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How good is your consent for orthodontics — really? More adults are having ortho, and more GDPs are providing it. So which risks should you be discussing with every single patient — and which ones depend on the person in the chair? When a case is heading for a big overjet or a tricky rotation, is that a conversation you have at the start, or one you scramble to explain halfway through? And what actually makes a consent form legally valid — the signature, or everything around it? This episode brings together two perspectives you don't often hear in the same room. Dr Zaid Esmail is a specialist orthodontist and founder of the Online Orthodontic Academy, who mentors GDPs through fixed and aligner cases. Dr Neel Jaiswal returns for the dento-legal view — he's a dentist and the founder of Professional Dental Indemnity (PDI). Together with Jaz, they get very specific about what individualised consent looks like in practice, and how to build a process your patients remember and a court respects. https://youtu.be/YvsiIiX1Q1w Watch PDP273 on YouTube Protrusive Dental Pearl: Make Your Patient Feel Unique It might be your 100th, 500th or 1,000th case — but for the patient in the chair, this is a significant event. Never forget that. A routine extraction is routine for you; for them it's a big deal, and remembering that makes you a better communicator. To make a specific risk stick, make the patient feel unique. Point to their OPG: “Your sinus here is actually really interesting,” or “Did you know your roots are unusually long?” Patients remember a risk framed as if they're a special case far better than a generic warning. Make it personal, and the consent becomes memorable. What You'll Take From This Episode The whole episode turns on one idea: generic, templated consent is no longer defensible — the skill is individualising the form to the patient in front of you. Premium members get the full breakdown; here's the shape: The layers of valid consent — consent is like an onion; a signed form and a documented conversation each cover a gap the other leaves open. Individualising risk from the records — how the OPG and photos turn a generic warning (resorption, devitalisation, recession, relapse) into a patient-specific one. The two-appointment consent flow — records, individualised risks, thinking time, and why you sign or initial every line. The Class II Div 2 overjet trap — the case that looks like simple crowding and ends in a big overjet, and how to consent for it before you start. When to treat, add an option, or refer — the GDC line on offering all options, and building alternatives into the form. Highlights of This Episode: 00:00 Teaser 01:01 Consent in Orthodontics: Why It Has to Be Individualised 02:59 Protrusive Dental Pearl: Make Your Patient Feel Unique 07:58 What Makes Orthodontic Consent Different 10:08 How Much Ortho Litigation Comes From Consent? 11:53 What Makes Consent Valid and Patient-Specific 12:26 Individualising Ortho Risk from the OPG 13:11 Using the ClinCheck as a Consent Tool 14:40 How to Structure the Consent Appointment 15:30 Root Resorption, Devitalisation, Recession and Relapse 19:37 Should You Initial Every Line of a Consent Form? 21:50 Midroll 27:11 Building a Multi-Layered Consent Process 29:31 Consenting for Fees, Relapse and Retainers 34:41 The Class II Div 2 Overjet Trap 37:51 When Should a GDP Refer an Ortho Case? 40:31 How to Learn Orthodontics with Mentorship 47:01 Outro Dr Zaid Esmail is a specialist orthodontist. He founded the Online Orthodontic Academy to teach GDPs orthodontics — assessment, diagnosis and treatment planning across fixed appliances and aligners — with one-to-one case mentorship. He's extended a 10% discount to the community with the code PROTRUSIVE.
How good is your consent for orthodontics — really? More adults are having ortho, and more GDPs are providing it. So which risks should you be discussing with every single patient — and which ones depend on the person in the chair? When a case is heading for a big overjet or a tricky rotation, is that a conversation you have at the start, or one you scramble to explain halfway through? And what actually makes a consent form legally valid — the signature, or everything around it? This episode brings together two perspectives you don't often hear in the same room. Dr Zaid Esmail is a specialist orthodontist and founder of the Online Orthodontic Academy, who mentors GDPs through fixed and aligner cases. Dr Neel Jaiswal returns for the dento-legal view — he's a dentist and the founder of Professional Dental Indemnity (PDI). Together with Jaz, they get very specific about what individualised consent looks like in practice, and how to build a process your patients remember and a court respects. https://youtu.be/YvsiIiX1Q1w Watch PDP273 on YouTube Protrusive Dental Pearl: Make Your Patient Feel Unique It might be your 100th, 500th or 1,000th case — but for the patient in the chair, this is a significant event. Never forget that. A routine extraction is routine for you; for them it's a big deal, and remembering that makes you a better communicator. To make a specific risk stick, make the patient feel unique. Point to their OPG: “Your sinus here is actually really interesting,” or “Did you know your roots are unusually long?” Patients remember a risk framed as if they're a special case far better than a generic warning. Make it personal, and the consent becomes memorable. What You'll Take From This Episode The whole episode turns on one idea: generic, templated consent is no longer defensible — the skill is individualising the form to the patient in front of you. Premium members get the full breakdown; here's the shape: The layers of valid consent — consent is like an onion; a signed form and a documented conversation each cover a gap the other leaves open. Individualising risk from the records — how the OPG and photos turn a generic warning (resorption, devitalisation, recession, relapse) into a patient-specific one. The two-appointment consent flow — records, individualised risks, thinking time, and why you sign or initial every line. The Class II Div 2 overjet trap — the case that looks like simple crowding and ends in a big overjet, and how to consent for it before you start. When to treat, add an option, or refer — the GDC line on offering all options, and building alternatives into the form. Highlights of This Episode: 00:00 Teaser 01:01 Consent in Orthodontics: Why It Has to Be Individualised 02:59 Protrusive Dental Pearl: Make Your Patient Feel Unique 07:58 What Makes Orthodontic Consent Different 10:08 How Much Ortho Litigation Comes From Consent? 11:53 What Makes Consent Valid and Patient-Specific 12:26 Individualising Ortho Risk from the OPG 13:11 Using the ClinCheck as a Consent Tool 14:40 How to Structure the Consent Appointment 15:30 Root Resorption, Devitalisation, Recession and Relapse 19:37 Should You Initial Every Line of a Consent Form? 21:50 Midroll 27:11 Building a Multi-Layered Consent Process 29:31 Consenting for Fees, Relapse and Retainers 34:41 The Class II Div 2 Overjet Trap 37:51 When Should a GDP Refer an Ortho Case? 40:31 How to Learn Orthodontics with Mentorship 47:01 Outro Dr Zaid Esmail is a specialist orthodontist. He founded the Online Orthodontic Academy to teach GDPs orthodontics — assessment, diagnosis and treatment planning across fixed appliances and aligners — with one-to-one case mentorship. He's extended a 10% discount to the community with the code PROTRUSIVE.
Is rotary really better than reciprocating? Can you safely skip the glide path with modern reciprocating systems? What is the best file system for a GDP who wants predictable endodontic results? And perhaps the biggest question of all: does the file system matter as much as we think it does? In Part 2 of the Endo Showdown, Dr Samuel Johnson returns to tackle some of the most common questions dentists have about file systems, glide path preparation, retreatment, and endodontic workflow. From practical negotiation tips to choosing a system that works in your hands, this episode focuses on the decisions that can make endodontics simpler, safer, and more predictable. https://www.youtube.com/watch?v=onZMR-872HQ Watch PDP271 on YouTube Protrusive Dental Pearl Cut your gutta-percha at the level of the canal orifice and thoroughly clean the pulp chamber before placing the coronal restoration. ⚠️ Leaving gutta-percha and sealer coronally can compromise the coronal seal and promote leakage. ✅ Use isopropyl alcohol to clean resin-based sealer residue before bonding. Water is effective for cleaning bioceramic sealers. Key Takeaways Establish a glide path before shaping whenever possible. D-Finders can negotiate difficult canals more predictably than traditional K-files. Intermediate files such as size 12 or 12.5 can help bridge the jump from size 10 to size 15. Straight-line access reduces file binding and improves shaping efficiency. Avoid forcing glide path files to working length. Gates Glidden drills may be unnecessarily aggressive for routine coronal flaring. Consistency with one file system is often more important than chasing the latest product. WaveOne Gold remains a simple and user-friendly option for many GDPs. Rotary and reciprocating systems can both achieve successful outcomes when used appropriately. A good glide path is often more important than the type of motion being used. Hand files and Hedström files remain valuable during retreatment. Mechanical GP removal near the apex increases the risk of extrusion. Solvents are best reserved for residual gutta-percha rather than used at the start of retreatment. Understanding motor settings, torque, and RPM improves file safety and efficiency. Knowing when to refer is a sign of clinical maturity, not weakness. Clear consent and expectation management reduce stress for both clinician and patient. Highlights of this episode: 00:00 Teaser 01:09 Introduction 02:15 Protrusive Dental Pearl: Coronal GP Removal & Pulp Chamber Clean-Up 03:59 Glide Path File Protocol & Canal Negotiation 06:24 Access Cavity Design & Coronal Flaring in RCT 08:38 File Taper & Canal Preparation Philosophy 09:54 Managing Difficult Canals in Endodontic Treatment 11:48 When to Introduce the Glide Path File 13:24 Using Intermediate File Sizes 15:39 Useful Negotiation & Shaping Tips 17:19 Choosing a File System 20:19 Rotary vs Reciprocating in Clinical Practice 21:29 Motor Settings & File Control 21:40 XP-Endo & Specialised File Designs 22:05 Endo Motor Ads 24:44 XP-Endo & Specialised File Designs 25:16 Retreatment Files & GP Removal 26:08 Preferred Gutta-Percha Removal 31:21 Recommended System for Simplicity 32: 44 Building Skills Faster in Endodontics 36:13 Consent & Managing Expectations 41:51 Reciproc vs WaveOne Gold 42:22 Preferred Retreatment Protocol 43:33 Using Rotary Files in Reciprocation 45:12 Curved Canals & Shaping Efficiency 46:32 Can Reciproc Blue Bypass the Glide Path? 49:29 Outro Want more? Check out the previous episode with Dr. Samuel Johnson: Working Lengths and Troubleshooting Apex Locators – PDP216
Is rotary really better than reciprocating? Can you safely skip the glide path with modern reciprocating systems? What is the best file system for a GDP who wants predictable endodontic results? And perhaps the biggest question of all: does the file system matter as much as we think it does? In Part 2 of the Endo Showdown, Dr Samuel Johnson returns to tackle some of the most common questions dentists have about file systems, glide path preparation, retreatment, and endodontic workflow. From practical negotiation tips to choosing a system that works in your hands, this episode focuses on the decisions that can make endodontics simpler, safer, and more predictable. https://www.youtube.com/watch?v=onZMR-872HQ Watch PDP271 on YouTube Protrusive Dental Pearl Cut your gutta-percha at the level of the canal orifice and thoroughly clean the pulp chamber before placing the coronal restoration. ⚠️ Leaving gutta-percha and sealer coronally can compromise the coronal seal and promote leakage. ✅ Use isopropyl alcohol to clean resin-based sealer residue before bonding. Water is effective for cleaning bioceramic sealers. Key Takeaways Establish a glide path before shaping whenever possible. D-Finders can negotiate difficult canals more predictably than traditional K-files. Intermediate files such as size 12 or 12.5 can help bridge the jump from size 10 to size 15. Straight-line access reduces file binding and improves shaping efficiency. Avoid forcing glide path files to working length. Gates Glidden drills may be unnecessarily aggressive for routine coronal flaring. Consistency with one file system is often more important than chasing the latest product. WaveOne Gold remains a simple and user-friendly option for many GDPs. Rotary and reciprocating systems can both achieve successful outcomes when used appropriately. A good glide path is often more important than the type of motion being used. Hand files and Hedström files remain valuable during retreatment. Mechanical GP removal near the apex increases the risk of extrusion. Solvents are best reserved for residual gutta-percha rather than used at the start of retreatment. Understanding motor settings, torque, and RPM improves file safety and efficiency. Knowing when to refer is a sign of clinical maturity, not weakness. Clear consent and expectation management reduce stress for both clinician and patient. Highlights of this episode: 00:00 Teaser 01:09 Introduction 02:15 Protrusive Dental Pearl: Coronal GP Removal & Pulp Chamber Clean-Up 03:59 Glide Path File Protocol & Canal Negotiation 06:24 Access Cavity Design & Coronal Flaring in RCT 08:38 File Taper & Canal Preparation Philosophy 09:54 Managing Difficult Canals in Endodontic Treatment 11:48 When to Introduce the Glide Path File 13:24 Using Intermediate File Sizes 15:39 Useful Negotiation & Shaping Tips 17:19 Choosing a File System 20:19 Rotary vs Reciprocating in Clinical Practice 21:29 Motor Settings & File Control 21:40 XP-Endo & Specialised File Designs 22:05 Endo Motor Ads 24:44 XP-Endo & Specialised File Designs 25:16 Retreatment Files & GP Removal 26:08 Preferred Gutta-Percha Removal 31:21 Recommended System for Simplicity 32: 44 Building Skills Faster in Endodontics 36:13 Consent & Managing Expectations 41:51 Reciproc vs WaveOne Gold 42:22 Preferred Retreatment Protocol 43:33 Using Rotary Files in Reciprocation 45:12 Curved Canals & Shaping Efficiency 46:32 Can Reciproc Blue Bypass the Glide Path? 49:29 Outro Want more? Check out the previous episode with Dr. Samuel Johnson: Working Lengths and Troubleshooting Apex Locators – PDP216
Is titanium still the gold standard for implants? Are zirconia implants just hype from biological dentistry… or something more? Do ceramic implants really integrate as well as titanium? And should we already be offering patients a choice? Zirconia implants are no longer a fringe concept—they're entering mainstream conversations. In this episode, Dr. Pav Khaira returns to break down the science, clinical decision-making, and real-world application of zirconia vs titanium implants. From corrosion and osteoimmunology to occlusion and case selection, this is a practical, evidence-led discussion for clinicians navigating modern implant options. https://youtu.be/-RCvf2KOdSc Watch PDP264 on YouTube Protrusive Dental Pearl: Thriving in Challenging Times
Is titanium still the gold standard for implants? Are zirconia implants just hype from biological dentistry… or something more? Do ceramic implants really integrate as well as titanium? And should we already be offering patients a choice? Zirconia implants are no longer a fringe concept—they're entering mainstream conversations. In this episode, Dr. Pav Khaira returns to break down the science, clinical decision-making, and real-world application of zirconia vs titanium implants. From corrosion and osteoimmunology to occlusion and case selection, this is a practical, evidence-led discussion for clinicians navigating modern implant options. https://youtu.be/-RCvf2KOdSc Watch PDP264 on YouTube Protrusive Dental Pearl: Thriving in Challenging Times
① A senior CPC official has stressed supporting patriotic pro-reunification forces in Taiwan and striking hard against separatists. Why is the Chinese mainland justified to do so? (00:55) ② We analyze China's provincial GDPs for 2025 and explore why “how fast” the economy grows becomes less important than “how well” it grows. (13:37) ③ South Africa's Cyril Ramaphosa has expressed support for Russia's efforts to end the Ukraine war in a call with Vladimir Putin. How are the two sides developing their ties amid global uncertainties? (25:02) ④ Survivors of Jeffrey Epstein's abuse are renewing their calls for the full release of files tied to Epstein's sex-trafficking network. What have led to their deep sense of frustration? (35:21) ⑤ Donald Trump has threatened to block the opening of a new US-Canada bridge, demanding that Canada turn over at least half of the project's ownership and agree to other US demands over cross-border trade issues. Does the threat make sense? (44:20)
Last week, we covered the best investments to preserve your money, but this week we are shifting gears to focus on growth. For retirees, the goal is to have an income that outpaces inflation, and historically, the best way to achieve that is by having 50% to 70% of your portfolio invested in stock funds. In this episode, I break down five specific Exchange Traded Funds (ETFs) that can help you grow your wealth in 2026. I discuss why I prefer ETFs over mutual funds, specifically focusing on cost, transparency, and liquidity, and provide the exact ticker symbols and expense ratios for the funds I use with my own clients to build diversified, growth-oriented portfolios. If you are willing to accept some volatility to achieve higher long-term returns, this episode provides a blueprint for structuring the equity side of your retirement plan. You will want to hear this episode if you are interested in... [00:00] Top 5 Growth ETFs to Own For 2026. [02:55] Why ETFs are superior to mutual funds. [05:23] The core holding: S&P 500 ETF. [09:28] Capturing extra growth with SPYG. [06:33] Small Cap stocks and the profitability factor. [13:38] Investing in the Developed World ex-US. [15:43] High growth potential in Emerging Markets. Why Choose ETFs? Before diving into specific funds, it is important to understand why Exchange Traded Funds (ETFs) are often a better choice than traditional mutual funds. I prefer them for four main reasons: Cost: ETFs often have significantly lower expense ratios, some less than a tenth of a percent, compared to actively managed funds that can charge up to 2%. Performance: Many active funds struggle to outperform their benchmarks over time. Transparency: You can see exactly what an ETF holds, whereas mutual funds may only report holdings twice a year. Liquidity: You can trade ETFs throughout the day while the market is open, rather than waiting for the market close price required by mutual funds. The US Core: S&P 500 and Growth Variations For the core of a growth portfolio, I look to the S&P 500, which has averaged a 15% return over the last five years. State Street SPDR Portfolio S&P 500 ETF (SPYM/SPSM): This fund tracks the S&P 500 but was created to offer a lower cost (0.02% expense ratio) compared to the original SPY ETF. It is a massive fund with over $100 billion in assets, heavily weighted toward large technology companies like Nvidia, Apple, and Microsoft. S&P 500 Growth ETF (SPYG): If you want to lean more aggressively into growth, this fund tracks S&P 500 companies with high sales growth and momentum. It has a 3-year average return of 29% and a very low expense ratio of 0.04%. Diversifying with Small Caps While the S&P 500 is dominant, it has had "lost decades" in the past where returns were negative. To diversify, I recommend the S&P 600 Small Cap ETF. Unlike the Russell 2000, the S&P 600 index requires companies to be profitable, which filters out lower-quality stocks. Although it has lagged recently, small caps may be poised for a comeback due to economic shifts and tariffs. The expense ratio for this fund is just 0.03%. International Opportunities The US has outperformed international markets recently, but that trend could reverse. Developed World ex-US (SPDW): This fund invests in developed economies like Japan, the UK, and Canada. It offers exposure to major global players like Samsung and AstraZeneca with a low expense ratio of 0.03%. Emerging Markets (SPEM): For higher potential growth, this fund targets countries with rapidly growing GDPs, such as China, Taiwan, and India. These economies have a growing middle class, which can drive corporate earnings. The fund holds major companies like Taiwan Semiconductor and Alibaba. Resources Mentioned Retirement Readiness Review Subscribe to the Retire with Ryan YouTube Channel Download my entire book for FREE Connect With Morrissey Wealth Management www.MorrisseyWealthManagement.com/contact Subscribe to Retire With Ryan
In this episode, orthodontist Zaid Esmail opens up about what really matters in patient care—and it's not just straight teeth. From calling every patient the week after fitting braces to navigating the tension between NHS pragmatism and private practice perfectionism, Zaid reveals why communication trumps technique every time. He shares the terrifying moment a patient swallowed a spring mid-treatment, the legal nightmare of inventing an orthodontic device, and why he built an online academy to teach GDPs the skills they're inevitably going to use anyway. Plus, there's an honest take on conference culture, overtreatment trends, and why he refuses to become the kind of orthodontist who needs cases to pay bills. Want 10% off Zaid's Online Orthodontic Academy course and mentorship? Use code DLPOD10 at https://onlineorthodonticacademy.co.uk/In This Episode00:01:20 - What makes a great orthodontist 00:06:25 - Why he'll never own a fully private practice 00:14:40 - From Iraq to Wales via dental school 00:28:00 - Teaching philosophy and the dangers of weekend courses 00:37:50 - Where GDPs go wrong with orthodontics 00:41:45 - Building the Online Orthodontic Academy 00:52:50 - Blackbox thinking 00:58:05 - Inventing the Eruptor device 01:16:45 - Conference culture and the problem with celebrity orthodontists 01:24:10 - Fantasy dinner party 01:27:10 - Last days and legacyAbout Zaid EsmailZaid Esmail is an orthodontist working at Grosvenor House Orthodontic Practice in Tunbridge Wells, part of the Bupa Dental Care group. He runs the Online Orthodontic Academy, providing diploma-level training and case mentorship for dentists looking to incorporate orthodontics into their practice. Zaid also invented the Eruptor, a device for managing partially erupted teeth. Follow him on Instagram at @onlineorthoacademy and @zaid_mails.
Michael Zuber and Jason Hartman, are forecasting economic and housing trends for 2026. They discuss several key variables, including the unemployment rate, which Hartman predicts will slightly increase due to automation and artificial intelligence, but argues this will ultimately lead to greater prosperity and new industries. The conversation then shifts to interest rates, with Jason expressing optimism for rates hovering around six percent, partly due to the Federal Reserve's move back into quantitative easing (QE), which he believes will positively impact the housing market by increasing credit availability. They anticipate modest GDP growth and increased home sales volume for 2026, rejecting crash scenarios and predicting home price appreciation of around 3-4%. They conclude by affirming that inflation is the government's likely strategy to manage massive debt, which they see as a hidden wealth creator for real estate investors through inflation-induced debt destruction. #2026EconomicVariables #UnemploymentU3 #RisingUnemployment #AIandAutomation #IncreasedProductivity #InsatiableWants #EconomicProsperity #LuxurySectors #SpasAndMedSpas #CarAsAService #LowerInterestRates #QuantitativeEasing #MoneySupply #MortgageCreditAvailabilityIndex #HousingLockinEffect #AffordableHousing #NoForeclosureCrisis #MBSBuyingGameChanger #ScarceInventory #HousingPriceAppreciation #GDPBullish #ResilientEconomy #TheConsumer #InflationInducedDebtDestruction #RealEstateWealthCreation Key Takeaways: 1:43 Where do you think these things go in 2026 9:39 Money supply and Quantitative Easing (QE) 13:46 GDPs and Recession calls 15:39 A crash in transactions versus price 17:58 The consumer 19:14 6 Ways to get out of this mess Transcript HERE Follow Jason on TWITTER, INSTAGRAM & LINKEDIN Twitter.com/JasonHartmanROI Instagram.com/jasonhartman1/ Linkedin.com/in/jasonhartmaninvestor/ Call our Investment Counselors at: 1-800-HARTMAN (US) or visit: https://www.jasonhartman.com/ Free Class: Easily get up to $250,000 in funding for real estate, business or anything else: http://JasonHartman.com/Fund CYA Protect Your Assets, Save Taxes & Estate Planning: http://JasonHartman.com/Protect Get wholesale real estate deals for investment or build a great business – Free Course: https://www.jasonhartman.com/deals Special Offer from Ron LeGrand: https://JasonHartman.com/Ron Free Mini-Book on Pandemic Investing: https://www.PandemicInvesting.com
Let's be honest – the occlusion after Aligner cases can be a little ‘off' (even after fixed appliances!) How do you know if your patient's occlusion after aligner treatment is acceptable or risky? What practical guidelines can general dentists follow to manage occlusion when orthodontic results aren't textbook-perfect? Jaz and Dr. Jesper Hatt explore the most common challenges dentists face, from ClinCheck errors and digital setup pitfalls to balancing aesthetics with functional occlusion. They also discuss key strategies to help you evaluate, guide, and optimize occlusion in your patients, because understanding what is acceptable and what needs intervention can make all the difference in long-term treatment stability and patient satisfaction. https://youtu.be/e74lUbyTCaA Watch PDP250 on YouTube Protrusive Dental Pearl: Harmony and Occlusal Compatibility Always ensure restorative anatomy suits the patient's natural occlusal scheme and age-related wear. If opposing teeth are flat and amalgam-filled, polished cuspal anatomy will be incompatible — flatten as needed to conform. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Common mistakes in ClinCheck planning often stem from occlusion issues. Effective communication and documentation are crucial in clinical support. Occlusion must be set correctly to ensure successful treatment outcomes. Understanding the patient's profile is essential for effective orthodontics. Collaboration between GPs and orthodontists can enhance patient care. Retention of orthodontic results is a lifelong commitment. Aesthetic goals must align with functional occlusion in treatment planning. Informed consent is critical when discussing potential surgical interventions. The tongue plays a crucial role in orthodontic outcomes. Spacing cases should often be approached as restorative cases. Aligners can achieve precise spacing more effectively than fixed appliances. Enamel adjustments may be necessary for optimal occlusion post-treatment. Retention strategies must be tailored to individual patient needs. Case assessment is vital for determining treatment complexity. Highlights of this episode: 00:00 Teaser 00:59 Intro 02:53 Pearl – Harmony and Occlusal Compatibility 05:57 Dr. Jesper Hatt Introduction 07:34 Clinical Support Systems 10:18 Occlusion and Aligner Therapy 20:41 Bite Recording Considerations 25:32 Collaborative Approach in Orthodontics 30:31 Occlusal Goals vs. Aesthetic Goals 31:42 Midroll 35:03 Occlusal Goals vs. Aesthetic Goals 35:25 Challenges with Spacing Cases 42:19 Occlusion Checkpoints After Aligners 50:17 Considerations for Retention 54:55 Case Assessment and Treatment Planning 58:14 Key Lessons and Final Thoughts 01:00:19 Interconnectedness of Body and Teeth 01:02:48 Resources for Dentists and Case Support 01:04:40 Outro Free Aligner Case Support!Send your patient's case number and get a full assessment in 24 hours—easy, moderate, complex, or referral. Plus, access our 52-point planning protocol and 2-min photo course. No uploads, no cost. [Get Free Access Now] Learn more at alignerservice.com If you enjoyed this episode, don't miss: Do's and Don'ts of Aligners [STRAIGHTPRIL] – PDP071 #PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A and C. AGD Subject Code: 370 ORTHODONTICS (Functional orthodontic therapy) Aim: To provide general dentists with practical guidance for managing occlusion in aligner therapy, from bite capture to retention, including common pitfalls, functional considerations, and case selection. Dentists will be able to – Identify common errors in digital bite capture and occlusion setup. Understand the impact of anterior inclination and mandibular movement patterns on occlusal stability. Plan retention strategies appropriate for aligner and restorative cases.
Let's be honest – the occlusion after Aligner cases can be a little ‘off' (even after fixed appliances!) How do you know if your patient's occlusion after aligner treatment is acceptable or risky? What practical guidelines can general dentists follow to manage occlusion when orthodontic results aren't textbook-perfect? Jaz and Dr. Jesper Hatt explore the most common challenges dentists face, from ClinCheck errors and digital setup pitfalls to balancing aesthetics with functional occlusion. They also discuss key strategies to help you evaluate, guide, and optimize occlusion in your patients, because understanding what is acceptable and what needs intervention can make all the difference in long-term treatment stability and patient satisfaction. https://youtu.be/e74lUbyTCaA Watch PDP250 on YouTube Protrusive Dental Pearl: Harmony and Occlusal Compatibility Always ensure restorative anatomy suits the patient's natural occlusal scheme and age-related wear. If opposing teeth are flat and amalgam-filled, polished cuspal anatomy will be incompatible — flatten as needed to conform. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Common mistakes in ClinCheck planning often stem from occlusion issues. Effective communication and documentation are crucial in clinical support. Occlusion must be set correctly to ensure successful treatment outcomes. Understanding the patient’s profile is essential for effective orthodontics. Collaboration between GPs and orthodontists can enhance patient care. Retention of orthodontic results is a lifelong commitment. Aesthetic goals must align with functional occlusion in treatment planning. Informed consent is critical when discussing potential surgical interventions. The tongue plays a crucial role in orthodontic outcomes. Spacing cases should often be approached as restorative cases. Aligners can achieve precise spacing more effectively than fixed appliances. Enamel adjustments may be necessary for optimal occlusion post-treatment. Retention strategies must be tailored to individual patient needs. Case assessment is vital for determining treatment complexity. Highlights of this episode: 00:00 Teaser 00:59 Intro 02:53 Pearl – Harmony and Occlusal Compatibility 05:57 Dr. Jesper Hatt Introduction 07:34 Clinical Support Systems 10:18 Occlusion and Aligner Therapy 20:41 Bite Recording Considerations 25:32 Collaborative Approach in Orthodontics 30:31 Occlusal Goals vs. Aesthetic Goals 31:42 Midroll 35:03 Occlusal Goals vs. Aesthetic Goals 35:25 Challenges with Spacing Cases 42:19 Occlusion Checkpoints After Aligners 50:17 Considerations for Retention 54:55 Case Assessment and Treatment Planning 58:14 Key Lessons and Final Thoughts 01:00:19 Interconnectedness of Body and Teeth 01:02:48 Resources for Dentists and Case Support 01:04:40 Outro Free Aligner Case Support!Send your patient's case number and get a full assessment in 24 hours—easy, moderate, complex, or referral. Plus, access our 52-point planning protocol and 2-min photo course. No uploads, no cost. [Get Free Access Now] Learn more at alignerservice.com If you enjoyed this episode, don't miss: Do's and Don'ts of Aligners [STRAIGHTPRIL] – PDP071 #PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A and C. AGD Subject Code: 370 ORTHODONTICS (Functional orthodontic therapy) Aim: To provide general dentists with practical guidance for managing occlusion in aligner therapy, from bite capture to retention, including common pitfalls, functional considerations, and case selection. Dentists will be able to – Identify common errors in digital bite capture and occlusion setup. Understand the impact of anterior inclination and mandibular movement patterns on occlusal stability. Plan retention strategies appropriate for aligner and restorative cases. Click below for full episode transcript: Teaser: The one thing that we always check initially is the occlusion set correct by the aligner company. Because if the occlusion is not set correctly, everything else just doesn't matter because the teeth will move, but into a wrong position because the occlusion is off from the beginning. I don't know about you, but if half the orthodontists are afraid of controlling the root movements in extraction cases, as a GP, I would be terrified. Teaser:I don’t care if you just move from premolar to premolar or all the teeth. Orthodontics is orthodontics, so you will affect all the teeth during the treatment. The question’s just how much. Imagine going to a football stadium. The orthodontist will be able to find the football stadium. If it’s a reasonable orthodontist, he’ll be able to find the section you’re going to sit in, and if he’s really, really, really good, he will be able to find the row that you’re going to sit in, but the exact spot where you are going to sit… he will never, ever be able to find that with orthodontics. Jaz’s Introduction: Hello, Protruserati. I’m Jaz Gulati. Welcome back to your favorite dental podcast. I’m joined today by our guest, Dr. Jesper Hatt. All this dentist does is help other dentists with their treatment plans for aligners. From speaking to him, I gather that he’s no longer practicing clinically and is full-time clinical support for colleagues for their aligner cases. So there’s a lot we can learn from someone who day in day out has to do so much treatment planning and speaking to GDPs about their cases, how they’re tracking, how they’re not tracking, complications, and then years of seeing again, okay, how well did that first set of aligners actually perform? What is predictable and what isn’t? And as well as asking what are the most common errors we make on our ClinChecks or treatment plan softwares. I really wanted to probe in further. I really want to ask him about clinical guidelines for occlusion after ortho. Sometimes we treat a case and whilst the aesthetics of that aligner case is beautiful, the occlusion is sometimes not as good. So let’s talk about what that actually means. What is a not-good occlusion? What is a good occlusion? And just to offer some guidelines for practitioners to follow because guess what? No orthodontist in the world is gonna ever get the occlusion correct through ortho. Therefore, we as GPs are never gonna get a perfect textbook occlusion, but we need to understand what is acceptable and what is a good guideline to follow. That’s exactly what we’ll present to you in this episode today. Dental PearlNow, this is a CE slash CPD eligible episode and as our main PDP episode, I’ll give you a Protrusive Dental Pearl. Today’s pearl is very much relevant to the theme of orthodontics and occlusion we’re discussing today, and it’s probably a pearl I’ve given to you already in the past somewhere down the line, but it’s so important and so key. I really want to just emphasize on it again. In fact, a colleague messaged me recently and it reminded me of this concept I’m about to explain. She sent me an image of a resin bonded bridge she did, which had failed. It was a lower incisor, and just a few days after bonding, it failed. And so this dentist is feeling a bit embarrassed and wanted my advice. Now, by the way, guys, if you message me for advice on Instagram, on Facebook, or something like that, it’s very hit and miss. Like my priorities in life are family, health, and everything that happens on Protrusive Guidance. Our network. If you message me outside that network, I may not see it. The team might, but I may not see it. It’s the only way that I can really maintain control and calm in my life. The reason for saying this, I don’t want anyone to be offended. I’m not ignoring anyone. It’s just the volume of messages I get year on year, they’re astronomical. And I don’t mind if you nudge me. If you messaged me something weeks or months ago and I haven’t replied, I probably haven’t seen it. Please do nudge me. And the best place to catch me on is Protrusive Guidance. If you DM me on Protrusive Guidance, home of the nicest and geekiest dentists in the world, that’s the only platform I will log in daily. That’s our baby, our community. Anyway, so I caught this Facebook message and it was up to me to help this colleague. And one observation I made is that the lower teeth were all worn. The upper teeth were really worn, but this resin bonded bridge pontic, it just looked like a perfect tooth. The patient was something like 77 or 80. So it really made me think that, okay, why are we putting something that looks like a 25-year-old’s tooth in a 77-year-old? But even forgetting age and stuff, you have to look at the adjacent teeth in the arch. Is your restoration harmonious with the other teeth in the arch, and of course is the restoration harmonious with what’s opposing it? Because it’s just not compatible. So part one of this pearl is make sure any restoration you do, whether it’s direct or indirect, is harmonious with the patient’s arch and with the opposing teeth and with their occlusal scheme. Because otherwise, if you get rubber dam on and you give your 75-year-old patient beautiful composite resin, it’s got all that cuspal fissure pattern and anatomy, and you take that rubber dam off and you notice that all the other teeth are flat and the opposing teeth are flat amalgams, guess what? You’re gonna be making your composite flat, whether you like it or not. You created a restoration that’s proud, right? That’s why you did not conform to the patient’s own arch or existing anatomical scheme. So the part B of this is the thing that I get very excited to talk about, right? So sometimes you have a worn dentition, but then you have one tooth that’s not worn at all. It’s like that in-standing lateral incisor, right? Think of an upper lateral incisor that’s a bit in-standing, and you see some wear on all the incisors, but that lateral incisor does not have any wear in it because it was never in the firing line. It was never in function. It was never in parafunction. Now, if you give this patient aligners or fixed appliances, you’re doing ortho and you’re now going to align this lateral incisor. So it’s now gonna eventually get into occlusion and it will be in the functional and parafunctional pathways of this patient. Do you really think you can just leave that incisor be? No. It’s not gonna be compatible with the adjacent teeth. It’s not going to be compatible with the opposing tooth and the occlusal scheme. So guess what? You have to get your bur out or your Sof-Lex disc out, and you have to bake in some years into that tooth. Or you have to build up all the other teeth if appropriate for that patient. You’ve just gotta think about it. And I hope that makes sense so you can stay out of trouble. You’re not gonna get chipping and you can consent your patient appropriately for enamel adjustment, which is something that we do talk about in this episode. I think you’re in for an absolute cracker. I hope you enjoy. I’ll catch you in the outro. Main Episode: Doctor Jesper Hatt, thank you so much for coming to Protrusive Dental Podcast. We met in Scandinavia, in Copenhagen. You delivered this wonderful lecture and it was so nice to connect with you then and to finally have you on the show. Tell us, how are you, where in the world are you, and tell us about yourself. [Jesper] Well, thank you for the invitation, first of all. Well, I’m a dentist. I used to practice in Denmark since I originally come from Denmark. My mother’s from Germany, and now I live in Switzerland and have stopped practicing dentistry since 2018. Now I only do consulting work and I help doctors around the world with making their aligner business successful. [Jaz] And this is like probably clinical advice, but also like strategic advice and positioning and that kinda stuff. Probably the whole shebang, right? [Jesper] Yeah. I mean, I have a team around me, so my wife’s a dentist as well, and I would say she’s the expert in Europe on clear aligners. She’s been working for, first of all, our practice. She’s a dentist too. She worked with me in the practice. We practiced together for 10 years. Then she became a clinical advisor for Allion Tech with responsibility for clinical support of Scandinavia. She was headhunted to ClearCorrect, worked in Basel while I was doing more and more consulting stuff in Denmark. So she was traveling back and forth, and I considered this to be a little bit challenging for our family. So I asked her, well, why don’t we just relocate to Switzerland since ClearCorrect is located there? And sure we did. And after two years she told me, I think clinical support, it’s okay. And I like to train the teams, but I’d really like to do more than that because she found out that doctors, they were able to book a spot sometime in the future, let’s say two weeks out in the future at a time that suited the doctors… no, not the doctors, ClearCorrect. Or Invisalign or whatever clear aligner company you use. So as a doctor, you’re able to block the spot and at that time you can have your 30 minutes one-on-one online with a clinical expert. And she said it’s always between the patients or administrative stuff. So they’re not really focused on their ClearCorrect or clear aligner patient. And so they forget half of what I tell them. I can see it in the setups they do. They end up having to call me again. It doesn’t work like that. I would like to help them. [Jaz] It’s a clunky pathway of mentorship. [Jesper] Yes. And so she wanted to change the way clinical support was built up. So we do it differently. We do it only in writing so people can remember what we are telling them. They can always go back in the note and see what’s been going on, what was the advice we gave them, and we offer this co-creation support where we take over most of the treatment planning of the ClearCorrect or Clear Aligner or Spark or Invisalign or Angel Aligner treatment planning. So we do all the digital planning for the doctor, deliver what we think would be right for the patient based on the feedback we initially got from the doctor. And then the doctor can come back and say, well, I’d like a little more space for some crowns in the front, or I would like the canines to be in a better position in order to achieve immediate post disclusion. And so we can go into this discussion back and forth and adjust the digital setup in a way that is more realistic and predictable and do it all for the doctors. So they, on an average, they spend four to six hours less chair time when they use that kind of service compared to if they do everything themselves. And on top of that, you can put your planning time. She was responsible for that and it works quite well. I still remember when we initially got on all these online calls and we would see fireworks in the background and confetti coming down from the top and all of that. [Jaz] Exactly. So excuse that little bit, but okay. So essentially what you’re doing is, for an aligner user myself, for example, you’re doing the ClinChecks, you are helping, supporting with the ClinChecks, the planning. And I’ve got a lot of questions about that. The first question I’ll start with, which is off the script, but there’s probably a hundred different mistakes that could happen in a ClinCheck, right? But what is the most repeatable, predictable, common mistake that you’ll see when a new user sends a case to you to help them with their planning? What’s the most common mistake that you will see in a setup? [Jesper] Two things, actually. The one thing that we always check initially is the occlusion set correct by the aligner company. Because if the occlusion is not set correctly, everything else just doesn’t matter because the teeth will move but into a wrong position because the occlusion is off from the beginning. And so we always check that as the first part. How does this— [Jaz] So let’s talk about that ’cause that might be confusing for a younger colleague because they’re like, hey, hang on a minute. I scanned the bite left and right. What do you mean the occlusion is wrong? Because surely that gets carried through into what I see on the ClinCheck. So what do you think is the mechanism for this to happen? [Jesper] Two different reasons. I’m from a time when I graduated in 2003, so that was before digital dentistry. So when I went to the Pankey Institute and learned everything about functional occlusion and all of that stuff, I also found out that most of my patients, when I put silicone impression material between the teeth and asked the patients to bite together, they would always protrude a little bit unless I instructed them to bite hard on the posterior teeth. And when we got the scanners, when we put a scanner into the cheek and pull the cheek, most patients, when we asked them to bite together to do the intraoral scan of the bite, they also protruded a little bit, not much, but enough to set the bite wrong. So that is the one challenge when the technicians of the aligner companies put the models together. The other challenge is that some of the aligner companies, they let the technicians set the models. We always, as the first thing when we see a case, we always look at the photos, the clinical photos. And that’s why the clinical photos have to be of great quality. So we look at the clinical photos of the patient— [Jaz] And also in those clinical photos, Jesper, you have to coach them correctly to bite. You have to notice if they’re biting wrong even in the photos ’cause then it just duplicates the error. And that’s why good photography and actually being able to coach the patient is so imperative. [Jesper] Yes, that’s correct. But we compare the two and usually if we see a difference, we ask the doctor, is what we see in the photo correct, or is what we see on the digital models correct? And because we don’t like differences. So that would be the first step to look for. And what’s the second? The second thing is that when you look at the setup, the anterior teeth are usually—I’m trying to show you—the anterior teeth are very, very steep. Typically with aligners it’s a lot easier to tip the crowns. So when you have a class II patient, deviation one, where the anteriors are in a forward position, proclined, and you have a lot of space between the anteriors of the maxilla and the mandible, then the easiest thing on a digital setup is to just retrocline the anteriors of the upper to make them fit the lowers, which you could then procline a little bit, but usually you have very steep relationships between the two and this— [Jaz] So you’re more likely to restrict the envelope of function, functional interference anteriorly. You are obviously reducing the overjet, but you may end up reducing like a wall contact rather than an elegant, more open gate. [Jesper] Yes. And there’s another dimension to this because when we work with orthodontics, one of the most important things to look for is actually the profile of the patient. Because let’s say I’m trying to illustrate this now, so I hope you get a 90— [Jaz] So describe it for our audio listeners as well. So we’re looking at a profile view of Jesper. [Jesper] Yes. So I’m turning the side to the camera. I hope you can see my profile here. So let’s say I had flared anterior maxillary teeth and I wanted to retrocline them. It would have an effect on my upper lip, so the lip would fall backwards if I just retrocline everything. And every millimeter we move the anteriors in the maxilla in a posterior direction, we will have a potential lip drop of three millimeters. In addition, if we don’t get the nasolabial angulation correct, we risk the lower face will simply disappear in the face of the patient. So soft tissue plays a role here, so we cannot just retrocline the teeth. It looks great on the computer screen, but when it comes to reality, we’ll have a functional challenge. We’ll have a soft tissue support challenge, and in addition we’ll have long-term retention challenges as well. Because when you have a steep inclination, the anterior teeth in the mandible, they don’t have any kind of support. They will not be stopped by anything in the maxillary teeth, which you would if you had the right inclination between the teeth, which would be about 120 degrees. So why do aligner companies always set the teeth straight up and down in the anterior part? We wondered about this for years. We don’t have a strict answer. We don’t know exactly why it’s like this, but I have a hunch. I think there are two things to it. First of all, the easiest thing to do with aligners is to move the crown, so we can just tip the teeth. You take them back, you make a lot of IPR, and then you just tip them so they’re retroclined. Secondly, all aligner companies, they come from the United States. And in the United States there is a higher representation of class III patients. Now why is that important? All our patients can be put into two different categories in regards to how they move their mandible. They are the crocodiles that only open and close, like move up and down, and then we have the cows. And then we have the cows that move the mandible around, or the camels. I mean, every camel, if you’ve seen a camel chew, it’s just moving from side to side. [Jaz] Horses as well. Horses as well. [Jesper] They kind of do that. [Jaz] But I’m glad you didn’t say rats ’cause it’s more elegant to be a crocodile than a rat. [Jesper] Exactly. And I usually say we only tell the crocodiles. So why is this a challenge and why isn’t it a challenge with class III patients? Well, all real class III patients act like crocodiles, so they don’t move them side to side. From a functional perspective, it’s really not a problem having steep anterior inclination or steep relationships as long as you have a stable stop where the anteriors—so the anteriors will not elongate and create the red effect. So they just elongate until they hit the palate. If you can make a stop in the anterior part of the occlusion, then you’ll have some kind of stability with the class III patients. But with class II patients, we see a lot more cows. So they move the mandible from side to side and anterior and back and forth and all… they have the mandible going all kinds of places. And when they do that, we need some kind of anterior guidance to guide the mandible. I usually say the upper jaw creates the framework in which the mandible will move. So if the framework is too small, we fight the muscles. And whenever we fight the muscles, we lose because muscles always win. It doesn’t matter if it’s teeth, if it’s bone, if it’s joints, they all lose if they fight the muscles— [Jaz] As Peter Dawson would say, in the war between teeth and muscles or any system and muscles, the muscles always win. Absolutely. And the other analogy you remind me of is the maxilla being like a garage or “garage” from UK, like a garage. And the mandible being like the car, and if you’re really constrained, you’re gonna crash in and you’re gonna… everything will be in tatters. So that’s another great way to think about it. Okay. That’s very, very helpful. I’m gonna—’cause there’s so much I wanna cover. And I think you’ve really summed up nicely. But one thing just to finish on this aspect of that common mistake being that the upper anteriors are retroclined, really what you’re trying to say is we need to be looking at other modalities, other movements. So I’m thinking you’re saying extraction, if it’s suitable for the face, or distalisation. Are you thinking like that rather than the easier thing for the aligners, which is the retrocline. Am I going about it the right way? [Jesper] Depends on the patient. [Jaz] Of course. [Jesper] Rule of thumb: if you’re a GP, don’t ever touch extraction cases. Rule of thumb. Why? Because it is extremely challenging to move teeth parallel. So you will most—especially with aligners—I mean, I talk with a very respected orthodontist once and I asked him, well, what do you think about GPs treating extraction cases where they extract, you know, two premolars in the maxilla? And he said, well, I don’t know how to answer this. Let me just explain to you: half of my orthodontist colleagues, they are afraid of extraction cases. And I asked them why. Because it’s so hard to control the root movement. Now, I don’t know about you— [Jaz] With aligners. We’re specifically talking about aligners here, right? [Jesper] With all kinds of orthodontic appliances. [Jaz] Thank you. [Jesper] So now, I don’t know about you, but if half the orthodontists are afraid of controlling the root movements in extraction cases, as a GP, I would be terrified. And I am a GP. So I usually say, yeah, sometimes you will have so much crowding and so little space in the mandible, so there’s an incisor that is almost popped out by itself. In those cases, yes. Then you can do an extraction case. But when we’re talking about premolars that are going to be extracted, or if you want to close the space in the posterior part by translating a tooth into that open space, don’t. It’s just the easiest way to end up in a disaster because the only thing you’ll see is just teeth that tip into that space, and you’ll have a really hard time controlling the root movements, getting them corrected again. [Jaz] Well, thank you for offering that guideline. I think that’s very sage advice for those GPs doing aligners, to stay in your lane and just be… the best thing about being a GP, Jesper, is you get to cherry pick, right? There’s so many bad things about being a GP. Like you literally have to be kinda like a micro-specialist in everything in a way. And so sometimes it’s good to be like, you know what, I’ll keep this and I’ll send this out. And being selective and case selection is the crux of everything. So I’m really glad you mentioned that. I mean, we talked and touched already on so much occlusion. The next question I’m gonna ask you then is, like you said, a common error is the bite and how the bite appears on the ClinCheck or whichever software a dentist is using. Now, related to bite, vast majority of orthodontic cases are treated in the patient’s existing habitual occlusion, their maximum intercuspal position. Early on in my aligner journey, I had a patient who had an anterior crossbite. And because of that anterior crossbite, their jaw deviated. It was a displaced—the lower jaw displaced. And then I learned from that, that actually for that instance, perhaps I should not have used an MIP scan. I should have used more like centric relation or first point of contact scan before the displacement of the jaw happens. So that was like always in my mind. Sometimes we can and should be using an alternative TMJ position or a bite reference other than MIP. Firstly, what do you think about that kind of scenario and are there any other scenarios which you would suggest that we should not be using the patient’s habitual occlusion for their bite scan for planning orthodontics? [Jesper] Well, I mentioned that I was trained at the Pankey Institute, and when you start out right after—I mean, I spent 400 hours over there. Initially, I thought I was a little bit brainwashed by that because I thought every single patient should be in centric relation. Now, after having put more than 600 patients on the bite appliance first before I did anything, I started to see some patterns. And so today, I would say it’s not all patients that I would get into centric relation before I start treating the teeth. But when we talk about aligner therapy and orthodontic treatment, I think it’s beneficial if you can see the signs for those patients where you would say, hmm, something in the occlusion here could be a little bit risky. So let’s say there are wear facets on the molars. That will always trigger a red flag in my head. Let’s say there are crossbites or bite positions that kind of lock in the teeth. We talked about class III patients before, and I said if it’s a real skeletal-deviation class III patient, it’s a crocodile. But sometimes patients are not real class III skeletal deviation patients. They’re simply being forced into a class III due to the occlusion. That’s where the teeth fit together. So once you put aligners between the teeth and plastic covers the surfaces, suddenly the patients are able to move the jaws more freely and then they start to seat into centric. That may be okay. Usually it is okay. The challenge is consequences. So when you’re a GP and you suddenly see a patient moving to centric relation and you find out, whoa, on a horizontal level there’s a four- to six-millimeter difference between the initial starting point and where we are now, and maybe we create an eight-millimeter open bite in the anterior as well because they simply seat that much. And I mean, we have seen it. So is this a disaster? Well, it depends. If you have informed the patient well enough initially and said, well, you might have a lower jaw that moves into a different position when we start out, and if this new position is really, really off compared to where you are right now, you might end up needing maxillofacial surgery, then the patient’s prepared. But if they’re not prepared and you suddenly have to tell them, you know, I think we might need maxillofacial surgery… I can come up with a lot of patients in my head that would say, hey doctor, that was not part of my plan. And they will be really disappointed. And at that point there’s no turning back, so you can’t reverse. So I think if you are unsure, then you are sure. Then you should use some kind of deprogramming device or figure out where is centric relation on this patient. If there isn’t that much of a difference between maximum intercuspation and centric— [Jesper] Relation, I don’t care. Because once you start moving the teeth, I don’t care if you just move from premolar to premolar or all the teeth. Orthodontics is orthodontics, so you will affect all the teeth during the treatment. The question’s just how much. And sometimes it’s just by putting plastic between the teeth that you will see a change, not in the tooth position, but in the mandibular position. And I just think it’s nicer to know a little bit where this is going before you start. And the more you see of this—I mean, as I mentioned, after 600 bite appliances in the mouths of my patients, I started to see patterns. And sometimes in the end, after 20 years of practicing, I started to say, let’s just start, see where this ends. But I would always inform the patients: if it goes totally out of control, we might end up needing surgery, and there’s no way to avoid it if that happens. And if the patients were okay with that, we’d just start out. Because I mean, is it bad? No. I just start the orthodontic treatment and I set the teeth as they should be in the right framework. Sometimes the upper and the lower jaw don’t fit together. Well, send them to the surgeon and they will move either the upper or the lower jaw into the right position, and then we have it. No harm is done because we have done the initial work that the orthodontist would do. But I will say when I had these surgical patients—let’s say we just started out with aligners and we figured, I can’t control this enough. I need a surgeon to look at this—then I would send them off to an orthodontist, and the orthodontist and the surgeon would take over. Because then—I mean, surgical patients and kids—that’s the second group of patients besides the extraction cases that I would not treat as a GP. ‘Cause we simply don’t know enough about how to affect growth on kids. And when it comes to surgery, there’s so much that is… so much knowledge that we need to know and the collaboration with the surgeons that we’re not trained to handle. So I think that should be handled by the orthodontists as well. [Jaz] I think collaborative cases like that are definitely specialist in nature, and I think that’s a really good point. I think the point there was informed consent. The mistake is you don’t warn the patient or you do not do the correct screening. So again, I always encourage my guests—so Jesper, you included—that we may disagree, and that’s okay. That’s the beauty of dentistry. So something that I look for is: if the patient has a stable and repeatable maximum intercuspal position, things lock very well, and there’s a minimal slide—like I use my leaf gauge and the CR-CP is like a small number of leaves and the jaw hardly moves a little bit—then there’s no point of uncoupling them, removing that nice posterior coupling that they have just to chase this elusive joint position. Then you have to do so many more teeth. But when we have a breakdown in the system, which you kind of said, if there’s wear as one aspect, or we think that, okay, this patient’s occlusion is not really working for them, then we have an opportunity to do full-mouth rehabilitation in enamel. Because that’s what orthodontics is. And so that’s a point to consider. So I would encourage our GP colleagues to look at the case, look at the patient in front of you, and decide: is this a stable, repeatable occlusion that you would like to use as a baseline, or is there something wrong? Then consider referring out or considering—if you’re more advanced in occlusion studies—using an alternative position, not the patient’s own bite as a reference. So anything you wanna add to that or disagree with in that monologue I just said there? [Jesper] No, I think there’s one thing I’d like the listeners to consider. I see a lot of fighting between orthodontists and GPs, and I think it should be a collaboration instead. There’s a lot of orthodontists that are afraid of GPs taking over more and more aligner treatments, and they see a huge increase in the amount of cases that go wrong. Well, there’s a huge increase of patients being treated, so there will be more patients, just statistically, that will get into problems. Now, if the orthodontist is smart—in my opinion, that’s my opinion—they reach out to all their referring doctors and they tell them, look, come in. I will teach you which cases you can start with and which you should refer. Let’s start there. Start your aligner treatments. Start out, try stuff. I will be there to help you if you run into problems. So whenever you see a challenge, whenever there’s a problem, send the patient over to me and I’ll take over. But I will be there to help you if anything goes wrong. Now, the reason this is really, really a great business advice for the orthodontists is because once you teach the GPs around you to look for deviations from the normal, which would be the indication for orthodontics, the doctors start to diagnose and see a lot more patients needing orthodontics and prescribe it to the patients, or at least propose it to the patients. Which would initially not do much more than just increase the amount of aligner treatments. But over time, I tell you, all the orthodontists doing this, they are drowning in work. So I mean, they will literally be overflown by patients being referred by all the doctors, because suddenly all the other doctors around them start to diagnose orthodontically. They see the patients which they haven’t seen before. So I think this is—from a business perspective—a really, really great thing for the orthodontists to have a collaboration with this. And it’ll also help the GPs to feel more secure when they start treating their patients. And in the end, that will lead to more patients getting the right treatment they deserve. And I think that is the core. That is what’s so important for us to remember. That’s what we’re here for. I mean, yes, it’s nice to make money. We have to live. It’s nice with a great business, but what all dentists I know of are really striving for is to treat their patients to the best of their ability. And this helps them to do that. [Jaz] Ultimate benefactor of this collaborative approach is the patient. And I love that you said that. I think I want all orthodontists to listen to that soundbite and take it on board and be willing to help. Most of them I know are lovely orthodontists and they’re helping to teach their GPs and help them and in return they get lots of referrals. And I think that’s the best way to go. Let’s talk a little bit about occlusal goals we look for at the end of orthodontics. This is an interesting topic. I’m gonna start by saying that just two days ago I got a DM from one of the Protruserati, his name is Keith Curry—shout out to him on Instagram—and he just sent me a little message: “Jaz, do you sometimes find that when you’re doing alignment as a GP that it’s conflicting the orthodontic, the occlusal goal you’re trying to get?” And I knew what I was getting to. It’s that scenario whereby you have the kind of class II division 2, right? But they have anterior guidance. Now you align everything, okay, and now you completely lost anterior guidance. And so the way I told him is that, you know what, yes, this is happening all the time. Are we potentially at war between an aesthetic smile and a functional occlusion? And sometimes there’s a compromise. Sometimes you can have both. But that—to achieve both—needs either a specialist set of eyes or lots of auxiliary techniques or a lot more time than what GPs usually give for their cases. So first let’s touch on that. Do you also agree that sometimes there is a war between what will be aesthetic and what will be a nice functional occlusion? And then we’ll actually talk about, okay, what are some of the guidelines that we look for at the end of completing an aligner case? [Jesper] Great question and great observation. I would say I don’t think there’s a conflict because what I’ve learned is form follows function. So if you get the function right, aesthetics will always be great. Almost always. I mean, we have those crazy-shaped faces sometimes, but… so form follows function. The challenge here is that in adult patients, we cannot manipulate growth. So a skeletal deviation is a skeletal deviation, which means if we have a class II patient, it’s most likely that that patient has a skeletal deviation. I rarely see a dental deviation. It happens, but it’s really, really rare. So that means that in principle, all our class II and chronic class III patients are surgical patients. However, does that mean that we should treat all our class II and class III patients surgically? No, I don’t think so. But we have to consider that they are all compromise cases. So we need to figure a compromise. So initially, when I started out with my occlusal knowledge, I have to admit, I didn’t do the orthodontic treatment planning. I did it with Heller, and she would give me feedback and tell me, I think this is doable and this is probably a little bit challenging. If we do this instead, we can keep the teeth within the bony frame. We can keep them in a good occlusion. Then I would say, well, you have a flat curve of Spee. I’d like to have a little bit of curve. It’s called a curve of Spee and not the orthodontic flat curve of Spee. And then we would have a discussion back and forth about that. Then initially I would always want anterior coupling where the anterior teeth would touch each other. I have actually changed that concept in my mind and accepted the orthodontic way of thinking because most orthodontists will leave a little space in the anterior. So when you end the orthodontic treatment, you almost always have a little bit of space between the anterior teeth so they don’t touch each other. Why? Because no matter what, no matter how you retain the patient after treatment, there will still be some sort of relapse. And we don’t know where it’ll come or how, but it will come. Because the teeth will always be positioned in a balance between the push from the tongue and from the cheeks and the muscles surrounding the teeth. And that’s a dynamic that changes over the years. So I don’t see retention as a one- or two-year thing. It’s a lifelong thing. And the surrounding tissues will change the pressure and thereby the balance between the tongue and the cheeks and where the teeth would naturally settle into position. Now, that said, as I mentioned initially, if we fight the muscles, we’ll lose. So let’s say we have an anterior open bite. That will always create a tongue habit where the patient positions the tongue in the anterior teeth when they swallow because if they don’t, food and drink will just be splashed out between the teeth. They can’t swallow. It will just be pushed out of the mouth. [Jaz] So is that not like a secondary thing? Like that tongue habit is secondary to the AOB? So in those cases, if you correct the anterior open bite, theoretically should that tongue posture not self-correct? [Jesper] Well, we would like to think so, but it’s not always the case. And there’s several reasons to it. Because why are the teeth in the position? Is it because of the tongue or because of the tooth position? Now, spacing cases is one of those cases where you can really illustrate it really well. It looks really easy to treat these patients. If we take away all the soft tissue considerations on the profile photo, I mean, you can just retract the teeth and you close all the spaces—super easy. Tipping movements. It’s super easy orthodontically to move quickly. Very easy as well. However, you restrict the tongue and now we have a retention problem. So there are three things that can happen. You can bond a retainer on the lingual side or the palatal side of the teeth, upper, lower—just bond everything together—and after three months, you will have a diastema distal to the bonded retainer because the tongue simply pushes all the teeth in an anterior direction. [Jaz] I’ve also seen—and you’ve probably seen this as well—the patient’s tongue being so strong in these exact scenarios where the multiple spacing has been closed, which probably should have been a restorative plan rather than orthodontic plan, and the retainer wire snaps in half. [Jesper] Yes, from the tongue. [Jaz] That always fascinated me. [Jesper] Well, you’ll see debonding all the time, even though you sandblast and you follow all the bonding protocol. And debonding, breaking wires, diastemas in places where you think, how is that even possible? Or—and this is the worst part—or you induce sleep apnea on these patients because you simply restrict the space for the tongue. So they start snoring, and then they have a total different set of health issues afterwards. So spacing—I mean, this just illustrates the power of the tongue and why we should always be careful with spacing cases. I mean, spacing cases, in my opinion, are always to be considered ortho-restorative cases. Or you can consider, do you want to leave some space distal to the canines? Because there you can create an optical illusion with composites. Or do you want to distribute space equally between the teeth and place veneers or crowns or whatever. And this is one of those cases where I’d say aligners are just fabulous compared to fixed appliances. Because if you go to an orthodontist only using fixed appliances and you tell that orthodontist, please redistribute space in the anterior part of the maxilla and I want exactly 1.2 millimeters between every single tooth in the anterior segment, six years later he’s still not reached that goal because it just moves back and forth. Put aligners on: three months later, you have exactly—and I mean exactly—1.2 millimeters of space between each and every single tooth. When it comes to intrusion and extrusion, I would probably consider using fixed appliances rather than aligners if it’s more than three millimeters. So every orthodontic system—and aligners are just an orthodontic system—each system has its pros and cons, and we just have to consider which system is right for this patient that I have in my chair. But back to the tongue issue. What should we do? I mean, yes, there are two different schools. So if you have, let’s say, a tongue habit that needs to be treated, there are those that say we need to get rid of the tongue habit before we start to correct the teeth. And then there are those that say that doesn’t really work because there’s no room for the tongue. So we need to create room for the tongue first and then train the patient to stop the habit. Both schools and both philosophies are being followed out there. I have my preferred philosophy, but I will let the listener start to think about what they believe and follow their philosophy. Because there is nothing here that is right or wrong. And that is— [Jaz] I think the right answer, Jesper, is probably speak to that local orthodontist who’s gonna be helping you out and whatever they recommend—their religion—follow that one. Because then at least you have something to defend yourself. Like okay, I followed the way you said. Let’s fix it together now. [Jesper] That’s a great one. Yeah, exactly. [Jaz] Okay, well just touching up on the occlusion then, sometimes we do get left with like suboptimal occlusions. But to be able to define a suboptimal occlusion… let’s wrap this occlusion element up. When we are completing an orthodontic case—let’s talk aligners specifically—when the aligners come off and the fixed retainers come on, for example, and the patient’s now in retention, what are some of the occlusal checkpoints or guidelines that you advise checking for to make sure that, okay, now we have a reasonably okay occlusion and let things settle from here? For example, it would be, for me, a failure if the patient finishes their aligners and they’re only holding articulating paper on one side and not the other side. That’s for me a failure. Or if they’ve got a posterior open bite bilaterally. Okay, then we need to go refinement. We need to get things sorted. But then where do you draw the line? How extreme do you need to be? Do you need every single tooth in shim-stock foil contact? Because then we are getting really beyond that. We have to give the adaptation some wiggle room to happen. So I would love to know from your learning at Pankey, from your experience, what would you recommend is a good way for a GP to follow about, okay, it may not be perfect and you’ll probably never get perfect. And one of the orthodontists that taught me said he’s never, ever done a case that’s finished with a perfect occlusion ever. And he said that to me. [Jesper] So—and that’s exactly the point with orthodontics. I learned that imagine going to a football stadium. The orthodontist will be able to find the football stadium. If it’s a reasonable orthodontist, he’ll be able to find the section you’re going to sit in. And if he’s really, really, really good, he will be able to find the row that you’re going to sit in. But the exact spot where you are going to sit, he will never, ever be able to find that with orthodontics. And this is where settling comes in and a little bit of enamel adjustments. [Jaz] I’m so glad you said that. I’m so glad you mentioned enamel adjustment. That’s a very dirty word, but I agree with that. And here’s what I teach on my occlusion courses: what we do with aligners essentially is we’re tampering with the lock. Let’s say the upper jaw is the lock. It’s the still one. We’re tampering with the key, which is the lower jaw—the one that moves—we tamper with the key and the lock, and we expect them both to fit together at the end without having to shave the key and to modify the lock. So for years I was doing aligners without enamel adjustment ’cause my eyes were not open. My mind was not open to this. And as I learned, and now I use digital measuring of occlusion stuff and I seldom can finish a case to get a decent—for my criteria, which is higher than it used to be, and my own stat—is part of my own growth that’s happened over time is that I just think it’s an important skill that GPs are not taught and they should be. It’s all about finishing that case. And I think, I agree with you that some adjustment goes a long way. We’re not massacring enamel. It’s little tweaks to get that. [Jesper] Exactly. I like the sound there because sometimes you hear that “ahh,” it doesn’t really sound right, but “tsst,” that’s better. [Jaz] That’s the one. You know, it reminds me of that lecture you did in Copenhagen. You did this cool thing—which I’ve never seen anyone do before. You sat with one leg over the other and you said, okay guys, bite together. Everyone bit together. And then you swapped the legs so the other leg was over the other and bite together. And then you said, okay, whose occlusion felt different? And about a third of the audience put their hand up, I think. Tell us about that for a second. [Jesper] Well, just promise me we go back to the final part because there are some things we should consider. [Jaz] Let’s save this as a secret thing at the end for incentive for everyone to listen to the end—how the leg position changes your occlusion. Let’s talk about the more important thing. I digressed. [Jesper] Let’s talk about the occlusal goals because I think it’s important. I mean, if you do enamel adjustments in the end—so when we finish the treatment, when we come to the last aligner in the treatment plan—I think we should start by breaking things down to the simplest way possible. Start by asking the patient: are you satisfied with the way the teeth look? Yes or no? If she’s satisfied, great. How do you feel about the occlusion? “Well, it fits okay.” Great. Now the patient is happy. There’s nothing she wants to—or he wants to—change. Then you look at the occlusion. Now, it is important to remember that what we see on the computer screen, on the aligner planning tools, will never, ever correspond 100% to what we see in the mouth of the patient. And there are several reasons for that. But one of the things that we have found to be really interesting is that if you take that last step and you say, okay, the occlusion doesn’t fit exactly as on the screen, but it’s kind of there… if you use that last step and you don’t do a re-scan for a retainer, but you use the last step of the aligner treatment as your reference for your aligner retainer… We sometimes see that over six months, if the patient wears that aligner 22 hours a day for another three to six months, the teeth will settle more and more into the aligner and create an occlusion that looks more and more like what you see on the screen. Which to me just tells me that the biology doesn’t necessarily follow the plan everywhere in the tempo that we set throughout the aligner plan. But over time, at the last step, if it’s just minor adjustments, the teeth will actually move into that position if we use the last stage as a reference for the retainer. Now, if we do a scan at that point and use that as a reference for creating an aligner retainer, then we just keep the teeth in that position. Now, if the teeth are a little bit more off— [Jaz] I’m just gonna recap that, Jesper, ’cause I understood what you said there, but I want you to just make sure I fully understood it. When we request, for example, Align, the Vivera retainer, it gives you an option: “I will submit a new scan” or “use the last step.” And actually I seldom use that, but now I realize you’re right. It makes sense. But then on the one hand, if the occlusion is—if the aesthetics are good and the patient’s occlusion feels good, what is your own judgment to decide whether we’re still going to allow for some more settling and occlusal changes to happen over a year using the Vivera retainers based on the ClinCheck last-aligner profile, rather than, okay, let’s just retain to this position? What is making you do the extra work, extra monitoring? [Jesper] To me, it’s not extra monitoring. It’s just basic. I mean, it’s just part of my protocol. I follow the patients. And honestly, to me, it’s just time-saving to just use the last step in the aligner. Because I mean, if the plan is right and if the teeth have been tracking well, they should be in that position. Why do I then need to re-scan for Vivera retainers or for other kinds of retainers? Now, if the occlusion is a little bit more off—and in a minute you’ll probably ask me when do I see which is which, and I can’t really tell you; it’s about experience—but that’s the beauty of this. If I see there’s a little bit more deviation and I like some teeth, the occlusion isn’t really good on one side compared to the other side, I would rather have a bonded retainer from first premolar to first premolar in the mandible, combined with a Hawley or Begg or something like that retainer for the upper. And you can order them with an acrylic plate covering some of the anterior teeth so they keep that position, but that allows the teeth to settle. And over three months you should see some kind of improvement. If you don’t see enough improvement and let’s say you still have a tendency for a kind of an open bite on one side, you can always add some cross elastics, put some buttons on the upper, on the lower, instruct the patient to use these, and then in three months you will have the occlusion you want. Now, once that is established—you have that kind of occlusion—you need to keep the teeth there for at least six months before you do some kind of equilibration or enamel adjustment. Because if you do the enamel adjustment right after you have reached your final destination for the teeth, the teeth will still settle and move. So you do the equilibration, two weeks later everything looks off again. You do the equilibration, two weeks later things have changed again. So I prefer to wait six months before I do the final equilibration. Now, in this equation what we’ve been talking about here, it goes from very simple to more and more complex. And then we have to consider, well, did I expand the mandible posterior segment? If so, I can’t just use a bonded retainer on the lower and I need to add something to keep the teeth out there in combination with whatever I want in the upper. Do I want to keep the Begg retainer or the Hawley, or do I want to change to something differently? So these kinds of considerations have to be there from the beginning of the treatment because, I mean, it costs additional money to order a Begg retainer compared to just an aligner. [Jaz] A Begg retainer is the same as Hawley? [Jesper] Well, no. It has a little different design. [Jaz] Oh, a Begg as in B-E-G-G? [Jesper] Yes. [Jaz] Yeah, got it. Got it. Okay. [Jesper] And then in Denmark we use the Jensen retainer, which is a Danish invention, which goes from canine to canine or from first premolar to first premolar but with a different type of wire which keeps the teeth more in place compared to a round wire. So there are different variations. The most important part here is it allows the posterior teeth to settle so they can move, which they can’t in an aligner to the same degree at least. Now, this is all really nice in teeth that only need to be moved into the right position, but most of our patients are adult patients, or they should at least be adult patients. Most of my patients were more than 30 years old. So if you have a patient with anterior crowding and you move the teeth into the right position where the teeth should be, the teeth are in the right position, but they still look ugly because they have been worn anteriorly by the position they were in when they were crooked. So when we position them, we still need to do some restorative work. Then what? We still need to retain those teeth. The patient wants to be finished now as fast as possible, so we can’t wait the six months to make the final touches. So we have to figure out: what do we do? And then we have to think of some kind of retention strategy to keep the teeth in place during that restorative procedure. And I mean, at the end of an aligner treatment or any orthodontic treatment, two days is enough to have relapse in some patients. Some patients it’s not a problem. The teeth are just there to stay in the same position for three months, and then they start to move a little bit around. But other patients—I mean, you just have to look away and then go back to the teeth and they’re in a different position. You can’t know what kind of patient you have in your chair right now. So you have to consider the way you plan your restorative procedure in regards to how you retain the teeth during that phase. So if you want to do anterior composites or veneers, do it all at once. Put in a bonded retainer, scan, and get your aligner retainer as fast as possible. Or use a Begg or a Hawley or something like that that’s a little bit more flexible. If you want to do crowns, then we have a whole different challenge and then we have to consider how do we then retain the teeth. [Jaz] Okay. Well I think that was lovely. I think that gives us some thoughts and ideas of planning sequence of retention, which is the ultimate thing to consider when it comes to occlusion. Okay, yeah, you get the occlusion, but how do you retain it? But in many cases, as the patient’s wearing aligners, the occlusion is embedding in and is fine. And you take off the aligners, the patient’s happy with how it looks. They bite together. It feels good. You are happy that yes, both sides of the mouth are biting together. Now, it might not be that every single contact is shim-hold, but you got, let’s say, within 20 microns, 40 microns, okay? Then some bedding happens. In that kind of scenario, would you be happy to say, okay, I’m gonna scan your teeth as they are because I’m happy with the occlusion, the occlusal goals are good, and they’re near enough the ClinCheck, and go for the retainers to that position? Or is your default preference as a clinician to go for the Vivera or equivalent based on the last aligner, on the ClinCheck projection? [Jesper] I would still go for the last aligner because I think the planning I’ve done is probably a little bit more precise than what I see clinically. However, I still expect that I will have to do a little bit of enamel reshaping at the end after six months, but that’s okay. I mean, the changes are so small, so you can still use the last aligner or the Vivera retainer that you already have ordered. So it’s not that much of a problem. [Jaz] Which goes back to your previous point: if it’s a big deviation, then you’ve gotta look at the alternative ways, whether you’re gonna go for refinement or you’re gonna allow some occlusal settling with a Hawley and a lower fixed-retainer combination, or the elastics like you said. Okay. Just so we’re coming to the end of the podcast—and I really enjoyed our time—I would like to delve deep into just a final thing, which is a little checklist, a helpful checklist for case assessment that you have for GDPs. [Jesper] Yeah, thank you. First of all, one of the big challenges in a GP practice is being able to take a full series of clinical photos in two minutes without assistance. I think most dentists struggle with that, but that is a foundational prerequisite to any aligner treatment. Once you have the photos, I would sit down with the photos and I would consider six different steps. One: is this a patient that I could treat restoratively only? Because that would be the simplest for me to do. Next, moving up in complexity: would be, do I need periodontal crown lengthening? Or next step would be: do I need to change the vertical dimension, or is there something about centric relation that I should consider? Moving up a little bit on the complexity: are there missing teeth? Do I need to replace teeth with implants? Next step would be orthodontics. So this is step five. The next most complex case we can treat is actually an aligner case—orthodontics in general. And the last part would be: are the teeth actually in the right position in the face of the patient, or do I need surgery to correct the jaw position? So these six steps, I think they’re helpful to follow to just think, how can I break this case down into more easy, digestible bits and pieces to figure out what kind of patient I have in front of me? Now, if you consider it to be an orthodontic case or ortho-restorative case, here comes the challenge: case selection. How do you figure out is this an easy, moderate, complex, or referral case? And here’s the trick: do 500 to 1000 treatment plans or treatments with clear aligners. And then you know. But until then, you really don’t. This is where you should rely on someone you can trust who can help you do the initial case selection. Because you can have two identical patients—one is easy and one is super complex—but they look the same. So it’s really nice if you have done less than 500 cases to have someone who can help you with the case selection. And I don’t say this to sell anything, because we don’t charge for that. Because it’s so essential that we don’t do something that is wrong or gives us a lot of challenges and headaches in the practice. I mean, the practice runs really fast and lean-oriented, so we need to make things digestible, easy to work with. And I think that’s really important. [Jaz] It goes full circle to what we said before about having that referral network, staying in your lane, knowing when to refer out, cherry-picking—it all goes back full circle with that. And not even orthodontics, but restorative dentistry—case selection is just imperative in everything we do. [Jesper] Yes. And there is—we always get the question when we do courses and we do consulting—can’t you just show me a couple of cases that are easy to start with? And it works with implants, kind of. But with orthodontics where we move—I mean, we affect all the teeth—it’s just not possible. I know the aligner companies want to show you some where you say, you can only just do these kinds of cases and they are really easy. The fact is they’re not. But they want to sell their aligners. [Jaz] I get it. They are until they’re not. It’s like that famous thing, right? Everyone’s got a plan until they get punched in the face. So yeah, it can seemingly be easy, but then a complication happens and it’s really about understanding what complications to expect, screening for them, and how you handle that. But thanks so much. Tell us—yeah, go on, sorry. [Jesper] There are three things I’d like to end on here. So, first of all, we’ve been talking together for about an hour about a topic that, if you want to take postgraduate education, it takes three years to become an orthodontist. And there is a reason it takes three to four years. However, I want to encourage the listener to think about this: Mercedes has never, ever excused last year’s model. Meaning that they always strive for perfection. So if we go into the practice and we do the very best we can every single day, there is no way we can go back and excuse what we
✅ Speak Better English With Me https://brentspeak.as.me/ Use code Fall15 for 15% off. Original Link to Newscast: https://youtu.be/8wl3j-ayOJg?si=Vl7camJRGYaZuFeI1. Take My Chances: To try something even if it might not work.: I'll take my chances and try out for the soccer team.2. You Don't Mind: You are okay with something; it doesn't bother you.: I hope you don't mind if I sit here.3. Incredible: Very good or amazing.: The view from the mountain was incredible!4. Respect: To think someone or something is important and treat them well.: We should respect our teachers and classmates.5. Successful: Doing well; reaching your goals.: She worked hard and became a successful doctor.6. Fantastic: Very good or wonderful.: The food at that new restaurant tastes fantastic.7. Best Seat: The most comfortable or most desired place.: Reporters had the best seat to witness history being made at the trial.8. Roasting: Making jokes about someone in a funny way: My friends were roasting me for being late again. 9. GDP (Gross Domestic Product): The total value of everything a country makes in a year.: The United States has one of the largest GDPs in the world.10. Come Here: To move closer to where the speaker is.: Come here and look at this picture!11. Going Well: Happening in a good or successful way.: My English classes are going well this year.12. 20-Minute Notice: A warning or message given 20 minutes before something happens.: The doctor has to perform emergency surgery with only 20 minutes notice. 13. Complements: something that fits well with something else.: The blue shirt complements your eyes.14. Unique: One of a kind; special or different from others.: The snowflake has a unique shape that no other snowflake has.15. Assembled: Put together or gathered in one place.: The students assembled in the gym for the school meeting.: We assembled all the materials we needed for the science project.
LET'S GET POLITICAL!Companies from Delta to Office Depot are disciplining and/or firing employees for their public comments on Charlie Kirk's death Trump wants to end a half-century-old mandate on how companies report earningsCompanies should instead only be required to post earnings every six months, pending the U.S. Securities and Exchange Commission's approval. This change would break a quarterly reporting mandate that's been in place since 1970.“This will save money, and allow managers to focus on properly running their companies.” Appeals court allows Trump administration to end the ‘climate bank' where $20B was set aside to fund climate change projects Donald Trump tilts balance of power from investors to CEOsA BUNCH OF ESG CRAP!Exxon Reportedly Rolls Out Auto-Voting System To Boost Retail Investor Participation, Curb Activist InfluenceOpt-in proxy system would automate retail investor votes to support board positionsElon Musk's $1 Trillion Pay Proposal: Redefining CEO Compensation in the 21st CenturyFirst Elon Musk, now Larry Ellison: The world's richest men are buying huge media companies--because they canLachlan Murdoch Secures Control of Fox and News Corp, Ending Succession FightGoogle tops $3 trillion for the first time, joining select market-cap club with only 3 other membersApple, Microsoft, NvidiaOnly 7 countries have GDPs greater than $3TToxic Fumes Are Leaking Into Airplanes, Sickening Crews and PassengersDoctors compare brain effects to concussions in NFL players.A Wall Street Journal investigation shows the problem is getting worse and not much is being done about it. The Journal's reporting shows that aircraft manufacturers and their airline customers have played down health risks, successfully lobbied against safety measures, and made cost-saving changes that increased the risks to crew and passengers.The gender pay gap is getting wider, reversing progress US shareholders fail to pass any green proposals for first time in 6 years CLIMATE CHANGE/AI SPEED ROUNDCarbon emissions from oil giants directly linked to dozens of deadly heatwaves for first timeBrace for impact: Climate change is set to intensify flight turbulence, warn scientistsWhy climate change is making dengue fever a global threat Climate change will make 1-in-100-year crop failures more commonClimate Change Drives Surge in Deadly Supercell Storms Across EuropeClimate change is pushing venomous snakes into new regionsClimate Change Drives Surge in Deadly Flesh-Eating Bacteria on US CoastsOne out of every 4 homes is at ‘severe or extreme' climate risk, study saysOpenAI foresees millions of AI agents 'somewhere in the cloud' in just a few years--with human supervision Experts Concerned AI Is Going to Start a Nuclear WarPsychologist Says AI Is Causing Never-Before-Seen Types of Mental DisorderSam Altman says people are starting to talk like AI, making some human interactions ‘feel very fake' Sen. Cruz introduces bill to reduce regulatory burden facing AI companies
US Mainstream Media and politicians keep saying US 'defense' spending annual is about $850 billion. Why that's just an initial budget proposal and just for Pentagon spending. Today's show shows what US annual actual defense (e.g. war) spending is $2 trillion a year. The show then reviews the condition of the USA and EU economies and why GDPs are much lower than reported. A quick review of emerging global conflicts is also reported in Venezuela, Armenia-Iran, India, etc.
In this episode of Shift Happens, host Jeff Edwards sits down with Rakesh Samtani, Senior Director of Partner Networking Sales at Cisco, to explore how AI is transforming network management and how the Cisco 360 Partner program initiative is reshaping the partner landscape. From key innovations unveiled at Cisco LIVE to actionable insights that can drive growth and profitability, this conversation dives into the $43 billion network refresh opportunity and what it means for partners ready to lead with AI. What you'll learn: • Why AI is the engine of next-gen networking • How Cisco the 360 Partner Program is evolving the partner model • The power of new messaging and partner engagement • Big takeaways from Cisco Live • How to capitalize on the $43B opportunity Mic drop moments: “We are investing with our partners.” “AI is moving GDPs.” “It's time to buzz the tower.”
In this episode of RiskMatters, Dr Annalene Weston from Dental Protection speaks with Dr Trudy Lin. Trudy's accolades are many and in this podcast, she shares her personal journey into general practice and later special needs dentistry, as well as providing some guiding principles for the inclusion of specials needs care, in general practice. In addition to her impressive dental career, Trudy is also a mindset coach so listen in as Annalene and Trudy discuss her ‘other passion', which is engaging, insightful and relevant to us all, as practitioners and people. 3.27 - Special needs dentistry4.48 - Risk management strategies when looking after patients who have specialist needs7.15 - The relevance of renal conditions8.54 - Role of GDPs in the management of patients with special needs10.48 - Reaching out to special need specialists12.48 - Specialists special training pathways15.50 - Why Trudy became a specialist16.50 - Impact of self limiting beliefs20.30 - Mindset and leadership coaching21.44 - What is a belief?23.44 - How Trudy become a mindset coach27.25 - Safe Failure32.33 - Who benefits from having a mindset coach?38.00 - (Self) perception39.50 - Support and Ahpra's view44.40 - Techniques - reframing51.00 - Techniques - awesome and brain dumps54.45 - Techniques - Self-care and wellness56.15 - Loading101.05 - How burnout fits in and saying nohttps://extramiledental.com.au/about/
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
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. Need to Read it? Check out the Full Episode Transcript below! 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
A Clinician's guide to TMD Management Walkthrough of the latest TMD Guidelines with the authors! What's the right approach when a patient presents with both acute and chronic painful jaw symptoms? How can the latest RCS guidelines simplify your diagnosis and treatment process? In this episode, Professor Justin Durham and Mrs. Emma Beecroft join Jaz to unpack the latest Royal College of Surgeons TMD guidelines designed specifically to help GDPs navigate these tricky cases. Together, they explore practical strategies for managing TMD, breaking down the step-by-step flowchart that makes handling these cases less intimidating. From understanding the key principles to applying them in everyday practice, this episode will help you feel more confident in delivering better patient care for TMD. https://youtu.be/R0NaBJr5g5E Watch PDP213 on Youtube Protrusive Dental Pearl: Important takeaway: Download the New TMD Guidelines The folder includes: A patient version of the guidelines A dentist version of the guidelines The full guidelines document Video of delivering an equilibrated soft bite guard using heat technique Key Takeaways: The guidelines for TMD are designed to simplify diagnosis and treatment. Self-management is crucial for TMD patients and can lead to better outcomes. Understanding the difference between muscle and joint pain is essential in TMD management. Early intervention in TMD can lead to significant improvements for patients. The importance of patient-centered care in managing TMD effectively. TMD is a common issue that requires a collaborative approach among dental professionals. The role of pain management in TMD is about improving quality of life, not just curing the condition. Continuous education and training are vital for dental professionals dealing with TMD. Understanding the pathogenesis of TMD is crucial for effective treatment. Stabilization splints can provide relief but should be used judiciously. Effective communication can significantly impact patient pain experiences. Tailoring treatment to individual patient needs is vital. Need to Read it? Check out the Full Episode Transcript below! Highlights for this episode: 00:48 Protrusive Dental Pearl 05:20 Introducing the Guests: Prof. Justin Durham and Mrs. Emma Beecroft 13:05 Stigma and Complexity of TMD in Dentistry 17:01 Challenges of Navigating TMD Treatment Perspectives 22:07 Diagnosing TMD: Tools and Techniques 27:09 Simplified Approach to TMD Examination 30:54 Muscle Palpation Pressure 32:20 Acute Limited Opening: Muscle vs. Joint Origin 40:20 Diazepam for Acute Myogenous TMD 54:58 Debating Soft vs. Stabilization Splints 57:17 Patient-Centered TMD Management 01:09:28 Conclusion and Resources This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes B and C. AGD Subject Code: 200 OROFACIAL PAIN (Diagnosis and treatment) Dentists will be able to – Explore the varied approaches to TMD care and how to align them with evidence-based practices. Emphasize the importance of self-management strategies and their role in improving patient outcomes. Advocate for a patient-centered approach, focusing on listening, communication, and individualized care plans. If you loved this episode, be sure to check out this episode: TMD Full Exam with ‘The TMJ Doc' Dr Priya Mistry – PDP064
A Clinician's guide to TMD Management Walkthrough of the latest TMD Guidelines with the authors! What's the right approach when a patient presents with both acute and chronic painful jaw symptoms? How can the latest RCS guidelines simplify your diagnosis and treatment process? In this episode, Professor Justin Durham and Mrs. Emma Beecroft join Jaz to unpack the latest Royal College of Surgeons TMD guidelines designed specifically to help GDPs navigate these tricky cases. Together, they explore practical strategies for managing TMD, breaking down the step-by-step flowchart that makes handling these cases less intimidating. From understanding the key principles to applying them in everyday practice, this episode will help you feel more confident in delivering better patient care for TMD. https://youtu.be/R0NaBJr5g5E Watch PDP213 on Youtube Protrusive Dental Pearl: Important takeaway: Download the New TMD Guidelines The folder includes: A patient version of the guidelines A dentist version of the guidelines The full guidelines document Video of delivering an equilibrated soft bite guard using heat technique Key Takeaways: The guidelines for TMD are designed to simplify diagnosis and treatment. Self-management is crucial for TMD patients and can lead to better outcomes. Understanding the difference between muscle and joint pain is essential in TMD management. Early intervention in TMD can lead to significant improvements for patients. The importance of patient-centered care in managing TMD effectively. TMD is a common issue that requires a collaborative approach among dental professionals. The role of pain management in TMD is about improving quality of life, not just curing the condition. Continuous education and training are vital for dental professionals dealing with TMD. Understanding the pathogenesis of TMD is crucial for effective treatment. Stabilization splints can provide relief but should be used judiciously. Effective communication can significantly impact patient pain experiences. Tailoring treatment to individual patient needs is vital. Highlights for this episode: 00:48 Protrusive Dental Pearl 05:20 Introducing the Guests: Prof. Justin Durham and Mrs. Emma Beecroft 13:05 Stigma and Complexity of TMD in Dentistry 17:01 Challenges of Navigating TMD Treatment Perspectives 22:07 Diagnosing TMD: Tools and Techniques 27:09 Simplified Approach to TMD Examination 30:54 Muscle Palpation Pressure 32:20 Acute Limited Opening: Muscle vs. Joint Origin 40:20 Diazepam for Acute Myogenous TMD 54:58 Debating Soft vs. Stabilization Splints 57:17 Patient-Centered TMD Management 01:09:28 Conclusion and Resources This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes B and C. AGD Subject Code: 200 OROFACIAL PAIN (Diagnosis and treatment) Dentists will be able to - Explore the varied approaches to TMD care and how to align them with evidence-based practices. Emphasize the importance of self-management strategies and their role in improving patient outcomes. Advocate for a patient-centered approach, focusing on listening, communication, and individualized care plans. If you loved this episode, be sure to check out this episode: TMD Full Exam with ‘The TMJ Doc' Dr Priya Mistry – PDP064
It has been 25 years since Macao's return to the motherland. Over the past quarter-century, the Macao Special Administrative Region has undergone a remarkable transformation. Once struggling economically, it is now an international free port with one of the world's highest per capita GDPs and life expectancies. During a gathering in Macao to mark the anniversary, Chinese President Xi Jinping says "one country, two systems" is a sound policy that must be adhered to for a long time.What's behind Macao's success story over the past 25 years? How will Macao continue to diversify its economy and better integrate into China's broader development plans? Host Zhao Ying is joined by Angus Chu, Distinguished Professor and Head of Department of Economics, University of Macau; Liu Baocheng, Director of the Center for International Business Ethics at University of International Business and Economics; Harvey Dzodin, Senior Fellow of the Center for China and Globalization.
Why action is needed to avoid some countries being labelled as 'scam states'. Synopsis: Every third and fourth Friday of the month, The Straits Times' global contributor Nirmal Ghosh shines a light on Asian perspectives of global and Asian issues with expert guests. With their heavy security, territorial control and global reach, we look at South-east Asia's industrial-size scam compounds, where thousands are lured from low-employment countries to work as forced labour stealing billions of dollars from victims worldwide. They are a national security threat to the countries they are based in as well as to the countries they target. The criminal organisations running these centres emanate mostly from China, and are physically located mainly in Laos, Cambodia, and Myanmar but across the region in other countries as well. Sporadic crackdowns of the type recently seen in Laos' Golden Triangle Special Economic Zone, are often choreographed ahead of time, enabling kingpins to evade them. According to a report released in May by the US Institute of Peace (USIP), as at the end of 2023, scam centres operating out of Myanmar, Cambodia, and Laos had accounted for US$39 billion (S$50.1 billion) in stolen funds. Jason Tower, Myanmar country director at USIP, joins host Nirmal Ghosh in this episode of Asian Insider to talk about the many aspects of this criminal industry, from human trafficking to forced labour and cybercrime. He suggests that Malaysia - as the next chair of Asean - has an opportunity to exercise leadership as 2025 will mark the 10th anniversary of the Kuala Lumpur Declaration on Combating Transnational Crime. Highlights (click/tap above): 2:37 Victims from over 100 countries, with the average scam victim losing more or less all of their assets 5:17 Why Chinese police are becoming more proactive and responding to the situation 7:19 How scam compounds are extremely well-networked around the globe and can get advance information about an upcoming crackdown 11:22 The amounts brought in by these online scams can rival countries' formal GDPs 15:50 Role of sanctions in combating scams - such as one on Ly Yong Phat, a notorious business figure involved in online scam compounds 19:32 A global crisis that demands action now Follow Nirmal Ghosh on X: https://str.sg/JD7r Read Nirmal Ghosh's articles: https://str.sg/JbxG Register for Asian Insider newsletter: https://str.sg/stnewsletters Host: Nirmal Ghosh (nirmal@sph.com.sg) Produced and edited by: Studio+65 and Fa'izah Sani Executive producer: Ernest Luis Follow Asian Insider on Fridays here: Channel: https://str.sg/JWa7 Apple Podcasts: https://str.sg/JWa8 Spotify: https://str.sg/JWaX Feedback to: podcast@sph.com.sg --- Follow more ST podcast channels: All-in-one ST Podcasts channel: https://str.sg/wvz7 ST Podcast website: http://str.sg/stpodcasts ST Podcasts YouTube: https://str.sg/4Vwsa --- Get The Straits Times' app, which has a dedicated podcast player section: The App Store: https://str.sg/icyB Google Play: https://str.sg/icyX --- #STAsianInsiderSee omnystudio.com/listener for privacy information.
Why action is needed to avoid some countries being labelled as 'scam states'. Synopsis: Every third and fourth Friday of the month, The Straits Times' global contributor Nirmal Ghosh shines a light on Asian perspectives of global and Asian issues with expert guests. With their heavy security, territorial control and global reach, we look at South-east Asia's industrial-size scam compounds, where thousands are lured from low-employment countries to work as forced labour stealing billions of dollars from victims worldwide. They are a national security threat to the countries they are based in as well as to the countries they target. The criminal organisations running these centres emanate mostly from China, and are physically located mainly in Laos, Cambodia, and Myanmar but across the region in other countries as well. Sporadic crackdowns of the type recently seen in Laos' Golden Triangle Special Economic Zone, are often choreographed ahead of time, enabling kingpins to evade them. According to a report released in May by the US Institute of Peace (USIP), as at the end of 2023, scam centres operating out of Myanmar, Cambodia, and Laos had accounted for US$39 billion (S$50.1 billion) in stolen funds. Jason Tower, Myanmar country director at USIP, joins host Nirmal Ghosh in this episode of Asian Insider to talk about the many aspects of this criminal industry, from human trafficking to forced labour and cybercrime. He suggests that Malaysia - as the next chair of Asean - has an opportunity to exercise leadership as 2025 will mark the 10th anniversary of the Kuala Lumpur Declaration on Combating Transnational Crime. Highlights (click/tap above): 2:37 Victims from over 100 countries, with the average scam victim losing more or less all of their assets 5:17 Why Chinese police are becoming more proactive and responding to the situation 7:19 How scam compounds are extremely well-networked around the globe and can get advance information about an upcoming crackdown 11:22 The amounts brought in by these online scams can rival countries' formal GDPs 15:50 Role of sanctions in combating scams - such as one on Ly Yong Phat, a notorious business figure involved in online scam compounds 19:32 A global crisis that demands action now Follow Nirmal Ghosh on X: https://str.sg/JD7r Read Nirmal Ghosh's articles: https://str.sg/JbxG Register for Asian Insider newsletter: https://str.sg/stnewsletters Host: Nirmal Ghosh (nirmal@sph.com.sg) Produced and edited by: Studio+65 and Fa'izah Sani Executive producer: Ernest Luis Follow Asian Insider on Fridays here: Channel: https://str.sg/JWa7 Apple Podcasts: https://str.sg/JWa8 Spotify: https://str.sg/JWaX Feedback to: podcast@sph.com.sg --- Follow more ST podcast channels: All-in-one ST Podcasts channel: https://str.sg/wvz7 ST Podcast website: http://str.sg/stpodcasts ST Podcasts YouTube: https://str.sg/4Vwsa --- Get The Straits Times' app, which has a dedicated podcast player section: The App Store: https://str.sg/icyB Google Play: https://str.sg/icyX --- #STAsianInsiderSee omnystudio.com/listener for privacy information.
THE BEST BITS IN A SILLIER PACKAGE (from Thursday's Mike Hosking Breakfast) How Come America Gets Such a Big Cut?/Vance vs Harris vs Trump vs the English Language/F1 vs LegoSee omnystudio.com/listener for privacy information.
The US national debt has hit a new $35 trillion landmark, according to the latest data from the US Treasury Department. That is equal to the GDPs of China, Japan, Germany, India, and Britain combined. This year alone, the International Monetary Fund has twice sounded alarm, saying the escalating US debt load poses a growing risk to the global economy.What has led to the continued rise of the US government debt? In what ways could this issue become risky for America and beyond? Host Ding Heng is joined by William Lee, Chief Economist of Milken Institute, a California-based economic think tank; Professor Qu Qiang, Fellow of Belt and Road Research Center at Minzu University of China; Professor Liu Baocheng, Director of the Center for International Business Ethics with University of International Business and Economics; David Blair, Vice President and Senior Economist of the Center for China and Globalization.
Space Power: NATO Summit - Defense Industry! Can You Hear The Demand Signal Now? Before meeting with heads of state, NATO Secretary General Jens Stoltenberg told leaders from the Allied defense industrial base that more than two-thirds of the Alliance's 32 member nations were spending at least 2% of the GDPs on defense. “So there is a good market outlook for you.” To understand what the secretary general meant and this summit's outcomes for the space domain, Laura Winter speaks with Malcolm Davis, a Senior Policy Analyst at the Australian Strategic Policy Institute focusing on space policy, security, strategy, and capability development; Brig. Gen. Bruce McClintock USAF (Ret.), RAND Corporation Space Enterprise Initiative lead, and former U.S. Defense Attaché to Russia; and John Neal, Executive Director for Space Policy at the U.S. Chamber of Commerce.
Want to feel optimistic about your day? In this Friday episode, Simon Kuestenmacher talks to Jon Krohn about demography: What it is, why it's so important, and why its forecasts should give us reason to hope for a better future. In an increasingly globalized world, and with an aging population in countries with the biggest GDPs, demography is more valuable than ever. Additional materials: www.superdatascience.com/796 Interested in sponsoring a SuperDataScience Podcast episode? Email natalie@superdatascience.com for sponsorship information.
Tesla's shareholders want to give him $56 billion. Now, it's up to a judge if he gets it. The sum is astounding: more than the 2023 federal budget of Nigeria or Pakistan; more than twice Israel's annual military budget; more than the individual GDPs of 100 countries. We look at Elon's record at Tesla and examine why some investors say he needs the money to stay engaged.Sumi Somaskanda talks to BBC Business reporter Natalie Sherman and Tim Higgins, author of “Power Play: Tesla, Elon Musk, and the Bet of the Century.”The Global Story brings you trusted insights from BBC journalists worldwide. We want your ideas, stories and experiences to help us understand and tell #TheGlobalStory. Email us at theglobalstory@bbc.com You can also message us or leave a voice note via WhatsApp on +44 330 123 9480.TGS is part of the BBC News Podcasts family. The team that makes The Global Story also makes several other podcasts, such as Americast and Ukrainecast, which cover US news and the war in Ukraine. If you enjoy The Global Story, you may well like some of our other pods, too. To find them, simply search on your favourite podcast app.This episode was made by Laurie Kalus and Neal Razzell. The technical producer was Antonio Fernandez. The assistant editor is Sergi Forcada Freixas and the senior news editor is Sam Bonham.
Yan Kugel is joined by Paul Sarrazin, an esteemed expert in good distribution practices (GDP) within the pharmaceutical sector. Here, he provides a glimpse into his journey from a permanent employee to a consultant specializing in GDP compliance. With a strong background in bioengineering and a rich portfolio of collaborations with industry giants like GSK, UCB, and Takeda, Paul's expertise in GDPs is rooted in his early consulting career and subsequent roles within pharmaceutical companies. Paul sheds light on the advantages of being a consultant in the pharmaceutical industry, emphasizing the autonomy and diversity of projects that come with the role.
Specialist orthodontist Annika Patek opens up about the challenges of dental study and practise for those who don't fit the mould. The conversation delves into the challenges of being a career-focused woman in dentistry, including sacrificing family and relationships for speciality training. Annika discusses her experiences with marriage and motherhood while working as a specialist, the importance of mental resilience and camaraderie and support within the profession. Enjoy! In This Episode 00:02:25 - Backstoty 00:06:00 - Discovering dentistry 00:09:30 - Dental school 00:15:20 - General practice, VT and specialist training 00:22:10 - Conformity and non-conformity 00:25:58 - Family, study, and careers 00:34:10 - Ortho training challenge 00:40:20 - GDPs and ortho 00:44:25 - Marriage and motherhood 00:52:30 - Ortho highs and lows 00:54:05 - Support and camaraderie 00:57:00 - Mental resilience 01:00:00 - Lingual Vs Invisalign About Annika Patel Annika gained a Bachelor of Dental Surgery degree and postgraduate Masters in Orthodontics from King's College London. She trained in maxillofacial and oral surgery and paediatric dentistry before completing specialist training in Orthodontics at Guy's Hospital and the Queen Victoria Hospital, East Grinstead. Annika has a keen interest in the intersection of science, orthodontics, and art.
① China and Serbia have agreed to upgrade their ties to jointly build a China-Serbia community of shared future. What are the key factors behind the highlights in bilateral ties? (00:52)② We take a look at the first-quarter GDPs across China's provincial regions. (13:26)③ What is the prospect of Putin's fifth term as Russia's president? (25:11)④ Inflation has forced Argentina to circulate its first 10,000-peso banknotes. Is there an easy way out of the country's hyperinflation? (34:34)⑤ The US Commerce Department is hearing testimony on whether to designate Vietnam as a "market economy". Is granting that status to the Asian country part of Washington's strategy to make Vietnam a counterbalance to China? (45:01)
It's no secret that the economies of Central Asian countries like Uzbekistan, Kyrgyzstan, and Tajikistan rely heavily on labor migration to stay afloat. In 2022, according to the International Organization for Migration, remittances from Russia accounted for just over half of Tajikistan's GDP, and made up more than 20 percent of the GDPs of Kyrgyzstan and Uzbekistan. Many of the workers sending these remittances are their families' sole breadwinner — and given the lack of employment opportunities at home, working in Russia is often their best option, even if means dealing with a maze of bureaucracy and relentless discrimination. The aftermath of last month's terrorist attack in Moscow has brought the xenophobia that Central Asian migrants face in Russia back into the spotlight, with media outlets reporting on a surge in blatant discrimination and, in some cases, targeted violence. Meanwhile, the Russian authorities have launched a renewed crackdown on migrant workers. This is despite the fact that Russia, with its shrinking population and labor shortage made worse by the war, needs migrants to keep its economy functioning. To learn about Russia's migration policy under Vladimir Putin and how the xenophobic backlash to last month's attack has affected ethnic and religious minorities, The Naked Pravda spoke to Moscow Times special correspondent Leyla Latypova; Carnegie Russia Eurasia Center fellow Temur Umarov; and political scientist Caress Schenk, an associate professor at Nazarbayev University. And be sure to check out Temur Umarov's previous appearance on The Naked Pravda: How Russia pressures Central Asian migrants into military service. Timestamps for this episode: (2:35) Xenophobia in the wake of the Crocus City Hall attack (16:55) Russia's dependence on migrant labor (27:35) How Russia uses migration policy for political aims (31:25) The migration-extremism fallacy (39:13) The long-term effects of Russia's current migration crackdownКак поддержать нашу редакцию — даже если вы в России и вам очень страшно
Payman chats with Hasham Ali about his journey from the Middle East to Manchester, UK, where he now practices as a specialist orthodontist. Hesham discusses the value and challenges of professional networking, what it takes to turn GDPs into competent orthodontists, and why the term specialist orthodontist will always be a secondary identity. In This Episode 02:00 - Specialising 08.04 - The UK, NHS and private work 12.15 - Networking, communication and social media 24.57 - Teaching and events 28.28 - Roots and relationships 37.15 - Ortho training, planning and treatment 57.35 - Blackbox thinking 01.02.54 - Knowing Vs not knowing 01.06.05 - Orthodontics and health 01.11.06 - Dark days 01.21.21 - In retrospect 01.22.55 - Free time 01.25.24 - Being a twin 01.27.58 - Fantasy dinner party 01.35.49 - Last days and legacy About Hesham Ali Hesham Ali is a specialist orthodontist and consultant at the Royal Bolton Hospital in Greater Manchester. He also teaches orthodontics through his Orthodontia brand.
Did you know being “Hispanic” is not a thing in Europe? Just ask Claudia Romo Edelman. While living in many countries -- as a Head of Public Relations for the World Economic Forum, to a Marketing Professor in Geneva -- she was simply Mexican, no different from how her friends from Venezuela or Guatemala were identified by their own nationalities. Then, Edelman moved to the U.S. and got a new label – "Hispanic" or "Latina." She's embraced the description with the same spirit she welcomes any respectful nod to her heritage. For her, it's all about just making sure she and the LatinX community are part of a broader, more inclusive narrative. In fact, all humans should be respected equally – in society and in marketing. So, she founded “We Are All Human” to advocate for diversity and inclusion. In an incredibly insightful conversation Edelman, we discussed her remarkable journey – from growing up with a professional basketball player-turned economist-turned actor mom (talk about a role model!) to her own impressive path from Special Advisor at the UN to “Founder/Factivist”.... An Empowering Hispanic Star Edelman's experience gives her a unique perspective on brand purpose, which she eloquently shared during our discussion. One of many fascinating parts of our conversation was about her involvement insuch influential pro-social campaigns such as Product Red and the Sustainable Development Goals (SDGs). She described the significance of these initiatives then what sparked her commitment to elevating the perception of the Hispanic community by founding "We Are All Human" – and supporting the "Hispanic Star" initiative -- which aims to unify and empower the Hispanic community. Edelman addressing the Hispanic Marketing Summit held at the UN 12/23 "Purpose-led branding is not just a trend; it's a necessity for survival in today's market." "Understanding the Hispanic community goes beyond language; it's about respecting and investing in their culture and values." You'll learn about the importance of addressing systemic barriers such as education, health, and job opportunities. Her insights into the challenges and opportunities within the Hispanic community were eye-opening but should be of particular interest for brands. Especially given some of the stats she shared about the power of the Hispanic US population as a “factivist!” (Per her book, "Hispanic Stars Rising", "We are the engine of the U.S. economy. Responsible for 2.6 trillion dollars of GDP, which puts us among the top ten GDPs in the world. Our purchasing power is $1.9 trillion. We are entrepreneurial — 86% of all new businesses launched in the past 10 years were started by Hispanics.") Authentic Engagement with the Hispanic Community: Edelman emphasized the importance of understanding and respecting cultural nuances. A significant part of our dialogue centered around how brands can authentically engage with the Hispanic population. A genuine investment in community initiatives, rather than superficial marketing tactics, is key to connecting with this demographic. Listen for more of these insights along with some of her personal stories that added an intimate touch to our discussion. Memorable Moments: [00:03:00] Meet Claudia Romo Edelman... where she lived around the world and why she now lives in a gymnasium! [00:04:11] Background on Claudia's role in global campaigns – from Project Red to UN Sustainable Development Goals [00:07:33] Discussion on and definition of brand purpose [00:11:52] The mission and vision behind the creation of non-profit foundation, "We Are All Human" [00:16:43] The significance and development of the Hispanic S tar initiative and its symbolism [00:20:48] Claudia's motivation – past, present and future [00:25:54] Comparing podcast plans and the thru line of Hispanic executive women featured on the podcast "A La Latina" [00:33:00] Using 'factivism' in targeting Latino communities
The problem I found with endodontics was that the more you learn, the less you can cut corners, and the longer it ends up taking! I was keen to learn how to be more efficient with endodontics so I brought on Dr Omar Ikram to talk us through his sequencing and protocols for RCTS. Turn those challenging appointments into seamless, lunchtime-friendly successes. Follow @specialistendo on Instagram to keep up to date with Dr. Ikram's endo-endeavours! https://youtu.be/yHoiX4gijpQ Watch PDP163 on Youtube Need to Read it? Check out the Full Episode Transcript below! Download the EndoPrep app for access to: Online study guides Links to free webinars An MB2 guide An endodontic calculator tool And so much more! If you liked this episode, you will also like PDP133 - Pulpotomies for Irreversible Pulpitis? Did you know? You can get CPD from the Web App or Phone App and watch premium clinical videos, for less than a tax deductible Nando's per month? Click below for full episode transcript: Jaz's Introduction: When I qualified from dental school, I was really into restorative, but the part of restorative I was most into was actually endodontics. In fact, I actually did quite a lot of root canals when I was a dental student. Jaz's Introduction:And the funny story is that because of orthodontics, I actually lost vitality of my four lower incisors.I had root canals from specialists for all my lower four incisors. So I actually experienced root canal treatment as a patient while I was a dental student. And also having really inspirational tutor and someone called Dr. Stephen Godfrey at dental school meant that I was actually really looking at these postgraduate options for specializing in endodontics as one of my serious career considerations. I went on to win the Tom Pitt-Ford prize, which is given to like one student per dental school every year. And I also won like this runner up prize in the Julian Webber Harley Street prize. And I was basically about submitting a case. And I did an MTA case back when I was a DCT in Sheffield. That was pretty cool. Using a scope, learning how to do simple retreatments. So I was on the path to really consider endodontics. Now fast forward 10 years. And my favorite type of endodontics is the referral pad. Okay, I'm joking but I'm kind of not joking because it's not my favorite thing to do anymore. I do TMD, I do restorative, I do occlusal stuff, tooth wear, and I get a lot of joy from that. Root canals is low down in my pecking order and one of the reasons I'm so keen to refer to my specialist colleagues is how long it takes me and I'm thinking if this tooth is going to take two hours with me and it's going to take one hour and 15 minutes with the specialist and they'll probably do a better job than I will. Then it just makes sense to see a specialist, right? If the patient can afford it, great. And also, in terms of an hourly rate, like GDPs doing endodontics that are particularly tricky and pushing boundaries and spending longer on it, it just doesn't make sense as a financial point of view. Because if your patient is paying for your time, then they may end up paying you more than the endodontist. And that just is bizarre. That should never happen, right? So I'm more than happy to rely on my endodontic colleagues. The way that this ties in to the superstar guest that we have today, Dr. Omar Ikram, who I'm sure many of you know of. He's very prolific on social media. He puts out such good stuff to the world in terms of being helpful in our endodontic treatments. He's very giving with his time and knowledge. So it's a great pleasure to have on Dr. Omar Ikram today. And I was thinking, what could I ask him? There's so many different topics that we could ask him. There's some topics I've already covered on the show when it comes to endodontics. And I thought it'd be a really good one about how to make root canals more efficient.
Last year, The Guardian did a five-month investigation into “carbon bombs,” or fossil fuel projects that would, over the course of their life, emit over one billion tons of carbon. They found that there are 195 planned oil and gas carbon bombs around the world, and if they proceed as planned, these projects alone would blow past internationally agreed upon climate targets. For our thirteenth deep dive on carbon bombs, we take a look at the North Dome Gas Field: the world's largest gas field located in northern Qatar, singlehandedly home to eleven carbon bomb projects that collectively could emit over 41 billion tons of carbon dioxide. But North Dome has a unique history, transforming Qatar from a largely impoverished nation to one with one of the highest GDPs per capita, rapidly blossoming education and tourism, and the home of global sporting competitions like 2022's FIFA World Cup. Despite these exciting developments, the North Dome Gas Field does present challenges from an environmental, human rights, geopolitical, and even economic perspective. This week, we cover the issues facing the North Dome Gas Field, why Qatar has incentive to transition away from natural gas exports and diversify their economy, and what a sustainable and feasible path forward could look like. With special guest Dr. Geoff Harkness: Associate Professor of Sociology at Rhode Island College. Now more than ever, The Sweaty Penguin needs your help to continue! Support the show and unlock exclusive merch, bonus content, and more for as little as $5/month at patreon.com/thesweatypenguin. CREDITS Writers: Alia Bonanno, Owen Reith, Mo Polyak, Ethan Brown Fact Checker: Ainsley Jane Tambling Editor: Megan Antone Producers: Ethan Brown, Hallie Cordingley, Megan Antone Ad Voiceover: Mo Polyak Music: Brett Sawka
Strap in for a deep conversation as Prav sits down to chat with GDPR consultant to the dental industry, Adrian Dray. Adrian talks candidly about his difficult formative experiences as the victim of bullying at an early age, a crisis spurred by the passing of his father, and the confronting of his mortality following a brutal confrontation with COVID. There's also plenty of practical insight as Adrian discusses the impact of much-misunderstood GDPR on dentistry and the potentially paradigm-shifting effects of emerging AI technologies. To learn more about AI's potential impact, listen to the Implement AI podcast with Piers Linney and Aaalok Shukla. Grab Adrian's Exclusive AI & GDPR Freebies! Adrian is giving away two essential guides on AI and GDPR exclusively to Dental Leaders listeners. Get Adrian's Chat GPT Guide for Dentists Get ChatGPT - A Dental Business Game Changer with 100% by following this link or entering code DL100 at checkout. (Offer limited to the first 100 listeners only.) Exclusive Free Download for Dental Practices You can grab Adrian's invaluable Privacy Notice Template for dental practices (usually £57) here with this exclusive link or by entering code DL100 at checkout. Exclusive Free Download for Dental Associates Associates can download Adrian's website Privacy Notice Template (usually £52) by following this link or entering code DL100 at checkout. In This Episode 01.52 - Backstory 05.03 - Bullying 22.07 - The dental community 34.48 - Breakdown and recovery 47.54 - GDPR—issues and risks 01.05.47 - Real-world examples 01.24.17 - AI for dentists 01.36.53 - Health, COVID and fasting 02.07.24 - Compassion and internal family systems 02.13.59 - Last days and legacy About Adrian Dray Adrian Dray is a leading advisor to UK dentists on GDPR privacy and data regulation and a former Data Protection Officer for over 600 dental practices. He is passionate about helping dentists take advantage of emerging AI technologies.
This episode of the Cyberlaw Podcast kicks off with a stinging defeat for the Federal Trade Commission (FTC), which could not persuade the courts to suspend the Microsoft-Activision Blizzard acquisition. Mark MacCarthy says that the FTC's loss will pave the way for a complete victory for Microsoft, as other jurisdictions trim their sails. We congratulate Brad Smith, Microsoft's President, whose policy smarts likely helped to construct this win. Meanwhile, the FTC is still doubling down on its determination to pursue aggressive legal theories. Maury Shenk explains the agency's investigation of OpenAI, which raises issues not usually associated with consumer protection. Mark and Maury argue that this is just a variation of the tactic that made the FTC the de facto privacy regulator in the U.S. I ask why policing ChatGPT's hallucinatory libel problem constitutes consumer protection, and they answer, plausibly, that libel is a kind of deception, which the FTC does have authority to police. Mark then helps us drill down on the Associated Press deal licensing its archives to OpenAI, a deal that may turn out to be good for both companies. Nick Weaver and I try to make sense of the district court ruling that Ripple's XRP is a regulated investment contract when provided to sophisticated buyers but not when sold to retail customers in the market. It is hard to say that it makes policy sense, since the securities laws are there to protect the retail customers more than sophisticated buyers. But it does seem to be at least temporary good news for the cryptocurrency exchanges, who now have a basis for offering what the SEC has been calling an unregistered security. And it's clearly bad news for the SEC, which may not be able to litigate its way to the Cryptopocalypse it has been pursuing. Andy Greenberg makes a guest appearance to discuss his WIRED story about the still mysterious mechanism by which Chinese cyberspies acquired the ability to forge Microsoft authentication tokens. Maury tells us why Meta's Twitter-killer, Threads, won't be available soon in Europe. That leads me to reflect on just how disastrously Brussels has managed the EU's economy. Fifteen years ago, the U.S. and EU had roughly similar GDPs, at about $15 trillion each. Now the EU GDP has scarcely grown, while U.S. GCP is close to $25 trillion. It's hard to believe that EU tech policy hasn't contributed to this continental impoverishment, which Maury points out is even making Brexit look good. Maury also explains the French police drive to get explicit authority to conduct surveillance through cell phones. Nick offers his take on FISA section 702 reform. Stories. And Maury evaluates Amazon's challenge to new EU content rules, which he thinks have more policy than legal appeal. Not content with his takedown of the Ripple decision, Nick reviews all the criminal cases in which cryptocurrency enthusiasts are embroiled. These include a Chinese bust of Multichain, the sentencing of Variety Jones for his role in the Silk Road crime market, and the arrest of Alex Mashinsky, CEO of the cryptocurrency exchange Celsius. Finally, in quick hits, Mark and I duel over the lawsuit claiming that Texas's TikTok Ban on government phones will threaten academic freedom. I praise the surprisingly good National Cybersecurity-Strategy Implementation Plan and puzzle over the decision not to nominate the acting head of that office to head the office permanently. And I note that the Allow States and Victims to Fight Online Sex Trafficking Act, also known as FOSTA-SESTA, reviled by the left, has withstood a constitutional challenge in the DC Circuit. Download 468th Episode (mp3) You can subscribe to The Cyberlaw Podcast using iTunes, Google Play, Spotify, Pocket Casts, or our RSS feed. As always, The Cyberlaw Podcast is open to feedback. Be sure to engage with @stewartbaker on Twitter. Send your questions, comments, and suggestions for topics or interviewees to CyberlawPodcast@gmail.com. Remember: If your suggested guest appears on the show, we will send you a highly coveted Cyberlaw Podcast mug! The views expressed in this podcast are those of the speakers and do not reflect the opinions of their institutions, clients, friends, families, or pets.
This episode of the Cyberlaw Podcast kicks off with a stinging defeat for the Federal Trade Commission (FTC), which could not persuade the courts to suspend the Microsoft-Activision Blizzard acquisition. Mark MacCarthy says that the FTC's loss will pave the way for a complete victory for Microsoft, as other jurisdictions trim their sails. We congratulate Brad Smith, Microsoft's President, whose policy smarts likely helped to construct this win. Meanwhile, the FTC is still doubling down on its determination to pursue aggressive legal theories. Maury Shenk explains the agency's investigation of OpenAI, which raises issues not usually associated with consumer protection. Mark and Maury argue that this is just a variation of the tactic that made the FTC the de facto privacy regulator in the U.S. I ask why policing ChatGPT's hallucinatory libel problem constitutes consumer protection, and they answer, plausibly, that libel is a kind of deception, which the FTC does have authority to police. Mark then helps us drill down on the Associated Press deal licensing its archives to OpenAI, a deal that may turn out to be good for both companies. Nick Weaver and I try to make sense of the district court ruling that Ripple's XRP is a regulated investment contract when provided to sophisticated buyers but not when sold to retail customers in the market. It is hard to say that it makes policy sense, since the securities laws are there to protect the retail customers more than sophisticated buyers. But it does seem to be at least temporary good news for the cryptocurrency exchanges, who now have a basis for offering what the SEC has been calling an unregistered security. And it's clearly bad news for the SEC, which may not be able to litigate its way to the Cryptopocalypse it has been pursuing. Andy Greenberg makes a guest appearance to discuss his WIRED story about the still mysterious mechanism by which Chinese cyberspies acquired the ability to forge Microsoft authentication tokens. Maury tells us why Meta's Twitter-killer, Threads, won't be available soon in Europe. That leads me to reflect on just how disastrously Brussels has managed the EU's economy. Fifteen years ago, the U.S. and EU had roughly similar GDPs, at about $15 trillion each. Now the EU GDP has scarcely grown, while U.S. GCP is close to $25 trillion. It's hard to believe that EU tech policy hasn't contributed to this continental impoverishment, which Maury points out is even making Brexit look good. Maury also explains the French police drive to get explicit authority to conduct surveillance through cell phones. Nick offers his take on FISA section 702 reform. Stories. And Maury evaluates Amazon's challenge to new EU content rules, which he thinks have more policy than legal appeal. Not content with his takedown of the Ripple decision, Nick reviews all the criminal cases in which cryptocurrency enthusiasts are embroiled. These include a Chinese bust of Multichain, the sentencing of Variety Jones for his role in the Silk Road crime market, and the arrest of Alex Mashinsky, CEO of the cryptocurrency exchange Celsius. Finally, in quick hits, Mark and I duel over the lawsuit claiming that Texas's TikTok Ban on government phones will threaten academic freedom. I praise the surprisingly good National Cybersecurity-Strategy Implementation Plan and puzzle over the decision not to nominate the acting head of that office to head the office permanently. And I note that the Allow States and Victims to Fight Online Sex Trafficking Act, also known as FOSTA-SESTA, reviled by the left, has withstood a constitutional challenge in the DC Circuit. Download 468th Episode (mp3) You can subscribe to The Cyberlaw Podcast using iTunes, Google Play, Spotify, Pocket Casts, or our RSS feed. As always, The Cyberlaw Podcast is open to feedback. Be sure to engage with @stewartbaker on Twitter. Send your questions, comments, and suggestions for topics or interviewees to CyberlawPodcast@gmail.com. Remember: If your suggested guest appears on the show, we will send you a highly coveted Cyberlaw Podcast mug! The views expressed in this podcast are those of the speakers and do not reflect the opinions of their institutions, clients, friends, families, or pets.
Dambisa Moyo is an economist and board member of Chevron and 3M. She's also author of the 2018 book Edge of Chaos. In this week's episode of Merryn Talks Money, Moyo and host Merryn Somerset Webb discuss whether the world has finally slipped off the edge. Moyo says it feels that way. Most economies were already stagnating before the pandemic struck, she says. Growth was trending downwards, productivity was a problem and it was hard to see how countries could all grow their GDPs at 3% a year.Now there's a new and urgent question, she says: what to do with people who won't have work in an AI dominated economy. It won't be long before pretty much every country—even the UK—has too many workers, she warns. There are, however, some easy wins Britain can notch, she says. Namely, lowering taxes and loosening regulations. The UK has gotten a bad rap thanks to Brexit and political uncertainty, Moyo says, but that doesn't mean it can't take advantage of its intellectual base and prime location. Sign up to John Stepek's daily newsletter Money Distilled. https://www.bloomberg.com/account/newsletters/uk-wealth And as promised, Baroness Moyo's Maiden Speech.See omnystudio.com/listener for privacy information.
As you may recall from the first part of this series, Dr. Wayne William is an amazing dentist in our community who has been kind enough to share his insights into local anaesthetics with us. Today we'll be talking about the second half of this topic: The most commonly used anesthetic agents used by GDPs (and why we should ditch one)Is it safe to inject lingually? Adrenaline for Cardiac Risk Patients - is it really a worry? https://youtu.be/E9q4t5z7LdI Check out this full episode on YouTube Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content The Protrusive Dental Pearl: Do NOT use the technique of lingual infiltration that I did! There IS a better way! (Lingual Infiltrations are not bad - just the way I did them was not ideal) If you're curious what technique that was, Protrusive Premium will get to see it in the middle of this episode including Dr Williams' 'live' unedited, uncut reaction. This is GOLDEN content! Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 4:34 The Protrusive Dental Pearl 5:38 Large red headed people are difficult to numb. Is it a myth or is it real?8:29 Lingual Infiltrations17:02 Adrenaline being avoided for certain patients23:49 Adrenaline for Cardiac Risk Patients Occlusion: Basics and Beyond is the most tangible, real-world, and comprehensive occlusion training on the planet. Get the OBAB One-Time Pre-Launch Deal which SOLD OUT - the only way now is the Waiting List as IAS are preparing 20 extra starter kits. Be sure to watch the first part of this episode: Articaine ID Blocks and the ‘CIA Technique' for Local Anaesthetic Click below for full episode transcript: Jaz's Introduction: Welcome back Protruserati to Articaine ID Blocks Part Two. How good was part one? Thanks to Dr. Wayne Williams. [Jaz]What I love about bread and butter episodes like these is the engagement it gets from the community. So you guys, Protruserati on the Instagram app @protrusivedental, had some really interesting things today. Like for example, Cony, Cony Caravotas we met in Brighton and also at the Finlay Sutton course. Hope you're doing well. She said that she hasn't done an ID block since 2009, so that was 14 years ago. That is bloody impressive, right? I told you I do about one a month. Coney hasn't done once in 2009. She said, buccal articaine infiltrations all the way. And there were loads of comments just like that about how we're all getting really good results with buccal articaine. But of course, Dr. Wayne Williams suggested that it's only really appropriate for single tooth procedures. But I know many of you, including myself on many occasions, use it for quadrant dentistry in the lower molar. Now, I wouldn't use it, like I said in the previous episode of people with large bones, large heads, big bony exostosis. But for the average person, I think it does work well in my hands, and that's what it's all about. Don't change your technique if something is working well, unless there's more efficiency, more safety involved, or lower cost involved. But if you're not compromising a lot on those areas and something is working well in your hands, I wouldn't change anything about your protocol as long as you're safe, efficient, and cost effective. So more power to anyone who's getting great success with buccal articaine. I personally will say that by putting it in the attached gingiva. Now, something that, @ohheyitsdoctoralbert also said on Instagram is the importance of attached gingiva. I find that the attached gingiva retains it, and probably by going in the attached gingiva I'm entering that coal area that Dr. Wayne Williams talked about in the first episode, and therefore, these em mystery canals, these holes in the mandible to allow our anesthetic to get in the right place.
As you may recall from the first part of this series, Dr. Wayne William is an amazing dentist in our community who has been kind enough to share his insights into local anaesthetics with us. Today we'll be talking about the second half of this topic: The most commonly used anesthetic agents used by GDPs (and why we should ditch one) Is it safe to inject lingually? Adrenaline for Cardiac Risk Patients – is it really a worry? https://youtu.be/E9q4t5z7LdI Check out this full episode on YouTube Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content The Protrusive Dental Pearl: Do NOT use the technique of lingual infiltration that I did! There IS a better way! (Lingual Infiltrations are not bad – just the way I did them was not ideal) If you're curious what technique that was, Protrusive Premium will get to see it in the middle of this episode including Dr Williams' ‘live' unedited, uncut reaction. This is GOLDEN content! Highlights of this episode: 4:34 The Protrusive Dental Pearl 5:38 Large red headed people are difficult to numb. Is it a myth or is it real? 8:29 Lingual Infiltrations 17:02 Adrenaline being avoided for certain patients 23:49 Adrenaline for Cardiac Risk Patients Occlusion: Basics and Beyond is the most tangible, real-world, and comprehensive occlusion training on the planet. Get the OBAB One-Time Pre-Launch Deal which SOLD OUT – the only way now is the Waiting List as IAS are preparing 20 extra starter kits. Be sure to watch the first part of this episode: Articaine ID Blocks and the ‘CIA Technique' for Local Anaesthetic
Dr. Karl Walker-Finch shares his journey of pain to passion as he reveals the secrets to finding YOUR passion in Dentistry. We started by discussing our crippling imposter syndrome as we left public Dentistry to practice privately. Along that theme we highlight the importance of taking control of your own destiny. Karl's new book, 'In The Loupe' raises money for Confidental (emotional first aid for Dentists) and is a powerful book for Dentists that wish to practise without fear and establish the right work-life balance. https://youtu.be/YPv71yr62tE Check out this full episode on YouTube Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content “We do not need thousands of specialists in full mouth rehabilitation” - Dr. Karl Walker-Finch Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 3:12 Dr.Karl Walker-Finch's introduction5:48 Experiencing Imposter Syndrome11:40 Private Practice vs Public Practice16:31 Finding Passion - Ideal work for dentists20:59 Top tips to help dentists find their 'whys' - Dr. Karl's pathway before niching down29:34 Taking control of our own destiny39:32 Implementing the power of atomic habits in Dentistry44:12 Dr. Karl supporting 'Confidental' - helping dentists with their mental health You can now grab a copy of In The Loupe: The Secrets to Finding a Passion in Dentistry by Dr. Karl Walker-Finch! If you enjoyed this episode, you will love Passion and Values in Dentistry with Dr. Dhru Shah Click below for full episode transcript: Jaz's Introduction: n this episode, I'm joined by Dr. Karl Walker-Finch, who's the author of the book called In the Loupe, the Secrets to Finding a Passion in Dentistry. Hence why the name of this episode. Now, some of the other titles that are also considered were GDPs, just Want to Have Fun. Jaz's Introduction:And the other one that describes this episode really well, which I almost considered was Fall in Love with Dentistry all over again. Hello, Protruserati. I'm Jaz Gulati and I'm the host of Protrusive Dental Podcast. This is a non-clinical interruption. We call this an Interference Cast. If it's your first time listening, thanks for joining me. I appreciate it. It's a whole three or four years worth of content that you need to explore, but if you are a regular listener, thanks for joining us again. This episode is a bigger picture episode. This episode is kind of like a feel good and an emotional exploration of your why and your purpose in your life and in your career. Some of the themes that we cover are things like imposter syndrome, my goodness. So I do get imposter syndrome less now than I used to, but when I get it, I get it in a big way. So we'll talk about how Karl experience is and how we both overcome that. We also talk about our journeys in moving to private density and how we actually felt bad about leaving the public health dentistry and what that kind of looked like. Our little roadmap. The other thing we discuss is how we both want to, we're both on a mission, Karl and I to infect you guys, you listening right now with enough positivity that you can head into work with excitement. In fact, the thing I love about protrusive and what it's become and you guys is the messages I get are kind of like in this vein here. I'm just going to read a message out to you from, oh, hey, it's Dr. Albert, Albert, thanks so much, for freeing a listener. You sent a really lovely message. He said lots of nice things and I'll cut to chase. He said, I've been practicing for seven years and have been stuck in a lot of routine, mundane mindsets that have been holding me back. And watching PDP episodes on YouTube has gotten me so excited about all sorts of new things. Thank you again, and please keep up the great work. So, these messages,
Money makes the world go ‘round, as they say. But who is really behind the manipulation of Wall Street? Why are massive hedge fund managers able to control so much of the market—such as BlackRock, which controls more than most countries' GDPs combined? What role do proxy advisors like Glass Lewis and ISS have, and do they really possess more power than most governments of the world? Find out what all this and more mean on this Edge of Wonder Live.
Which type of sedation is best for my patient? Are Temazepam tablets good enough? Is that even allowed? How can I safely provide Sedation in my practice? We are joined by the calming tones of Dr. Roy Bennett who busts some myths and guides us clinicians on Sedation in Clinical Practice. https://youtu.be/F6tf6HqqxD8 Check out this full episode on Youtube Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content Protrusive Dental Pearl: Communicating Risks to your Patient: Be calm and SLOW your pace down when communicating with your patients to EMPHASISE certain words. Becoming a visual educator to the patients is also a really good way to communicate risks – intra-oral camera is the best investment you will ever make. FocusDent MD740 Dental Intraoral Camera Highlights of this episode: 1:07 Protrusive Dental Pearl – Communication 4:27 Dr. Roy Bennett's Introduction 5:40 Pre-medication – is Temazepam any good? 9:27 GDPs entering the world of Sedation 13:48 Which Type of Sedation, When? 15:12 Level of training required to provide sedation in practice 17:32 Sedation and Clinical Dentistry at the same time? 19:09 Learning Sedation 21:48 How long can we Sedate a patient for? Is it just 1 Hour Max? 23:41 Offering sedation in YOUR practice 25:41 Ideal personality traits of operator-sedationist 28:15 Thing to know about implementing sedation 32:21 Two good qualities that an operator-sedationist should have: 34:24 The “New Drug” – Remimazolam Check out Dr. Roy's training site: Web: mellowdental.co.uk As a senior clinical advisor – Webinar and Presentations: uksedation.com UK Sedation will be presenting at the Royal Society of Medicine on the 15th of February on the new drug If you enjoyed this episode, you may also like another sedation episode: What Every Dentist Should Know About Managing Dental Anxiety with Dr. Mike Gow
Which type of sedation is best for my patient? Are Temazepam tablets good enough? Is that even allowed? How can I safely provide Sedation in my practice? We are joined by the calming tones of Dr. Roy Bennett who busts some myths and guides us clinicians on Sedation in Clinical Practice. https://youtu.be/F6tf6HqqxD8 Check out this full episode on Youtube Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content Protrusive Dental Pearl: Communicating Risks to your Patient: Be calm and SLOW your pace down when communicating with your patients to EMPHASISE certain words. Becoming a visual educator to the patients is also a really good way to communicate risks - intra-oral camera is the best investment you will ever make. FocusDent MD740 Dental Intraoral Camera Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 1:07 Protrusive Dental Pearl - Communication4:27 Dr. Roy Bennett's Introduction5:40 Pre-medication - is Temazepam any good?9:27 GDPs entering the world of Sedation13:48 Which Type of Sedation, When?15:12 Level of training required to provide sedation in practice17:32 Sedation and Clinical Dentistry at the same time?19:09 Learning Sedation21:48 How long can we Sedate a patient for? Is it just 1 Hour Max?23:41 Offering sedation in YOUR practice25:41 Ideal personality traits of operator-sedationist28:15 Thing to know about implementing sedation32:21 Two good qualities that an operator-sedationist should have: 34:24 The “New Drug” - Remimazolam Check out Dr. Roy's training site: Web: mellowdental.co.ukAs a senior clinical advisor - Webinar and Presentations: uksedation.com UK Sedation will be presenting at the Royal Society of Medicine on the 15th of February on the new drug If you enjoyed this episode, you may also like another sedation episode: What Every Dentist Should Know About Managing Dental Anxiety with Dr. Mike Gow Click below for full episode transcript: Jaz's Introduction: What's the deal with prescribing Temazepam as part of oral sedation or pre sedation? Are there any concerns about giving this to your patients or maybe sometimes the doctor, the general practitioner has given this to your patients? Jaz's Introduction:And what about deciding whether inhalation station, AKA gas and air versus intravenous sedation is best for your patient, and what is the correct path you have to take to be able to safely provide sedation in practice? These are all the questions we'll be covering in today's episode. Hello, Protruserati. I'm Jaz Gulati, and welcome back to your favorite dental podcast. It's not often we do an episode on sedation. It's quite a niche thing, but it complements some of the previous episodes we've done such as the one about hypnosis with Mike Gow. You have to listen to that one. And Mike and Roy, today's guests are actually really good friends, and it makes total sense. You know, Roy was a fantastic calm communicator. I would feel very safe in his hands as a patient. And that's what we all want. We all want our patients to feel safe around us, and that come from how we communicate to our patients. So, before we start on this episode about sedation, all those things that I just discussed, let's get to the Protrusive Dental Pearl. Protrusive Dental Pearl:So, if you're new to the podcast, every main episode, every PDP episode, I will share a Protrusive Dental Pearl. One tip that you can apply straight away. And this one is about communication. I very often like to do well communication one and this is not because I am some sort of master of communication. This is far from it. This is just something that I've been very much in tune with myself. I try to reflect on my communication skills and try to improve, and I try to look at other clinicians when I shadow them or when I see them in practice.
HealthCare Untold Hosts Gerardo and Barbara discuss a recent Executive Summary on the 2022 Latino Gross Domestic Product by Matthew Fienup from the Center for Economic Research, California Center for Economic Research, California Lutheran University. This report highlights the power of the Latino dollar and the total economic output (or GDP) of Latinos in the United States. The Latino GDP was $2.8 trillion in 2020, up from $2.1 trillion in 2015, and $1.7 trillion in 2010. According to this report, the Latino GDP would be the fifth largest GDP in the world, larger even than the GDPs of the United Kingdom, India or France. The fact that members of the Latino community are younger and have not hit their top earnings means that our GDP will continue to grow and further support the US economy. Gerardo and Barbara emphasize the importance of investing in the Latino community's health and education to ensure that the US economy remains vibrant and booming!
The 2022 LDC U.S. Latino GDP Report seeks to provide a factual view of the large and rapidly growing economic contribution of Latinos living in the United States. "As a summary statistic for the economic performance of Latinos, the 2020 U.S. Latino GDP is extraordinary. The total economic output of Latinos in the United States was $2.8T in 2020, up from $2.1T in 2015. If Latinos living in the U.S. were an independent country, the U.S. Latino GDP would be the fifth largest GDP in the world, larger than the GDPs of the United Kingdom, India, or France," says Sol Trujillo.
Nate Hagens is the Director of The Institute for the Study of Energy & Our Future. Energy drives our entire world. It keeps our GDPs growing, our cars moving and our hospital's working. If there was a shortage of energy, life would change very dramatically. Nate has spent 20 years researching the state of our current energy reliance and creating an assessment and philosophy for the future. Expect to learn how energy is intrinsically linked to our economy, why solar and wind are not a solution, why the things that humans value needs to change if we want to continue flourishing, what would happen if the price of energy went up by even a small margin, the real reason that the USA has a ton of bases in the Middle East and much more... Sponsors: Get 10% discount on all Optimal Carnivore's products at www.amazon.com/optimalcarnivore (use code: WISDOMSAVE10) Get 15% discount on the amazing 6 Minute Diary at https://bit.ly/diarywisdom (use code MW15) (USA - https://amzn.to/3b2fQbR and use 15MINUTES) Get over 37% discount on all products site-wide from MyProtein at https://bit.ly/proteinwisdom (use code: MODERNWISDOM) Extra Stuff: Check out Nate's website - https://www.thegreatsimplification.com/ Get my free Reading List of 100 books to read before you die → https://chriswillx.com/books/ To support me on Patreon (thank you): https://www.patreon.com/modernwisdom - Get in touch. Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx YouTube: https://www.youtube.com/modernwisdompodcast Email: https://chriswillx.com/contact/
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