is single point obturation good enough?...
Jaz's Introduction: What i mean by that is you prepare your chemo mechanically prepare your canal and now when you come to the obturation stage you just stick one of those fat master gp cones in there potentially a matching size to a rotary file you just used and then you just fill up the rest with the sealer is that good enough? See i think this is what GDPs all of the world are doing. We're not doing warm vertical compaction, we can be doing cold lateral compaction as a whole but a lot of times you stick the fat gp cone in and it fits well enough and there's not enough space for cold lateral compaction. So is this technique of obturation up to the mark? So that's what i'm gonna find out today from from Ammar Al-Hourani, who's a specialist endodontist and we're gonna jump straight away just one thing to say is the splint course is now just under two weeks away i'm looking to launch it march 12th. It's the first time i'm revealing this. So march 12th it should be a launching online this splint course is 100% online. it's packed full of videos like my resin bonded bridge course i thought i'm really proud of it. It's got loads of rave reviews but it lacked video so i took that several notches further with the splint course and you're basically like watching me like you're like over the shoulder kind of training while i'm adjusting splints, while i'm going through diagnostic process. It very much teaches you the very basis basics of an anatomy as a gdp and building up to a diagnosis and how to choose which splint will help your patient the most. Sometimes we're looking just use a protective splint but also with that protective splint to protect your restorative work or prevent the patient from pathologically destroying their teeth, there's a bit of a decision-making tree as to which splint why and when and what are the risks of certain splints. So i'm going to go through eight or seven of that including the delivery from a stabilization splint to AMPSAs, the whole lot in between. So i'm so excited to share that if you're interested why don't you download one of my flow charts i've got a free flow chart for you to download which pretty much even if you don't do the course you're going to find it valuable because it's going to show you when i prescribe certain appliances. Now just a disclaimer i made a flowchart and really it's a guide but you should be deviating away from guide any sort of guideline you should always be happy to deviate away from a guideline because there's no such thing as a cookie cutter approach to occlusion.
I recorded an Instagram Live with Dr Prateek Biyani of The Dental Notebook to answer a question sent in from the Protruserati:
Hi Jaz, I hope you are well. I'm working as a NHS associate for nearly 3 years and I was thinking whether it's worth doing DCT training or if it's better to keep up with private courses to improve skills?Anonymous question from a fellow listener
https://www.instagram.com/tv/CKRxwRGJv6H/?utm_source=ig_web_copy_link Full IGTV Video
Listen to find out what me and Prateek recommended!
Need to Read it? Check out the Full Episode Transcript below!
Check out Prateek's new book, Single Best Answer Questions for Dentistry!
If you enjoyed this episode, you might also like Making your Dental Portfolio by Jaz
Click below for full episode transcript:
Opening Snippet: Welcome to group function where the Protruserati work together to find good solutions to worthy problems in dentistry with your host, Jaz Gulati...
Jaz's Introduction: Hi guys, if you've ever wondered about doing a residency post or a senior house officer or just a year in hospital, then this episode is to help you whether you're newly qualified and you're looking for that next step, or like the question that was sent in for this group function if you're a couple years qualified and you're still considering having that year in hospital, is it worth it for you? But as you may gather this was done live on Instagram so do excuse the live shoutouts but I'm still hoping there's a lot of value in you listening today. So thank you Protruserati, hope you enjoy. So guys, I'm not gonna waste time because this is a group function is another one the arms of the protrusive dental podcast and someone has sent in a question and would answer it in the best person I have to answer it is Prateek Biyani, aka the dental notebook. He makes some fantastic content around this very topic. Hello, dental bro. Thanks so much for joining. Hi, Andy. I'm going to speak to you in about 45 minutes, I think what meeting? Hello, Chris. Nice to see you, buddy. So yeah, thanks for for joining me guys. This is mostly for someone who is stuck as an associate and they're considering further training. Hello, amen. Hey, guys, Alex. Hey, everyone. So the question that was sent in I'm gonna get Prateek in a moment is a question that was sent in was "Hi, Jaz, have been an NHS associate for three years, it's been an associate for three years, I was wondering if DCT training is worth it? Or is it better to keep up with private courses to improve skills?" So basically, three years qualified, NHS associate full time I imagine. Should I do DCT now, or private courses? So let's get. Hi Haley. Hey, everyone. Let's get Prateek.
Main Interview:
[Jaz]Hey, buddy. How you doing, man? I'm good. How are you? I'm good. Do I look fat now? Like, you know the camera adds 10 pounds, right? You have a little bit, that's how much it's fine. The camera really does add 10 pounds. Look at that. So at the bottom, I'm reading the comments, Ali. Oh, man, Ali, I love your work. Manual photography, your flow is awesome. And you said you love DCT. I also had a very positive well, mostly positive DCT experience. One of my posts was phenomenal in Sheffield, the other one in Guys was a bit, half and half. But we can we can touch on that in this episode. But listen, this is a group function. So it has to be time efficient, right? So I'm not going to make it a full one hour long. It's going to be a 10 minute 15 Minute. So Prateek, I'm going to say the question again, for those who just joined us and for you again. "Hi, Jaz I'm an NHS associate. I've been qualified three years. I was wondering Should I do DCT? Is it worth it now? Or should I continue to invest in private courses to improve my skills?" So the first thing I'm thinking Prateek before you jump in is like why do anything? What's the purpose? Right? And I think the very end of her question is to improve my skills.
When you present your patients with the ideal options, but they end up choosing 'patch-up' Dentistry...this is a real world problem, and we will tackle it in a comprehensive way in this Group Function!
Thank you Anonymous Dentist on Instagram for sending in this BRILLIANT question:
Hey jaz! I've been listening to your podcast and I'm a huge fan!I especially enjoyed the Chris Orr one and the communication one.I just wondered if I could have some advice please..I'm working across two practices at the moment, 1 fully private and 1 mixed practice.At the mixed practice, often patients with broken teeth don't want to pay for crowns/onlays even though I spell out the benefits, often they will go for a replacement amalgam (which I hate doing) or a large private composite (again risk of debond due to the size)What would you recommend? If a patient doesn't want to pay for a crown /onlay but you've spelt it all out then I'm not sure what else I can do?Thanks in advance! XAnonymous Dentist in the UK, Instagram
https://youtu.be/Y9xGee14LMg Real world problem in Dentistry...what is the solution? Full episode above
You all know what happens when you get Zak Kara to give a quick answer....there is not such thing! Dr Zak Kara goes way beyond the call of duty and delivers us solutions in his signature comprehensive fashion!
We tried to steer away from the NHS vs Private Dentistry debate too much - but definitely your environment and the values of your patients plays a huge role.
Thank you so much for sending this question in - if anyone has a question they want to submit, do contact me via the website or send your question via DM on Protrusive Dental Instagram.
If you found this valuable, share it with your associates and principals.
If you liked this, you will also like Zak's gems on Communication in Episode 10!
Here are some comprehensive notes/episode summary was written by fellow Protruserati, Taha Adamji - Thank you, Taha!:
PDP GF002 - Communication with Zak Kara - patients always choosing the inferior option
ROLE PLAY
Building rapport as you’re coming up/welcoming them in
E.g. How was your journey in today?/How’s your day going today?
Feel free to put your things over there and take a seat - give them clear direction when they come in about what to do
What can I do for you?
My molar broke - yes I heard, (Receptionist name) told me you’re having a bit of trouble with a tooth on the UL I’ve had a look through your notes/X-rays/photos etc - from your previous visits - this shows you are well prepared to help them
Sorry to hear that/ that can happen sometimes (empathy)
Is this the first time this has happened to you or has it happened before? (History) Am I right that it doesn’t/does it hurt right now?Is it rough to your tongue/uncomfortable?
Patient mentioned the clinic/gave praise
Thank you/that’s kind of you to say, I’m reassured by that/what do you already know about us?/it’s your first time seeing me /you saw (x) dentist previously is that right? - all shows you have taken the time time to read their notes/are interested in them and their past experiences
Patient apologised for not coming
That’s no problem/Don’t apologise/there’s no need to apologise. What we do here is always blame free/judgement free dentistry
Let’s see how we can help you with this problem tooth today:
Because this is a “get you of of trouble type of appointment”/urgent/emergency appt, the aim for today is to focus on that one toothI’m not going to do a full health check/exam today if that’s okay, I’m going to focus on this main problem for youBut let’s also check there’s nothing else urgent going on and then we’ll see if we can get this problem solved for you by the end of the visit What did you hope or expect was going to happen today? (Check expectations)
“I was hoping it could be patched up and then I would be on my way”
that’s definitely something we could do for you to make it...
This is the very first Group Function and we are tackinling RBBs! I will take questions from the fellow Protruserati - I will use your help to come up with some helpful solutions.
TLDR: You can do Dahl RBBs, but it doesn't always mean you should. A little prep of enamel will not be THAT detrimental for the tooth.
https://youtu.be/VtRlzodts8c
Need to Read it? Check out the Full Episode Transcript below!
Thank you Aaron for helping this episode happen as our first question! It is about a technique dear to my heart - Resin Bonded Bridges!
Firstly, if you know nothing about the Dahl technique, you totally need to listen to the episodes with Tif Qureshi on Dahl Part 1 and Part 2.
It CAN be a good way to place Resin Bonded Bridges in a way to eliminate any preparation for the occlusal surface - in young patients it can be very successful.
However, it just seems a shame to prop someone's bite open on just ONE tooth and allow what naysayers refer to as 'unpredictable orthodontics' to work it's sweet magic.
I am totally fine with a little prep - staying in enamel (which is so key!) - every case is unique so treat on it's merits. In a younger patient, I am more likely to consider that approach.
I hope this helps! If you find this useful - send it to a colleague.
I cover Dahl RBBs extensively in the Resin Bonded Bridges CPD Online Masterclass as well as Zirconia RBBs.
Click below for full episode transcript:
Opening Snippet: You know sometimes when you get asked a question and then you help to answer that question or you know someone who knows the answer and you connect them and then the topic that you discuss becomes so helpful, so useful. You kind of wish that 'hey you know what i wish more people had access to this' because i'm sure if this person benefited from these answers that many others will also benefit from these answers...
Main Topic: So this is why, this is the first ever group function okay? So i'm calling this series group function because it's us, you and i working as a group. You guys the listeners, myself, the previous guest of the podcast, the future guest podcast and those on the Protrusive D,ental community facebook group we're going to ask questions, we're going to answer questions. They're going to share answers, we're going to try and be i guess a fly on the wall when these helpful conversations happen. So for the first ever group function, someone messaged me yesterday with a question his name's Aaron Raju. Aaron, thanks so much for the question and he gave his consent for this to be go on an ama so i can ask me anything but of course i'm calling this the group function. So what Aaron asks is to do with resin bonded bridges so aka maryland bridges you know i don't like that term but anyway maryland bridges and using maryland bridges as part of the dahl technique. Now if you are totally unfamiliar with a dahl technique you need to end this episode now and go back to episode 16 and 17 where we are joined by Dr Tif Qureshi and we talk everything and anything about dahl, about how it works, the mechanisms, the indications, contraindications. So this is a really important background knowledge to have, to be able to answer this question and resin bonded bridges are something very dear to my heart. I've got a little mini series online on rbbmasterclass.com so i placed hundreds of resin bonded bridges. I've published on this technique in dental update. So Aaron thanks so much for the question basically i'll read it out "Dr Gulati.." Well first you don't need to call me Dr Gulat. I am Jaz, you know that. Hope you don't mind answering quick query. I read your papers in dental update regarding resin bonded bridges. I have a case where a resin bonded bridge is used to replace an upper right five with the upper right six as an abutment with the wing overlying the palatal cusps and the palatal surface. This was no prep and the plan is to dahl to reestablish posterior occlusi...