Podcasts about extractions

Kiera is joined by the tooth-healer himself, Jason Dent! Jason has an extensive background in pharmacy, and shares with Kiera where his pharmaceutical experience has bled over into dentistry. This includes the difference between anti-quag and anti-platelet and which medications are probably safe, what to do to shorten the drag time in the pharmacy, how to write prescriptions most efficiently, and more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Hello, Dental A Team listeners. This is Kiera and today is a really awesome and unique day. It is, think the second time I've had somebody in the podcast studio with me live for a podcast and it's the one and only Jason Dent. Jason, how are you? I'm doing well. Good morning. Thanks for having me. It is crazy. I I watch Instagram real like this all the time where people are like in the podcast and they're hanging out on two chairs and couches and now look at us. We're doing it. Cheers. Cheers.   That was a mic cheer for those of you who are only listening, but yeah, Jace, how does this feel to be on the podcast? It's weird. Like I was not nervous at all talking about it. I got really nervous as soon as you hit play. So if I stumble over my words, please forgive me ahead of time. Well, Jason, I appreciate you being on the podcast because marketing had asked me to do a topic about teledentistry and I was like, oh shoot, that's like not my forte at all. so   You and I were actually chatting in the hot tub. call it Think Tank session and you and I, we have a lot of good ideas that come from that Think Tank. A lot of business. no phones. That's why. We do leave our phones out. But I was talking to Jason and this is actually a podcast we had talked about quite a while ago. Jason has a lot of information on pharmacy. And if you don't know, Jason isn't really, we were going through all of it last night. It's kind of a mock in the tub. And I think it's going to be great because I feel like this is an area, I'm working at Midwestern and   knowing about how dentists, pharmacology was surely not your favorite one. Jason actually helps a lot of dentists with their clearances. And so we were talking about it and I like it will just be a really awesome podcast for you guys to brush up on pharmacology, different things from a pharmacist's side. So Jason, welcome. Thank you. Yeah, no, we were talking about it and here's like, what should I talk about on the podcast next? I have all these different topics and she's like, what do you know? And the only real interaction I have with dentists is doing clearances for procedures. We get them all the time, which makes sense.   Lots of people are on blood thinner, I've always told Kiera, like, hey, I could talk about that. Like, that's kind of a passion of mine. I'm not a dentist. Or my name is Jason Dent. So in Hebrew, Jason means tooth. No, no, no, sorry. Nerves are getting to me. Jason means healer and Dent means tooth. So my name means tooth healer. So, here's a little set. Hold on, on, hold Can we just talk about? I brought that up before you could talk about it more. So.   My name means tooth healer but I did not become a dentist. I know you wanted me to become a dentist. did. I don't know why. I enjoy medicine. I know what you're going to get to already. The things you're going to ask me. There's been years of this. But nevertheless, that's my name. We'll get that out of the way. But you did give me a great last name. So I mean, it's OK. You're All is fair and love here. SEO's up for that. But yeah, Jason, I'm going to get you right into the show. And I'm going to be the host. And we're going to welcome to the podcast show. Jace, how are you?   Good, good, good. Good, good, good. So by getting into clearances, right? This is what you're kinda talking about with you know, before we get to clearances, I actually wanted Jason, for the listeners who don't know you, who haven't talked to you, who don't know, let's kinda just give them like, how did you go from, Kiera wanted you to be a dentist, to now Jason, you are on the podcast talking as our expert on pharmacy. fantastic. I've always really loved medicine, a ton. As a kid getting headaches and taking Excedrin, like you just feel like a miserable pile of crap.   and then you take two pills and all of a sudden you feel better. Like that's amazing, like how does that happen? Also getting ear aches as a kid, just being in so much pain and then taking some medicine and you start feeling a lot better. I always had a lot of appreciation for that. I've always been mechanically inclined. I went to, started doing my undergrad and took biology and learned about ATP synthase, which is a spinning enzyme that's inside the mitochondria, like a turbine engine. I used to work on small engines on my dirt bike and thought that is so cool. So I really got wrapped up into chemistry.   All the mechanics of chemistry really pulled me in. I'm not getting goosebumps. checking. I usually get goosebumps when I think about chemistry. But it's so cool. You think an engine's awesome, like pistons and camshafts and pressures, the cell is the same thing. It's not as loud, so it's not as cool. But it's fascinating. that's why we're like. ⁓   chemistry and really got into coagulation. So I did my residency after pharmacy school. we went to Arizona for three years. ⁓ You did and your main focus, you were never wanting to be the guy behind the counter. No, I haven't done that. Yeah. No, I love them though. I've always really want to go clinical. ⁓ But I love my retail ⁓ pharmacists. They're amazing resources. And ⁓ I use the retail pharmacist every day still to this day, but I went more the clinical route, really love the chemistry aspect of it.   did my doctorate degree and then I did my residency in Reno. Reno's kind That's how we got here everybody. Welcome to Reno. Strategically placed because I was really interested in critical medicine and where we're located we cover a huge area. So we pull in to almost clear, we go clear to Utah, clear to California, all of Northern Nevada. We get cases from all over. So we actually are kind like the first hub of care for lot of areas. So we really get an eclectic mixture of patients that come in that need-   all kinds of different cases that are coming to them. So it's what I really wanted. So I did my residency in critical care there. And then for the next 10 years, I worked in vascular medicine with my final five years being the supervisor of the clinic. Ran all the ins and outs of that. So my providers, two doctors were on our view. So when we talk about dentistry, talk about production, those kinds of things, totally get it. My doctors were the exact same way, my vascular providers. ⁓   There's some pains there, right? You wanna be seeing patients as much as possible, being able to help as many people, keeping the billing up. And had other nurse practitioners, four practitioners, a fleet of MAs, eight pharmacists. We also had that one location we had, going off the top of my head, I think we had eight locations running as well. And we took care of all the different kinds of vascular cases that came to us. Most common was blood clots, ⁓ which is just a...   which is an easier way of saying VTE. There's so many different ways to say a blood clot. Like you might hear patients say, I've had a PE or a DVT or a venous thromboembolism or a clot in my leg, right? They're all clots, but in different locations. Same with an MI, and MI can be a clot as well. ⁓ there's a lot of, everybody's kind of saying the same thing, but sometimes the nomenclature can make it sound hard, but it really is actually pretty simple.   No. And Jason, I love that you went through, you've been in like, and even in your, ⁓ when you were getting your doctorate, you were in the ER. You also worked in retail pharmacy. remember you having a little sticker on your hand. And retail pharmacy, I have a lot of respect for those guys. They have a lot of pressure on them. and then you also, ⁓ what was that test that you had to take that? I don't know. You were like studying forever for it. ⁓ board certification for, ⁓ NABP. Yeah. So I did that board certification as well.   And now you've moved out of the hospital side onto another section in your career. Now in the insurance, right? So it's really, really interesting. So now I'm on the other side reading notes and evaluating clinical appropriateness and trying to help patients with getting coverage and making those kinds of determinations. So yeah, I've really jumped all over. Really love my clinical days. I know. don't I don't I do miss them. But yeah, kind of had a good exposure to a lot of.   pharmacy a lot a lot of dentists actually with all the places that come through which Jason I really appreciate that and honestly I know you are my spouse and so it's fun to have you on but when I go into conversations like this I don't know any of this information and so finding experts and Jason I think here's me talk more about dentistry and my business than I do hear about him on pharmacy so as we were chatting about this I really realized you are a wealth of knowledge because you've been on the clinical side so you've done a lot of patient care and you've seen how   medications interact and I know you've had a few scares in your career and ⁓ you've known some physicians that have had a few scares and ⁓ you've seen plenty of patients pass away working in the ER and gosh in Arizona drownings were such a big deal. I remember when you were in the ER on your rotations I'd be like who died today? Like tell me the stories and you've really seen and now going on to the insurance side I felt like you could just be such a good wealth of knowledge because I know dentists are sometimes so   I would say like maybe just a little more anxious when it comes to medications. I know that dental students from Midwestern were like here was like four months and we had to like pass it, learn it. And Jason, you've done four years plus clinical residency, plus you've been in it. And something I really love about Nevada Medicine is they've been so collaborative with you.   like your heart, your cardiologist, they diagnose and then they send to you to treat with medicine and... Yeah, I've been really lucky being here in Reno too. The cardiology team has been amazing to work with. We started a CHF program, sorry, congestive heart failure program for patients. So we would collaborate with cardiologists. They'd see the cardiologists and then they send them to the pharmacist to really manage all the medications. So there's pillars of therapy ⁓ called guideline directed medical therapy and the pharmacist would take care of all that. So that's gonna be your...   your beta blockers, your ACEs, your ARBs, your Entresto, which would be a little bit better, spironolactone. So just making sure that all these things are dosed appropriately, really monitoring the heart, and make sure that patients are getting better. we've had real positive outcomes when the, sorry, this is totally off topic. do, talk about that study. When we looked at when patients were coming to see our pharmacists in our clinic that we started up, the patients were half as likely to be readmitted. And this was in 2018, and our pharmacists,   We're thinking about all the medications. We're usually adjusting diabetes medications too at the same time. Just kind of naturally just taking care of all the medications because we kind of got a go ahead from the providers, a collaborative practice agreement that we could make adjustments to certain medications within certain parameters. So we weren't going rogue or maverick, but we were definitely trying to optimize our medications as much as possible. And then years later, some studies came out with, I'm sure you've seen Jardins and Farseegh. not trying to, I'm not.   I don't get any kickback from them. I have no conflicts to share. But because our pharmacists were really optimizing that medication, those medications were later shown to reduce hospitalizations and heart failure, even though they're diabetes medications. Fascinating. So it wasn't really the pharmacists. It was just the pharmacists doing as much as they can with all the tools that were in front of them. And then we found out that the patients were going back to the hospital.   half as much as regular patients. So, yeah, being here, it's been so amazing to work with providers here. the providers here want help, want to help patients, don't have an ego. I mean, I just, it's awesome. I love it. I do love how much I think Jason sees me geek out about dentistry and I watching Jay's geek about his pharmacy and how much he loves helping patients. And ⁓ really that was the whole idea of, all right.   Dentistry has pharmacy as a part of it. And I know a lot of dentists are sending in clearances and I know working in a chair side, it would be like, oh no, if they're on warfarin or on their own blood clot, you guys, honestly don't even know half of what I'm talking about because this is not my jam, which is why Jason's here. But I do know that there was always like, well, we got to talk with their provider. And so having Jason come in and just kind of explain being the pharmacist that is approving or denying or saying yes or no to take them off the blood thinners in different parts, because you have seen several dental   I don't know what they're called. What is it? Clarence's? that what comes to you? don't even know. All day my mind, it's like, here is the piece of paper that gets mailed to you to the pharmacist and then you mail it back. So whatever that is. But Chase, let's talk about it because I think you can give the dentist a lot of confidence coming from a pharmacist. What you guys see on that side. When do you actually need to approve or disapprove? Let's kind of dig into that. Yeah. Well, first of all, I think I'm not a replacement for any kind of clinical judgment whatsoever. Every patient's different. But the American Diabetes Association, you   I work with diabetes a lot. American Dental Association has some really great guidelines on blood thinners and I would always reference them. I actually looked at their website today. Make sure I'm up to speed before I get back on this again. They have resources all around making decisions for blood thinners. And I think the one real important thing in putting myself in the shoes of a dentist or any kind of staff that's around a patient that's in a chair, if they say I'm on a blood thinner, right, a flag goes up. At least in my mind, that's what goes up.   Like, okay, how do we get across this bridge? And I think the important thing to really distinct right then when they say they're on a blood thinner is that is kind of a slang word for a lot of different medications, right? Like it's the overarching word that everybody pulls up saying, I'm on a blood thinner. It's like, okay, but I don't know what say. It's like, I have a car. You're like, okay, do you have a Mazda? Do you have?   Toyota, Honda, what do you have? or even worse it'd be like saying I have a vehicle, right? So when somebody says they're on a blood thinner, it opens up a whole box of possibilities of what they're Blood thinners are also, doesn't, when they're taking these types of medications that are quote unquote a blood thinner, it doesn't actually thin the blood, like adding water to the blood, if that makes sense, or like thinning paint, or like thinning out a gravy, right? It doesn't do the same thing. Blood thinners, really what they're doing is they're working on the blood, which.   which is really cool, try not to tangent on that. ⁓ When they're working on the blood, it's not thinning it per se, but it's making it so that the proteins or platelets that are in it can't stick together and make a cloth quite as easy. So whenever somebody's on a blood thinner, I usually ask, what's the name of the blood thinner that you're on? It's not bad that they use that slang, that's okay, on the same page, but it's really broken into two different classes. There's anticoagulant and antiplatelet.   And a way to kind of remember which is which, when residents would come through our clinics, the way that I teach them is a clot is like a brick wall. You know, it's not always a brick wall. Usually the blood is a liquid going through. But once they receive some kind of chemical message, it starts making a brick wall with the mortar, which is the concrete between the and the bricks, the two parts. When it's an anti-quagent, it's working on that mortar part. When it's an anti-platelet, it's working on the bricks part, right? You need both to make a strong clot or strong brick wall.   But if you can make one of them not work, obviously like if your mortar is just water, it's not working, right? You're not gonna make a strong brick wall. So that's kind of the two deviants right there. So that's what I do in my mind real quickly to find out because antiplatelets are usually, so that's gonna be like your Plavix, Ticagrelor, Brilinta. And hold on, antiplatelets are bricks? Good job, bricks. They're the bricks. And so the reason I was thinking you could remember this because I'm, antiplatelets, it's a plate and a plate is more like a brick.   And anti coagulant, I don't know why quag feels like mortar to me, like quag, like, know, it's like slushy in the blood, like it's coagulating. It's a little bit of that, like, honestly, I'm just thinking like coagulated blood is a little bit more mortar-ish. And so platelet is your plate, like a brick, and anti-quag is like.   the gilly between the bricks. Okay, okay, I got it. Yeah, so there's an exception to every rule, but when they're on that Don't worry, this is Kiera, just like very basic. You guys are way smarter listening to this, and that's why Jason's here. No, no, you helped me pass pharmacy school. When we were doing all the top 200, you helped me memorize all know what flexorill is, all right? That's a muscle relaxant. Cyclo? I don't know that part. It's a cyclo, because you guys are cycling and flexing. I don't actually know. just know it's a muscle relaxant, so that's about as far as I got. When we're looking at antitick platelets, so that's the brick part, so that's going to be your, you know,   Hecagrelor, Breitlingta, Clopidogrel is the most common one. It's the cheapest one, so probably see that one the most. Those, I mean, there's an exception to every rule, but that's generally being used after like a stent's placed in the heart. It can be used for VTE, there's some out there, but that's pretty rare. But also for some valves that are placed in the hearts, it can be used for that as well. So antiplatelet, really thinking more like a cardiac event, right? Like I said, there's always an exception to every rule, but that's kind of where my mind goes real quickly, because we're gathering information from the patient.   They're on anticoagulant. Those are like going to be the new ones that you see commercials for all the time. So Xeralto, Alequis, those are the two big ones right now. They're replacing the older one. And also we were supposed to do a disclaimer of this is current as of today because the ADA guidelines do change. this will be current as of today. And Jason, as a pharmacist, is always looking up on that. I had no clue that you are that up to speed on dental knowledge. so just throwing it out there that if you happen to catch his podcast,   a few years back that obviously check those guidelines for sure. But the new ones are the Xarelto and Eloquist. They're replacing the older ones of warfarin. Warfarin's been around for a really long time. We've seen that one. Those are anti-coagulants. So when you're looking, when a patient says that, generally they're on that medication because they've possibly had a clot in the past or they have a heart condition called atrial fibrillation. Those are kind of the two big ones. Like I said, there's always caveats to it, but that's kind of where my mind goes real quickly. And then,   as far as getting patients cleared, the American Dental Association has really good resources on their website. You can look at those and they're always refreshing that up. They even say in their own words that there's limited data around studying patients in the dental chair and with anticoagulants or anti-platelets. It's pretty limited. There's a few studies, some from 2015, some from 2018. There's one as recent as 2021, which is nice. But really, all of those studies come together and it's really more of an expert consensus.   And with that expert consensus, they have kind of simplified things for dentistry, which is really nice. ⁓ comparing that to, we have more data for like total hip replacement, total knee replacement. We have a lot of data and we know really what we should be doing around then. But going back to dentistry, we don't have as much information, so they always say use clinical judgment, but they do give some really great expert guidance on that. So if a patient's on an anticoagulant, ⁓   they generally recommend that it doesn't need to be stopped unless there's a high bleeding risk for a patient. as a provider or as a clinician in the practice, you can be looking at high bleeding risk. Some things that make an oral procedure a little bit lower risk is one, it's in the compressible site, right? Like we can actually put pressure on that site. That's the number one way to stop bleeding is adding pressure. It's not like it's in the abdominal cavity where we can't get in and can't apply pressure. So number one, that kind of reduces the bleeding risk.   is number one. Two, we can add topical hemostatic agents. Dentists would know that better than me. There's a lot of topical ways to do that. So not only pressure, but there's those things as well. And also, but there are some procedures that are a little bit more likely to bleed. And that's where you and dentists would come in hand in What's the word in APO? Oh, the APOectomy. I got it right. Good job. like, didn't you tell me last night that the ADA guideline was like what?   three or four or more teeth? great question. So you can extract one to three teeth is what their expert consensus One to three teeth without. Without really managing or stopping anticoagulation or doing anything like that. I think that's some good guidance from them. I'm gonna add a Jasonism on that though. So with warfarin, I do see why dentists would be a little bit more conservative or worried about stopping the warfarin because warfarin isn't as stable as these newer agents. Warfarin, the levels.   quote unquote levels can go really high, they can go really low. And if the warfarin levels are high, they're more likely to bleed. So I do think it makes sense to have a really recent INR. That's how we measure what the warfarin's doing. I think that makes a lot of sense, but the ADA guidelines really go into the simplification version of all these blood thinners. Generally, it's recommended to not stop them because the risk of stopping them outweighs the benefit of stopping them in almost every case. Almost every case.   ⁓ So when you're with that patient, right, they say I'm on a blood thinner, finding out which kind of blood thinner that they're on, you find out that they're on Xeralto, right? How long have you been on Xeralto for? I've been on it for years. You don't know exactly why, but if they haven't had any recent bleeding, you're only gonna remove one tooth. ⁓ You can do what's called a HasBlood score. That kind of looks at the bleeding risk that they'd have. That'd be kind of going a notch above, but in my mind, removing one tooth isn't a real serious bleeding risk. I'd love to hear from my dentist friends if they...   disagree, right, but ADA says one to three tooth removals, extractions, that's the fancy word. Extractions, yeah, for extracting teeth out. Is not really that invasive. Sure. It's not that high risk, so it's usually perfectly fine. So if a patient was on Xarelto, ⁓ no other, this is in a vacuum, right? I'm not looking at any other factors, which you should be looking at other factors. I would be perfectly fine to just remove one to two.   And when those clearances come in, because dentists do send them, talk about what happens. You guys were working in the hospital and you guys would get these clearances all the time. do. We get them so often. I mean, we get like four or five a day. We'd love to give it to our students, student pharmacists, and ask them what to do. And they would usually look up the American Dental Association guidelines and come up with something. We're like, yep, that's what we say too. In fact, we say it so many times a day that we have a smart phrase.   which just blows in the information real quickly and faxes it right back to the So it's like a copy paste real quick. So what I wanted to point out when Jason told me this is dentists like hearing this and learning this, this can actually save you guys a ton of time to be able to be more confident, to not need to send those clearances on. And we were actually talking last night about how I think this might be a CYA for dentists. like, as we were talking, I think Jason, you seeing so many other aspects of medicine, like you've literally seen patients die, you've seen other areas.   And so coming from that clinical vantage point, we were realizing that dentists, we are so blessed to live in an injury. I enjoy dentistry because possibly there's someone dying, not super high, luckily in dentistry. The only time that I have actually had a doctor have a patient pass away, and it was only when they were completely sedated and doing ⁓ some other things, but that was under the care of an anesthesiologist. And so that's really our high, high risk. And so hearing this, Jason,   That was one of the reasons I wanted him to come on is to give you doctors more confidence of do we have to always send to a pharmacist? I mean, hearing that on the pharmacy side, they're just sending these back and not to say to not see why a to not cover this because you might be questioning like, well, do I really need to? But you also were talking about some other ways of so number one, you guys are just going to copy back the 88 guidelines. So so 88 guidelines. Yeah. And I think that that gives a lot of confidence to a provider or a dentist is that you can go to the 88 guidelines and read them, right? Like you're listening to some   nasally monotone pharmacist on a podcast. Rumor has it, people love him at the hospital. were like, you're the voice, he's been told he has a good radio So for the clinic, I was the voice. Like, yeah, you've reached the vascular clinic, right? And they're like, oh my gosh, you're the voice. But sorry, you me distracted. That'll be your next career, Jace. You're going to be a radio host. OK. I would love that. I love music. But you're hearing from a nasally guy, but you can actually read the ADA guidelines. You just go right to the ADA, click on Resources, and under Resources, it has the   around anticoagulants, I think that's the best way to get a lot of confidence about it because they have dentists who are the experts making calls on these. I'm just reiterating what they say, but I think it makes a lot of sense to help providers. And the reason why my heart goes out to you as well is having the providers that used to work underneath me, they're always looking for our views, which is a fancy way of making sure that they're drilling and filling. Can I say that? Yeah, can say drilling and filling. They're being productive, right? They're being productive, right?   They're always looking to make sure if a patient's canceling, like get somebody in here. Like I need to be helping people all day long. That's how I, we keep the lights on. That's how I help as many people. And so if you have a patient coming in the chair and it has an issue, they say I'm on Xeralto. Well, you can ask real quickly, why are you on Xeralto? I had a clot 10 years ago. my gosh. Well, yeah, we're pretty good to go. Then I'm not worried. We're only removing one tooth or we're just doing a cavity or a cleaning. Something like that. Shouldn't be an issue whatsoever because there's experts in the dental. ⁓   in the dental society, the ADA guidelines that recommend three teeth or less, minimally invasive. They really recommend if it's gonna be really high bleeding risk. And clinically, that's where you would come in, ⁓ or yourself. know, apioectomy is one that's like on the fence line. I don't know where implants set. though, and like we were talking, implants aren't usually like a date of procedure. Most people aren't popping in, having tooth pain, and we're like, let's do an implant. Now sometimes that can be the case, but typically that one's gonna have   a few other pieces involved. And so that is where you can get a clearance if you want to. ⁓ But we were really looking at this of like so many dentists that I know that you've seen will just send in these clearances because they are. And I think maybe a way to help dentists have more confidence is because you know, I love routines. I love to not have to remember things. So why don't we throw it in, have the team member set it up where every quarter we just double check the ADA guidelines. Are there any updates? Are there any other things that we need to do on that? That way you can just see like   getting into the language of this, of what do I need to do? Because honestly, you guys, know pharmacy was not a big portion for it, so, recommending different parts, but I think this is such a space where you can have confidence, and there's a few other things I wanna get to, and I you- I some pearls too. Okay, go. I'm so when she get me into talking about drugs, I'm not gonna stop. So, some other things around that too is these newer blood thinners like Xarelto Eloquist, they now have reversal agents, so a lot of providers in the past were really worried about bleeding because we can't turn it off. We can turn those off. Warfarin has reversal as well, right?   So I'm looking at these patients. It's really low risk. It's in the mouth, generally speaking. Very rarely are they a high bleeding risk. Now if you're doing maxillofacial surgery, this does not apply, right? This does not apply whatsoever. you're like general dentist, you're pediatric dentist. Yeah, yeah, and it's kind of on the fly. So just trying to really help you to be able to take care of those patients on the moment, have that confidence, look at the ADA guidelines, have that in front of you. I don't think it's a bad thing to ever...   check with their provider if you need to. If you're thinking, I feel like I should just check with the provider, I would never take that away from you. But I just want to kind of steer towards those guidelines that I have to help. But what did you want to share? No, yeah, I love that. And I think there were just a few other nuggets that we were chatting about last night that can help dentists just kind of get things passed a little bit easier. So you were mentioning that if they were named to their cardiologist, what was it? was like, who is the last? Great question. Yeah, when a patient's on a blood thinner,   It could be prescribed by the cardiologist. It could be prescribed by the family provider or could have been punted to like a vascular clinic like where I was working. It can go to any of those. And when you send that fax, right, if it goes to the cardiologist and it's supposed to go to the family care provider, like it just kind of goes, goes nowhere, right, from there. So I think it's a really good idea to find out who prescribed it last. If the patient doesn't know who prescribed their blood thinner last, you can call their pharmacy. I call pharmacies all day long.   I have noticed in the last year, they are way easier to get a hold of, which has made my job a lot easier, working on the insurance portion. So reaching out to the pharmacy, finding out who that provider is and sending it to them, because they should be able to help with that. I thought that was a good shift in verbiage that you had of asking instead of like the cardiologist, because that's who you would assume was the one. But you said like so many times you guys would take care of them, and then they go back to family practitioner, and you guys would get the clearances, but you couldn't clear because you weren't overseeing. So just asking the patient.   who prescribed their medication for them last time. That way you can send the clearance to the correct provider. then- And they might not know. You know patients, right? They're like, I don't know, my mom's or else, I don't know who gave it to me. Somebody told me I need to be on this. But at least that could be another quick thing. And then also we were talking last night about-   ⁓ What are some other things that dentists can do when like writing scripts to help them get what I think like overarching theme of everything we discussed is one how to help dentists have less I think drag through pharmacy. ⁓ Because pharmacy can take a little while and so perfect we now know the difference between anti-quag and anti-platelet. We know which medications are probably safe. We know we can check the ADA guidelines so that we were not having to do as many clearances. We also know if they're on a medication to find out and we do need a clearance.   who we can go to for the fastest, easiest result. And now, in talking about prescriptions, you had some really interesting tips that you could share with them. Yeah, so with writing prescriptions, right, pharmacies are pharmacies. So I'm not gonna say good thing or bad thing. There are challenges working with pharmacies. I'm not gonna play that down at all. ⁓ If you're writing prescriptions and having issues and kickbacks from pharmacies, there's some interesting laws around ⁓ writing prescriptions. Say that you're trying to ⁓ prescribe   augmentin, you know, 875 BID, and you tell the patient, hey, I want you to take this twice a day for seven days, and then you put quantity of seven, because you're moving fast, right? You want it for seven days, quantity of seven. Quantity would actually be 14, right? It's not that big of a deal. Anybody with common sense would say if you're taking a pill for twice a day for seven days, you need 14 tablets. But LAHA doesn't allow pharmacists to make that kind of a change, unfortunately. They have to follow what you're saying there. So you're going to get a...   An annoying callback that says, you wrote for seven tablets. I know you need 14. Is that OK? Just delays things, right? So ⁓ I really like the two letters QS. That's Q isn't queen. S isn't Sam. Yeah. It stands for quantity sufficient. So you don't have to calculate the amount of any medication that you're doing. So for me, as a pharmacist, when I was taking care of patients, I hated calculating the amount of insulin they would need for an entire month. So I would say.   Mrs. Jones needs 15, I'd say 15 units ⁓ QD daily. ⁓ And then I say QS, quantity sufficient, ⁓ 90 day supply through refills. So the pharmacy can then go calculate how much insulin that they need. I don't have to even do that. So anytime you're prescribing anything, I like that QS personally. So that lets the pharmacy use ⁓ common sense, as I like to call it, instead of giving you a call. I think that's super helpful. I also thought of one thing too.   going back to blood thinners is when it's kind of like a real quick, like they're not gonna have you stop the blood thinner at all. like you're seeing if you can stop the blood thinner for a patient, there's some instances it's just not gonna happen. And that's whenever they've been, they've had a clot or a stroke or a heart attack within the last three months. Three months. Yeah, that's kind of like the.   Because so many people are like, they had a heart thing like six years ago. And so I think a lot of my dentists that I worked with were like, we got to stop the blood thinners. But it sounds like it's within three months. Yeah, well, I'm just the time. Like this is general broad strokes. What I'm just trying to say is when you want to expect a no real quick. Got it. Right. So because benefits of stopping a blood thinner within those first three months of an event is very, very risky versus the, you know, the benefit of reducing a little bit of blood coming out of the mouth. Right. Like that's not that bad.   when somebody's had a stroke or a heart attack or pulmonary embolism, a clot in the lung, like we can't replace the lung, heart or brain very easily. We can replace blood a lot better. We've got buckets of it at most hospitals have buckets of it, right? So I'm always kind of leaning towards I'd rather replace blood than tissue at all times. So that's kind of a quick no. If they've had one those events in the last three months, we are really, really gonna watch their brain instead of getting.   root canal, right? Like really worried about them. So you'll just say no. And they could the dentist still proceed with the procedure or would you recommend like a three month wait? Or is it provider specific way the pros and cons because sometimes you need to get that tooth out. Great question. think then it's going to come into clinical. That's that's when you send in the clearance, right? Like, and it's great to reach out to the provider who's managing it for you. But I think it's kind of good to know exactly when you get a quick no quick no is going to be less than three months.   ⁓ Or when it's going to be like a kind of a typical, yeah, no problem. If it's been no greater than six months, they're on the typical anticoagulants or alto eloquence. Nothing crazy is going on for them. You're only removing two teeth. This is very, very low risk. But again, I'd urge everybody to read the ADA guidelines. That way you feel more comfortable with it. I'm not as eloquent as they do. They do a real good job. So I don't want to take any of their credit. I think they do a real good job of simplifying that and making you feel confident with providing.   more timely care for patients. Which is amazing. And Jayce, one last thing. I don't remember what it was. You were talking about the DEA and like six month rule. yeah. Let's just quickly talk about that and then we'll wrap this because this is such a fascinating thing for me last night. Yeah. So when comes to prescribing controlled substances, most providers have to have a DEA license. OK. First of all, though, what's your take on dentist prescribing controlled substances? ⁓ I don't think, you know, I worked on the insurance side of things. Right. And I look at the requirements for the   as the authorizations, what a patient, the criteria a patient needs to hit in order to qualify for certain medications. A lot of times for those controlled substances, they have pretty significant issues going on, like fibromyalgia or cancer-related pain or end-of-life care versus we don't, in all my scanning thread, I don't have a ⁓ perfect picture memory. Sure. But I don't usually see oral.   pain in there. There is some post-operative pain that can be covered for those kind of medications but I really recommend to keep those lower and in fact in a lot of our criteria it recommends you know have they tried Tylenol first, they tried, have they filled NSAIDs or are they contraindicated with the patient. So really they should be last line for patients in my two cents but there's always going to be a caveat to the rule right? Of course. comes through that has oral cancer and you're taking   like that would make sense to me. Got it, so then back to the DEA. Yeah, okay. Okay, ready. So as a provider, you should be checking the, if you're doing controlled substances, you should be checking the prescription drug monitoring program, or sometimes called the PDMP, looking to see if patients are getting ⁓ controlled substances from another provider. So it's really just a check and balance to make sure that they're not going from provider to provider to getting too many narcotics and causing self harm or harm to others.   And so with checking that PDMP before prescribing, I think a lot of providers do that. A lot of softwares that I'm aware of, EMRs, electronic medical records, sometimes have links so that you can do that more quickly. However, I don't think it's as intuitive that they need to be checking that every six months in some states. And like here in Nevada, you're supposed to be checking it every six months, not for a patient, but for your actual DEA registration to see if anybody else is prescribing underneath you. Because if you don't check that every six months, you could get in some serious trouble with...   not only DEA, but even more the Board of Pharmacy and your state. Now, I don't know all 50 states, so I check with your state to see if you need to be checking that every six months, but set an alarm just to check that real quickly, keep your nose clean. ⁓ I've had providers, I've had to remind to do that. And if somebody was using your account, prescribing narcotics, you'd never know unless you went and checked that PDMP.   Yeah, I remember last night you were like, and if that was you, I would not want to be you. The Board of Pharmacy is going to be real excited to find you. So that was something where I was like, got it. So, and we all know I'm big on let's make it easy. And Jason, I love that you love this so much and you just brought so much value today. And like also for me, it's just fun to podcast. fun. Yeah. But I got a nerd out on my world a little bit. Bring it into yours. I work with dentists or at least you know, when I was working in Vascular Clinic all day long. Great questions that would come through. Yeah.   So I think for all of us, as a recap on this is number one, I think setting yourself ⁓ some cadences. So maybe every quarter we check our ADA guidelines and we check our, what is it, PDMP. PDMP. so each state, so they call it Prescription Drug Monitoring Program. We need that. Yeah, but there are different acronyms in different states, though. That's just what it's called in Nevada. I forget what it is in California, but you can check your state's prescription monitoring program, make sure that opioids aren't being prescribed under your name. Got it. So we just set that as a cadence.   We know one to three teeth most likely if they're on a blood thinner is According to the 88 as of today is good to go You know things that are going to get a quick know are going to be within the last three months of the stroke the heart attack or the Clot I'm thinking like the pulmonary embolus. Yeah, that's what we're trying to prevent   Those are gonna be quick knows and then if we're prescribing, let's do QS. We've got quantity is sufficient so that we're not getting phone calls back on those medications that we are. And then on narcotics, just being a bit more cautious. Of course, this is provider specific and in no way, or form did Jason come on here to tell you you are the clinical expert.   Jason's the clinical expert on medications. And if you guys ever have questions, I know Jason, you geek out and you want to talk to people so that anyone wants to chat shop. Be sure to reach out and we'll be able to connect you in. we've even talked about possibly, so let me know listeners. You can email in Hello@TheDentalATeam.com of ask a pharmacist anything. I talked to Jason. I was like,   We'll just have them like send in questions and maybe get you back on the podcast or we do a webinar. But any last thoughts, Jace, you've got of pharmacy and dentistry as we as we wrap up today? No, I think that's pretty much it. So check the ADA guidelines. I think it's really good to have cross communication between professions. Right. If you're working with the pharmacy, CVS, Walgreens or something like that or Walmart, I know that it can be challenging. Right. They're under different pressures. You're under different pressure. So I think ⁓ just coming in with an understanding, not being angry at each other.   you know what mean, is super beneficial and working together. When it comes to it, every dentist that I've talked to is actually worried about their patient. Every pharmacist that I've worked with is really worried about the patient as well. So we're trying to accomplish the same thing, but we have different rules and our hands are bound in different ways that annoy each other, right? Like I know Dr. Jones, want 14 tablets, but you said seven. And I know Common Sense says I should give them 14, but I've got to make that change.   knowing that their hands are tied by the law. They can't use as much common sense, which is aggravating. I mean, that's why I love what I gotta do here. I gotta just kind of help a lot more and use common sense and improve patient care. But those kinds of things I think are really beneficial as you work together and then not being so afraid of blood thinners, right? So I think those guidelines do a great job of giving you confidence and not worrying about the side effects. And there's a lot of things that you can do locally for bleeding.   You have a lot of control over that. I think that's pretty cool, the tools they have. Yeah. And at the end of the day, yes, you are the clinician. You are the one who is responsible for this. so obviously, chat, but I think collaborating, talking to other pharmacists, talking to them in your state, finding out what are the state laws, things like that I think can be really beneficial just to give you peace of mind and confidence. And again, dentistry, are maybe a bit more risk adverse because luckily we don't have patients dying That's great thing. Yeah, that's fantastic. I want my dentists to be risk adverse. I think so too. But Jason, I appreciate you being on the podcast today.   And for all of you listening, ⁓ more confidence, more clarity, more streamline to be able to serve and help our patients better. if we can help you in any way or you've got more questions, reach out Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.  

Guest: Jaclyn Tomsic MD DMD FACS https://www.instagram.com/doctorjacci/   Host: Serv Wahan MD DMD https://www.drwahan.com/   Keywords extractions, dental surgery, complications, tooth mobility, dental techniques, patient comfort, dry sockets, anticoagulation, dental tools, oral surgery, Serv Wahan, Jaclyn Tomsic, Dental Influencer, Dental Podcast Summary In this conversation, Dr. Serv Wahan and Dr. Tomsic discuss the intricacies of dental extractions, focusing on techniques, tools, and complications. They explore various approaches to tooth removal, the importance of patient comfort, and the management of complications such as dry sockets and infections. The discussion also touches on the protocols for patients on anticoagulation therapy and the significance of proper communication in dental referrals. Takeaways There's no one way to take teeth out; different techniques work for different practitioners. Mobility of the tooth is crucial before extraction; it helps in the process. Using bite blocks is essential for patient comfort during extractions. Anticoagulation therapy should not be stopped for single tooth extractions. Dry sockets can be managed with specific pastes and follow-up care. Communication with patients about their dental history is vital for successful extractions. Understanding the anatomy of the tooth and surrounding structures is key to successful extractions. Using the right tools and techniques can minimize complications during extractions. Patient education on post-operative care can prevent complications like dry sockets. Experience and adaptability in techniques improve extraction outcomes.  Titles Mastering Dental Extractions: Techniques and Tips Navigating Complications in Tooth Removal Sound bites "You have to have all the sizes." "It's not a race." "I don't like fracturing teeth." Chapters 00:00 Introduction to Extractions and Complications 03:01 Approaching Extractions: Techniques and Tools 06:03 Understanding Tooth Mobility and Elevation 09:02 Sectioning Techniques for Difficult Extractions 11:54 Managing Adjacent Teeth and Crowns 15:04 The Importance of Assistant Support 17:47 Advanced Techniques for Challenging Canines 20:54 Final Resort Techniques for Root Extraction 23:59 Extraction of Anterior Teeth 30:00 Exploring Extraction Techniques and Tools 41:58 Understanding Complications in Dental Extractions 54:01 Managing Post-Extraction Care and Patient Concerns

Commentary by Dr. Jian'an Wang.

Quality dental care at a price you can afford...

INÉDIT - Dans ce nouvel épisode de "Symptômes", le dentiste Nicolas Dray raconte une rencontre intrigante. Une jeune patiente de 25 ans se présente avec une demande surprenante : l'extraction de toutes ses dents. Derrière cette requête inhabituelle, le docteur Dray s'engage dans une enquête délicate pour comprendre les véritables raisons de cette demande. Retrouvez chaque mois un nouvel épisode inédit de "Symptômes", ainsi qu'un bonus la semaine suivante.Hébergé par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

INÉDIT - Dans ce nouvel épisode de "Symptômes", le dentiste Nicolas Dray raconte une rencontre intrigante. Une jeune patiente de 25 ans se présente avec une demande surprenante : l'extraction de toutes ses dents. Derrière cette requête inhabituelle, le docteur Dray s'engage dans une enquête délicate pour comprendre les véritables raisons de cette demande. Retrouvez chaque mois un nouvel épisode inédit de "Symptômes", ainsi qu'un bonus la semaine suivante.Hébergé par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

Quality dental care at a price you can afford...Support the showThanks for listening to PHANTOM LIMB! We're a sci-fi, horror, and weird fiction anthology podcast; we create strange new tales with original music and immersive sound design.For the ideal listening experience, we recommend using headphones! Check out our Patreon to get access to over 10 hours of PHANTOM LIMB episodes you can't get anywhere else, plus behind-the-scenes stuff, photos, art, merch, and more! www.patreon.com/phantomlimbPHANTOM LIMB is produced by Free Jambalaya Studio. Logo and cover art by Caroline Harrison. https://linktr.ee/carolinedraws

If you've ever felt like your blackheads have permanently landed, or that your pores are starting to sag, today's episode is for you. This uninterrupted bonus conversation is brought to you in partnership with our friends at Curology and we're diving deep into the most common pore mysteries with Dr. Whitney Tolpinrud, MD, FAAD, Board Certified Dermatologist and Medical Director at Curology. Listen in as Dr. Tolpinrud debunks the myth of "shrinking" your pores, and reveals the true causes of clogging—from hormones and comedogenic ingredients to invisible micro dust pollution.You'll learn:Pore size & aging: Why your pores appear to sag as your collagen breaks down.Sebaceous filaments vs. blackheads: How to figure out what you're dealing with before you treat.What's in her doctor's bag: How Dr. Tolpinrud chooses the right prescription-strength ingredients to treat breakouts and improve skin texture for varying skin types.Myth-busted rituals: Does dunking your face in ice water or using a steamer really "open or close" your pores? Plus, are extractions a do or a don't, according to the derm?Introducing Curology Day Prime Rx, the first-ever prescription acne treatment that doubles as a blurring, shine-reducing primer—customizable to treat acne, dark spots, or even rosacea!For any products or links mentioned in this episode, check out our website: https://breakingbeautypodcast.com/episode-recaps/ When you support our sponsors, you support the creation of Breaking Beauty Podcast! Curology Curology, the pioneer of personalized prescription skincare, is our exclusive show partner for this episode. They have treated over 5.5 million patients across the USA. Curology is giving Breaking Beauty listeners a special link to try DayPrimeRx - the first-ever prescription acne treatment and primer - for FREE when you subscribe, just pay $5.45 shipping and handling! To claim this offer, go to curology.com/beauty to take Curology's skin quiz! In just a few minutes, you'll share your current skin concerns and a few photos with a Curology dermatology provider who will create a personalized treatment plan tailored to your unique skin goals. This will include DayPrimeRx if it's right for your unique skin! Restrictions apply. See website for full details and important safety information. Get social with us and let us know what you think of the episode! Find us on Instagram, Tiktok,X, Threads. Join our private Facebook group. Or give us a call and leave us a voicemail at 1-844-227-0302. Sign up for our Substack here. Subscribe to our YouTube Channel to watch our episodes! Related episodes like this: The Ultimate 101 Guide to At-Home Skincare Treatments To Remedy Your Skin Conundrum With Next-Gen “Status Facialist” Raquel Medina-CleghornHailey Bieber's Facialist Biba De Sousa On Debunking Breakout Triggers, Oil Cleanser Truths and MoreHow-to Make Your Makeup Last Longer! A 101 Masterclass on Skin Prep, Primers, Powders & Setting Sprays with Makeup Artist Pro Ruby Hammer, MBE *Disclaimer: Unless otherwise stated, all products reviewed are gratis media samples submitted for editorial consideration.* Hosts: Carlene Higgins and Jill Dunn Theme song, used with permission: Cherry Bomb by Saya
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In this jam-packed episode of Micannacast, Cannadave and Groovee sit down with Trent, founder of Exquisite Extractions, to talk hash, hustle, and hard lessons from the cannabis grind.

Ready to elevate your veterinary dentistry skills? https://ivdi.org/inv Request an invitation to the Veterinary Dental Practitioner Program ------------------------------------------------------------------------- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM  In this episode of The Vet Dental Show, Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM, tackles common challenges in veterinary dentistry, including extracting fractured carnassial roots in small dogs and feline incisor extractions. Learn valuable techniques to improve your dental procedures and patient outcomes.  What You'll Learn ✅ Best approaches for extracting fractured carnassial roots (310 or 410) in small dogs. ✅ Techniques for accessing and removing buccal bone. ✅ How to perform atraumatic feline incisor extractions. ✅ Tips for differentiating bone from root in cases of ankylosis. ✅ The importance of magnification and lighting in veterinary dentistry.  Key Takeaways ✅ Patience is key when extracting teeth without a full flap. Use slow, continuous pressure with a luxator elevator. ✅ For fractured roots, adequate retraction and bone removal are essential for successful extraction. ✅ An 18-gauge needle can be used as a mini luxator for feline incisor extractions. ✅ High-quality loops and lighting are crucial for precision in dental procedures. ✅ A UV penlight may help differentiate between tooth root and bone in ankylosis cases -------------------------------------------------------------------------  Call to Action Reminder Don't miss out on the opportunity to enhance your veterinary dentistry skills. Request an invitation to the Veterinary Dental Practitioner Program today! https://ivdi.org/inv ------------------------------------------------------------------------- What are your biggest challenges in veterinary dentistry? Share your questions and experiences in the comments below! ------------------------------------------------------------------------- Veterinary Dentistry, Carnassial Tooth Extraction, Feline Incisor Extraction, Ankylosis, Veterinary Dental Practitioner Program, Dr. Brett Beckman, Veterinary Dental Show, Veterinary CE, Small Animal Dentistry, Dental Extraction Techniques, Veterinary Dental Equipment, Veterinary Loupes, Veterinary Lighting, IVDI, International Veterinary Dentistry Institute

Ready to take your veterinary dentistry skills to the next level? https://ivdi.org/inv Request an invitation to the Veterinary Dental Practitioner Program ------------------------------------------------------------------------- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM  In this episode of The Vet Dental Show, Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM, answers pressing questions from veterinary professionals about root canal limitations, explaining the importance of extractions, and how to communicate effectively with clients about dental procedures. What You'll Learn ✅ Why general practitioners aren't taught root canal therapy. ✅ How to explain the necessity of extractions to clients, even when their pets seem fine. ✅ What to advise clients about the monitoring and maintenance involved with root canals. ✅ How to assess and manage fractured crowns with tertiary dentin. ✅ The role of radiographs in client education and treatment planning. Key Takeaways ✅ Root canal therapy requires extensive training and is best left to specialists. ✅ Client education is crucial for explaining the importance of addressing dental issues, even if they aren't immediately obvious. ✅ Crowns are essential for protecting teeth after root canal procedures. ✅ Radiographic follow-ups are necessary to monitor the long-term success of root canals. ✅ Tertiary dentin can sometimes seal off fractured crowns, but careful radiographic evaluation is essential. ------------------------------------------------------------------------- Don't miss the opportunity to enhance your veterinary dentistry skills! Request an invitation to the Veterinary Dental Practitioner Program: https://ivdi.org/inv Want to expand your skills even further? Explore Dr. Beckman's full selection of courses and resources designed specifically for veterinary professionals!  https://veterinarydentistry.net/ ------------------------------------------------------------------------- Questions? What are your biggest challenges in veterinary dentistry? Leave a comment below! ------------------------------------------------------------------------- veterinary dentistry, vet dental show, Brett Beckman, root canal, tooth extraction, client communication, veterinary education, veterinary technician, IVDI, Veterinary Dental Practitioner Program, dental radiographs, tertiary dentin, fractured crown, pulp necrosis, silent suffering, dental referral, veterinary continuing education

https://ivdi.org/inv Ready to transform your dentistry skills? Request your invitation to the Veterinary Dental Practitioner Program now. ------------------------------------------------------------------------- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM  In this episode of The Vet Dental Show, Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM, tackles challenging dental scenarios, offering expert tips on large breed incisor extractions, managing root tips in the mandibular canal, and extracting specific teeth in small dogs. Plus, insights on effective periodontal treatments. What You'll Learn: ✅ Effective techniques for extracting maxillary lateral incisors in large breed dogs. ✅ How to manage cases where a root tip goes into the mandibular canal. ✅ Tips for extracting the apical root of 310 and 410 in small dogs. ✅ When to use envelope flaps versus releasing flaps in extractions. ✅ Best practices for removing lower canines in cats with minimal bone support. ✅ The efficacy of products like Clindoral and the benefits of using hyaluronic acid (PerioVive) in periodontal treatments. Key Takeaways: ✅ For difficult maxillary lateral incisor extractions, use a combination of luxators and elevators, progressing slowly and applying consistent pressure. ✅ If a root tip enters the mandibular canal, prioritize patient safety and refer the case unless you have advanced training. ✅ When extracting the apical root of 310 and 410 in small dogs, section the tooth and use gentle elevation techniques to avoid fractures. ✅ Hyaluronic acid (PerioVive) is highly effective for promoting reattachment in periodontal pockets after closed root planing. ✅ Surgical extraction times can vary, but with experience, a fractured maxillary canine extraction in a large dog can be completed efficiently. ------------------------------------------------------------------------- Don't miss the opportunity to enhance your veterinary dentistry skills! Request an invitation to the Veterinary Dental Practitioner Program: https://ivdi.org/inv Want to expand your skills even further? Explore Dr. Beckman's full selection of courses and resources designed specifically for veterinary professionals!  https://veterinarydentistry.net/ ------------------------------------------------------------------------- Questions? Leave your questions and comments below! We love hearing from you. ------------------------------------------------------------------------- Keyword Tags: Veterinary Dentistry, Dog Dental Extraction, Cat Dental Extraction, Veterinary Dental Practitioner Program, Brett Beckman, IVDI, Incisor Extraction, Mandibular Canal, Root Tip Removal, Periodontal Treatment, Hyaluronic Acid, PerioVive, Veterinary Education, Vet Dental Show, Large Breed Dogs, Small Breed Dogs, Dental Flaps, Tooth Resorption, Veterinary CE

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Research Investigates Patient and Practitioner Perspectives on Tooth Extractions without Clinical JustificationBy Today's RDH ResearchOriginal article published on Today's RDH: https://www.todaysrdh.com/research-investigates-patient-and-practitioner-perspectives-on-tooth-extractions-without-clinical-justification/Need CE? Start earning CE credits today at ⁠⁠⁠⁠⁠⁠⁠⁠https://rdh.tv/ce⁠⁠⁠⁠⁠⁠⁠⁠Get daily dental hygiene articles at ⁠⁠⁠⁠⁠⁠⁠⁠https://www.todaysrdh.com⁠⁠⁠⁠⁠⁠⁠⁠ Follow Today's RDH on Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/TodaysRDH/⁠⁠⁠⁠⁠⁠⁠⁠Follow Kara RDH on Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/DentalHygieneKaraRDH/⁠⁠⁠⁠⁠⁠⁠⁠Follow Kara RDH on Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/kara_rdh/

Journal de brèves Des mines et des empires 5/5: les frontières extractives se déplacent Le virus dʹEpstein Barr impliqué dans la sclérose en plaques Tout sur le régime alimentaire du panda

Ready to elevate your veterinary dentistry skills? Learn to confidently interpret dental radiographs and improve your diagnostic skills! https://ivdi.org/rad Request your invite to the Veterinary Dental Practitioner Program: https://ivdi.org/inv ------------------------------------------------- Host: Dr. Brett Beckman, Board Certified Veterinary Dentist In this episode of the Vet Dental Show, Dr. Brett Beckman tackles common challenges in veterinary dentistry, including managing fractured root tips, the use of hyaluronic acid in periodontal treatment, and best practices for deciduous tooth extractions. Tune in to refine your techniques and improve your patient outcomes. What You'll Learn: ✅ How to manage fractured root tips during extractions, especially in mandibular premolars. ✅ The benefits and application of hyaluronic acid (Perio Vibe) in periodontal defects. ✅ Considerations for extracting resorbing incisor roots. ✅ Proper techniques for deciduous tooth extractions, including differences between maxillary and mandibular teeth. ✅ The role of veterinary technicians in periodontal pocket cleaning and curettage. Key Takeaways: ✅ Bone Removal is Key: Remove sufficient bone during extractions to prevent fracturing root tips and pushing them into the mandibular canal. Aim for "baby butt clean" roots. ✅ Hyaluronic Acid Benefits: Hyaluronic acid aids in tissue regeneration and bone growth in periodontal defects, potentially preventing future extractions. ✅ Deciduous Extraction Techniques: Use appropriate techniques for deciduous extractions to avoid damaging developing adult teeth. ✅ Technician Training: Properly trained veterinary technicians can effectively perform periodontal pocket cleaning. ✅ Dr. Brett's Pets: Utilize DrBrettsPets.com as a resource for vetted dental instruments and supplies. Don't miss out on the opportunity to deepen your knowledge of radiographic interpretation! https://ivdi.org/rad Questions? What are your biggest challenges in veterinary dentistry? Share your questions and experiences in the comments below! ----------------------------------------------------- veterinary dentistry, vet dental, dog teeth, cat teeth, tooth extraction, fractured root, hyaluronic acid, Perio Vibe, periodontal disease, deciduous teeth, radiographic interpretation, veterinary technician, dental instruments, Dr. Brett Beckman, IVDI, veterinary education, vet continuing education, small animal dentistry

Struggling to read dental x-rays with confidence? https://ivdi.org/rad Unlock the secrets of radiographic interpretation in our FREE training – perfect for techs and vets alike!   Want to stand out in veterinary dentistry? https://ivdi.org/inv Take your skills to the next level with the Veterinary Dental Practitioner Program — our most comprehensive training yet.   -----------------------------   Host: Dr. Brett Beckman, Board Certified Veterinary Dentist   In this episode of The Vet Dental Show, Dr. Brett Beckman guides you through the essential techniques for successful veterinary dental extractions. You'll master periodontal pocket management, learn the importance of proper patient positioning, and discover the benefits of hyaluronic acid application for enhanced dental procedures.   What You'll Learn: ✅ How to identify periodontal pockets using a periodontal probe. ✅ The technique for curettage to remove granulation tissue from periodontal pockets. ✅ The application of hyaluronic acid for pocket management. ✅ Why hyaluronic acid is a superior alternative to Doxyrobe. ✅ Proper patient positioning for various dental extractions (mandibular canine, first molar, maxillary first molar). ✅ How technicians should assist in patient positioning for optimal exposure. ✅ Incision techniques for canine extractions.   Key Takeaways: ✅ Bleeding on probing indicates the presence of granulation tissue in periodontal pockets. ✅ Curettage is essential for removing diseased tissue and promoting healing. ✅ Hyaluronic acid is easy to apply and promotes tissue regeneration. ✅ Correct patient positioning is crucial for successful extractions and suturing. ✅ Proper technician assistance ensures optimal visibility and efficiency during procedures.   -----------------------------   What are your biggest challenges with managing periodontal pockets or performing extractions? Share your questions and experiences in the comments below!   -----------------------------   Keyword Tags: Veterinary Dentistry, Surgical Extractions, Radiographic Interpretation, Veterinary Dental Practitioner Program, Periodontal Disease, Dental Radiography, Veterinary Medicine, Dr. Brett Beckman, IVDI, Hyaluronic Acid, Curettage, Patient Positioning, Veterinary Dental Care, General Practice, Doxyrobe, Veterinary Dental Extractions

We have a conversation with Creed Taylor, Chief of Extractions at Leaf Infusion and he has long history in extractions, I think you'll enjoy the conversation.  We also stop on Cultivar Corner, brought to you by Up In Smoke, we try 3rd Coast Genetics and Jack Truffle – a delightful sativa.Leaf Infusions3rd Coast Genetics Jack TruffleUp In Smoke

Ready to take your veterinary dentistry skills to the next level? Request an invitation to the Veterinary Dental Practitioner Program: https://ivdi.org/inv Host: Dr. Brett Beckman, DVM, DAVDC, FAVD In this episode, Dr. Beckman tackles common challenges in veterinary dentistry, including difficult extractions in small dogs and the dangers of at-home dental cleaning devices. Learn practical techniques and essential knowledge to provide the best possible dental care for your patients. What You'll Learn: ✅ How to approach fractured coronal roots in small dogs (310/410). ✅ A flapless extraction technique for mandibular first molars. ✅ Tips for extracting fractured incisors in cats using minimal equipment. ✅ How to differentiate between bone and root in cases of ankylosis. ✅ The dangers of battery-powered ultrasonic teeth cleaning devices. ✅ Why proper subgingival curettage and root planing are crucial for preventing periodontal disease. Key Takeaways: ✅ Patience is key when extracting difficult teeth; slow, continuous pressure with a luxator can prevent fractures. ✅ Using an 18-gauge needle as a mini-luxator can simplify incisor extractions in cats. ✅ UV penlights may help differentiate between tooth root and bone in ankylosis cases. ✅ At-home ultrasonic dental devices can cause more harm than good due to lack of polishing and potential for tissue damage. ✅ Cleaning alone is insufficient; subgingival curettage and root planing are essential for treating periodontal disease. ✅ Proper training and equipment are crucial for providing effective dental care in general practice. Don't miss out on the opportunity to excel in dental care! Request your invitation now: ivdi.org/inv Questions? Leave a comment below with your questions or experiences related to veterinary dentistry! Keyword Tags: veterinary dentistry, dog teeth extraction, cat teeth extraction, dental cleaning, periodontal disease, ankylosis, root planing, subgingival curettage, veterinary dental practitioner, Brett Beckman, IVDI, dental instruments, feline dentistry, canine dentistry, veterinary education, dental training, dental instruments, loops, magnification, ultrasonic scaler, at-home dental care, veterinary CE, veterinary continuing education

L'annonce de l'extraction de Mohamed Amra a suscité des remous, tant dans la sphère politique que dans le milieu carcéral. Le 11 juin dernier, ce narcotrafiquant notoire a été extrait de sa cellule à la prison de Condé-sur-Sarthe pour être conduit au tribunal judiciaire de Paris. Objectif: le présenter aux juges d'instruction dans le cadre de l'enquête sur son évasion meurtrière survenue l'an dernier au péage d'Incarville. Encadré par le GIGN, équipé d'un casque anti-bruit, menotté et les yeux masqués, Mohamed Amra a été transporté dans un convoi hautement sécurisé. Comment les autorités organisent-elles ces transferts de détenus à haut risque? Quelles mesures sont mises en œuvre pour prévenir toute tentative d'évasion? Dans cet épisode d'Affaire suivante, Elisa Trannin et Florine Silvant reçoivent Jérémy Ducolombier, représentant local FO Justice. Production et rédaction: Elisa Fernandez, journaliste police-justice à BFMTV.com.

This throwback episode features Dr. Steven Dold joining Kevin and Zach from the Voices of Dentistry 2023 in Scottsdale, Arizona! They discuss the common myth that a variety of specific instruments are required for dental extractions. Dr. Dold shares his streamlined approach, emphasizing the effectiveness of a minimalistic toolset. The conversation covers essential instruments, the use of handpieces, and practical tips for simpler and more efficient extractions. Join the Very Dental Facebook group using the password "Timmerman," Hornbrook" or "McWethy," "Papa Randy," "Lipscomb" or "Gary!" Very Clinical is brought to you by Zirc Dental Products, Inc., your trusted partner in dental efficiency and organization. The Very Clinical Corner segment features Kate Reinert, LDA, an experienced dental professional passionate about helping practices achieve clinical excellence.  Connect with Kate Reinert on LinkedIn: Kate Reinert, LDA  Book a call with Kate: Reserve a Call  Ready to upscale your team? Explore Zirc's solutions today: zirc.com    

Welcome back to The Treatment Room! I'm Tessa and I am a licensed esthetician, acne specialist and NASM-certified nutrition coach. In this episode, we discuss acne as a specialty for estheticians, why extractions can go so wrong, is purging a thing?, client relationships, skin picking, and more real world acne application tips for estheticians.ABOUT THE GUESTToday I am joined by my friend, mentor and former esthetician, Douglas Preston. Douglas Preston's career spans over 40-years in professional esthetics, technical education and as a developer of new skin therapies. Preston‘s age management treatment methods are in use throughout the United States, Canada, Australia, New Zealand, Hong Kong and beyond. He is a pioneer in non-medical corrective acne therapies in the skincare industry. In 2022 Preston was inducted into Dermascope Magazine's Academy of Legends, a prestigious honor recognizing a distinguished career and considerable contributions to the professional esthetics industry. He is also the inventor of the remarkable Preston Comedone Rxtractor™, a unique acne treatment tool favored by skincare professionals the world over.SHOP THE RXTRACTOR (code Tess10)TAKE A CLASS W DOUGLAS (code Tess10%)MY VIRTUAL SERVICES⁠⁠⁠⁠⁠⁠⁠⁠⁠Join acne care with me!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠POMP STOREFRONT⁠⁠⁠⁠GLYMED STOREFRONT⁠⁠⁠⁠MY SKINCARE BRAND⁠⁠Follow me on IG/ TikTok: @myestytessa @freeskinbytessaMY LINKS ⁠⁠⁠⁠ https://www.tessaskin.com/servicesSEND ME VOICENOTES! tessaskinconsulting@gmail.commy new food ig: @acnefriendlyfoodShop FreeSKIN by Tessa⁠⁠⁠⁠: www.freeskinbytessa.com Thank you for listening! I love you!

Researchers Examine Nonopioid vs. Opioid Analgesics Effectiveness after Third Molar ExtractionsBy Today's RDH ResearchOriginal article published on Today's RDH: https://www.todaysrdh.com/researchers-examine-nonopioid-vs-opioid-analgesics-effectiveness-after-third-molar-extractions/Need CE? Start earning CE credits today at ⁠⁠⁠⁠⁠https://rdh.tv/ce⁠⁠⁠⁠⁠Get daily dental hygiene articles at ⁠⁠⁠⁠⁠https://www.todaysrdh.com⁠⁠⁠⁠⁠ Follow Today's RDH on Facebook: ⁠⁠⁠⁠⁠https://www.facebook.com/TodaysRDH/⁠⁠⁠⁠⁠Follow Kara RDH on Facebook: ⁠⁠⁠⁠⁠https://www.facebook.com/DentalHygieneKaraRDH/⁠⁠⁠⁠⁠Follow Kara RDH on Instagram: ⁠⁠⁠⁠⁠https://www.instagram.com/kara_rdh/

Join Dr. Sausha in this episode of Clinical Unfiltered as he chats with Dr. Vanessa Watts about all things wisdom teeth surgery! They dive into the art of building patient trust, the crucial role of thorough consultations, and the nitty-gritty of surgical techniques. Dr. V shares her go-to methods for incision design and how to tackle potential complications, all while emphasizing the importance of clear communication with patients. Whether you're in the dental field or just curious about the process, this conversation is packed with valuable insights and best practices for successful wisdom tooth extractions!

Lisa Fischer sits down with Drew Lupkey and Garrett Collums, the founders of Sound Extractions, to explore the fascinating intersection of sound wave frequency and botanical healing. They share their personal journeys through trauma, addiction, and recovery, revealing how functional mushrooms and innovative extraction methods are transforming mental health and wellness. From the science behind their process to the deeper meaning of sobriety and natural healing, this conversation dives into the future of plant-based medicine.     WEBSITE:  https://soundextractions.co/ 20% off all products with code LISA20     FACEBOOK: https://www.facebook.com/sound.extractions     INSTAGRAM:  https://www.instagram.com/soundextractionsco/     EPISODE SPONSOR:  https://www.ralstonfamilyfarms.com/     EPISODE SPONSOR:  https://www.akelscarpetone.com/     EPISODE SPONSOR:  https://marlsgate.com     LISA'S LINKS:     Lisa Fischer Said Academy:  https://lisafischersaid.com/academy/     Website:  lisafischersaid.com     For more information on group intermittent fasting  coaching with Lisa, email fasting@lisafischersaid.com     For more information on one-on-one or group health coaching with Lisa, email healthcoaching@lisafischersaid.com     Podcast produced by clantoncreative.com

From the prehistoric to the modern, the history of dentistry can be a bit painful. Starting crudely and moving up to the idea of "tooth worms" we slowly and painfully made progress in how we care for our teeth. Then in the 1800s we made amazing leaps in knowledge and treatment, and luckily with the help of novocaine.

This week, Mary and Chappell discuss episode 4 of Extracted.

Are you confident in managing patients on bisphosphonates or biologics? Which medications increase the risk of medication-related osteonecrosis of the jaw (MRONJ)? How do you decide when to extract a tooth and when to refer to a specialist? In this episode, Jaz is joined by oral surgery consultant Dr. Pippa Cullingham to explore the complexities of MRONJ. They break down the key risk factors, share expert advice on when to proceed with extractions, and discuss the latest guidelines for managing patients at risk. They also discuss the importance of early assessment - by identifying at-risk teeth early, you can help prevent serious complications and ensure the best outcome for your patients. https://youtu.be/KnQoI8Z-FhM Watch PDP215 on Youtube Protrusive Dental Pearl: it is so important to assess patients before they start taking high-risk medications like bisphosphonates or biologics, using radiographs to identify potential issues. Extractions should ideally be done before medication starts to avoid complications, as MRONJ risk increases once treatment begins. Key Takeaways: Medication-related osteonecrosis of the jaw concerns medications other than bisphosphonates. Risk assessment is crucial when considering dental extractions for patients on certain medications. Guidelines from the Scottish Dental Clinical Effectiveness Partnership are valuable resources for dentists. Higher-risk patients require careful management and communication with their medical teams. Denosumab has a different risk profile compared to bisphosphonates. Patients on long-term bisphosphonates may still have risks even after stopping the medication. Dentists should feel empowered to manage certain extractions in primary care with proper guidance. The decision to extract a tooth should weigh the risks and benefits for the patient. Always assess the patient's risk before extraction. Eight weeks is a critical time for assessing healing. Antibiotics are not recommended for preventing MRONJ in the UK. Radiotherapy history significantly impacts extraction risk. Referral to specialists may be necessary for high-risk patients. Highlights of this episode: 02:15 Protrusive Dental Pearl 03:52  Interview with Dr. Pippa Cullingham: Insights and Experiences 06:40 Medications and Their Risks 10:02 MRONJ: Incidence and Prevalence 13:13 Biologics and other medications 14:19 Guidelines and Best Practices 17:22 Managing High-Risk Patients 25:03 Prophylactic Antibiotics  26:55 Risk Assessment 28:47 Radiotherapy & ORN Risk 31:49 Tips and Key Takeaways 33:32 New Medications & Prevention Strategies For the best approach to managing MRONJ, check the SDCEP Guidelines and the American White Paper. This episode is eligible for 0.5 CE credits via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Diagnosis, management and treatment of oral pathologies) Dentists will be able to - 1. Be aware of the medications that increase the risk of MRONJ. 2. Learn how to assess the risk of MRONJ in patients, particularly before starting high-risk medications. 3. Understand when to proceed with extractions and when to refer patients to specialists for management. If you liked this episode, check out PDP206 - White Patches

Dr. Beckman's International Veterinary Dentistry Institute offers courses in all areas of vet dentistry.    Online & Live Courses for Vets and Techs https://veterinarydentistry.net/    To request an invitation to the VDP Program: https://ivdi.org/    Complications of Extractions or Oro-Nasal Fistula (ONF) Closure After Radiation in Humans and Dogs Introduction  Radiation therapy is a common treatment modality for certain cancers affecting the oral cavity in both humans and dogs. While effective for managing malignancies, radiation can lead to significant challenges in dental procedures, particularly tooth extractions and oro-nasal fistula (ONF) closures. This evaluation synthesizes literature discussing complications associated with these procedures in both species, highlighting parallels and species-specific differences.   Human Literature Osteoradionecrosis (ORN)  Pathophysiology: ORN is a major complication following extractions in irradiated fields. Radiation induces hypovascularity, hypocellularity, and fibrosis in the bone, reducing its ability to heal and resist infection. Incidence: Studies report ORN rates between 5% and 15% after dental extractions in irradiated patients. Risk Factors: Total radiation dose exceeding 60 Gy. Location: Mandible is more prone due to poorer vascular supply. Timing: Extractions performed within 6 months post-radiation have higher risks. Comorbidities: Diabetes, smoking, and poor oral hygiene exacerbate risks. Management: Prophylactic measures include hyperbaric oxygen therapy (HBOT). Surgical debridement or segmental resection may be necessary for severe ORN.  Soft Tissue Complications Delayed Healing: Radiation-induced fibrosis and reduced vascularity lead to delayed mucosal healing. Infections: Secondary infections, such as osteomyelitis, are common due to impaired immune response and reduced tissue integrity. Dehiscence: Closure of oro-nasal fistulas is often complicated by wound dehiscence due to tension at the suture site and poor healing capacity. ONF Closure Challenges: High recurrence rates due to radiation-induced tissue fragility. Limited availability of local tissue for flap reconstruction. Surgical Options: Use of pedicled flaps, such as buccal or palatal flaps, has been successful. Free tissue transfers (e.g., radial forearm free flap) are utilized for extensive defects. Tissue engineering with growth factors or stem cells is an emerging area of interest. Pre-Surgical Preparation: Hyperbaric Oxygen Therapy (HBOT): While not universally applied, HBOT is frequently recommended before surgical interventions in patients at high risk for ORN. Protocols often involve 20-30 preoperative dives (2.0-2.5 ATA for 90-120 minutes per session) and 10 postoperative dives. Antibiotics: Broad-spectrum antibiotics may be prescribed prophylactically to reduce the risk of infection. Nutritional Optimization: Ensuring the patient's nutritional status is optimized can improve surgical outcomes. Veterinary Literature (Dogs) Osteoradionecrosis (ORN)  Pathophysiology: Similar to humans, radiation in dogs leads to hypovascularity and reduced bone turnover. The mandible is the most commonly affected site. Incidence: Published reports indicate a lower incidence of ORN in dogs compared to humans, possibly due to differences in fractionation protocols and total radiation doses. Risk Factors: Total radiation dose (commonly > 50 Gy). Larger tumor burden and proximity to the bone. Management: Conservative treatment includes antibiotics and analgesics. Surgical intervention involves debridement or mandibulectomy in severe cases. Soft Tissue Complications Delayed Healing: Radiation reduces epithelial turnover and fibroblast activity, delaying healing of mucosal wounds. Fistula Formation: ONF formation is common after radiation and can be exacerbated by dental extractions, particularly in the caudal maxillary region. ONF Closure Challenges: Dogs often have limited tissue for local flap reconstruction. Radiation reduces the availability and viability of tissue for surgical manipulation. Surgical Options: Buccal mucosal advancement flaps and rotation flaps are commonly used. Palatal flaps are an alternative for larger defects. Advanced techniques, such as axial pattern flaps, have shown promise. Adjunctive Therapies: HBOT has been explored in veterinary medicine with anecdotal success, though systematic studies are limited.   Comparative Analysis Common Complications Delayed Healing: Both species exhibit delayed healing due to radiation-induced vascular and cellular changes. ORN: A significant risk in humans and dogs, although reported incidences and management strategies differ. Wound Dehiscence: Tissue fragility and tension at surgical sites are common across species.   Species-Specific Differences Risk Factors: Humans are more affected by lifestyle factors such as smoking and systemic conditions like diabetes. Dogs are less influenced by these factors but may have different radiation fractionation protocols affecting outcomes. Management: Free flap techniques and tissue engineering are more advanced in human medicine. Veterinary approaches often rely on local flaps and less invasive options due to cost and availability constraints.   Hyperbaric Oxygen Therapy (HBOT) Protocol Human Protocol  Hyperbaric oxygen therapy (HBOT) is commonly recommended presurgically for patients who have undergone radiation therapy, especially in the head and neck region, to reduce the risk of complications such as osteoradionecrosis (ORN) after oral surgery.   Typical HBOT Protocol for Pre-Surgical Cases: Presurgical Sessions: Number of Sessions: Usually 20-30 sessions. Duration of Each Session: Each session typically lasts 90 minutes at a pressure of 2.0 to 2.5 atmospheres absolute (ATA). Postsurgical Sessions: Additional 10-20 sessions may be recommended following the oral surgery to further promote healing and reduce the risk of complications. Scheduling: Presurgical HBOT is ideally started at least 3-4 weeks before the planned surgery to ensure adequate time to complete the prescribed sessions.   Why HBOT Helps: Increases oxygen delivery to tissues damaged by radiation. Promotes angiogenesis (growth of new blood vessels) in irradiated tissues. Enhances fibroblast function and collagen synthesis. Reduces infection risk by boosting tissue oxygen levels.   Important Notes: The specific number of sessions may vary depending on individual factors, such as the extent of prior radiation damage, the site of surgery, and the overall health of the patient. Close coordination between the oral surgeon, oncologist, and a hyperbaric medicine specialist is crucial for optimizing outcomes. Veterinary Protocol  The use of HBOT in dogs follows adapted protocols based on human medicine, with adjustments for size and species-specific factors. Presurgical Sessions: Number of Sessions: Typically 10-20 sessions are suggested. Duration of Each Session: Sessions last approximately 60-90 minutes at pressures of 1.5-2.0 atmospheres absolute (ATA). Postsurgical Sessions: Additional 5-10 sessions may be recommended depending on the dog's healing progress and surgical outcomes. Monitoring: Dogs should be carefully monitored for signs of oxygen toxicity or other adverse effects during HBOT. Sedation may be required for some patients. Future Directions Human Medicine: Further research into tissue engineering and stem cell therapies to improve healing. Optimization of prophylactic measures such as HBOT and pharmacologic agents. Veterinary Medicine: Development of standardized protocols for managing post-radiation complications, including recommendations for the use of hyperbaric oxygen therapy (HBOT) in veterinary medicine. Emerging guidelines suggest that HBOT can support pre-surgical preparation by improving tissue oxygenation, enhancing vascularization, and promoting healing. Typical protocols involve 10-20 sessions at 1.5-2.0 atmospheres absolute (ATA) for 60-90 minutes per session, with an additional 5-10 sessions postoperatively to ensure optimal healing. Further research is needed to validate these approaches and refine their application for specific conditions. Exploration of advanced reconstructive techniques and adjunctive therapies like HBOT in controlled studies. Cross-Species Insights: Comparative studies to assess shared pathophysiology and potential therapeutic strategies across species. Conclusion  Complications following extractions or ONF closures in irradiated fields pose significant challenges in both humans and dogs. While similarities in pathophysiology exist, differences in risk factors, management, and available interventions highlight the need for species-specific approaches. Continued research, particularly in cross-species translational medicine, is essential to improve outcomes for both populations.   Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

Dr. Beckman's International Veterinary Dentistry Institute offers courses in all areas of vet dentistry.    Online & Live Courses for Vets and Techs https://veterinarydentistry.net/    To request an invitation to the VDP Program: https://ivdi.org/    In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, and Annie Mills, LVT, Dental Technician Specialist (VTS), share tips on preventing hypothermia in patients, managing anesthesia during full mouth extractions, and the role of veterinary technicians in dental charting. This episode also discusses post-op care, the importance of nerve blocks, and using sedation for anxious pets.   Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

What's the best way to reduce post-op pain after extractions? And why should we never use the term “painkiller” with patients? What to do when you hear the dreaded *crack* of a tuberosity? In this episode we talk about all things post-operative extraction complications! And I'm joined by one of the nicest guys in dentistry - Dr. Nekky Jamal  Complications are something we ALL experience, so this episode is great for any dentist. Whether you're brushing up on dry socket prevention, mastering post-op communication, or just curious about advanced healing hacks, tune in for real-world advice to make extractions smoother - for both you and your patients https://youtu.be/BvB3hDESYDY Watch PDP210 on Youtube Protrusive Dental Pearl: The "Niche Kebab" concept encourages dentists to narrow their focus by reducing the variety of procedures they perform and prioritizing those they genuinely enjoy. By evaluating every new skill or treatment added and strategically dropping less-loved procedures, dentists can avoid overextension and the "jack of all trades, master of none" pitfall.  Learn how to Extract Impacted 3rd Molars, don't miss out on Third Molars Online and use the coupon code ‘protrusive' to get 15% off! Key Takeaways Pain management is about setting realistic expectations. Dexamethasone can be beneficial but must be used cautiously. Dry socket is often overhyped; proper care can prevent it. Effective communication can alleviate patient anxiety and prevent misunderstandings and complaints. Preoperative care can help manage pain expectations. Understanding the signs of infection is essential for diagnosis. Chlorhexidine rinses can significantly reduce dry socket risk. Patients appreciate being informed about their unique dental situations. PRF can significantly reduce the incidence of dry socket. Dentists should embrace new techniques like PRF to enhance patient care. Patient involvement in post-surgical care is crucial for healing. Dentists should not hesitate to refer complex cases to specialists. Highlights of this episode: 02:54 Protrusive Dental Pearl 04:05 Dr. Nekky Jamal  08:39 Managing Post-Extraction Pain and Swelling 21:37 Infection 25:02 Identifying Dry Socket and How to Prevent it 28:30 Case Selection and Communication 37:13 Mitigating Dry Socket with Platelet-Rich Fibrin (PRF) 39:47 The Importance of Nicheing in Dentistry 43:19 Cryotherapy and Post-Surgery Care 47:32 Handling Tuberosity Fractures 55:08 Patient Consent  57:55 Litigation and Patient Communication This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A, C and D. AGD Subject Code: 310 ORAL AND MAXILLOFACIALSURGERY (Exodontia) Dentists will be able to: Identify and differentiate common postoperative complications, and recognise the  key symptoms associated Evaluate the ethical and clinical considerations of case selection for extractions Communicate effectively with patients regarding potential complications If you loved this episode, be sure to check out another epic episode with Dr. Nekky Jamal - Wisdom Teeth Extractions – SURGICAL TOP TIPS

OMS Dr. David Cummings discusses how an OMS and orthodontist can work together to provide comprehensive treatment plans for procedures: Temporary Anchorage Devices, Expose and Bond, Extractions and Surgical Uprighting.

Application points, luxation vs elevation, avoiding common mistakes - this one's an episode that I wish I had when I was at dental school! How do you know when you've found the application point during extractions? What are the key protocols that can help make your extractions more efficient? https://youtu.be/rOBPnCTyAwM Watch PS012 on Youtube This week's Protrusive Student episode is all about exodontia - and again I'm joined by Emma Hutchison, our Protrusive Student Ambassador, to discuss some tips and tricks on how to make extractions that little bit easier. Jaz also shares a memorable analogy—could removing a stone from an avocado be the perfect way to describe an extraction?! Key Takeaways Tactile feedback is crucial during tooth extractions. Understanding application points can improve extraction techniques. Using the right amount of pressure is essential to avoid breaking teeth during extraction. Luxators are typically used to sever the PDL before extraction. Atraumatic extraction techniques are important for preserving bone for future implants. Luxators should not be used as elevators. Understanding the mechanics of elevators is crucial for effective extractions. The ‘six second rule' helps in assessing extraction progress. Having a plan for extractions can prevent complications. Communicating with patients about the extraction process is essential. Avoid tunnel vision; consider the surrounding teeth during extractions. Breaking interproximal contacts can simplify extractions. Always check the patient's medical history before procedures. An audible checklist can prevent mistakes during extractions. Highlight of this episode: 00:00 Introduction 02:07 Catching Up with Emma 05:58 Teeth are like avocados! 11:13 Understanding Application Points in Extractions 17:01 Luxators vs. Elevators: Techniques and Safety 24:10 Extraction Technique 25:08 The Six-Second Rule 28:04 Having a plan 29:58 Common Mistakes and  How to Avoid Them 38:17 Conclusion and CE Certification This episode is eligible for 0.75 CE credit via the quiz on below.  This episode meets GDC Outcomes B and C. AGD Subject Code: 310 Oral and Maxillofacial Surgery (Exodontia) Dentists will be able to - 1. Recognise essential steps to establish secure application points 2. Develop approaches for patient communication around extraction procedures, potential risks, and expected outcomes 3. Implement the “6-second rule” and other practical techniques to streamline extractions and troubleshoot common challenges If you loved this episode, make sure to watch Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth [B2B] – PDP085

Mohamed is joined once again for some crossover goodness by the Very Clinical guys...Zach and Kevin!    The trio shares personal anecdotes from their school days, common dental school nightmares, and detailed step-by-step guidelines for performing lower molar extractions.   They emphasize the importance of using a handpiece for sectioning teeth, the value of cone beam CT scans, and provide practical tips for improving surgical techniques. The VC crew aims to help dental students build confidence and competence in oral surgery procedures!   Episode Index: 02:42 Finals Week Stress Stories 07:17 Recurring Dental School Nightmares 10:01 Discussion on Tooth Extractions 21:28 Mastering the Instrumentation (Kevin weighs in on the elevatome) 23:05 Personal Experiences and Challenges in Oral Surgery 24:06 Tools and Techniques for Efficient Extractions 28:44 Step-by-Step Guide to Extracting a Lower Molar 34:30 Advanced Extraction Techniques and Tips Join the Very Dental Facebook group using the password "Timmerman," Hornbrook" or "McWethy," "Papa Randy" or "Lipscomb!" The Very Dental Podcast network is and will remain free to download. If you'd like to support the shows you love at Very Dental then show a little love to the people that support us! -- Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code “VERYDENTAL10” you'll get another 10% off your order! Go save yourself some money and support the show all at the same time! -- The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! -- Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! -- CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even  their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!  

Ep 149 - Wondering how to handle canine extractions without risking jaw fractures? Quick Summary of the Episode: In this episode of The Vet Dental Show, board-certified veterinary dentist Brett Beckman tackles challenging questions about canine extractions, jaw fracture risks, and the importance of correct tools and techniques. Topics include the reattachment of gingiva after canine extraction, preventing iatrogenic fractures, and the best burrs for precision in veterinary dental procedures. Guest, Cast, and Crew Information: Host: Brett Beckman, DVM, FAVD, DAVDC, DAAPM (Board Certified Veterinary Dentist) Featured Pathologist: Dr. Cindy Bell, Oral Pathology Specialist Main Talking Points: Gingiva reattachment and the importance of cone collars post-extraction. Preventing jaw fractures during canine extractions, particularly with small breeds. Using the Dental Explorer for periodontal pocket measurement. Managing lucencies around canine roots and deciding when to perform root canal therapy. The importance of having the correct burr sizes and types for safe dental work. Interesting Quotes From the Episode: "Gingiva reattaches within days unless disrupted by tension or trauma at the extraction site." "With proper training and technique, the risk of a jaw fracture during extraction is minimal, even in challenging cases." "The correct burr can make all the difference in a complex canine extraction—it's a must-have for precision." Timestamps for Major Segments: 00:00-01:00 – Introduction and sponsor mention (Veterinary Dental Practitioner Program) 01:00-03:30 – Answering Aaron's question on gingiva reattachment post-extraction 03:30-07:30 – Discussion on jaw fracture risks in canine extractions with Kristen's question 07:30-10:00 – Using the Dental Explorer and the importance of anesthesia in dental exams 10:00-13:30 – Understanding lucencies, root fractures, and periodontal involvement 13:30-16:30 – Essential burrs and tools for canine extractions and restoration 16:30-18:00 – Wrapping up with a call to action and course details   Learn more about the Veterinary Dental Practitioners Program at https://ivdi.org/inv   and request an invitation. Canine extraction techniques, Preventing jaw fractures in small dogs, Veterinary Dental Practitioners Program, Dental tools for veterinary dentists, Managing root fractures in canine teeth Key Takeaways: Gingiva reattachment happens quickly but requires cone collars to prevent dehiscence. Using the right tools and techniques can minimize the risk of jaw fractures during canine extractions. Radiographic interpretation and familiarity with lucencies are essential for knowing when to extract or save a tooth. Veterinary dental equipment selection, especially burr types and sizes, is crucial for efficient and safe procedures. Affiliate & Sponsor Links: Veterinary Dental Practitioner Program: https://ivdi.org/inv  

Quick Summary: In this episode of the Vet Dental Show, Dr. Brett Beckman shares practical advice for veterinary dental teams. Topics covered include using mouth gags during surgery, managing incisor extractions, handling complex tooth extractions, and using tools like the Vetome. Dr. Beckman also discusses the importance of choosing appropriate methods for specific malocclusions and the pros and cons of referrals versus in-house procedures.     Guest, Cast, and Crew Information: Host: Dr. Brett Beckman, Board Certified Veterinary Dentist Guest: None Sponsored by: IVDI      Main Talking Points: Using syringe barrels as mouth gags in different-sized animals. Tips for incisor extractions and dealing with difficult suture closures. Managing extraction of complex teeth, especially lateral incisors. The value of the Vetome tool for easy extractions. Treating class II malocclusion with mandibular canine extractions. Why the mandibular second molar extraction can be particularly challenging.     Interesting Quotes: "When it comes to extractions, slow, deliberate movements ensure better control and prevent fractures." "The Vetome has been a game-changer in how we approach extractions—efficient, precise, and effective."     Timestamps: [00:00] – Introduction and overview. [01:10] – Discussion on using mouth gags and practical techniques. [04:05] – Tips and tricks for incisor extractions and managing dehiscence. [07:30] – Importance of the Vetome tool for easy and efficient extractions. [10:20] – Treating class II malocclusions and mandibular canine extractions. [12:50] – Managing the mandibular second molar extraction challenges.     (Veterinary dentistry, mouth gags, tooth extraction, incisor extraction, Vetome, dental surgery tools, class II malocclusion, canine tooth extraction, veterinary dental procedures, periodontal disease)     Key Points Summary: Use syringe barrels as mouth gags for different animal sizes, ensuring comfort. Avoid flaps in simple incisor extractions; they often lead to dehiscence. The Vetome is an invaluable tool for efficient extractions in challenging cases. Class II malocclusions can be treated with mandibular canine extractions if other treatments are not viable. The mandibular second molar presents specific extraction challenges due to its deep placement and thick bone structure.     Affiliate & Sponsor Links: Link: IVDI.org/inv  

Welcome back to Beyond the Mirror! In this episode, we dive deep into the world of facials, covering all the essential elements, benefits, and why regular facials are a key part of maintaining healthy skin. Joining us today is Sarah Stafford, a passionate esthetician who recently completed her studies at the Salon Professional Academy and is now practicing at Elemental Aesthetics.Together, we explore the following topics: Sarah's Journey to Becoming an Esthetician: Sarah shares her path from her passion for beauty to joining the skincare industry and how her goal is to help people feel comfortable in their own skin. The Importance of Knowing Your Skin Type: Many people struggle with understanding their true skin type. Sarah talks about her personal discovery and how knowing your skin can transform your skincare routine. The Structure of a Facial: From double cleansing to chemical peels and dermaplaning, we walk through what happens during a professional facial, why each step is important, and how it can improve your skin health. Why You Should Get Regular Facials: Sarah explains how facials help maintain a healthy skin cell turnover, especially as we age, and why it's essential to get facials every 4-6 weeks to keep skin glowing and youthful. Product Recommendations and Aftercare: Learn about the importance of sunscreen, exfoliation, and maintaining results with a solid at-home skincare routine. Extractions, Peels, and Exfoliation Tips: We also discuss when to use scrubs versus chemical peels, how to handle congested skin, and the transformative effects of professional-grade exfoliation treatments. Relaxation and Anti-Aging: Facials aren't just about skincare—they also help reduce stress and inflammation, which is key to maintaining a youthful complexion.For anyone new to facials or those who want to deepen their knowledge, this episode is packed with insights and practical advice. Sarah also shares her tips for maintaining radiant skin in between facials and why regular skincare at home is just as important as professional treatments.Key Takeaways: Regular facials every 4-6 weeks promote healthy skin cell turnover. Facials not only rejuvenate your skin but also help reduce stress and inflammation. A solid at-home skincare routine, including sunscreen and gentle exfoliation, is essential for long-lasting results.Hosts Contact Information: Website: www.elementalwellnessandlongevity.com www.elementalesthetics.com Social Media: www.instagram.com/ElementalWellnessandLongevity www.instagram.com/ElementalEsthetics www.facebook.com/ElementalWellnessandLongevity www.facebook.com/ElementalEsthetics

Ep 144 - What Are the Key Considerations for Root Canals, Extractions, and Dentigerous Cysts in Veterinary Dentistry?   Ever wondered about the intricacies of root canals, when to extract teeth, and how to handle dentigerous cysts in veterinary patients? Discover the answers in this informative episode!   Quick Summary: In this episode, Brett Beckman, a board-certified veterinary dentist, addresses various dental issues in veterinary practice. He covers topics such as root canal training, client education for tooth extractions, monitoring after root canals, handling fractured deciduous teeth in puppies, and managing dentigerous cysts in brachycephalic breeds.   Guest, Cast, and Crew Information: 1. Host: Brett Beckman, Board Certified Veterinary Dentist 2. Sponsored by: IVDI   Main Talking Points: 1. Availability and challenges of root canal training for general practitioners 2. Client education strategies for tooth extractions 3. Post-root canal monitoring and expectations 4. Handling fractured deciduous teeth in puppies 5. Identifying and managing dentigerous cysts in brachycephalic breeds   Interesting Quotes: 1. "I used to tell people 10 years ago, 12 years ago, whatever it may be, that I've been doing root canals after becoming a specialist for 10 years. And I think I'm just now getting good." 2. "If there's no radiographic changes after that month or multiple months that it's taken for that to happen, then there's a chance that they won't [need extraction]."   Timestamps: 1. **[00:00]** – Introduction and sponsorship information 2. **[01:30]** – Discussion on root canal training availability 3. **[03:45]** – Client education for tooth extractions 4. **[07:30]** – Post-root canal monitoring and expectations 5. **[11:00]** – Handling fractured deciduous teeth in puppies 6. **[12:30]** – Identifying and managing dentigerous cysts   Key Points Summary: 1. Root canal training is not available for general practitioners due to the high learning curve and time investment required. 2. Effective client education, including the use of dental images, is crucial for explaining the need for tooth extractions. 3. Post-root canal care often involves crown placement and regular radiographic check-ups. 4. Fractured deciduous teeth in puppies should be extracted promptly to prevent infection and discomfort. 5. Dentigerous cysts are common in brachycephalic breeds with missing premolars and should be addressed early to prevent bone destruction.   Affiliate & Sponsor Links: 1. Sponsored by: Veterinary Dental Practitioner Program 2. Link: ivdi.org/inv   (Veterinary dentistry, root canal therapy, tooth extraction, client education, dentigerous cysts, brachycephalic breeds, dental radiographs, veterinary dental procedures)

Ever wondered when a fractured tooth in a canine patient should stay, or when it's time to extract? Discover the intricacies of root fractures and vital pulp therapy in this quick 13-minute episode!   Quick Summary: In this episode, Brett Beckman dives deep into key dental decisions faced by veterinarians, focusing on canine tooth fractures. He covers when to extract, signs of periodontal disease, and alternative treatments like root canals and vital pulp therapy. This informative episode will enhance your practice skills in veterinary dentistry.   Guest, Cast, and Crew Information: Host: Brett Beckman, Board Certified Veterinary Dentist Sponsored by: IVDI   Main Talking Points: Root fractures in canines – extraction vs. retaining the tooth. Periodontal disease and its impact on fractured teeth. Understanding lucency around fractured roots. When and how to use root canal or vital pulp therapy. Best practices for extraction with a mucoperiosteal flap.   Interesting Quotes: “If there's no lucency and no periodontal disease, a root fracture below the bone might never be an issue.” “Vital pulp therapy can save teeth, but timing is critical – ideally within 24-48 hours of the fracture.”   Timestamps: [00:00] – Introduction and opening. [01:30] – Monique's question: When to keep or extract a fractured tooth. [03:45] – Signs that a fractured tooth needs extraction. [05:50] – Vicko's question: Lucency and root canals. [09:10] – Kimberly's question: Explanation of vital pulp therapy. [11:50] – Carol's question: Root canal viability over time.     (Veterinary dentistry, canine tooth extraction, root fracture, periodontal disease, vital pulp therapy, root canal, veterinary dental procedures, lucency in teeth, tooth extraction in dogs)   Key Points Summary: Not all fractured teeth require extraction if there's no periodontal involvement or lucency. Proper diagnosis using radiographs and probing is key to decision-making. Vital pulp therapy can save teeth when treated within 24-48 hours post-fracture. Root canals are viable even years after fractures, provided radiographic evidence isn't severe.   Affiliate & Sponsor Links: Sponsored by: IVDI Link: IVDI.org/INV

 "Ever wondered how to perfect your dental extractions while safeguarding against iatrogenic jaw fractures in canine patients? In this episode, we dive deep into best practices, essential techniques, and expert tips to enhance your veterinary dental procedures!" The focus is on specific procedures such as canine extractions, jaw fracture risks, the Chevron effect in radiographs, and much more. Dr. Beckman answers real-world questions from practitioners, sharing expert advice that can be immediately applied in your clinic.       Guest & Host: Host: Dr. Brett Beckman, Board-Certified Veterinary Dentist Sponsor: Veterinary Dental Practitioner Program (IVDI)       Main Talking Points: Envelope Flaps in Canine Extractions: How and when to use envelope flaps. Expected healing time and the importance of post-surgical care, including the use of Elizabethan collars. Avoiding Jaw Fractures in Canine Patients: Risk of iatrogenic jaw fractures during extraction, particularly in smaller dogs. Importance of correct technique and bone preservation. Chevron Effect in Radiographs: Explanation of Chevron effects, and how to discern them in mandibular and maxillary teeth. Dental Composites and Longevity: How long dental composites last and how to monitor their effectiveness over time.       Interesting Quotes: "It literally takes just days for the gingiva to reattach, but it's crucial to prevent the patient from disturbing the surgical site." "A Chevron effect can sometimes be mistaken for a more severe lucency, so it's important to be discerning in your interpretation."       Timestamps: 0:00 – Introduction to the show and sponsor. 2:00 – Understanding envelope flaps in canine extractions. 6:30 – Risks of iatrogenic jaw fractures in small dogs. 10:45 – How to identify and interpret the Chevron effect in radiographs. 16:30 – Dental composites: When and how to use them, and their longevity.         [Veterinary dentistry, canine extraction techniques, iatrogenic jaw fracture, Chevron effect in radiographs, veterinary dental composites, dental radiography, veterinary dental training]       Affiliate & Sponsor Links: For more information on enhancing your skills in veterinary dentistry, submit a request for the Veterinary Dental Practitioners Program at ivdi.org/inv. 

JR has been to Disc Golf's biggest event of the year, and he liked it!   Bad Monkey! And lastly, JR had 4 teeth extracted all in one visit to the dentist. You get to hear his voice before and after! JomezPro - YouTube www.tobefare.com www.wiiay.com --- Support this podcast: https://podcasters.spotify.com/pod/show/threethingswithjr/support

How do we ensure that men and women both receive the dental care that they need? Today, we are joined by Dr. Robert John, an Oral and Maxillofacial Surgeon practicing in Michigan, to discuss noteworthy trends in men's dental health and the types of interventions that should be considered to address these. Dr. John observes that, in his practice, approximately two-thirds of women have had their wisdom teeth extracted, as opposed to 34% of men. These numbers reflect broader trends in how men and women tend to prioritize and pursue dental healthcare. So how can we help more men seek out and receive the dental health they need, especially as practitioners? Join us today as we get into these numbers, the reasons for these disparities in dental care, and practical steps to address these imbalances.Key Points From This Episode:Dr. John's career history, from training in Canada and the US to his Michigan private practice.Unpacking the disparity in dental care for men and women.The high number of women who have had their wisdom teeth removed.Interrogating why only 34% of men have had their wisdom teeth removed.Evidence that women prioritize dental healthcare more than men.How providers can help men invest more in their dental health.The key role of education in helping men take better care of their dental health.Making sure people have positive dental health experiences from a young age.Dr. John's recommended resources for learning more on this topic.Career advice for young surgeons and residents, and lessons on running a private practice.Forrest Gump, weekly massages, and more rapid-fire question answers!Links Mentioned in Today's EpisodeDr. Robert John — https://www.troyoralsurgery.com/Dr. Robert John Email — info@troyoralsurgery.comDr. Robert John Phone — (248) 665-8769Forrest Gump — https://www.imdb.com/title/tt0109830/The Shawshank Redemption — https://www.imdb.com/title/tt0111161/Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Think you know the ins and outs of comedone removal? Think again. This week, we're joined by Douglas Preston as he discusses a tool he created for an even cleaner comedone removal. Listen in as he walks us through client experience, offers useful tips, and talks about his experience working with dermatologists. Each Thursday, join Dr. Raja and Dr. Hadar, board-certified dermatologists, as they share the latest evidence-based research in integrative dermatology. For access to CE/CME courses, become a member at LearnSkin.com.   Douglas Preston's career spans 40+years in professional esthetics, acne treatment and training, author, and esthetician career mentoring. His business articles appear in many of the top trade journals and magazines. In 2022 Preston was inducted into Dermascope magazine's acclaimed Academy of Legends, a coveted distinction for spa and skincare professionals who've made exceptional contributions to the growth and excellence of the esthetics industry.   Preston is the creator of the celebrated Preston Comedone Rxtractor®️, a special precision tool for the removal of follicular blockages in the skin, widely used by professional estheticians throughout the world.   Want to know more about "How Skilled Comedone Extractions Can Build Your Esthetics Career?" Join Douglas Preston at the 2024 Integrative Esthetics Track.

In this episode, Dr. Brett Beckman, Board Certified Veterinary Dentist, dives deep into practical aspects of veterinary dentistry. From understanding the longevity of crowns to the success rates of vital pulp therapy, this episode is packed with valuable insights for veterinarians and technicians. Brett also addresses common concerns, provides guidelines for referrals, and discusses the intricacies of root canal treatments.   Host: Dr. Brett Beckman, Board Certified Veterinary Dentist Sponsor: Veterinary Dental Practitioner Program Main Talking Points Crown Longevity: Expected lifespan of dental crowns. Vital Pulp Therapy Success Rates: Overview of studies and recommendations. Referral Guidelines: When to refer for root canals. Root Canal Learning: Challenges and learning curve. Client Education: Explaining the need for extractions. Root Canal Monitoring: Expectations and follow-up. Tertiary Dentin: Decisions on extraction based on radiographs. Puppy Dental Care: Handling fractured deciduous teeth. Interesting Quotes "You expect that for the lifetime of the patient if it's done correctly." "Vital pulp therapy success rates drop exponentially after 48 hours." "Client education is crucial in explaining the need for dental procedures." Timestamps 00:00 - 00:30: Introduction 00:31 - 01:30: Crown Longevity 01:31 - 03:00: Success Rates of Vital Pulp Therapy 03:01 - 04:30: Referral Guidelines for Root Canals 04:31 - 06:00: Learning Challenges in Root Canal Therapy 06:01 - 07:30: Client Education for Extractions 07:31 - 09:00: Monitoring Root Canals Post-Treatment 09:01 - 10:30: Tertiary Dentin and Extraction Decisions 10:31 - 12:00: Managing Fractured Deciduous Teeth in Puppies 12:01 - 13:00: Conclusion and Call to Action   For more information about the Veterinary Dental Practitioner Program, visit IVDI.org    [Veterinary dentistry, crown longevity, vital pulp therapy, root canal referral, veterinary dental procedures, client education, tertiary dentin, puppy dental care, dental extractions, veterinary dental training] Key Points Summary Crown Longevity: Expect dental crowns to last the patient's lifetime if done correctly. Vital Pulp Therapy: Success rates significantly drop after 48 hours. Referral Guidelines: Refer for root canals if there's pulp exposure or radiographic evidence of larger pulp chambers or periapical lucency. Learning Curve: Root canal therapy has a steep learning curve, not recommended for general practitioners without extensive training. Client Education: Use visual aids and radiographs to explain the need for extractions to clients. Monitoring: Routine radiographs are essential for monitoring root canal-treated teeth. Tertiary Dentin: Extract if there are radiographic changes; otherwise, monitor. Puppy Dental Care: Always extract fractured deciduous teeth promptly.   Thank you for tuning in to the Vet Dental Show. We hope you found this episode informative and useful. See you next week!

Infertility changes a person, physically, mentally, and emotionally — it affects our identity, our relationships, our hopes and expectations for the future. How we manage these changes will be different for each person.  In this unique and personal episode, Dr. Lora Shahine is a guest on the Infertility Feelings podcast with hosts Doug and Jesse. Listeners will hear her share her own fertility journey and all the emotions she experienced being simultaneously doctor and patient.  Jesse and Doug also explain their process groups — safe spaces where members can talk about the issues and feelings that come with infertility. A great tool for managing the emotional toll that infertility takes, this form of group therapy could help members come out the other side understanding what their bodies and minds have gone through.  In this episode you'll hear: [:46] Meet the hosts of the Infertility Feelings Podcast [2:35] Dr. Lora Shahine shares her fertility journey through 2 pregnancies [7:04] Being a Fertility Doctor and Fertility patient at the same time [10:28] The impact of fertility on other parts of your life [13:51] Acceptance of a new reality [16:24] Infertility as a first “real” struggle [18:47] How infertility changes you [23:27] The changes your body goes through during infertility [28:24] Dealing with feelings of failure [30:19] Doug & Jesse's Process Groups [36:06] Balancing patient's dreams with best course of action Resources mentioned:  Uniquely Knitted www.uniquelyknitted.org Process Groups: www.uniquelyknitted.org/programs/process-groups Infertility Feelings Podcast: www.uniquelyknitted.org/podcast/infertility-feelings-podcast Stay Up to Date in Fertility News and Events:  Weekly Newsletter Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Welcome back to The Treatment Room!  The man, the myth, Douglas Preston, founder of Preston Acne Pros, and esthetician of over 40 years shares his insights on treating acne, how to master comedones extractions, and spills the tea on his upcoming partnership with Face Reality. Follow Douglas. Save on the RXtractor with code Tess10: https://www.prestonskincenter.com/product-page/preston-comedone-rxtractor-single MY LINKS ⁠⁠⁠⁠ Shop FreeSKIN by Tessa⁠⁠⁠⁠: www.freeskinbytessa.com Follow me on IG/ TikTok: @myestytessa