The Dr. Phil Klein Dental Podcast

Dr. Phil Klein | Dentist
  • 4.8 (41)
  • Medicine
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The Dr. Phil Klein Dental Podcast is the #1 clinical dental podcast for evidence-based dentistry. Hosted by endodontist Dr. Phil Klein, DMD - trusted by 250,000+ dental professionals with 750+ episodes since 2018. The fastest-growing dental podcast worldwide, The Dr. Phil Klein Dental Podcast delivers cutting-edge clinical dentistry, state-of-the-art dental education, and actionable practice management strategies to more than 250,000 dental professionals globally. Two new episodes every Monday and Thursday featuring world-renowned clinicians, dental school faculty, academic researchers, specialty leaders, and practice management experts discussing the latest advances in evidence-based dentistry and modern practice growth you can apply immediately in practice. Episodes span every major dental specialty - from implant dentistry, endodontics, and restorative dentistry to cosmetic dentistry, digital workflows, sleep dentistry, oral surgery, periodontics, infection control, and pediatric dentistry - giving dental professionals a single trusted source for cutting-edge clinical education across the full scope of modern dentistry. Guests include leading clinicians from Harvard School of Dental Medicine, University of Pennsylvania School of Dental Medicine, University of Florida College of Dentistry, the American Academy of Cosmetic Dentistry, the American Academy of Endodontists, and top dental institutions across the United States and internationally. Every episode is focused on clinical excellence and state-of-the-art dental techniques — evidence-based dentistry at its highest level. Perfect for: General dentists seeking cutting-edge clinical techniques and evidence-based protocols Dental specialists staying current across adjacent specialties Dental hygienists and assistants accessing clinical education beyond typical CE options Dental students and new graduates building a strong clinical foundation Practice owners integrating state-of-the-art digital workflows, modern dental materials, and proven practice management strategies Full episode library and clinical show notes: philkleindentalpodcast.com

  1. 3d ago

    The Highest ROI Hire: How to Interview Your Dental Office Manager

    What separates a thriving dental practice from a struggling one often comes down to a single hire — and it's not the associate. It's the office manager. Your host, Dr. Phil Klein, brings over 40 years of experience across private practice, dental education, and industry to this solo episode on one of the most consequential hiring decisions a dentist can make. Dr. Klein holds a Bachelor of Applied Science from the University of Pennsylvania College of Engineering and Applied Science, a DMD from Penn Dental, and a Post-Doctorate specialty degree in Endodontics from Penn Dental (1985). He spent fourteen years as an Endodontic specialist in private practice before founding multiple dental technology and education companies, including Viva Learning LLC — now the largest dental continuing education entity in the world — where he serves as Chairman of the Board. He currently holds three dental patents and hosts this podcast, which draws more than 30,000 listens per month from a global user base of over 460,000 dental professionals. In this episode, Dr. Klein presents a structured, stage-by-stage framework for hiring a dental office manager — from the initial virtual screening all the way through to the formal offer letter. The discussion is grounded in practice management realities, emphasizing that the office manager is the operational leader of the practice, not simply an administrative hire. Dr. Klein explains why rushing or under-structuring this process puts cash flow, culture, team retention, and patient experience at risk. The framework is practical, immediately applicable, and designed to help dentists approach this hire with the same rigor they would apply to a clinical procedure. Episode Highlights: The initial virtual interview should be treated as a professional evaluation, not a casual screening. Candidates should be assessed for communication clarity, on-camera professionalism, and the ability to cite specific, measurable outcomes — such as improvements in collections rates, reductions in accounts receivable days, or tightened cancellation metrics — rather than vague claims of efficiency.The in-person interview should include an observed office tour where the interviewer watches how the candidate interacts with team members, assesses workflow, and demonstrates natural curiosity about practice operations. Role-playing scenarios involving upset patients or scheduling conflicts are recommended to evaluate composure, emotional intelligence, and the candidate's willingness to take ownership rather than escalate to the doctor.Skills assessments are a critical and frequently skipped step. Candidates should be asked to perform live tasks in the practice management software — such as scheduling mock appointments, entering patient data, or generating production reports — and to walk through how they would code and submit a mock insurance claim. Because billing proficiency directly impacts cash flow, verification of claimed skills before hiring is essential.Background and reference checks should go beyond confirming employment dates. Meaningful reference questions should probe how candidates handled high-pressure situations, contributed to team morale, and demonstrated reliability. Criminal background checks are recommended for all candidates in this role given their access to patient data, financial transactions, and payroll. Credit checks may also be appropriate when significant financial oversight is involved.Before extending a formal offer, a final alignment conversation should establish shared expectations around practice vision, growth trajectory, and the candidate's own long-term goals. The written offer should clearly define salary, benefits, incentive structures, leadership responsibilities, work hours, and any probationary period, as ambiguity in these areas is a primary driver of early turnover and workplace conflict.Perfect for: General dentists, group practice owners, dental residents entering practice ownership, and any dental team leader responsible for administrative hiring decisions who wants a structured, repeatable process for evaluating and onboarding practice leadership. If you have ever hired the wrong office manager — or want to make sure you never do — this episode gives you the exact framework to get it right.

  2. 6d ago

    Master the Social 6 with Injection Composite

    What if you could deliver stunning anterior composite restorations in half the time it takes to freehand sculpt them — without relying on advanced artistic ability? This episode breaks down exactly how to do it. Dr. Mackenzie Kelly is a cosmetic dentist, educator, and adjunct faculty member at Indiana University School of Dentistry, where she graduated with highest distinction and received the American College of Prosthodontists award for excellence in crowns, bridges, restorative, and cosmetic procedures. She is currently pursuing accreditation through the American Academy of Cosmetic Dentistry — one of the most prestigious and rarely achieved designations in the field. With hundreds of hours of continuing education in minimal prep veneers, cosmetic bonding, clear aligners, and digital dentistry, Dr. Kelly brings both technical mastery and genuine artistic talent to every case. In this episode, Dr. Kelly provides a thorough clinical walkthrough of the injection composite technique — a digital workflow that uses a clear custom matrix fabricated from a diagnostic wax-up to guide composite placement and eliminate the need for freehand sculpting. She explains why this approach is applicable across nearly all anterior composite scenarios, how it compares to indirect porcelain restorations, and how proper case planning on the front end is the single most important factor in achieving consistent, beautiful outcomes. The conversation covers the full process from digital scan and CAD design through matrix fabrication, tooth preparation, isolation, injection protocol, and final finishing — with specific clinical tips at every step. Episode Highlights: The injection composite technique uses a clear matrix fabricated from a digital or analog diagnostic wax-up, with small injection ports pierced into the matrix through which composite is injected once the matrix is fully seated. Creating two separate matrix variants — one for every other tooth and one for all teeth — dramatically reduces interproximal cleanup and improves contour control, especially in multi-tooth cases like the social six.Tooth preparation for injection composite is performed entirely within enamel when possible, using air abrasion rather than a handpiece to achieve micro-surface preparation without structural reduction. After isolation with Teflon tape on alternating teeth, unprepped enamel is phosphoric acid etched for 30 to 60 seconds, followed by application of a universal self-etching bonding agent to ensure reliable adhesion even if small areas of dentin are inadvertently exposed.A high-filler-content composite — specifically one with approximately 91% filler loading in the packable formulation and approximately 81% in the flowable formulation — provides significantly greater strength and stain resistance compared to conventional composites, which typically contain filler content in the 60 to 70 percent range for flowables. Higher filler content reduces the resin component responsible for polymerization shrinkage and staining, supporting long-term durability of direct anterior restorations.A partial cure of approximately 10 seconds before removing the clear matrix allows the composite to reach sufficient rigidity for matrix removal while remaining manageable for flash cleanup. A sharp scalpel blade is used immediately after matrix removal to trim excess composite at the gingival and interproximal margins before completing the final cure — this technique minimizes finishing time and reduces the risk of over-contouring.Executing a provisional mock-up using a putty matrix and a bisacryl provisional material before any etching or preparation allows the clinician to verify tooth length, proportion, and shade masking in the patient's face under natural conditions. This critical step also helps identify whether darker underlying tooth structure will require a more opaque composite selection, and provides a reversible checkpoint for patient approval before any irreversible clinical steps are taken.Perfect for: General dentists looking to expand their direct aesthetic composite capabilities, cosmetic dentistry enthusiasts at any career stage, dental residents building confidence with anterior restorations, and any clinician interested in integrating digital workflows into their cosmetic dentistry practice. If anterior composite cases have been a source of stress or hesitation in your practice, this episode gives you a concrete, step-by-step protocol to change that starting with your very next case.

  3. Sep 24

    It Starts With Leadership: Creating the Exceptional Patient Experience

    What does it actually take to make a patient say, "I'm really glad you didn't try to sell me anything today"? The answer has very little to do with your handpiece or your composite, and everything to do with how your practice makes people feel. Dr. Lori Trost is a full-time clinician whose Columbia, Illinois practice centers on esthetic dentistry with a wellness-focused approach to patient care. A sought-after lecturer across North America, clinical evaluator for numerous dental manufacturers, and prolific author of professional dental articles, Dr. Trost is a member of the ADA, ASDA, and AGD, serves as a board member of the AACO, and is a recipient of the prestigious Shils Foundation Award from the ADA for Entrepreneurial Spirit and Leadership. She was also named one of the "Top 25 Women in Dentistry" by Dental Products Report. Her decades of clinical experience and her nationally acclaimed course on patient experience make her one of the most credible voices on this topic in dentistry today. In this episode, Dr. Trost breaks down what it truly means to create an exceptional patient experience — and why so many practices, even those with veteran clinicians, are falling short. Drawing on the response to a standing-room-only lecture she delivered to over 1,000 attendees, she reveals the three pain points that resonated most deeply and explains how practices can address them systematically. This conversation is a candid, practical look at the cultural and operational gaps that quietly erode patient trust, retention, and referrals. Episode Highlights: Research shows patients who wait more than 10 minutes in a reception area become disengaged, turn to their phones, and are significantly more likely to leave negative reviews. Software that tracks patient check-in time can help front desk teams intervene before frustration builds, and moving patients promptly is one of the simplest and most overlooked retention strategies in practice management.Only 35% of dental offices conduct a morning huddle, despite it being one of the most powerful tools for aligning a team before the clinical day begins. Practices that skip this daily communication ritual are more prone to in-office chaos, miscommunication between clinical and administrative staff, and patients who leave without understanding what happens next in their care.Patients who are not oriented to the value of their visit before they reach the front desk are more likely to question fees, dispute charges, and disengage from treatment planning. Building clear verbal handoffs between the operatory and the front desk — including scripted language to describe clinical findings like cracked teeth — is a trainable, systems-based solution that directly impacts case acceptance and perceived practice value.Phone distraction in the operatory is not just a behavioral nuisance — studies from major universities confirm that the mere presence of a phone reduces a patient's ability to retain health information. Practices that implement a phone-off policy during appointments report stronger patient engagement, fewer safety concerns during active procedures, and more meaningful clinical conversations.Leadership gaps are among the most commonly reported pain points in dental teams, yet many practice owners either avoid the leadership role or conflate being liked with being effective. Defining a clear leadership style early — including during the hiring process — and investing in leadership development through courses and reading reduces team dysfunction, lowers staff turnover, and creates a practice culture where doing excellent work is the norm rather than the exception.Perfect for: General dentists, practice owners, dental office managers, treatment coordinators, and any clinical team member who wants to understand how practice culture and patient communication directly impact retention, referrals, and long-term practice success. If you've ever lost a patient not because of your clinical work but because of how they felt walking out the door, this episode will show you exactly what to change.

  4. Sep 21

    Risk Is the New Diagnosis: Rethinking How We Practice Dentistry

    What if the true measure of clinical success in dentistry was not how well we treat disease, but how effectively we prevent it from ever developing in the first place? Penny Hatzimanolakis is a periodontist and prosthodontist who has been practicing evidence-informed, prevention-focused oral health care since 1994. A faculty member at the University of British Columbia's dental faculty since 2002, she is currently pursuing a doctorate in Educational Leadership. A published author, national speaker, and industry board advisor, she operates the Elevate Oral Health and Learning Centre, where she provides advanced training and individualized, patient-centred care with a strong commitment to serving underserved communities. This episode applies the P4 medicine framework — predictive, preventive, personalized, and participatory — to oral health care, challenging dentistry's long-standing habit of measuring success by treatment volume rather than disease prevention. Penny introduces a compelling fifth P, preservation, as the overarching clinical goal that should unify all dental disciplines. The conversation spans periodontal risk management, individualized recall protocols, peri-implantitis prevention, and the role of emerging AI technologies in moving dentistry from reactive repair toward precision prevention. Episode Highlights: Current dentistry measures success almost exclusively through treatment outcomes — restorations placed, pocket depths reduced, implants placed — while rarely quantifying how much disease was actually prevented. Reframing success to include avoided restorations, preserved attachment, and maintained healthy dentition would likely reveal that proactive prevention rates in most practices sit at only 10–15%, a standard no other medical discipline would accept.The standard twice-yearly dental recall interval has no scientific basis and originated largely from consumer advertising campaigns dating back to the 1920s and 1940s. Risk-based recall intervals — which may range from one to six months or beyond depending on the individual patient's disease activity, systemic health, and compliance — represent a more evidence-informed approach to maintenance scheduling.Guided biofilm therapy is an evidence-based, minimally invasive clinical protocol structured around a sequential eight-step framework that aligns directly with P4 medicine principles. The protocol incorporates disclosing agents to visualize biofilm, motivational interviewing, salivary diagnostics, nutritional counseling, and powered biofilm disruption using fine erythritol powder, allowing targeted management of biofilm as the primary etiological driver of both periodontal disease and peri-implantitis before a hand instrument is ever introduced.Patients with type 2 diabetes carry approximately a 50% elevated risk of developing peri-implantitis, and implant deterioration when it occurs progresses significantly faster than comparable breakdown around natural teeth due to the absence of a periodontal ligament and its associated host defense mechanisms. Thorough pre-implant risk stratification — including full medical history review, systemic disease assessment, and identification of compounding risk factors — is essential before implant placement is undertaken.Preservation of tooth structure is emerging as a unifying philosophy across dental specialties, exemplified in endodontics by the growing evidence base for vital pulp therapy including partial pulpotomy on mature teeth with carious pulp exposures. Using a calcium silicate-based hydraulic cement following incremental pulp tissue removal to achieve hemostasis can allow clinicians to avoid full pulpectomy and obturation, eliminating the associated costs of root canal treatment and the indirect restoration that typically follows.Perfect for: general dentists, dental hygienists, periodontists, prosthodontists, and dental residents seeking to integrate evidence-informed prevention protocols, risk-based recall strategies, and minimally invasive principles into daily clinical practice. If you have ever questioned whether dentistry's definition of success is truly serving your patients' long-term health, this conversation will change how you think about every patient you see.

  5. Sep 17

    What You Believe Is What You Build: Breaking Free from Corporate Dentistry

    Is corporate dentistry holding you back from the practice you actually want to build — or is the real obstacle something happening in your own head? Dr. Mark Kogut is a pediatric dentist, orthodontist, author, and educator with over 42 years of private practice experience. He built a thriving fee-for-service pediatric and orthodontic practice with more than 5,000 square feet, seven consultation rooms, and a team of 30, all while teaching orthodontics to pediatric dental residents for 22 years at what is now Texas A&M College of Dentistry. He is also the author of the Amazon bestseller Breaking Free: How to Escape Corporate Dentistry and Build Your Dream Practice. Dr. Kogut's depth of experience in both clinical care and practice leadership makes him one of the most compelling voices in independent dental practice today. In this conversation, Dr. Kogut unpacks the mindset framework at the core of his book — including the Mobius Method, a model for understanding how beliefs, behaviors, and results are cyclically linked and not simply linear. He and Dr. Klein explore why fear is the single greatest barrier preventing dentists from making the leap to ownership, how a fee-for-service model can be built from scratch even in today's insurance-heavy environment, and what it actually takes to develop the leadership skills and team culture that sustain a thriving independent practice. The discussion draws directly from Dr. Kogut's four decades of real-world experience and his years mentoring residents toward thinking beyond clinical training. Episode Highlights: The Mobius Method reframes the relationship between beliefs, behavior, and results as cyclical and multidirectional rather than linear. Recognizing that the results you get reinforce what you believe — and that your beliefs shape the results you pursue — is a foundational shift for any dentist considering the transition from associate to owner.Fear is identified as the single most significant obstacle preventing dentists from transitioning into ownership. Just as clinical skills like administering injections are learned through practice and repetition, business skills are also learnable — and many can be outsourced, reducing the threshold of knowledge required before making the leap.A gap analysis framework is presented as a practical tool for major practice decisions, including large equipment investments. The approach involves defining a clear target, honestly assessing the current state, identifying the gap between the two, and building a step-by-step plan to close it — applicable to financial planning, staffing, and practice growth.Structuring a practice as fee-for-service from the start is presented as both viable and preferable for dentists who want to deliver care on their own terms. In orthodontics specifically, full-fee collection before treatment begins was a consistent model in Dr. Kogut's practice, enabled by building trust with patients and families before financial conversations took place — and by equipping team members to have those conversations more effectively than the dentist alone.The wheelbarrow-versus-tractor metaphor captures the difference between a practice driven by poor systems that requires constant manual effort and one powered by well-trained, values-aligned team members who pull the practice forward. Hiring for growth mindset and cultural fit — rather than years of experience — and investing in team development through coaching, continuing education, and book clubs were central to sustaining that tractor model over four decades.Perfect for: General dentists and specialists considering transitioning out of corporate or DSO environments, dental residents approaching the end of their training, and any practice owner looking to strengthen team culture, leadership skills, and the mindset foundations of independent practice. If you have ever talked yourself out of ownership before you even started, this episode will show you exactly where that thinking comes from — and how to change it.

  6. Sep 14

    Universal Composites with Dr. Marc Geissberger: What Dentists Need to Know

    Are you still selecting composites based on shade count and marketing claims — or are you evaluating what actually matters clinically? This episode cuts through the noise and gets into the real science behind modern composite selection. Dr. Mark Geissberger brings over 30 years of clinical and academic experience to this conversation. He is Professor and Immediate Past Chair of the Department of Integrated Reconstructive Dental Sciences at the University of the Pacific, School of Dentistry, where he directed the Aesthetic and Complex Care Clinic and has taught for 25 years. Dr. Geissberger earned his dental degree from University of the Pacific in 1991, was elected to Omicron Kappa Upsilon, and later earned a Master of Arts in Educational Psychology. He has served as President of the National Chapter of Omicron Kappa Upsilon, serves as University Representative to the AACD University Council, and has authored a textbook on esthetic dentistry published by Wiley-Blackwell. With over 350 continuing education programs presented nationally and internationally, Dr. Geissberger is one of the most experienced restorative dental educators in the country. This episode explores how composite materials have genuinely evolved beyond marketing buzzwords, what dentists should actually evaluate when selecting a new restorative material, and how a new generation of universal composites is simplifying anterior and posterior workflows without sacrificing aesthetics. Dr. Geissberger provides a frank, science-based framework for evaluating handling, radiopacity, shrinkage, and shade matching that applies to any composite on the market. The conversation also covers composite warming, adhesive protocol selection, and isolation strategies for everyday clinical use. Episode Highlights: Single-shade composites made a bold promise that the science never fully supported. True shade matching requires cluster-engineered shade systems — a process that one leading manufacturer spent a decade developing to legitimately cover 16 Vita shades with just five carefully engineered shades, rather than simply repackaging existing best-selling SKUs.Radiopacity is one of the most underappreciated criteria in composite selection. Measured in aluminum equivalent, conventional composites typically range from 300 to 500 percent, while dentin measures approximately 100 percent and enamel 200 to 250 percent. A highly filled universal composite can reach 900 percent aluminum equivalent, making restoration margins, recurrent decay, voids, and overhangs far easier to identify diagnostically on radiographs.A composite filled at 91 percent by weight dramatically reduces polymerization shrinkage — down to approximately 1.4 percent compared to 2.2 percent or higher in conventional composites and 3 to 5 percent in flowables. Higher filler content also correlates with improved flexural strength, better wear characteristics, and a more sustained polish over time.Composite warming — heating material to approximately 155 degrees Fahrenheit — serves two distinct clinical purposes: it improves handling by reducing viscosity for better adaptation, and basic chemistry supports that the added heat drives greater monomer conversion, depth of cure, and final hardness when the composite is cured within approximately two minutes of placement. This technique allows clinicians to adjust the same material's behavior differently for class five restorations versus anterior cases.A universal adhesive used as a smart, substrate-driven etching strategy offers the most clinical flexibility. Total etch is appropriate for enamel-only preparations such as incisal edge repairs, selective etch suits combination restorations like class fives, and self-etch is preferable for root caries restorations. Over-etching dentin with total etch removes the mineralized substrate needed for effective bonding to the inorganic component of dentin and should be avoided in those situations.Perfect for: General dentists looking to optimize their direct restorative workflow, dental residents building composite technique foundations, and restorative specialists evaluating new universal composite systems for anterior and posterior use. If you place composite restorations in your practice, the clinical framework in this episode will change how you evaluate every new material that crosses your desk.

  7. Sep 10

    Scaling Up: The New Era of Dental Hygiene with Katrina Klein

    Are you leaving serious revenue on the table by treating your hygiene department as a break-even cost center? What if your hygienists could become the most powerful case acceptance drivers in your entire practice? Katrina Klein is a registered dental hygienist with 17 years of clinical experience, national speaker, author, competitive bodybuilder, Certified Personal Trainer, Certified Ergonomic Assessment Specialist, and Functional Range Conditioning Mobility Specialist. She is the founder of ErgoFitLife, an organization dedicated to making ergonomics and fitness a lifestyle for dental professionals to prevent, reduce, or eliminate occupational pain. With nearly 30 years in dentistry and a reputation as a leading voice in dental hygiene advocacy, Katrina brings a uniquely evidence-informed, practice-centered perspective to expanding the hygiene role. In this episode, Dr. Phil Klein and Katrina Klein challenge the widely held belief that the dental hygiene department is a loss leader, arguing instead that it can and should be a significant revenue-generating hub within any practice. The conversation covers how hygienists can move beyond scaling, root planing, and prophy to incorporate soft tissue laser therapy, adjunctive periodontal therapies, oral probiotic recommendations, airway assessment, implant maintenance, and orthodontic case co-diagnosis. They also address the current HR crisis in dental hygiene, the growing threat of DSO models utilizing minimally trained personnel for hygiene-adjacent procedures, and the critical importance of philosophical alignment between hygienists and practice owners. This discussion is essential for any dental team serious about elevating patient care and practice profitability simultaneously. Episode Highlights: A hygiene department focused solely on prophylaxis and scaling and root planing is unlikely to cover its own overhead at current wage rates. By incorporating comprehensive assessments, adjunctive periodontal therapies, airway screening, oral cancer screening, and co-diagnosis of restorative needs, hygienists can transform their operatory into a consistent revenue generator beyond insurance reimbursement ceilings.A real-world case was presented in which a non-compliant periodontal patient was introduced to an adjunctive peroxide-based tray delivery system, resulting in reduced calculus burden, improved periodontal health, tooth whitening, and ultimately full patient buy-in for clear aligner therapy and soft tissue laser treatment at every maintenance visit — all within an insurance-based practice.Soft tissue laser therapy is identified as one of the highest-impact tools available to hygienists, yet lasers frequently sit unused in practices because hygienists lack hands-on training and confidence. Sending the hygiene team together to live, hands-on continuing education courses — rather than passive lecture-format CE — is recommended as the most effective strategy for clinical adoption and team-wide implementation.Peri-implantitis is described as a growing clinical priority, with hygienists now encountering implant patients at nearly every maintenance appointment in periodontal-focused practices. Updated protocols have replaced outdated instrumentation approaches, and ongoing continuing education is emphasized as essential for hygienists to confidently probe, assess, and educate implant patients on proper home care.A legislative trend is emerging in multiple states allowing dental assistants with as few as 120 hours of training to perform supragingival scaling under DSO models, creating a direct workforce and quality-of-care challenge for registered dental hygienists. Hygienists are encouraged to proactively demonstrate their expanded clinical value, advocate for their scope of practice, and educate patients on the meaningful difference between credentialed hygiene care and minimally trained scaling services.Perfect for: Dental hygienists at all career stages looking to expand their clinical role and earning potential, general dentists and practice owners evaluating hygiene department productivity, and dental residents or new graduates building their philosophy around comprehensive team-based care. If you have ever wondered whether your hygiene department is working as hard as it could for your patients and your practice, this episode will completely reframe how you think about it.

  8. Sep 8

    Recognizing Risk: Oral Potentially Malignant Disorders Explained

    How confident are you that the white patch you noticed at your last exam wasn't something that needed a biopsy? The uncomfortable truth is that for every HPV-negative oral cancer, there was a visible precancerous lesion — and fewer than 5% of those lesions are identified before they become cancer. Dr. Ashley Clark is an Associate Professor and Division Chief of Oral Pathology at the University of Kentucky College of Dentistry. She holds a DDS from Indiana University and a certificate in Oral and Maxillofacial Pathology from the University of Florida. With over 40 published papers and abstracts, more than 200 continuing education courses delivered, a Fellowship in the American College of Dentists, a Fellowship in Health Education, and authorship of the oral pathology sections of both Dental Decks and Dental Hygiene Decks, Dr. Clark is one of the most prolific oral pathology educators in the country. She has earned multiple prestigious teaching awards, serves on the Commission on Dental Accreditation review board for oral and maxillofacial pathology programs, and sits on the Advisory Board for Oral Cancer Cause. In this episode, Dr. Clark breaks down the full spectrum of oral potentially malignant disorders (PMDs) — from leukoplakia and erythroplakia to erosive oral lichen planus and proliferative verrucous leukoplakia — and explains exactly why the dental profession is failing to intervene early enough. The conversation covers the clinical criteria that demand a biopsy with no exceptions, why the standard two-week watch-and-wait approach is inappropriate for sharply demarcated lesions, and how to structure long-term surveillance once a PMD is diagnosed. Dr. Clark also addresses the medicolegal exposure dentists face when PMDs go unmonitored, and makes a clear, evidence-based case that appropriately treating leukoplakia alone could reduce oral cancer rates by 50%. A sharply demarcated white lesion requires a biopsy regardless of patient history, smoking status, or lesion duration — no additional clinical information changes this decision. Watching such a lesion without a diagnosis is not a valid clinical strategy because it is impossible to treat something without knowing what it is, and the most common benign diagnosis is hyperkeratosis while the most common malignant result is squamous cell carcinoma.Autofluorescence devices can serve as a useful adjunct to white-light examination, but should not be used as standalone diagnostic tools. If a lesion loses fluorescence compared to surrounding healthy tissue, the clinician should return to white-light examination to determine whether the area is sharply demarcated — if it is, biopsy is indicated regardless of other findings.Once a PMD is diagnosed and treated, the standard of care supported by the literature requires monitoring every six months for 20 years, with each visit including photographic documentation and probe measurement of the lesion. Any change in size, surface character, or appearance at a surveillance visit warrants a new biopsy; if the lesion remains stable, continued observation without repeat biopsy is appropriate.When dysplasia is confirmed histologically, the recommended treatment escalates based on severity: mild dysplasia may be managed with laser ablation, while moderate dysplasia, severe dysplasia, or carcinoma in situ warrants surgical excision with a scalpel. After tissue destruction, the patient returns to the general dental office for long-term surveillance monitoring for recurrence or new sites of involvement.General dentists are technically capable of performing punch biopsies on accessible sites including attached gingiva, buccal mucosa, lateral tongue, dorsal tongue, labial mucosa, and hard palate. Sites including the floor of mouth, ventral tongue, soft palate, and gingival bumps with aesthetic considerations are better referred to oral surgery or periodontics; post-operative management of punch biopsy sites typically requires pressure hemostasis, chemical cauterization if needed, and a single suture for tongue sites, with minimal analgesic requirements for most patients.Perfect for: General dentists seeking clearer biopsy decision-making criteria, dental hygienists who perform oral cancer screenings, dental residents in any specialty, and practice owners who want to understand the medicolegal implications of PMD surveillance protocols. If you've ever hesitated before recommending a biopsy, this episode will give you the clinical framework and the conviction to act.

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About

The Dr. Phil Klein Dental Podcast is the #1 clinical dental podcast for evidence-based dentistry. Hosted by endodontist Dr. Phil Klein, DMD - trusted by 250,000+ dental professionals with 750+ episodes since 2018. The fastest-growing dental podcast worldwide, The Dr. Phil Klein Dental Podcast delivers cutting-edge clinical dentistry, state-of-the-art dental education, and actionable practice management strategies to more than 250,000 dental professionals globally. Two new episodes every Monday and Thursday featuring world-renowned clinicians, dental school faculty, academic researchers, specialty leaders, and practice management experts discussing the latest advances in evidence-based dentistry and modern practice growth you can apply immediately in practice. Episodes span every major dental specialty - from implant dentistry, endodontics, and restorative dentistry to cosmetic dentistry, digital workflows, sleep dentistry, oral surgery, periodontics, infection control, and pediatric dentistry - giving dental professionals a single trusted source for cutting-edge clinical education across the full scope of modern dentistry. Guests include leading clinicians from Harvard School of Dental Medicine, University of Pennsylvania School of Dental Medicine, University of Florida College of Dentistry, the American Academy of Cosmetic Dentistry, the American Academy of Endodontists, and top dental institutions across the United States and internationally. Every episode is focused on clinical excellence and state-of-the-art dental techniques — evidence-based dentistry at its highest level. Perfect for: General dentists seeking cutting-edge clinical techniques and evidence-based protocols Dental specialists staying current across adjacent specialties Dental hygienists and assistants accessing clinical education beyond typical CE options Dental students and new graduates building a strong clinical foundation Practice owners integrating state-of-the-art digital workflows, modern dental materials, and proven practice management strategies Full episode library and clinical show notes: philkleindentalpodcast.com

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