Protrusive Dental Podcast

Jaz Gulati
  • 4.9 (158)
  • Medicine
  • Updated weekly

The Forward Thinking Dental Podcast

  1. 2 days ago

    Putting the ENT into dENTistry – PDP272

    Sleep, Airway and Mouth Breathing: An ENT’s Guide for Dentists Could a “normal” sleep study still be missing your patient’s airway problem? Why do women and children with real symptoms keep scoring “mild”? Should a mouth-breathing child see a myofunctional therapist — or an ENT first? And which four questions screen a child for sleep problems in under a minute? The roof of the mouth is the floor of the nose — so ENT and dentistry should be in constant dialogue. In practice, they rarely are. In this one, Dr David McIntosh — an Australian ear, nose and throat surgeon with a deep niche in sleep-disordered breathing — makes the case for why that has to change, and gives dentists practical ways to screen and refer. He is direct, analogy-rich and doesn’t mince words; expect a few positions that cut against the grain of how sleep apnoea is usually handled. https://youtu.be/QVEc0ocxTCc Watch PDP272 on YouTube Protrusive Dental Pearl: When the Numbers Mislead Dentists love data — the AHI, the cut-offs (over 5 is mild, over 30 is severe). But take those numbers with a pinch of salt: the thresholds are arbitrary, and a single score tells you nothing about why a patient has the problem. They don’t account for individual variability — especially in women and children, where a mild score can sit right alongside significant symptoms. Read the number with the anatomy and the phenotype — the clinical signs and the airway assessment — never instead of them. What You’ll Take From This Episode This conversation reframes sleep-disordered breathing from a number on a report into something you can localise and refer.  A sleep study tells you IF, not WHY — sleep-disordered breathing is the whole spectrum; a normal study doesn’t mean normal breathing. Phenotyping the airway — map the individual anatomical causes instead of trusting a single score. Why women get missed — the gender bias built into standard adult screening tools, and what to ask instead. The four-question filter for children — snore, mouth breathe, stop breathing, wake up tired: any ‘yes’ means refer. Treat the cause before the function — why myofunctional therapy comes after the obstruction is cleared, not before, and how expansion and surgery are matched to the anatomy. Highlights of This Episode 00:00  Teaser 01:00  Why ENT and Dentistry Should Be Talking 02:51  Protrusive Dental Pearl: When Sleep Data Misleads You 03:46  Meet the ENT Who Works With Dentists 06:00  Sleep Physician, ENT or Dentist: Who Should Lead? 07:26  Why Children and Adults Are Completely Different 08:58  Sleep-Disordered Breathing Is Not the Same as Sleep Apnoea 09:39  Why a Normal Sleep Study Doesn’t Mean Normal Breathing 10:01  Same AHI, Different Cause: A Tale of Two Patients 12:54  Why One Night’s Sleep Study Isn’t Enough 13:44  Where the AHI Cut-Off Numbers Really Came From 15:27  CPAP Explained: A Bridge, Not a Cure 18:27  When Snoring Hides Something Serious 19:10  What Phenotyping the Airway Actually Means 20:27  Splint, CPAP, or Both? 21:33  Why a CBCT Can Miss a Deviated Septum 25:32  Is STOP-Bang Enough to Screen for Sleep Apnoea? 26:06  Why the Epworth Sleepiness Scale Is a Blunt Tool 26:50  Why STOP-Bang Is Biased Against Women 31:17  Sleep Apnoea in Women: Mild on Paper, Severe in Life 32:05  Midroll 36:56  The Triad: Airway, TMD and Orthodontics 37:12  The Three Most Common Causes of Night-Time Grinding 39:41  The Four Questions That Screen a Child for Sleep Problems 41:03  Tired vs Not Tired: The Sign That Changes Everything 43:36  Should You Refer to Myofunctional Therapy Before an ENT? 45:58  The Hidden Dangers of Forcing Nasal Breathing 52:28  Maxillary Expansion vs Surgery: Which One Fixes It? 54:51  How Dentists Can Assess Adenoids 56:25  Save the Child First: The Drowning Analogy 57:56  Where Dentistry and ENT Go From Here 1:00:05  Outro – New-Look Premium Notes & CPD Outro From the Guest Dr David McIntosh is an ear, nose and throat surgeon (MBBS, FRACS, PhD) with a special interest in sleep-disordered breathing and airway obstruction. A self-described compulsive educator, he is the author of several books on Amazon — including dENTal health, on the connection between ENT and dental disease, and Snored to Death, on the lesser-recognised causes of obstructive sleep apnoea in adults. References & Further Reading Sources discussed in this episode: Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Medicine, 2000;1(1):21–32. The 22-item PSQ; a score above 0.33 suggests sleep-disordered breathing. Loved This Episode? Try Next Airway Dentistry with Jeff Rouse – PDP229 Listen, Subscribe, Earn CPD This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C AGD Subject Code: 730 – Oral Medicine, Oral Diagnosis, Oral Pathology (Sleep medicine) #PDPMainEpisodes #OralSurgeryandOralMedicine Aim & Learning Outcomes Aim: To help dental practitioners recognise sleep-disordered breathing across the whole airway, screen adults and children appropriately, and refer at the right time and to the right clinician. Learning Outcomes — by the end of this episode, dentists will be able to: Differentiate sleep-disordered breathing from obstructive sleep apnoea, and explain why a normal sleep study does not exclude clinically significant breathing problems. Apply a structured screening approach for adults and children, including recognising why standard adult tools under-detect sleep-disordered breathing in women and children. Evaluate when to refer for specialist airway assessment, and articulate why addressing anatomical obstruction should precede functional (myofunctional) therapy.

    1hr 1min

  2. 17 Jun

    Your Dental Assistant Can Make or Break You – IC075

    The most important part of your surgery isn’t plugged in, mounted, or calibrated. It’s the person standing beside you. Have you ever dreaded walking into a beautiful practice with lovely patients — purely because of who you share the surgery with? What do you actually do, in the moment, when your assistant rolls their eyes at a request for rubber dam? And should you be friends with your assistant at all — or does that cross a line you’ll regret? This is an Interference Cast — a non-clinical but deeply practical episode — with Dr. Sarah Braun, a dentist in Australia and a fellow Protrusive Guidance member who DM’d to suggest this very topic. No course, no book, nothing to sell: just two clinicians comparing notes (and the odd scar) on the one relationship that quietly shapes your whole working life. It sits inside this month’s theme of the relationships that support your career. https://youtu.be/OyztRyPpcHM Watch IC075 on YouTube What You’ll Take From This Episode The full breakdown is in the Premium Notes; here’s the shape of the thinking that runs through the episode: Engagement is the whole game — the assistant relationship sets the mood of the room, the patient’s experience, and whether good people stay. Speak their language — appreciation only lands if it’s delivered in the form that particular person actually values. Appreciation is a verb — specific, named praise lands far harder than a vague “good job.” Let them, let me — you don’t control how someone reacts in the moment; you only control your response to it. Lead the room — dentistry is a performance, and the room takes its emotional cue from whoever is leading it. Highlights of this episode: 00:00 TEASER 01:13 Why This One Relationship Can Make or Break You 03:49 A Non-Clinical Interference Cast: What to Expect 04:47 Meet the Guest: Nine Years In, City to Country 07:01 A Week in Private Practice 09:15 How Much Does the Dentist–Assistant Relationship Matter? 11:01 Engagement at Work: The Gallup Lens 12:30 People Remember How You Made Them Feel 14:21 When the Relationship Turns Toxic 15:23 The Power Imbalance You Might Not See 18:11 The First-Day Conversation 20:52 Keeping Your Assistant Engaged 22:23 Specific Praise Beats a Vague “Good Job” 23:55 Midroll 27:37 You Can Only Control Yourself 29:34 The Eye-Roll Moment: Let Them, Let Me 31:23 Off Days vs Patterns 32:12 Appreciation, Gifting & Speaking Their Language 35:32 Run the Relationship Like It Matters 36:48 Friends With Your Assistant, or Keep Your Distance? 39:08 A Best Friend at Work: The Engagement Link 41:15 Advice for New Grads: Start With Time Management 44:26 Teaching as a Tool: Show Your Working Out 48:05 Wrap-Up & a Healthy Debate 48:37 CPD Outro & the Protrusive Vault References & Further Reading: Sources and further reading from this episode: Chapman G. The Five Love Languages. Northfield Publishing, 1992. The five ways people give and receive appreciation — words of affirmation, quality time, acts of service, receiving gifts, and physical touch — applied here to the dentist–assistant relationship. Robbins M, Robbins S. The Let Them Theory. Hay House, 2024. The “let them / let me” reframe for releasing what you can’t control and owning your own response. Rath T. StrengthsFinder 2.0. Gallup Press, 2007. The CliftonStrengths assessment; “Learner” is one of its talent themes, referenced in the discussion of teaching as a way to engage your assistant. Gallup employee-engagement research. The Gallup Q12 engagement survey (including the validated “I have a best friend at work” item) and Gallup’s State of the Global Workplace reports. Source of the workforce-engagement framing in this episode. Exact figures vary by year — see Reviewer Note. Want more? If you enjoyed this episode, check out: How to Find a Mentor in 5 Seconds Flat! – IC058.  #InterferenceCast #CareerDevelopment #Communication #BeyondDentistry Listen, Subscribe, Earn CPD: This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A and B AGD Subject Code: 550 Practice Management and Human Relations Aim & Learning Outcomes: Aim: To help dental practitioners understand and strengthen the working relationship between dentist and dental assistant — recognising its impact on team engagement, patient experience and personal job satisfaction, and building practical habits to improve it. Learning Outcomes — by the end of this episode, dentists will be able to: Explain how the working relationship between a dentist and a dental assistant affects team engagement, the patient experience, and clinician wellbeing. Identify practical strategies for communicating appreciation and recognition in ways suited to the individual, and for involving an assistant according to their preferences. Apply self-management and emotional-regulation approaches to leading the surgery and responding constructively to interpersonal friction.

    49 min

  3. 10 Jun

    Rotary vs Reciprocating Files Part 2 with Samuel Johnson – PDP271

    Is rotary really better than reciprocating? Can you safely skip the glide path with modern reciprocating systems? What is the best file system for a GDP who wants predictable endodontic results? And perhaps the biggest question of all: does the file system matter as much as we think it does? In Part 2 of the Endo Showdown, Dr Samuel Johnson returns to tackle some of the most common questions dentists have about file systems, glide path preparation, retreatment, and endodontic workflow. From practical negotiation tips to choosing a system that works in your hands, this episode focuses on the decisions that can make endodontics simpler, safer, and more predictable. https://www.youtube.com/watch?v=onZMR-872HQ Watch PDP271 on YouTube Protrusive Dental Pearl Cut your gutta-percha at the level of the canal orifice and thoroughly clean the pulp chamber before placing the coronal restoration. ⚠️ Leaving gutta-percha and sealer coronally can compromise the coronal seal and promote leakage. ✅ Use isopropyl alcohol to clean resin-based sealer residue before bonding. Water is effective for cleaning bioceramic sealers. Key Takeaways Establish a glide path before shaping whenever possible. D-Finders can negotiate difficult canals more predictably than traditional K-files. Intermediate files such as size 12 or 12.5 can help bridge the jump from size 10 to size 15. Straight-line access reduces file binding and improves shaping efficiency. Avoid forcing glide path files to working length. Gates Glidden drills may be unnecessarily aggressive for routine coronal flaring. Consistency with one file system is often more important than chasing the latest product. WaveOne Gold remains a simple and user-friendly option for many GDPs. Rotary and reciprocating systems can both achieve successful outcomes when used appropriately. A good glide path is often more important than the type of motion being used. Hand files and Hedström files remain valuable during retreatment. Mechanical GP removal near the apex increases the risk of extrusion. Solvents are best reserved for residual gutta-percha rather than used at the start of retreatment. Understanding motor settings, torque, and RPM improves file safety and efficiency. Knowing when to refer is a sign of clinical maturity, not weakness. Clear consent and expectation management reduce stress for both clinician and patient. Highlights of this episode: 00:00 Teaser 01:09 Introduction 02:15 Protrusive Dental Pearl: Coronal GP Removal & Pulp Chamber Clean-Up 03:59 Glide Path File Protocol & Canal Negotiation 06:24 Access Cavity Design & Coronal Flaring in RCT 08:38 File Taper & Canal Preparation Philosophy 09:54 Managing Difficult Canals in Endodontic Treatment 11:48 When to Introduce the Glide Path File 13:24 Using Intermediate File Sizes 15:39 Useful Negotiation & Shaping Tips 17:19 Choosing a File System 20:19 Rotary vs Reciprocating in Clinical Practice 21:29 Motor Settings & File Control 21:40 XP-Endo & Specialised File Designs 22:05 Endo Motor Ads 24:44 XP-Endo & Specialised File Designs 25:16 Retreatment Files & GP Removal 26:08 Preferred Gutta-Percha Removal 31:21 Recommended System for Simplicity 32: 44 Building Skills Faster in Endodontics 36:13 Consent & Managing Expectations 41:51 Reciproc vs WaveOne Gold 42:22 Preferred Retreatment Protocol 43:33 Using Rotary Files in Reciprocation 45:12 Curved Canals & Shaping Efficiency 46:32 Can Reciproc Blue Bypass the Glide Path? 49:29 Outro Want more? Check out the previous episode with Dr. Samuel Johnson: Working Lengths and Troubleshooting Apex Locators – PDP216 🦷 Looking for an endomotor? Upgrade your endodontic workflow with the Woodpecker Endo Radar Pro. Head to protrusive.co.uk/endomotor and use coupon code PROTRUSIVE at checkout to claim an exclusive discount and your choice of complimentary file system. 🎁 Subscribe to Dr. Samuel Johnson’s amazing YouTube Channel: I Love The Pulp for more helpful endodontics tips and tricks.  #PDPMainEpisodes #EndoRestorative This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C AGD Subject Code: 070 – Endodontics Aim: To enhance clinicians’ understanding of glide path preparation, rotary and reciprocating instrumentation, canal negotiation, retreatment strategies, and risk management in contemporary endodontic practice. Dentists will be able to – Dentists will be able to evaluate the role of glide path preparation in improving shaping efficiency and reducing procedural errors. Dentists will be able to compare practical considerations when using rotary and reciprocating file systems. Dentists will be able to apply safe and predictable approaches to canal negotiation, retreatment, and clinical decision-making.

    52 min

  4. 3 Jun

    Rotary vs Reciprocating Files – The Endo Showdown with Samuel Johnson Part 1 – PDP270

    Rotary or reciprocating files — which should you actually be using? Is one safer than the other? Does reciprocation really reduce file separation? Are you choosing your system because it suits the canal anatomy, or because it is simply the one you were taught? Endodontic file systems can feel like a maze of brands, tapers, alloys, motions and marketing claims. But beneath all that noise, the real question is much more practical: what is your file doing inside the canal, and what compromise are you accepting? In this episode, Dr Samuel Johnson returns to unpack the Endo Showdown: rotary versus reciprocating files. We cover file motion, glide paths, shaping philosophy, NiTi metallurgy, cyclic fatigue, torsional fatigue, and why no system is perfect. https://youtu.be/HfWDBbNgjsA Watch PDP270 on YouTube Protrusive Dental Pearl A palliative root canal can be useful for an unrestorable tooth if disinfecting the canal allows infection to heal and natural bone to recover before extraction and future implant planning. ⚠️ Do not dismiss root canal treatment purely because the tooth is not a long-term functional restoration. ✅ Where appropriate, consider whether endodontic disinfection could improve the future implant site by allowing natural bone healing. Key Takeaways The purpose of shaping is not simply to scrape canal walls; it is to create space for irrigant flow. Irrigation is the most important part of root canal disinfection. Rotary files move in a continuous 360-degree rotation. Reciprocating files cut in one direction and reverse before excessive stress builds up. Modern reciprocation is designed to cut, release and gradually progress apically. File choice is not just about motion; metallurgy, taper, design and operator experience all matter. NiTi hand files with strong shape memory may be problematic in curved canals because they want to straighten. Martensitic heat-treated files are more flexible and can better follow canal curvature. Unwinding flutes are a warning sign that a file may be close to separation. Inspect files regularly during treatment, especially in curved, calcified or difficult canals. A glide path is essential before introducing larger rotary or reciprocating files. Without a glide path, a shaping file may create its own path, risking ledging, transportation or perforation. “Grabby” files pull themselves into the canal; this can be useful in experienced hands but risky if forced. Reciprocating systems can feel simpler and safer, but they are not foolproof. Cyclic fatigue happens when a file repeatedly bends around a curve until microcracks form. Torsional fatigue happens when part of the file binds while the motor continues to turn. Highlights of the episode: 00:00 Teaser 00:47 Introduction 02:13 Protrusive Dental Pearl: Palliative Root Canal Treatment 05:30 Main Question: Rotary vs Reciprocating Files 06:31 Hybrid File Motions 08:19 File Choice Is More Than Motion 10:26 Purpose of Shaping in Endodontics 11:10 Chemo-Mechanical Preparation 11:34 Rotary Motion in Root Canal Treatment 11:45 Origins of Reciprocation 12:21 Balanced Force Technique 18:00 NiTi K-Files vs Stainless Steel K-Files 22:37 Practical Advice: Inspect the File 23:40 Rotary Can Also Be a One File System 24:24 Reciprocation and Sense of Safety 24:47 “Grabby” Files 24:53 Midroll 33:54 Choosing Between Rotary and Reciprocating 35:20 Cyclic Fatigue 37:41 Endo Radar Pro Ads 40:20 Torque and RPM in Endodontics 41:41 Why Reciprocation Advances 42:56 Debris Extrusion in RCT 43:34 Benefits of Rotary Systems 44:13 Tactile Feedback in Root Canal Treatment 45:21 Outro Want more? Check out previous episode with Dr. Samuel Johnson: Working Lengths and Troubleshooting Apex Locators – PDP216 🦷 Looking for an endomotor? Upgrade your endodontic workflow with the Woodpecker Endo Radar Pro. Head to protrusive.co.uk/endomotor and use coupon code PROTRUSIVE at checkout to claim an exclusive discount and your choice of complimentary file system. #PDPMainEpisodes #EndoRestorative This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C AGD Subject Code: 070 Endodontics Aim: To improve dentists’ understanding of rotary and reciprocating endodontic file systems, including file motion, glide path creation, file metallurgy, fatigue mechanisms, irrigation principles, and practical steps to reduce procedural risks. Dentists will be able to – Understand the clinical differences between rotary and reciprocating file motions and how these may influence endodontic workflow Recognise key risk factors for file separation, including cyclic fatigue, torsional fatigue, file distortion and inappropriate file use Apply practical principles around glide path creation, irrigation, file inspection and system selection in endodontic treatment

    45 min

  5. 27 May

    A Practical Guide to Modern Caries Management Part 2 – Peptides, SDF, Hydroxyapatite and Xeristomia! – PDP269

    Should we still be drilling early caries lesions? Where do peptides, resin infiltration, fluoride varnish and SDF actually fit in modern practice? Is hydroxyapatite toothpaste a genuine alternative to fluoride, or just another dental trend? And when you see that suspicious grey occlusal shadow, do you seal it, explore it, or actively surveil it? In part two of this modern caries management episode, Jaz continues the conversation with Prof. Avijit Banerjee on minimal intervention dentistry. This episode moves beyond diagnosis and communication into the practical management of early and progressing caries lesions, including peptides, SDF, hydroxyapatite toothpaste, fissure sealing, xerostomia, root caries and selective caries removal. https://youtu.be/dGt7FW7C4N0 Watch PDP269 on YouTube Protrusive Dental Pearl Use the Contemporary Caries Management Implementation Pack as a chairside aid to turn the episode into daily clinical action. ⚠️ Learning the evidence is not enough if it never makes it into your patient conversations, risk assessment or treatment planning. ✅ Print it, laminate it, and use it to support communication, diagnosis, active surveillance and minimally invasive decision-making. Disclaimer: This is an educational resource produced by Team Protrusive, derived from the two-part Protrusive Dental Podcast episode featuring Prof. Avijit Banerjee. Its contents were not written, reviewed, or endorsed by Prof. Banerjee; they represent Team Protrusive’s own interpretation of the material discussed. It is intended as a practical summary and is not a substitute for primary sources. We strongly encourage all clinicians to consult the latest Clinical Practice Guidelines before making treatment decisions. Key Takeaways: Peptides are designed to infiltrate early enamel lesions and create a scaffold for mineral deposition. Peptide technologies still need minerals from saliva, toothpaste, mouthwash or other sources to work. Fluoride supports remineralisation; it acts more like the “mortar” than the “bricks”. Early E1 lesions are usually managed with prevention, fluoride, oral hygiene, diet control and biofilm control. Deeper enamel lesions, such as progressing E1 or E2 lesions, may be suitable for resin infiltration or peptide infiltration. SDF is better suited to cavitated lesions where arrest and stabilisation are needed. In the UK, SDF is licensed for dentine sensitivity, so caries arrest is an off-label use. SDF can be very useful for children, older adults, medically compromised patients and care-home patients. The main downside of conventional SDF is black staining, especially on anterior teeth. Hydroxyapatite toothpaste has more science behind it than charcoal-style fad toothpastes. Fluoride toothpaste remains the preferred baseline recommendation when patients are happy to use fluoride. A suspicious grey occlusal lesion should be assessed in the context of the patient’s overall caries risk. In selected cases, a tiny exploratory opening can act like a diagnostic biopsy. Sealing fissures on the same tooth being restored can be sensible when the fissure pattern is deep. For severe xerostomia and root caries risk, consider high-fluoride regimes, close recalls, trays or dentures as carriers for remineralising agents. YouTube Highlights: 00:00 Teaser 01:17 Introduction 02:17 Pearl: Caries Management Implementation Pack 05:54 What are Peptides? 14:42 SDF: Silver Diamine Fluoride 14:55 Early Enamel Lesion Pathway 15:11 When to Consider Resin or Peptide Infiltration 15:51 Best Use Case for SDF 20:14 Hydroxyapatite Toothpaste 21:18 Fluoride Safety and Evidence 27:00 Midroll 40:53 Preventive vs Therapeutic Sealants 42:09 Severe Xerostomia and Root Caries 44:40 Using Trays or Dentures as Carriers 45:48 Tooth Mousse and CPP-ACP 47:11 Artificial Saliva 47:46 Why the Patient Has Dry Mouth Matters 49:35 Current Position on Stepwise Excavation 50:09 Selective Caries Removal 51:15 Deep Caries Guidelines 53:01 Materials Are Not Everything in Caries Management 55:59 Further Learning Resource  56:44 Outro Want more? Check out part one of this modern caries management series for communication, diagnostics, triangulating data and deciding which caries detection tools are actually worth using. 🦷 Download the Contemporary Caries Management Implementation Pack Head to protrusive.co.uk/MID to access the free implementation pack, including key communication points, diagnosis guidance, management flowcharts and evidence links. Professor Avijit Banerjee’s recommended reading and ongoing work: New textbook: A Clinical Guide to Advanced Minimum Intervention Restorative Dentistry (Banerjee A., Elsevier, 2024) — the most comprehensive single reference for modern MIOC and MID. 👉  uk.elsevierhealth.com (ISBN 978-0-443-10971-3) Resources mentioned in this episode: S3 Guidelines: https://pmc.ncbi.nlm.nih.gov/articles/PMC13099699/  🦷 Interested in Proximal Resin Infiltration? Explore The Iconic Method with Cat Edney: a free 1-hour webinar on 24 June 2026, followed by a hands-on 1-day Birmingham course on 4 July 2026 covering Icon resin infiltration, tooth whitening and NIRI-guided enamel management, with verifiable CPD available.  Don’t miss out!DMG Icon Proximal discount for dental professionals at protrusive.co.uk/dmg #PDPMainEpisodes #BreadandButterDentistry  This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C AGD Subject Code: 250 Operative (Restorative) Dentistry Aim: To improve dentists’ confidence in modern minimal intervention caries management by applying risk-based decision-making, active surveillance, appropriate use of remineralising and arresting therapies, and evidence-informed restorative strategies. Dentists will be able to – Assess early and progressing caries lesions using patient risk, clinical signs, symptoms and radiographic findings. Select appropriate non-operative, microinvasive and stabilisation strategies, including fluoride, peptides, resin infiltration, sealants and SDF. Manage high-risk patients, including those with xerostomia or root caries risk, using prevention, recall planning and patient-specific delivery methods.

    57 min

  6. 20 May

    A Practical Guide to Modern Caries Management – MIOC and MID Part 1 – PDP268

    If you showed the same bitewing to 10 dentists, would they all agree on whether to pick up the drill? Why does the word monitoring mean nothing to a patient — and how does swapping it for active surveillance change everything from your notes to your indemnity to your government policy meetings? Is it overtreatment to act on an E2 lesion — or is “watch and wait” actually the lazy answer dressed up as minimally invasive? And what should you actually do with AI caries detection that flags shadows your eye doesn’t see? In this episode, Professor Avijit Banerjee — Professor of Cariology & Operative Dentistry at King’s College London, Honorary Consultant at Guy’s & St Thomas’, and First Dean of the Faculty of Dentistry at the College of General Dentistry — sits down with Jaz for what is genuinely one of the most important caries conversations on the podcast. Part one of two. Avijit doesn’t do soft answers. The drill-fill-bill model is broken. “Monitoring” needs to go. “Treatment planning” is antiquated terminology medics dropped twenty-five years ago. And AI in caries diagnosis? Useful — but the moment it gets things wrong, you are the one with indemnity, not the software. What you walk away with is a framework (MIOC), a decision filter (three factors that decide whether to pick up a bur), and a vocabulary shift you can implement tomorrow. Part two covers peptides, SDF, hydroxyapatite, stepwise excavation, and managing caries in xerostomia. https://youtu.be/YriLo8_hXNw Watch PDP268 on YouTube Protrusive Dental Pearl: Delete the Word “Monitor” from Your Vocabulary Stop saying monitor. Start saying active surveillance. ⚠️ Active surveillance must not mean passive delay — document your reasoning, risk assessment, and what would trigger intervention. ✅ Explain it to patients as structured, proactive care: clinical checks, radiographs, risk review, behaviour support, and timely action if things change. Key Takeaways Minimum intervention oral care is bigger than minimally invasive dentistry. MIOC is prevention-based, person-focused, susceptibility-related, and delivered by the whole oral healthcare team. MID is only one part of MIOC: operative dentistry when a tooth actually needs intervention. The four MIOC domains are: identify the problem, prevent lesions and control disease, provide minimally invasive operative care, then reassess. A care plan is more useful than a treatment plan because it includes justification, prevention, behaviour change, and review. Ask patients what matters to you, not just what’s the matter with you. Cavitation, cleansability, and lesion activity should guide whether to intervene operatively. A cavitated lesion that cannot be cleaned is much more likely to remain active. Smooth surface lesions may sometimes be made cleansable without conventional drilling. Restorations are not just about filling holes; they help recreate a cleansable tooth surface. There is no single perfect caries detection technology — clinical examination and good radiographs remain fundamental. If using NIRI, fluorescence, scanners, or AI, understand how the technology works and where it fails. AI should support diagnosis, not replace clinical judgement. For uncertain early lesions, triangulate: clinical findings, radiographs, risk, technology, and patient factors. Proximal resin infiltration has a role in the right patient and situation, especially as part of a wider prevention-led strategy. Highlights of This Episode 00:00 Teaser 02:17 Protrusive Dental Pearl: Active Surveillance, Not Monitoring 09:14 Minimum Intervention Oral Care vs Minimally Invasive Dentistry 11:28 Core Principles of MIOC 11:48 Domain 1: Identify the Problem 12:46 Domain 2: Prevention of Lesions and Control of Disease 13:18 Microinvasive Care Options 14:41 Domain 3: Minimally Invasive Operative Dentistry 16:38 Why “Active Surveillance” Matters 18:24 MIOC as a Practical Framework 19:43 Applying MIOC in Patient Communication 22:38 Sustainability & Salutogenesis 29:05 When to Pick Up a Drill 30:23 Biofilm as the Engine of Caries 31:33 Purpose of a Restoration in Caries Management 36:13 Caries Detection Technologies 42:44 Watch and Wait vs Detect and Manage 01:02:52 Outro Professor Avijit Banerjee’s recommended reading and ongoing work: New textbook: A Clinical Guide to Advanced Minimum Intervention Restorative Dentistry (Banerjee A., Elsevier, 2024) — the most comprehensive single reference for modern MIOC and MID. 👉  uk.elsevierhealth.com (ISBN 978-0-443-10971-3) 🦷 Interested in Proximal Resin Infiltration? Don’t miss out! DMG Icon Proximal discount for dental professionals at protrusive.co.uk/dmg Explore The Iconic Method with Cat Edney: a free 1-hour webinar on 24 June 2026, followed by a hands-on 1-day Birmingham course on 4 July 2026 covering Icon resin infiltration, tooth whitening and NIRI-guided enamel management, with verifiable CPD available.  Loved This Episode? Try this next: Is Caries Detector Dye BS? – PDP138 #PDPMainEpisodes #BreadandButterDentistry  Listen & Earn CPD This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A and C AGD Subject Code: 250 Operative Dentistry (Caries Detection and Prevention) Aim & Learning Outcomes Aim: To equip dental practitioners with a contemporary, evidence-informed framework for the diagnosis and non-operative or minimally invasive management of dental caries — with a particular focus on the decision-making that determines whether operative intervention is justified. Learning Outcomes — by the end of this episode, dentists will be able to: Describe the four underpinning principles and four clinical domains of Minimum Intervention Oral Care (MIOC), and articulate the difference between MIOC and minimally invasive dentistry. Apply a structured decision filter — incorporating cavitation, cleansability, and lesion activity — to determine whether a carious lesion requires operative intervention or microinvasive/non-operative management. Differentiate between passive monitoring and active surveillance, and use appropriate language in clinical communication, care planning, and contemporaneous notes

    1hr 3min

  7. 13 May

    Realism, Mistakes and Radical Honesty in Dentistry – IC074

    Why does dentistry on social media look so perfect? Are those flawless before-and-after cases the reality of everyday practice—or just the highlight reel? And why aren’t we talking more openly about the failures, frustrations, and imperfect outcomes that every dentist experiences? In this episode, Dr Artem Mkrtichyan joins Jaz for a refreshingly honest conversation about the realities of modern dentistry. Known for his candid and relatable social media posts, Dr. Artem has built a following by sharing what many dentists think—but rarely say out loud: dentistry is hard, results aren’t always perfect, and social media often paints an unrealistic picture of the profession. https://youtu.be/uTKaeewgrgE Watch IC074 on YouTube Key Takeaways Social media has become a powerful tool for dentists to connect and share experiences. Mistakes in clinical practice are common and should be openly discussed. Rural practice may not always lead to higher income as expected. Success in dentistry is subjective and varies for each individual. Continuous learning and skill development are crucial for career growth. Financial freedom in dentistry is not guaranteed and varies widely. Networking and mentorship can significantly impact career progression. Social media can be leveraged to attract patients and build a personal brand. Highlights of this episode: 00:00 Teaser 00:18 Introduction 02:24 Meet Dr Artem Mkrtichyan 05:27 Rejections And Resilience 09:03 Why Honesty Wins 10:58 Rural Dentistry Reality 14:58 Handling Online Criticism 16:01 Associate Vs Owner Myth 18:05 Midroll: Protrusive App 22:48 Dentistry Money Reality 26:57 Design Your Career Path 28:00 Standing Out In Saturated Markets 29:27 Content Marketing Strategy 31:46 Veneer Minimum Ethics 33:48 Final Advice And Community If this episode resonated with you, don’t miss “I Committed Fraud – Learn from My Mistakes” – PDP248 #InterferenceCast #BeyondDentistry This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan.

    34 min

  8. 11 May

    10 Occlusion Pearls That Will Blow Your Mind – PDP267

    Why does occlusion feel so confusing at dental school? What if the problem is not that occlusion is too complex, but that it was taught in the wrong order? How do you make sense of worn teeth, bite scans, shimstock, leaf gauges, provisionals and T-Scan without getting overwhelmed? And which small ideas can genuinely change the way you diagnose, plan and restore? In this episode, Jaz is joined by Dr. Mahmoud Ibrahim for a brilliant occlusion-focused conversation. They each bring five clinical “pearls” that helped occlusion finally click for them — from facially generated treatment planning to checking the contralateral side, muscle palpation, provisionals and digital occlusal data. https://youtu.be/REQ_L5NNEF4 Watch PDP267 on YouTube Protrusive Dental Pearl Create a PowerPoint or Keynote library of your clinical photos so you can quickly show patients relevant examples during consultations. ⚠️ Avoid hunting through random folders chairside — it feels clunky and breaks the flow of the conversation. ✅ Build a scrollable visual library of cracks, before-and-afters, complications, direct restorations, overlays, crowns and consent examples to support clearer patient communication. Key Takeaways Occlusion becomes easier when it is placed inside the treatment planning sequence, not treated as a separate subject. Facially generated treatment planning starts with where the upper teeth need to be for aesthetics. Once the central incisors are planned, the rest of the occlusion becomes easier to organise. Worn teeth that are still in occlusion are often in the wrong position. Anterior wear may be caused by tooth position, contact time, contact force, or a combination of all three. Gingival levels can reveal whether worn lower incisors have over-erupted. Digital bite scans are useful, but they are not always a perfect representation of the patient’s bite. Shimstock remains one of the most valuable and inexpensive tools for checking true occlusal contacts. After fitting a restoration, checking the contralateral side first can reveal whether the new restoration is high. Anterior guidance should be steep enough to separate the back teeth, but shallow enough to allow the lower incisors room to move. Muscle palpation should assess the quality and symmetry of contraction, not just whether the muscles exist. Always assess the opposing tooth before placing composite, ceramic or an indirect restoration. A leaf gauge can help create a more repeatable jaw position when planning more complex occlusal cases. Provisionals are essential for testing aesthetics, function, vertical dimension and occlusion before committing to final restorations. Highlights of the Episode: 00:00 Teaser 00:56 Introduction 03:36 Pearl: Build a Clinical Photo PowerPoint 12:48 Pearl 1: Facially Generated Treatment Planning 15:56 Pearl 2: Worn Teeth in Occlusion Are in the Wrong Position 18:05 Why Tooth Position Matters 18:22 Three Causes of Wear to Consider 19:34 Pearl 3: Digital Bite Scans Are Not Always Accurate 20:24 Why Shimstock Still Matters in Digital Dentistry 24:18 Pearl 4: Check the Contralateral Side After a Restoration 26:27 Pearl 5: The First Movement of Opening Is Not Pure Rotation 28:27 Midroll 33:10 Pearl 6: Healthy Occlusion Should Have Coordinated Muscle Contraction 35:22 Why Muscle Palpation Is a Useful Data Point 38:18 Practical Muscle Assessment Tip 38:58 Pearl 7: Always Look at the Opposing Tooth 39:33 What to Check Before an Indirect Restoration 39:44 Why the Opposing Tooth Matters 41:13 Pearl 8: Leaf Gauge for Finding a Repeatable Jaw Position 42:43 What a Leaf Gauge Is 44:33 Pearl 9: Provisionals Reduce the Fear of Complex Cases 47:49 Pearl 10: T-Scan Adds Objective Occlusal Data 53:16 Course Options and Learning Pathway 55:59 Outro ✨Connect with Dr. Mahmoud on Instagram 📍 Want to make occlusion more practical? Bulletproof is designed to take occlusion from abstract theory to real-world clinical application — covering posterior crowns, quadrant dentistry, PROPER conformative dentistry, occlusal risk assessment, shimstock, leaf gauges and daily protocols you can use straight away. The next Bulletproof course takes place on 26th–27th June at London Heathrow (Radisson Blu Hotel) Don’t miss it — find out more at bulletproofdentistry.com ➡️Check out more episodes on occlusion: Indirect Restorations For Guiding Teeth – PDP196 #PDPMainEpisodes  #OcclusionTMDandSplints This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C AGD Subject Code: 180 Occlusion Aim: To help dentists improve their understanding and clinical application of occlusion by recognising key diagnostic signs, using practical occlusal assessment tools, and applying occlusal principles to restorative treatment planning. Dentists will be able to – Apply facially generated treatment planning principles when assessing occlusal and restorative cases. Identify how tooth position, contact time and contact force contribute to tooth wear and restoration risk. Use practical occlusal assessment methods such as shimstock, contralateral checking, muscle palpation, leaf gauges, provisionals and T-Scan data.

    58 min
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4.9
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158 Ratings

About

The Forward Thinking Dental Podcast

Information

  • Creator
    Jaz Gulati
  • Years Active
    2018 - 2026
  • Episodes
    403
  • Copyright
    © 2025 Protrusive Dental Podcast
  • Show Website
    Protrusive Dental Podcast

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