Podcasts about occlusal

Can composite really outperform ceramic in the right case? Do you know when to choose an inlay over an onlay? What makes occlusal veneers so effective — even at just 0.6 mm thickness? After years of anticipation, Dr. Pascal Magne finally joins Jaz Gulati on the podcast for an episode packed with adhesive dentistry gold. They dive deep into occlusal veneers, material selection, and why indirect composite may be the best-kept secret for worn, root-filled molars. They also unpack the full bonding protocol step-by-step—from air abrasion and IDS to silane application and cementation with preheated composite. Whether you're doing full rehabs or composite repairs, this episode is your go-to guide for smarter biomimetic dentistry. https://youtu.be/WTsF1mD-nTo Watch PDP221 on Youtube Protrusive Dental Pearl: After applying silane, don't just let it evaporate—let it react for 30 seconds, then air dry, and crucially, use a heat source (like a hairdryer) for 60 seconds to activate it properly and achieve optimal bond strength. This enhances the effectiveness of silane and significantly improves the bond strength of indirect restorations like composite or lithium disilicate. Key Takeaways: Occlusal veneers can be as thin as 0.6 mm. Indirect composite is often a superior choice for restorations. Proper bonding protocols are crucial for successful restorations. Focusing on strengths rather than weaknesses is key in dentistry. Conservative approaches in dentistry can preserve tooth structure. The vital tooth is always preferable to a non-vital tooth. Composite resin has wear properties similar to enamel. Occlusal veneers provide excellent protection for compromised teeth. Porcelain veneers have long-term durability compared to composites. The evolution of composite materials has led to better options for restorations. Zirconia is strong but difficult to adjust and bond effectively. Immediate dentin sealing is crucial for successful bonding and patient comfort. The Dahl principle allows for minimal preparation in certain cases. Composites can be as effective as ceramics when used correctly. Understanding the properties of materials is essential for successful restorations. Thin occlusal veneers can be successfully bonded with proper techniques. Highlights of this episode: 0:00 Introduction 02:52 Protrusive Dental Pearl 04:42 Dr. Pascal Magne on His Current Focus 10:16 Understanding Cusp Coverage and Material Choices 15:48 Conservative Approaches in Dentistry 23:16 Unsupported Enamel: Can it Still be Reinforced? 28:05 Occlusal Veneers Indications 37:00 Material Selection: Composite vs Ceramic 01:24:42 Outro Referenced Studies - all below are available to download on Protrusive Vault in Protrusive Guidance Effect of immediate dentine sealing on the aging and fracture strength of lithium disilicate inlays and overlays  Short-fiber Reinforced MOD Restorations of Molars with Severely Undermined Cusps  Ultrathin CAD-CAM glass ceramic and composite resin occlusal veneers for the treatment of severe dental erosion  Strains in the marginal ridge during occlusal loading  Antagonist Enamel Wears More Than Ceramic Inlays  Outcomes of resin-bonded attachments for removable dental prostheses Performance of ceramic laminate veneers with immediate dentine sealing  Keep the learning going with Magne Education If you enjoyed this episode, don't miss A Geeky Discussion on Adhesive Onlays – that's PDP161! This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject Code: 250 OPERATIVE (RESTORATIVE)DENTISTRY (Indirect restorations) Aim: To provide clinicians with evidence-based guidance on occlusal veneer indications, material selection, and conservative restorative protocols—emphasizing the role of adhesive techniques and biomimetic prin...

  Join Elevated GP: www.theelevatedgp.com https://www.kokicheducation.com/about DOT - Use the Code DENTALDIGEST for 10% off Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram Connect with Melissa on Linkedin Jim McKee, DDS – Expert in TMD, Occlusion, and Comprehensive Dentistry   Dr. Jim McKee is a highly respected authority in the fields of temporomandibular joint disorders (TMD), occlusion, and restorative dentistry. With over three decades of clinical experience and a passion for teaching, Dr. McKee has dedicated his career to understanding and addressing the complexities of the masticatory system. His expertise has helped countless clinicians improve patient outcomes, particularly for those with challenging occlusal or TMJ-related issues. Educational Background and Clinical Practice   Dr. McKee earned his Doctor of Dental Surgery (DDS) degree from Loyola University School of Dentistry in Chicago. Following dental school, he focused on developing a comprehensive understanding of TMD, occlusion, and how these systems integrate with restorative and esthetic dentistry. Dr. McKee has maintained a private practice in Downers Grove, Illinois, for over 30 years. His practice focuses on treating patients with occlusal disorders, complex restorative cases, and TMD. His patient-centered approach combines advanced diagnostic techniques, individualized treatment planning, and a commitment to functional and esthetic excellence. Thought Leadership in TMD and Occlusion   Dr. McKee is internationally recognized for his deep understanding of the temporomandibular joint (TMJ) and its critical role in comprehensive dentistry. His work bridges the gap between TMD, occlusion, and restorative dentistry, providing clinicians with practical strategies to treat patients with: • Chronic facial pain. • TMJ dysfunction and joint instability. • Occlusal disharmony. • Complex restorative needs involving the entire masticatory system. He has developed innovative approaches to diagnosis and treatment planning, emphasizing the importance of collaboration between specialists and general practitioners to achieve optimal results. Teaching and Mentorship   Dr. McKee is a sought-after educator who lectures nationally and internationally on TMD, occlusion, and interdisciplinary dentistry. He is known for his clear, engaging teaching style and his ability to simplify complex topics, making them accessible for clinicians at all levels.   He serves as a faculty member and mentor for the prestigious Dawson Academy, where he trains dentists in comprehensive, patient-centered care. His courses focus on integrating occlusal concepts with restorative and esthetic dentistry while managing the functional health of the TMJ.   Dr. McKee is also a visiting faculty member at Spear Education in Scottsdale, Arizona, where he teaches advanced concepts in TMD, joint-based diagnosis, and interdisciplinary treatment planning.  

In this throwback episode Dr. Russell Schafer joins Kevin and Zach to talk about his second love in dentistry...pediatrics!  Key Topics & Discussion Points: Early Childhood Exams (Under 5): Importance of parent/caregiver relationship and communication. Lap-to-lap/Knee-to-knee exam technique. Focus on diet (sugar intake) and sleep (snoring). Identifying early signs of demineralization. Goal: Creating a safe dental home. Older Children (5-6 and up): Expectation of tolerating bitewing and PA radiographs. Addressing parent's anxieties and managing expectations. Importance of behavior management with both child and parent. Interproximal Decay: Varying treatment philosophies (aggressive vs. conservative). Stainless steel crowns vs. composite restorations. When to refer to a pediatric dentist. Pulpotomies: Different techniques and materials (Formocresol, Ferric Sulfate, MTA). Discussion on necrotic pulp and treatment options (extraction). Pulpotomies for diagnosis vs. therapy. Nitrous Oxide: Benefits of nitrous oxide for pediatric patients. Dosage and administration techniques. Anesthesia: Choice of anesthetic (Lidocaine vs. Septocaine). Techniques for minimizing discomfort during injections (e.g., shaking, "cold water" analogy). Importance of adequate anesthesia for procedures. Sealants: Concerns about over-prescription and improper technique. Discussion on the effectiveness of sealants. Alternative approach: Occlusal composites. Silver Diamine Fluoride (SDF): Use of SDF for caries management. SDF as a "time-buying" strategy. When to use SDF vs. restorative treatment. Very Clinical is brought to you by Zirc Dental Products, Inc., your trusted partner in dental efficiency and organization. The Very Clinical Corner segment features Kate Reinert, LDA, an experienced dental professional passionate about helping practices achieve clinical excellence.  Connect with Kate Reinert on LinkedIn: Kate Reinert, LDA  Book a call with Kate: Reserve a Call  Ready to upscale your team? Explore Zirc's solutions today: zirc.com  

Join Elevated GP: www.theelevatedgp.com https://www.kokicheducation.com/about DOT - Use the Code DENTALDIGEST for 10% off Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram Connect with Melissa on Linkedin Jim McKee, DDS – Expert in TMD, Occlusion, and Comprehensive Dentistry   Dr. Jim McKee is a highly respected authority in the fields of temporomandibular joint disorders (TMD), occlusion, and restorative dentistry. With over three decades of clinical experience and a passion for teaching, Dr. McKee has dedicated his career to understanding and addressing the complexities of the masticatory system. His expertise has helped countless clinicians improve patient outcomes, particularly for those with challenging occlusal or TMJ-related issues. Educational Background and Clinical Practice   Dr. McKee earned his Doctor of Dental Surgery (DDS) degree from Loyola University School of Dentistry in Chicago. Following dental school, he focused on developing a comprehensive understanding of TMD, occlusion, and how these systems integrate with restorative and esthetic dentistry. Dr. McKee has maintained a private practice in Downers Grove, Illinois, for over 30 years. His practice focuses on treating patients with occlusal disorders, complex restorative cases, and TMD. His patient-centered approach combines advanced diagnostic techniques, individualized treatment planning, and a commitment to functional and esthetic excellence. Thought Leadership in TMD and Occlusion   Dr. McKee is internationally recognized for his deep understanding of the temporomandibular joint (TMJ) and its critical role in comprehensive dentistry. His work bridges the gap between TMD, occlusion, and restorative dentistry, providing clinicians with practical strategies to treat patients with: • Chronic facial pain. • TMJ dysfunction and joint instability. • Occlusal disharmony. • Complex restorative needs involving the entire masticatory system. He has developed innovative approaches to diagnosis and treatment planning, emphasizing the importance of collaboration between specialists and general practitioners to achieve optimal results. Teaching and Mentorship   Dr. McKee is a sought-after educator who lectures nationally and internationally on TMD, occlusion, and interdisciplinary dentistry. He is known for his clear, engaging teaching style and his ability to simplify complex topics, making them accessible for clinicians at all levels.   He serves as a faculty member and mentor for the prestigious Dawson Academy, where he trains dentists in comprehensive, patient-centered care. His courses focus on integrating occlusal concepts with restorative and esthetic dentistry while managing the functional health of the TMJ.   Dr. McKee is also a visiting faculty member at Spear Education in Scottsdale, Arizona, where he teaches advanced concepts in TMD, joint-based diagnosis, and interdisciplinary treatment planning.  

Mohammed is joined by the one and only Dr. Jaz Gulati of the Protrusive Dental Podcast! Jaz is known for his occlusion credentials and Mohammed got to ask ALL his occlusion questions to perhaps the most enthusiastic occlusion educator I've ever heard! You aren't going to want to miss a second of this incredibly informative episode! Always check preop occlusion Articulating paper Centric relation Facebows...when do you use them? When you don't? And why! Can digital impressions/bite relations replace analog dentistry? Occlusal diagnosis and how it can affect single tooth dentistry. Did you find this stuff helpful? Check out the Protrusive Dental Podcast for more! Jaz used this interview as one of his episodes that you can see here!  Join the Very Dental Facebook group using the password "Timmerman," Hornbrook" or "McWethy," "Papa Randy" or "Lipscomb!" The Very Dental Podcast network is and will remain free to download. If you'd like to support the shows you love at Very Dental then show a little love to the people that support us! -- Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code “VERYDENTAL10” you'll get another 10% off your order! Go save yourself some money and support the show all at the same time! -- The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! -- Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! -- CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even  their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!

DOT - Use the Code DENTALDIGEST for 10% off https://www.oneplacecapital.com/ Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram Connect with Melissa on Linkedin   James Otten, DDS Bachelor of Science in Zoology & Minor in Microbiology University of Arkansas 1977 Doctor of Dental Surgery, University of Missouri-Kansas City School of Dentistry 1981 General Practice and Hospital Dentistry Residency-Certificate, Veterans Administration Medical Center in Leavenworth, Kansas 1982 Center for Advanced Dental Studies, St Petersburg FL, Completion of Curriculum in Advanced Restorative Care and the Evaluation, Diagnosis and Treatment of Occlusal and Temporomandibular Disorders 1989-1993 The Pankey Institute, Key Biscayne FL, Completion of Curriculum, Continuum I-VI plus Advanced Studies, 1991- present Piper Education and Research Center, St Petersburg FL, Seminars I-III, Advanced Diagnosis, Management and Treatment of TM Disorders, 1994-2013 Other: Compiled over 3500 hours of Continuing Education in the study of Occlusion, TM Disorders, Facial Pain, Esthetics, Invisalign Certification, Implant and Prosthodontic Restorative care. Associate Professor Prosthodontics University of Missouri-Kansas City School of Dentistry 1982-83 Fellow, American College of Dentists Visiting Faculty, L.D. Pankey Institute -1996-current Visiting Faculty, Newport Coast Orofacial Institute, Newport Beach CA 2010- present L.D. Pankey Institute – Associate/Lead Faculty 1999 – current Provost, L.D. Pankey Institute 2005 -2012 L.D. Pankey Institute Board of Directors/Advisors 2005 – current Medical Staff Lawrence Memorial Hospital Department of Surgery-current Private Practice Lawrence Kansas 1984 – present   Drew McDonald, DDS, MS Dr. McDonald attended dental school at the prestigious Creighton University in Omaha, Nebraska. Known for it's rigorous academic curriculum and intense clinical training, Dr. McDonald received many academic accolades while at Creighton including inductions into Omicron Kappa Upsilon (National Dental Honor Society) and Alpha Sigma Nu (Honor Society of Jesuit Universities). He also served in leadership positions as class president and student body president and on alumni relations committees. After graduating Cum Laude from Creighton, Dr. McDonald was accepted as one of only three residents nationwide into the University of Missouri-Kansas City Orthodontics program, a renowned two-and-a-half year, full-time residency known for its clinical excellence. Dr. McDonald graduated in December of 2016 with his certificate in orthodontics and master's degree in Oral and Craniofacial Sciences. When away from the office, Dr. Drew is a “girl-Dad” to two daughters, a self-proclaimed grill master, and minimally talented yet enthusiastic golfer, you can find him taking in a Lobo game, and spending time outdoors with his family.

DOT - Use the Code DENTALDIGEST for 10% off https://www.oneplacecapital.com/ Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram Connect with Melissa on Linkedin   James Otten, DDS Bachelor of Science in Zoology & Minor in Microbiology University of Arkansas 1977 Doctor of Dental Surgery, University of Missouri-Kansas City School of Dentistry 1981 General Practice and Hospital Dentistry Residency-Certificate, Veterans Administration Medical Center in Leavenworth, Kansas 1982 Center for Advanced Dental Studies, St Petersburg FL, Completion of Curriculum in Advanced Restorative Care and the Evaluation, Diagnosis and Treatment of Occlusal and Temporomandibular Disorders 1989-1993 The Pankey Institute, Key Biscayne FL, Completion of Curriculum, Continuum I-VI plus Advanced Studies, 1991- present Piper Education and Research Center, St Petersburg FL, Seminars I-III, Advanced Diagnosis, Management and Treatment of TM Disorders, 1994-2013 Other: Compiled over 3500 hours of Continuing Education in the study of Occlusion, TM Disorders, Facial Pain, Esthetics, Invisalign Certification, Implant and Prosthodontic Restorative care. Associate Professor Prosthodontics University of Missouri-Kansas City School of Dentistry 1982-83 Fellow, American College of Dentists Visiting Faculty, L.D. Pankey Institute -1996-current Visiting Faculty, Newport Coast Orofacial Institute, Newport Beach CA 2010- present L.D. Pankey Institute – Associate/Lead Faculty 1999 – current Provost, L.D. Pankey Institute 2005 -2012 L.D. Pankey Institute Board of Directors/Advisors 2005 – current Medical Staff Lawrence Memorial Hospital Department of Surgery-current Private Practice Lawrence Kansas 1984 – present   Drew McDonald, DDS, MS Dr. McDonald attended dental school at the prestigious Creighton University in Omaha, Nebraska. Known for it's rigorous academic curriculum and intense clinical training, Dr. McDonald received many academic accolades while at Creighton including inductions into Omicron Kappa Upsilon (National Dental Honor Society) and Alpha Sigma Nu (Honor Society of Jesuit Universities). He also served in leadership positions as class president and student body president and on alumni relations committees. After graduating Cum Laude from Creighton, Dr. McDonald was accepted as one of only three residents nationwide into the University of Missouri-Kansas City Orthodontics program, a renowned two-and-a-half year, full-time residency known for its clinical excellence. Dr. McDonald graduated in December of 2016 with his certificate in orthodontics and master's degree in Oral and Craniofacial Sciences. When away from the office, Dr. Drew is a “girl-Dad” to two daughters, a self-proclaimed grill master, and minimally talented yet enthusiastic golfer, you can find him taking in a Lobo game, and spending time outdoors with his family.

Ever heard of fremitus? Wondering what it really means for your patient's occlusion? In this episode we're joined again by Dr. Mahmoud Ibrahim, by popular demand, for an insightful discussion on dental fremitus. We understand that this topic can be a bit perplexing, so we're here to break it down step by step. https://youtu.be/LFZ4Uh0Y8sI Watch PDP160 on Youtube We share how we seamlessly integrate a fremitus check into an occlusal assessment, discussing the crucial aspects of when and how to intervene effectively, all while preserving your patient's chewing space. Check out our upcoming webinar “Unchippable” to learn about how to prevent chips and breaks on your lovely anterior composite restorations – protrusive.co.uk/unchippable 'Weakest Link' study that Jaz and Mahmoud referred to: https://www.tandfonline.com/doi/abs/10.1080/08869634.2000.11746142 The Awake Bruxism (habit breaking) appliance that Jaz uses called MAPA. More about Fremitus, how it's classified and occlusal trauma. Follow Dr. Ibrahim on Instagram @drmoidental Want to learn more about Occlusion? Head over to occlusion.online. Need to Read it? Check out the Full Episode Transcript below! Highlights of the episode:00:00 Intro00:39 The Protrusive Dental Pearl04:17 Dr. Mahmoud Ibrahim05:17 Mobility vs fremitus08:26 What is fremitus?09:52 The PDL12:54 The weakest link theory16:21 Checking for fremitus17:19 Class 1 fremitus21:57 Class 2 and 3 fremitus23:03 Treatment27:24 Envelope of function29:21 Orthodontic treatment36:34 Final remarks39:44 Outro If you liked this episode, you will also like PDP150 - Occlusion on Class IV Composite Restorations 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: Fremitus is this strange thing when your patient bites together and you feel, or you see a tooth move out of the way, classically a front tooth, right? It's a sign of Occlusal Overload. And in this episode, we're going to talk everything related to Fremitus with my good friend, Dr. Mahmoud Ibrahim. Jaz's Introduction:Hello, Protruserati. I'm Jaz Gulati, and welcome back to another Protrusive Dental Podcast episode. If you're new to the podcast, welcome. Thanks so much for joining us. And if you're a veteran Protruserati, thanks for coming time and time again. We hope to make complex topics in dentistry tangible for you. Protrusive Dental PearlBefore we join the main interview with Dr. Mahmoud Ibrahim, I'm going to give you the Protrusive Dental Pearl, which I always do for every main PDP episode. Today's Protrusive Pearl relates to cramp operations, and in particular, getting better impressions or scans. Look, once you've placed the retraction cord, and I know many people like to use things like Expasyl or Traxodent, which are like the pace systems. I quite like using retraction chords and also in combination with PTFE tape, especially as I do lots of vertical preparations or VertiPreps. Now I have got lots of webinars planned in October. As part of the live series I'm doing for the Protruserati, the premium subscribers, it's going to be VertiPrep for Plonkers. So that's coming soon. And one of the strategies I use to be able to scan subgingivally is once I've got my triple zero cord in place, I will put some PTFE tape over that. But sometimes what can happen is that the gingiva it sulks, right? It sulks on to the PTFE and sometimes even contacts the prep. So when I scan it because the tissues because the gums are touching the preparation it creates a nightmare scenario for my technician who wants that gingiva well out of the way So at that point the pearl the tip i'm giving you is if you've got a laser, fine. Great. Use a laser. If you've got any fancy burrs, use them. But the cheapest thing you can buy is something called a Thermocut Bur.

Join me for a summary looking at impacted teeth and key components of timing which affect not only the success of alignment, but also root formation. This podcast also explores the occurrence of asymmetries of both dental and facial due to impacted teeth, and what can be done about it. This podcast is a summary of the AAO lecture by Stella Chaushu and Adrian Becker. Timing Role of timing to the impacted tooth, the adjacent teeth and alveolar and skeletal growth. Implications of timing on impacted teeth: Eruptive potential Root development 1/ Eruptive potential and timing Interceptive treatment Ideal time for spontaneous eruption is ½ to 2/3 of final root length. Orthodontic traction: Ideal time for active (orthodontic traction) eruption is 2/3 to ¾  final root length. Principle: Peak of eruptive potential is at 2/3  to ¾ of final root length Root completed within 2.5 to 3 yrs post eruption Timing of impacted maxillary canine interceptive treatment Dental age of 9-10 years Interceptive treatment includes: extraction C, D, distalisation molars, RME Prognosis of treatment of impacted canines is uncertain and reduces with age. Ideal early adolescence Timing of impacted maxillary incisor interceptive treatment Before age of eruption 7-8 years Likely spontaneous eruption, but risk of damage to permanent incisor in surgery After age of eruption  > 8 years Spontaneous eruption not predictable, likely require active (orthodontic traction) Interceptive treatment  Removal of obstruction, spontaneous eruption 36-75%  Removal of obstruction + space creation spontaneous eruption 82-89%  (Sun et al AJODO 2006) Root development Impacted incisor due to obstruction – ideal time =7-8 yrs  Dilacerated upper incisors – ideal time – at ½ root or less = 6-7 yrs, as removal of root proximity to the anatomical barrier can reduce the dilaceration of the forming root Timing of impacted premolar interceptive treatment What to do when premolar root formation has not occurred in adolescent patient If apex is open = root formation occurring Timing of obstruction management Removal: As early as possible Orthodontic traction: Delay until bony infil, otherwise loss of gingivla and alveolar supoort 2/ Root development  Canine root development Hooked apex 3-4 times more likely with impacted canines Shorter root impacted incisor 2.3mm shorter root Sun 2016, Impacted canine 2.3mm shorter roo Cao 2021 Total volume unaffected (length + hook) Prevalence and severity of dilaceration increase with age until apex closed Dilacerated root respond to traction/ Yes but increased treatment difficulty and duration , example of 2 years Arrested root development Can arrested root development be reversed?  If root abuts with an anatomical barrier. Such as nasal floor, it is the cause of the arrested development  Orthodontic traction and movement away from the barrier = continued root development Early exposure and orthodontic traction Implication of impacted tooth and asymmetry Impacted tooth can affect alveolar and skeletal growth Cases with asymmetry significantly higher in impacted group. Asymmetry index 27% Vs 3.4% Chin asymmetry 52% Vs 14% Occlusal cant 38% Vs 10% Timing of treatment,  if delayed = occlusal cant increased with age. After treatment, asymmetry can persist = treat as early as possible to limit asymmetry (managing impaction will not correct asymmetry)

If you are interested in full mouth reconstruction and would like to join like minded people and learn about full mouth reconstruction, then don't forget to join my Facebook group called ‘Full Mouth Reconstruction for GDPs'https://www.facebook.com/groups/fullmouthreconstructionforgdpsIf you have any questions then do not hesitate to contact me via email at info@drdevangpatel.com or reach out to me on social media via Facebook, Instagram or LinkedIn.           I hope you enjoy this episode.

Occlusal appliances are commonly prescribed for the management of Bruxism - but they might be doing more harm than good if you have not screened for an airway issue. Dr. Aditi Desai discussed the link between airway and bruxism- could an airway problem cause bruxism? Why is it advised NOT to have a standard occlusal appliance if there is an airway issue? Did you know there are three levels of diagnosis for Sleep Bruxism? The 'Possible' Bruxist, the 'Probable' Bruxist and the 'Definite' Bruxist - in this episode Dr. Aditi Desai who also featured in PDP 139 on sleep disordered breathing and sleep apnea, will explain this and when it may be relevant to sleep apnoea. https://youtu.be/DozqYGEPNxY Watch PDP149 on Youtube The Protrusive Dental Pearl: Parafunctional Screening Sheet - A simple PDF that you can look for in terms of your extra-oral examination, intra-oral examination and the history - to give a clue that a patient might be a bruxist in just 2 minutes - download below: Parafunctional-ScreenDownload Download and Sign in to the Protrusive App on iOS and Android and head over to the freemium version of this episode and on The Protrusive Vault for those Protrusive Premium members (where you can get full CE or CPD Certificate by answering a few questions) Highlights of this episode 5:21 The Protrusive Dental Pearl6:28 Dr. Aditi Desai's Introduction9:17 Airway in Dentistry12:49 Lack of studies with regards to diagnosing sleep bruxism16:32 Signs to look for to a possible bruxist and how to communicate with them27:01 Nomenclature of sleep bruxism30:51 Learning points to assess airway35:43 Cases that caused the patient to become apnoeic Get in touch for different Board of Sleep Medicine: UK: British Academy of Dental Sleep Medicine (BADSM)USA: American Academy of Dental Sleep Medicine (AADSM)Australia: Australian Academy of Dental Sleep Medicine If you enjoyed this episode, you may also like Airway – Dentistry's Elephant in the Room with Prof Ama Johal

LIMITED DELEGATE SPOTS AVAILABLE NOW! Occlusion Online Course As we launch OBAB, Occlusion Basics and Beyond in today's episode, Dr. Mahmoud Ibrahim and I talked about our philosophy of occlusion. For us, the application of occlusion results in longevity, predictability and stopping your $#*7 from breaking. We are excited to share with you what we have learned over the years - in a way that you have never seen before! https://youtu.be/5vHKt3kUJ84 Click here to watch our Dots and Lines music video OBAB was developed to break down this seemingly complex topic in an understandable way that you can easily implement in daily practice in the real world. Occlusion: Basics and Beyond is the most tangible, real-world, and comprehensive occlusion training on the planet. But don't take our word for it: https://youtu.be/cFPTY0hfOtY Check out what our delegates had to say about OBAB Visit occlusion.online to learn more about the course and get the One-Time Pre-Launch Deal before 21st March to get £500 off enrolment and early bird access on April 7th. Plus get £1445 of exclusive extras!!! Highlights of this episode: 4:00 What is Philosophy of Occlusion?5:12 Dr. Mahmoud on his experience with occlusion7:02 Different schools of thought regarding Occlusion13:00 Importance of Occlusion22:23 Possible failures doing restorative work without conforming to occlusion25:13 Occlusion: Basics and Beyond

I will reveal a little 'trick' that might 'recapture the bite' on a patient who develops an anterior open bite (AOB) after wearing a nightguard/splint/occlusal appliance. There is a degree of risk and uncertainty when we prescribe occusal appliances as it hinges on patient compliance and factors that are out of our control. There are certain risks that come with treatment that we should consent for, and this includes bite changes. Occlusal appliances are not an exact science - the evidence base is not high quality. That does not mean they do not work, it just means that we need more data! We don't even know the mechanism of HOW occlusal splints work as that is yet to be proven. Hello Protruserati! Welcome back to the third episode of #AskJaz where I answered three main questions from our Protrusive Dental Community - 1) developing anterior open bite after an occlusal appliance, 2) how to scan/bite register at a desired OVD, and 3) what should the occlusion look like on composite veneers or edge bonding? https://youtu.be/Li2W-ysYRIE 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 Dr. Mahmoud Ibrahim and I are currently working on a huge project called OBAB, Occlusion Basics, and Beyond – it will be the best occlusion resource in the Milky Way…and that's our mission! We want to finally demystify Occlusion and make it Tangible AF! Join the waiting list HERE! Highlights of this episode: 1:51 Risk of having AOB after an Occlusal Appliance15:48 Trick to recover an AOB that has developed26:49 Bite Records for Stabilisation Splints30:25 Checking the Occlusion after Composite Veneers37:02 Occlusion Basics and Beyond Do join our Protrusive Dental Community Facebook Group. It has so many great gems and pearls shared in our little community - ONLY FOR LICENSED DENTAL PROFESSIONALS. If you enjoyed this episode, check out this episode with Dr. Barry Glassman - Do AMPSAs cause AOBs?

Join me for a topic summary looking at anterior openbites from the AAO. This summary looks at the differences in key diagnostic criteria, the options for treatment planning, and the evidence to support time. The summary is taken from Roberto Carrillo, Flavia Artese and Ravi Nanda's lectures. Separate treatment plan: · treatment of the aetiology · Treatment of mechanics Aetiology Tongue posture / thrust or mouth breathing, alter equilibrium of AP and vertical tooth position. · Tongue posture / thrust o Forwards position, not thrust / swallowing, as low intensity and duration o Different positions of tongue being forwards, results in different presentations of AOB, high = proclined uppers, horizontal bi-proclination, low procline lowers o See previous podcast on Flavia Artese in her Power2Reason lecture · Mouth breathing o Mouth breathing in itself is not considered factor for Tonsillectomy AAO-HNS guideline Treatment Extend of AOB does not determine treatment, Facial type and extent of AOB poor correlation r=0.2 Duplat 2016 o · Habit dissuader crib or spurs: o High tongue block tongue o Low tongue block and redirect o Removable – Aligner with lingual attachments, poke probe through and becomes uncomfortable · Adults like as removable, bonded is difficult to accept Voudouris 2022 o Cribs and spurs- relapse 17% Huang 1990 § Effective reduction in tongue forces and position at 1 year Taslan 2010 · Myofunctional therapy o Speech and language therapy – relapse 4% Smithpeter 2010 · Dental: o Incisor extrusion - relapse 38% Janson 2003 o Molar intrusion - relapse 27% Espinosa 2020 o Extractions – relapse 25% Janson 2006 · Skeletal: o Surgery – relapse 25% Greenlee 2011 Posterior intrusion · Screws / plates = depends on anatomical limitations Skeletal anchorage with aligners · Ct approach = C cuts and T-triangular elastics · C-cuts – through OCCLUSAL and buccal surface to prevent deflection premolar to molar · Pre-load elastics and then insert into the patients mouth · Posterior intrusion Lecture titles from AAO 2022 Key factors for vertical control with clear aligners Roberto Carrillo Game changers in open bite treatment – Dr Flavia Artese Biomechanic & Esthethic based management of open bite - Dr Ravi Nanda

When is Botox an appropriate option for the management of Temporomandibular Disorders? Knowing this will help you make better referrals, or even consider Botox as a management strategy. Dr. Sheila Li guides us on the use of Botox/Toxins for TMD pain management. We discuss indications, protocols and regulatory requirements (which surprised me!) - as well as learning if these patients will now require Botox indefinitely...? https://youtu.be/QJyxF0EGwsM Check out this full episode on YouTube Protrusive Dental Pearl: How do you routinely check the masseters and the temporalis at your new patient examination? As a restorative dentist, the most important thing I want to know (and what will influence the occlusal risk for my patient) is the size of the masseters. Start palpating and feeling for the size of the masseters to understand how much force these patients can generate! If you want to learn more, join the Facebook Group: Protrusive Dental Community because I'll be doing a little blog post on that about the significance of masseter size on Occlusal risk. Highlights of this episode: 2:50 Checking Masseters and Temporalis13:34 Dr. Sheila's journey in managing TMD pain patients16:13 Ideal case selection for Botox regarding TMD21:15 Botox as a standalone vs Botox as an adjunct to splint therapy24:26 Patient communication about the frequency of Botox treatment26:39 Place of Botox for myofascial pain patients30:01 Additional indemnity for GDPs in doing Botox33:31 Functional Perspective of Botox34:47 Success rates in using Botox for TMD pain management39:53 Experience of having Botox41:55 Long-term side effects of Botox Learn more about Botox with Dr. Sheila Li on her functional toxin course just for dentists to treat functional elements!  Want to level up occlusal appliance therapy and TMD management? Check out SplintCourse for a comprehensive online course. If you enjoyed this episode, do check out TMD Full Exam with ‘The TMJ Doc' Dr. Priya Mistry 

  Dental Marketing with Legwork Podcast Website Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram Connect with Melissa on Linkedin Dental Digest Podcast Facebook Youtube channel  Dr. DeWood is Executive Vice President of Spear Education. As one of the founding members of Spear, he directed Curriculum and Clinical Education for nearly a decade prior to joining in the launch of Spear Practice Solutions. Today, he splits time between teaching and consulting. Dr. DeWood serves as an instructor in multiple Spear Workshops, including Facially Generated Treatment Planning, Occlusion in Clinical Practice, Advanced Occlusion, Sleep Medicine in the Dental Practice and a special focus workshop on temporomandibular disorder. He also maintains a limited private practice on the Spear Campus in Scottsdale, Arizona, and lectures nationally and internationally on practice management, treatment planning, case management, case acceptance, TMD diagnosis, appliance therapy, occlusion, and esthetics. Prior to his contributions at Spear, Dr. DeWood maintained a private restorative general practice with his wife and fellow Spear Resident Faculty member, Dr. Cheryl DeWood, in Pemberville, Ohio, before dedicating most of his time to teaching full time. With 40 years in general dentistry, he provides a unique perspective to the application of the dental principles taught at Spear. He has spent years focused on diagnosing and treating functional occlusal problems and TMD, and as part of that focus completed the craniofacial pain mini-residency at the University of Florida College of Dentistry in the early 1990s. Dr. DeWood served as clinical director at The Pankey Institute from 2003 to 2008. He has held appointments as associate professor at the University of Tennessee College of Dentistry and assistant professor at the University of Toledo College of Medicine. He earned his D.D.S. from Case Western Reserve University in 1980 and an M.S. degree in biomedical sciences from the University of Toledo College of Medicine in 2004.  

Dental Marketing with Legwork Podcast Website Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram Connect with Melissa on Linkedin Dental Digest Podcast Facebook Youtube channel  Dr. Gunson is a board certified oral maxillofacial surgeon, resident faculty at spear education and lectures nationally and internationally on topics related to orthognathic surgery, OSA and facial esthetics

Join me for a summary of early treatment lectures from this years AAO meeting from May 2022. Topics will cover trauma, airway diagnosis and orthodontic treatment, and optimal timing of class 2 correction Lectures: Dental Trauma Eustaquio A. Araujo Airway-centered Orthodontic Diagnosis & Treatment for Pediatric Patients Hong He Predictors of Success for Early Mixed Dentition Treatment Heesoo Oh Dental Trauma Eustaquio A. Araujo Trauma protocol Reposition with firm grip 16x22NT Bite props to eliminate occlusal interference Soft diet Recall 2 weeks Re-implantation of avulsion success Less than 1hour 75% Up to 24 hours 25% Conclusion – look at the neighbours Airway-centered Orthodontic Diagnosis & Treatment for Pediatric Patients Hong He Nasal breathing Vs mouth breathing NB = Tongue rests on the palate. MB = Tongue floor of the mouth NB = Pressure of the cheeks is balanced with the tongue. MB Pressure of the cheeks is unopposed by tongue NB = U shape upper arch (normal). MB = V shaped arch Tonsillar hypertrophy Oropharynx obstruction Ventilation impaired Occlusal effects Tongue and mandible forwards Iwasaki 2017 Mandibular protrusion Class 3 malocclusion He's study n=1776 Greater tonsillar hypertrophy in children with class 3 Caution as limited studies pre-pubertal and controls also improved in scores Predictors of Success for Early Mixed Dentition Treatment Heesoo Oh When is it best to treat class 2 cases Study: optimal timing of the effectiveness and efficiency Early class 2 equally effective not as efficient BUT Mean changes = mask individual response Philosophy – correct some / all features of malocclusion Reduce / eliminate need for phase 2 Angle orthodontist Oh 2017 Treatment protocol 7-9 years Headgear night wear 11 hours RME 2 x 4 fixed appliances Lingual arch Greater 33 months = unsuccessful (time only marker of success, as occlusal and skeletal the same at the end) Results 15/54 (28%) phase 1 only Comparison No differences in occlusal and skeletal outcomes Time Total treatment times (phase 1 + phase 2): 67% less than 18 months in treatment active treatment 20% 4-5 years of total treatment time

Global Diagnosis Education Study Club Dental Marketing with Legwork Podcast Website Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram Connect with Melissa on Linkedin Dental Digest Podcast Facebook Today we'll be talking about the topic that can really feel like the big black box and that would be occlusion, how it can go wrong, our misconceptions as a profession and the tempromandibular joint.   My guest this week is Dr. James Otten. He's lectured nationally and internationally. He's a former visiting faculty member at the pankey institute and currently visiting faculty at spear education. He's a an active member of the American Academy of Restorative Dentistry. Finally, he and Dr. Bill Robbins co-founded the global diagnosis education study club.  

What happens when conservative care fails? What if you have prescribed patient education and the 'best' occlusal appliance and none of it is working? That's where surgery MAY be indicated for certain diagnoses. Listen or Watch my podcast with Professor Andrew Sidebottom Maxillofacial surgeon (who is limited to the management of TMJDs) to help us make timely and appropriate referrals to provide the best possible outcome for our patients. https://youtu.be/7m30jvUPlMA Need to Read it? Check out the Full Episode Transcript below! Ready to learn the management of Bruxism and TMD online? Click here to enrol to SplintCourse Protrusive Dental Pearl: Head over to the Protrusive Dental Community Facebook group where I posted an 8-minute walk-through video on how to screen which patients are at risk for getting a bite change or AOB after an occlusal appliance and how you can minimize that risk. The highlights of this episode: 12:47 Why you need to provide Conservative Care first15:57 TMD is a Spectrum19:21 Early Surgical Intervention?21:42 Acute disc displacement without reduction26:40 Imaging used when managing TMD patients35:10 Pain Management41:03 Arthroscopic procedure for TMD50:29 How much does TMJ Surgery cost in the UK?53:22 Successful management of temporomandibular disorders Check out these studies as mentioned on the podcast. Orofacial Pain Prospective Evaluation and Risk Assessment StudyDownload A Real-Time screening tool to aid management of Post-Traumatic Stress Disorder in facial traumaDownload Temporomandibular-joints-in-asymptomatic-and-symptomatic-nonpatient-volunteers-prospective-15-year-follow-up-clinical-and-MR-imaging-studyDownload Also check out Prof. Andrew Sidebottom's website for more information and download leaflets. Check out the Tubules Congress in Heathrow October 2022 If you enjoyed this episode, check out Stay away from TMD! [SPLINTEMBER]  Click below for full episode transcript: Opening Snippet: So I think understanding TMD is about understanding that it's a spectrum of care from joint related right down to muscular related, and patients are somewhere in the middle of that. Probably about 90% of the patients I see down at that muscular end as you say. Jaz's Introduction:What happens to our TMD patients when conservative care fails? Like you've done your patient education, you've given him the best occlusal appliance, you've worked alongside your TMJ physiotherapist, you've been through exercises, and you've even counseled them about the importance of recognizing awake bruxism, a huge player, and all this stuff isn't working. What happens next? Well, depending on your diagnosis, the next step for some patients will be see a maxillofacial surgeon, but not any old maxillofacial surgeon, you ideally want to send someone who's got an interest in TMJ and TMD. So I've got today a private physician, private maxillofacial surgeon in the UK, who exclusively treats TMD. So what this guy doesn't know about surgery and TMJ. And what happens in the latter parts once conservative care fails, how the referrals manage, when should we refer these patients, which patients are suitable for referral to Maxfax, once conservative care fails. Let me give you a clue, if your primary diagnosis is muscular, then really, you know, really need to go and exhaust conservative care and the physio and by the way, most TMDS are of a muscular nature that myalgia and myofascial pain and there's no real scope for surgery when it comes to muscles that are upset. That's when we really to give the best conservative care we can and involve a pain specialist sometimes potentially Botox and lots more which we will discuss. Now if you want to learn more about occlusal appliances, bruxism as a GDP as a restorative dentists who wants to just not be afraid of doing a TMJ exam when the patient comes into an emergency slot and they're complaining of pain from their jaw,

In this episode of the Postural Restoration Podcast I welcome Torin Berge, PT, MPT, PRC who practices at the Hruska Clinic and plays a vital role in the PRIME Program. Growing up Torin spent countless hours in a Pediatric PT setting with his brother who diagnosed with Cerebral Palsy was in and out of therapy frequently. It was during this time that his love for the profession grew. Torin graduated from the University of North Dakota in 1999 with his Masters in Physical Therapy. Torin was also an avid swimmer and swam throughout college and his entire childhood. Although he appreciates the foundation received in schooling he acknowledges that he was introduced to many "whats" but never really received the "whys" behind the symptoms or diagnosis studied.To start his career Torin provided care across pediatric clinics, and across both outpatient and acute hospital settings, but he quickly realized there had to be something more, a piece still missing. Torin was led to the PRI coursework through the community in Souix City, including Jane Stanley who got him to his first Protonics course. During which he heard someone discussing the relationship between the lower extremities and the cervical spine for the first time. Even though much of the science was still new at the time, Torin knew that there would be more to come, and slowly the "whys" behind all of his questions started being addressed. During these early years of coursework Torin began incorporating the science within his practice, but like many, continued to hit roadblocks along the way. The inability to incorporate PRI into his clinical setting helped him make the decision to look elsewhere. In 2011, Torin joined the Hruska Clinic in Lincoln, Nebraska and has been growing ever since. Shortly after accepting this position and moving his family, Torin became credentialed as part of the 2012 PRC Class. The timing of Torin's presence here coincided with a time period of tremendous growth within the Integration of PRI concepts. Not only was he surrounded with great colleagues who had been using PRI for decades, but he was now also a part of integrating with Optometrists, Dentists and Podiatrists on a regular basis. PRI Vision underwent its foundational years with his involvement, and the incorporation of dental integration was being explored like never before. These were the early days of integration, "pre-PRIME", and the level of exploration, integration, and evolving treatments, were at an all time high. As time went on, similar patterns of patient care became apparent. Patients came from international places because no other provider could find the "why" behind their "what" problem. The pieces of these patients' puzzles were not being put together, and even when each piece of dysfunction had been appropriately managed, they still failed to manage the  integration long term. Out of these years, working alongside Ron Hruska and the entire integrative team, the Postural Restoration Institute Multidisciplinary Engagement (PRIME) Program was founded. It too continued to evolve over the years and has remained a focal point of the PRI community when looking for models of integrative care. Today Torin and his team work not only with extremely hard to manage cases, but also with other PRI Providers, to provide guidance, support and treatment for patients and their providers they may already be working with. Through PRIME the pieces of the Podal, Occlusal, Visual and multiple other systems are put together and continuously managed by Torin and his colleagues, "The Integrators".

Episode 4 featuring the host of the Occlusal Table Podcast, Student Dr. Taylor Jackson, 4th-year dental student at Meharry Medical College. In this collaborative episode, we discuss our dental school experiences, common misconceptions about dentistry, and proven ways to succeed in our field.

It's the ultimate question: Which is the best Occlusal Camp/Training? Is there really a difference between Occlusal religions? Is Kois better than Spear and Dawson? Do you really need to study each one of them? Hear what Dr Bobby Supple says about the 'Occlusion Wars'! https://youtu.be/tlhrBcodzbA Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: Check the Video on How to successfully give lower first molar anesthesia using buccal articaine (without an inferior alveolar nerve block) https://youtu.be/cCXacw5DE4M “So, as it kind of turned out, they were all the same, except for neuromuscular. Neuromuscular was the odd one out." Dr Bobby Supple In  this episode, we discuss about History of Occlusion 14:35True Meaning of Anterior Guidance 17:04Bio-Aesthetics Group 22:015Different Occlusal Religions 27:31Equilibration 41:19Airway and TMD 51:12Differences between Occlusal Camps 52:09 If you enjoyed this episode, you will love Myth Busting Occlusion and TMJ Click below for full episode transcript: Opening Snippet: (Jaz) I think you said that when it comes to the Spear group, Kois and Dawson, what I think what you're trying to say is really they're not too different. They're just arguing a little bit about slightly different ways to fix the problem. Would you say there's any more nuances or differences that perhaps we didn't go into that is well worth mentioning between those religions? (Bobby) So, as it kind of turned out, then they were all the same, except for neuromuscular. Neuromuscular was the odd one out... Jaz' Introduction: Hello, Protruserati. I'm Jaz Gulati and welcome to Occlusion Wars episode 99 with Dr. Bobby Supple. This episode was inspired by a blog post I saw Dr. Bobby Supple right in his website. And it was about the differences between the different occlusal camps or these occlusal religions. Hencewhy the name occlusion wars because the most common questions I get is Jaz, What should I do? Should I study with Dawson? Or should I study with Pankey or Should I study with Kois or Spear and neuromuscular? So there's a lot of these occlusal religions and that's what we call them throughout this episode, you know, tongue in cheek kind of thing. And which one is the best one, which is the correct religion. That's what we're hoping to answer in this episode. And the main question I asked Dr. Bobby Supple was exactly that. And really, I don't want to give too much away from this episode. But one thing to consider is that the end goal of no matter who you train with, whether it is Spear or Pankey, Kois whoever. You will do wonderful dentistry, you will do it for the benefit of the patient, you will have more fun as a comprehensive dentist. So whoever you train with, just do everything they say and do it properly and follow that system. But don't be afraid to expose yourself to other ways of thinking because essentially, what these religions, these occlusal religions argue about is the processes. How do you get from A to B, the B is the same, A is the same. A is your patient. B is a stable position, whereas a better smile, a nice comfortable bite, all those things, right? So A and B are the same. What we're fighting about is everything in the middle. And that really doesn't matter. We should be outcome based ie a longevity in our restorations, happy patients. And I think all those whose religions deliver exactly that. That's one of the sentiments that Dr. Bobby Supple passed on. I just want to echo that. Now if you want to really skip to that bit. It's probably somewhere in the middle to the end of the episode where we really get to nitty gritty. We start off in this episode, discussing the origin story. I mean, origin stories always really powerful of these clinicians that we speak to Dr. Bobby Supple has so much experience to share. So we learn about his origin story,

This episode will review the primary dentition characteristics and functional significance. Occlusal classification of the primary dentition will be discussed. Clinical considerations of character traits related to form and function will also be reviewed. Take a look at a recent product I tried and recommend. BRIO https://bit.ly/thehappyflosser Promo Code: HAPPYFLOSSER --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/billie43/message

Intro Today, I welcome Dr. Jaz Gulati, host of the Protrusive Dental Podcast. He is a general dentist who has privately practiced in Singapore and now, the UK. In his practice, he especially enjoys ortho restorative dentistry and conservative Temporomandibular Joint Disorders (TMD) management. For the third episode in the Noobie and Friends series, we talk about TMD, bruxism, and occlusal appliances. Dr. Jaz shares his splints decision making workflow as well as tips for how to develop consistent manual dexterity and how to find a healthy work life balance.   Guest Details Social Media: Jaz Gulati's Instagram Protrusive Dental Podcast Splints Decision Making Flow Chart Use the code NOOBIE to get 10% off at https://www.splintcourse.com/referral/partner/WmPeiLbcoUawadjK Time Stamps [00:05:14] Dr. Jaz's origin story [00:09:06] The Protrusive Dental Podcast [00:11:58] Now is the best time to be a dentist [00:16:20] Finding work life balance [00:21:48] Don't compare, learning takes time  [00:24:47] How to develop consistent dexterity and hand skills [00:29:43] Reflective learning through journaling [00:33:19] Coping with a bad procedure [00:35:17] Effective teamwork with your dental nurse  [00:39:05] Differentiating TMD patients [00:45:38] Splints decision making process [00:50:01] Michigan Splints [00:51:05] Science based prescription of splints  [00:52:22] Canine guidance in occlusal splints [00:54:11] Recap of splint decision making [00:56:23] Is the anterior midpoint stop appliance for daily wear? [01:01:24] Dr. Jaz's online splint course  [01:03:54] Adjust soft splints with Dr. Jaz's expert tip     Podcast Details As always, if you enjoyed listening to the Noobie Dentist Podcast, please pass the podcast along to your friends, classmates and colleagues. If you haven't already, head over to iTunes and give the show a 5-star rating and if you have some time, leave a review! The Noobie Dentist podcast is now available on Spotify, YouTube, noobiedentist.com, the Apple podcast app, Stitcher and any other podcast apps out there!   Website: http://www.noobiedentist.com Instagram: @noobiedentist Sponsor Details   MoreDent is driving the charge forward in integrated digital dentistry by providing world class education, equipment, products, solutions, and support to thousands of practices. Their goal is simple: to enhance clinical and patient outcomes so that dentists and patients alike can enjoy the highest possible level of success.     To find out more, visit  www.moredent.com.au   Conclusion What new things did you learn about occlusal splints and TMD? Did you find Jaz's tips useful? We would love to hear your thoughts!    Remember to subscribe for more content!  

"Wait, Dentists still carry out Equilibration?!", that was the reply in our recent discussion on the Protrusive Telegram group when I announced this episode. Yes, Saranga, they still do! The topic of occlusal equilibration is a very controversial one. In this episode you'll realise the WHY and HOW an equilibration is carried out by one of the best Dentists I ever had a pleasure of shadowing (and also one of the most precise and OCD Dentists I know!) Dr Koray Feran. https://www.youtube.com/watch?v=0CjKu24R5GU Check out the full episode on the Protrusive YouTube Channel! Need to Read it? Check out the Full Episode Transcript below! Let us learn more about the potential benefits and challenges of equilibration with Dr. Koray Feran, who is a wet fingered practitioner of the highest calibre. Protrusive Dental Pearl: When you have a patient who has a crowding and they want veneers, and you want to convince them to have some orthodontics first..... Instead of saying, “Oh, I have to remove this part of the tooth.” You could instead say “I don't want to have to remove your healthy body parts to be able to achieve this goal.” Language is powerful! “Equilibration is one bit of the pie, it's a tool. It's not a magical process. It's to resolve a situation that you've diagnosed.” - Dr. Koray Feran In this episode, we talked about, Does equilibration matter? 9:38What is equilibration? 11:59What are we trying to achieve in equilibration? 21:12When should finding centric relation be a part of examination protocol? 29:18We discuss full mouth comprehensive dentistry and preventing failure 33:32Orthodontics is full mouth rehab! 49:26Risks and Benefits of Equilibration 46:00Fundamental rules of Occlusal Equilibration 52:33Protocol after equilibration 57:09Why is equilibration not routinely practiced by Dentists?  1:02:12 To learn more about equilibration, check out Dr. Koray's occlusion course! If you loved this episode, you will definitely like If You're Not In CR, You Will Die with Dr Kushal Gadhia! Click below for full episode transcript: Opening Snippet: And then suddenly you're through the enamel. Ouch that hurts. Equilibration should never be, never go through the enamel, never. Okay? If the equilibration has to go through that enamel you finally have to chop a large amount of a tooth. You should consider orthodontics or you should consider additive reconstruction to the whole occlusion. You shouldn't need to adjust three, four millimeters off a tooth. It's ridiculous... Jaz's Introduction: Equilibration is just one of those really controversial topics within occlusion and within dentistry in general, right? It can really split a room. Like the other day on Facebook and on the telegram group when I asked you guys which episode Do you want next? And I suggested we could have one about a Equilibration. My buddy Saranga said, Hey, we still do a Equilibration? I thought we didn't do equilibration anymore? And I remember attending a BDA event. I think I was maybe one year qualified. And Professor, actually I was a dental student, and Professor Robert Ibbotson, who was there, you know, very experience towards the end of his career, restorative consult at that time, he said he hadn't done an equilibration since 1984. And he thought it was pointless. Whereas I know other great clinicians who I really respect who carry out equilibration, a fair amount because they're doing bigger cases, and they see it as a really vital tool, a really vital step as part of their reconstruction. So which is the right answer? Hopefully in today's episode, you'll get a bit more information about equilibration, which is actually really difficult to find if you open your textbooks or if you search online, it's not much out there about equilibration, which is why I'm so excited to bring on an absolute superstar guest today. His name is Dr. Koray Feran, an absolute legend. I saw him lecture when I was just two months qualified...

Bulletproof Hygiene Podcast Episode 38 Hosts: Charissa Wood, RDH  & Brittany Simon, CRDH, BASD Key Takeaways:Intro Educate And Give Options Statistics Of Perio And Occlusal Disease Assess Perio Health Update Comprehensive Exam Evaluation References: Bulletproof Hygiene Network  Bulletproof Hygiene: The Guide For Finding Fulfillment Through Purposeful, Profitable Hygiene Occlusal Trauma and Periodontal Diseases Tweetables: Without follow-up, the initial treatment or therapy will not be successful. Brittany Simon

When it comes to the management of Temporo-manidbular Joint Disorders, we often NEED to adopt a multidisciplinary approach. I am a strong advocate of Dentists involving TMJ Physiotherapists (yes, they exist!) to help their patients. In this episode I am joined by The TMJ Physio Krina Panchal! https://youtu.be/5KcMOfdoDhg TMJ Physios are invaluable in the multidisciplinary management of TMDs Interestingly enough, Physiotherapists in the UK do not cover the TMJ in their studies - it is a postgraduate niche that Krina has travelled the world to learn - which is why I respect her even more! Protrusive Dental Pearl - have you checked out the 'Bruxchecker' foil as a tool to help diagnosis of Bruxism and much more? I comprehensively reviewed this product and thought it was very clever! https://www.youtube.com/watch?v=eQLGFc82EM0 In this episode I ask Krina: Whats the evidence that Physiotherapists can help our TMD patients?What does she think is the biggest aetiological factor for TMD?What is the most common diagnosis she makes, and what is her management of that diagnosisWhat should a Dentist do if, after a long procedure, the patient gets acute disc displacement without reduction?What kind of cases should we be working with physios for? I will add the promised downloads on to the Protrusive Dental Community Facebook Group (are you part of the Protruserati?!) If you enjoyed this episode, check out Stay Away from TMD - why you should think carefully before niching down to TMD as a Dentist. If you want to learn about Occlusal appliance as a protective appliance, to help with pain or as part of pre-restorative management, do check out the SplintCourse which launched a few days ago with a big bang! https://www.youtube.com/watch?v=2-Yt5YmEyes Click here to download the full Course Outline Enrollment ends 19th March at 10pm UK time so I can focus on Monthly Coaching! Thanks for your support, Protruserati! Enroll now to SplintCoure Online to finally understand Occlusal appliances!

In this long overdue (sorry, Protruserati!) episode I will go deeper in to Anterior Midpoint Stop Appliances as an occlusal splint for bruxism, myofascial pain and headaches. If you have not already, you must absolutely check out Understanding AMPSA Part 1 as this is the sequel! https://youtu.be/_dSkQFZa55w Protrusive Dental Pearl 55: Remember at Dental School where they taught us that 3 fingers worth of mouth opening is considered 'good' or normal? Well, make sure you remember it's the patient's fingers, not your fingers! I showed how to use a range of motion scale and the benefits of checking mouth opening objectively: https://youtu.be/LAlKNwedd6w I am so excited to announce pre-registration for SplintCourse - Splints Simplified for GDPs. Sign up for the launch offer which is just weeks away! You dig my logo, right?! I teach what I know, and I know Resin Bonded Bridges and Splints for GDPs as I have devoted my career to their study! "No amount of canine guidance or posterior disclusion or level of osseointegration of your implants will save you from the destructive forces of Bruxism"Jaz Gulati, PDP055 So here is a recap from AMPSA Part 1: Anterior appliances are not as evil as you were taughtWe myth busted the Dahl-concept-type occlusal changes with normal wear of such appliancesI gave the analogy of the 'locked-in' patient, and how when you allow them freedom of movement (reduce the resistance in grinding motions) it is like weight lifting and the weights have been removedWe looked at some of the contraindications - intra-capsular issues which are rarer - but also those who are just higher risk of anterior open bitesRemember, sometimes you WANT patients to get an AOB! In this Episode I summarise: What is the difference between these various anterior appliances and is one better than the other?Deciding upper arch or lower arch, or sometimes both arches?How many of my patients have developed Anterior open bites, which splints caused them, and how to manage such a scenario?Why even an AMPSA can be an overkill and which patients may actually benefit from a soft bite guard, for example! These appliances can bring HUGE solution to a MASSIVE problem for our patients. Many of my patients are pain-free and no longe require painkillers for headaches and jaw pain. My strongest bruxists (whose teeth I have restored) are religious at wearing the appliance (despite a favourable occlusal scheme) and they love it and KNOW that their Dentistry is protected. This is not a cheap piece of plastic. It is a custom made Orthotic Appliance - I charge anywhere from £450 - £1,300 for appliances (simple AMPSAs, complex AMPSAs, Michigan/Tanner appliances - every case is different). One of my previous delegates from The Splint Course (when it was delivered live) called in to the show and asked 'I am concerned about charging a high fee for this appliance? What is the appliance does not work?' - towards the end of this episode we discuss this in full depth! If you enjoyed this episode, you will like why Michigan Splints are overrated! Don't forget to sign up to The Splint Course for an exclusive launch offer.

Chris Chang describes the use of aligners (Invisalign), and how to resolve common aligner issues and incorporate TADs to achieve predictable outcomes. Aligners work as a pushing appliance: · Pushing surface (active surface) should be at 90 degrees to the direction of tooth movement. · Pulling movements can be achieved through combining with TADs. Reduced aligner predictability: 1. Distalisation 2. Expansion 3. Extraction 4. Incisor intrusion 5. Deep bites The details below describe how to resolve the reduced predictability of aligners. 1. Distalisation · Aligners cannot distalise teeth en-mass, and require sequential distalisation but with incorporating TADs it is possible, for example: o Distalisation in the lower arch: § Buccal shelf TAD in the lower arch (vertically placed, lateral/ buccal to the lower molars). § Intra-arch elastic wear (4.5 ounces) from the lower canine to terminal molar. 2. Expansion · Aligners result in tipping (buccal flaring) with expansion, this can be resolved through attachment placement: o Long horizontal attachment placed buccally with a gingival bevel. § Stage 1 of expansion = Buccal flaring. § Stage 2 of expansion = Attachment aligner interaction results in pushes force palatally, the balancing of moment results in - Buccal root torque = uprights tooth = bodily expansion 3. Premolar / bicuspid extractions & 4. Incisor intrusion · Aligners result in tipping of teeth into the extraction site, this can be resolved through creating a counter moment through attachments o G6 optimised attachments have their pushing surface / active surface positioned to counter the tipping movement and bodily translate the tooth o G6 attachments are located at different heights to generate a force in the direction desired and creating a counter moment. o Kenji formula: change G6 attachments to  long vertical attachments · Aligners and extractions can also result in (Fan-fan Dai 2019): o Incisor extrusion and torque loss. o 3mm of posterior anchorage loss and intrusion of molars. Correction · TAD placed in upper incisor region, and elastic wear: o 2 anterior labial TADs – intrude anterior teeth § Elastic from palatal cut out of aligner over occlusal surface to labial TAD. o 2 posterior buccal TADs preserve anchorage § Elastic wear from canines to TAD for retraction 5. Deep bite · Aligners under correct deep bites due to the bite plane affect, this can be resolved with a 3 stage approach 1. Overcorrection of Deep bite in planning. 2. Chewies – on the anterior teeth. 3. Incisor screw – incisor intrusion with elastics. Anterior Crossbite tips 1. Occlusal attachment – to open the bite. References Grünheid, T., Loh, C. and Larson, B.E., 2017. How accurate is Invisalign in nonextraction cases? Are predicted tooth positions achieved?. The Angle Orthodontist, 87(6), pp.809-815. Dai, F.F., Xu, T.M. and Shu, G., 2019. Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: First premolar extraction treatment with Invisalign. The Angle Orthodontist, 89(5), pp.679-687.

Part 1 Mark explains the dilemmas and dogmas behind hypodontia management. Dogma / idea influence opening vs closing 1. Canine guidance o Dogma: Canine guidance better than group function § Only evidence of negative affects relate to canine inclination, when tucked in = greater muscular activity, seems to relate to degree of freedom in occlusion Sugimoto 2011 o Dogma: Proprioception from canine essential / special § Some have considered the proprioception of canines to be essential in the reflex arc of chewing. § However the ‘special' proprioception not been shown to be of consequence. SR on occlusal schemes: Abduo 2015 · Neither canine vs group function occurs naturally · Occlusal schemes are dynamic · Neither scheme pathological or therapeutic · Crucial factor = degree of freedom in occlusion Sugimoto 2011 2. Implants: § Idea / dogma: Implants are ideal prosthesis / without risk 1. Infraposition of implant – vertical growth of adjacent teeth and dentoalveolus, result in relative infaocclusion / position of implant o Between age of 10-30 = infraposition phenomenon of implants more obvious than 30-40 Schwartz-Arad 2015 o Ideal age of implant placement varies § Delay until growth complete to prevent infraposition of implant assessed through serial radiographs 2. Implant problems o Tooth wear, loss of contact points Papageorgiou 2018 SR o 5-10% implants fail LONG TERM Pablos 2019 Timing of orthodontic treatment o Idea / dogma: treat hypodontia patient at the usual age i.e. adolescence with 2 stages § In between stages the following can occur: risk of root change, boney changes -most significant is of spaces are greater than 6mm = likely to require bone augmentation in 60-80% of cases Bertl 2017 o One should delay to treat in single phase or space closure Beyer 2005 Literature consistent § Nordquist 1975 - Silveira 2016 SR, supporting space closure better aesthetics, periodontal outcomes, and no TMD. Lay people perception Prefer space closure Qadri 2016

A comprehensive look at cervical biomechanics and exercise The Wu-Tang clan once said “Protect Ya Neck,” but how in the heck can you do that if you don't know the biomechanics?????? The neck can be quite complicated considering all the factors that influence it's dynamics: Ribcage position Thoracic spine Hyoid bone Cranium Temperomandibular joint OH MY! Yet despite all of these influences, there are simple, useful heuristics you can follow that can lead to favorable changes in neck mobility! Want to make the neck, cranium, and more ridiculously simple to understand and apply? Then tune in for Movement Debrief Episode 125. Here is a copy of the video for your viewing pleasure. Enjoy! If you want to watch these live, add me on Instagram.   t Show notes Check out Human Matrix promo video here Here are some testimonials for the class. Want to sign up? Click on the following locations below: August 1st-2nd, Boston, MA (Early bird ends July 5th at 11:55pm!) September 12th-13th,  Montreal, Canada (Early bird ends August 16th at 11:55pm!) [6 CEUs approved for Athletic Therapists by CATA!] October 3rd-4th, Ann Arbor, MI (Early bird ends September 6th at 11:55pm!) November 7th-8th, Charlotte, NC (Early bird ends October 11th at 11:55pm!) November 21st-22nd, San Diego, CA (Early bird ends October 25th at 11:55pm!) February 20th-21st, 2021, Atlanta, GA (Early bird ends January 17th at 11:55 pm!) May 1st-2nd, 2021, Minneapolis, MN (Early bird ends April 4th at 11:55pm!) Dickinson College in Carlisle PA (POSTPONED DUE TO COVID-19) [Approved for 14 Category A CEUs for athletic trainers] Or check out this little teaser for Human Matrix home study. Best part is if you attend the live course you'll get this bad boy for free! (Release date not known yet :( Here's a signup for my newsletter to get nearly 5 hours and 50 pages of content, access to my free breathing and body mechanics course, a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies. Bill Hartman - Without question my biggest influence. A lot of of the tests and concepts originate from his ideas. The armbar screwdriver with cervical rotation is a great way to drive posterior thorax expansion. You may not feel much of it within the move, but I've seen some dope mobility changes in shoulder flexion. The curl to press is a great move that helps explore neck rotation while respecting upper thorax mechanics. Reaching: Theory and Practice - If you've ever wondered how upper body exercises influence thorax mobility, then you definitely want to check this out. A basic overview of the infrasternal angle can be found here If a narrow infrasternal angle has reduced pump handle, forward-reaching is quite useful, like quadruped. Wide infrasternal angles benefit more from reaching at 120 degrees of shoulder flexion to restore pump handle mechanics, like the hooklying pullover. Introduction to Myofunctional Therapy Course Review - If you want to maximize cervical spine and upper airway dynamics, this post is a must! The smiling swallow is a terminal exercise in myofunctional therapy, and a great move if you have a forward head posture. The pointy tongue exercise is a great move to work the muscles needed to drive lateral palate expansion. Joe Cicinelli - He's a physical therapist and my go-to guy for all things upper airway. He helped me out after my tongue surgery Compensatory Movement Patterns - Check out this debrief if you want to better understand the hierarchy of what movement limitations ought to be focused on first. Here is an example of an occlusal splint (Photo credit: Mik81) Cervical biomechanics 101 (1:11) You've talked at length about the foot, pelvis, ribcage, scapulae, and spine, but how about one talking about the head and neck? I understand relative motions are supposed to exist within the cranium, but I'll be damned if I understand them! Love your work! Cervical spine's relationship to the thorax and scapula (4:53) What is the relationship between neck, thorax, and scapula? How does the influence programming for things such as forward head posture and medial scapular pain? My neck pops (12:52) What's the thought process for dealing with necks that crack and pop when you rotate them? Self-assessment for hyoid position (14:58) How can I self assess my Hyoid? Exercise to improve neck mobility (23:35) How can I inhibit front neck muscles which are in an overactive state leading to a forward head posture? Myofunctional therapy and the cervical spine (30:16) I've seen your tongue exercises on the YouTube channel, when do you use those and how do you think about those?  Does this relate to palate shape and cranial positioning? Wide infrasternal angles with forward head posture (35:31) How would a wide infrasternal angle get a forward head posture? Neck pain during headstands (36:15) In terms of unilateral neck pain in a headstand, what could be causing that? Cervical spine or TMJ movements? (37:45) What type of assessment would you do to see if the patient can benefit would it just simply neck rotation and jaw mobility, or would the infrasternal angle put into consideration? Also, would the exercise still be breathing base or more cervical stuff like protrusion that you used to do back in the day?  Armbar vs inversion (42:43) How would you differentiate between using armbars vs inversion to get expansion in the upper body? The connection between teeth and neck movement (44:54) How can an occlusal splint inhibit neck breathing? How do teeth influence neck position? Sum Up Cervical rotation involves motion all the way down to T4, the jaw, and cranial movement. Forward head posture involves lower cervical flexion and upper cervical extension. Military posture involves lower cervical extension and upper cervical flexion. Posterior thorax expansion is paired with ipsilateral cervical rotation. Neck popping during movement is largely benign and nothing to worry about. A low resting tongue posture can contribute to forward head posture. Treatment can involve teaching a palatal tongue posture. Hyoid dynamics can be assessed by resting posture and cervical extension. Occlusal splints can alter bite and cervicocranial muscle tone, but are not a long term solution.

Dr. Harold Menchel discusses the use of occlusal appliances in the management of temporomandibular disorders. Learning Objectives: 1. Discuss the evidence available in the literature for the use of occlusal appliances in temporomandibular disorders. 2. Summarize the different types of occlusal appliances for management of temporomandibular disorders. 3. Describe the clinical protocols for occlusal appliance therapy. Dr. Harold Menchel limits his practice to Orofacial pain in Coral Springs Florida. He is faculty in the Department of Prosthodontics at NOVA Southeastern School of Dental Medicine. His Orofacial Pain training was under Drs. Parker Mahan and Henry Gremillion at the University of Florida Facial Pain Center. He received his Diplomate American Board of Orofacial Pain in 2000 He is an international speaker, educator, and has published articles in peer-reviewed journals including JADA and Oral and Maxillofacial Clinics of North America. He reviews articles for JPD, JADA Dr. Menchel is liaison to the American Medical Association for Orofacial pain coding and access to care.

Assess biological consequences of overload

Controversy this week! Kevin Fryer is pro-biteguard with his NTI's and sleep appliances. Mac goes on a mile long rant about biteguards and how much they suck. Frankly it's the most passion I've seen from Mac on a dental topic. Zach is pro-biteguard but despite efforts to make biteguards affordable, they are still a tough sell and even tougher to get people to comply with. We discuss various types of niteguards and how we make them and implement them in our offices. Occlusion and biteguards a a divisive topic and if you want to weigh in and let us know how wrong we are, please head to the Clinical Hacks Facebook Page.

Not only did I finally get Michael Melkers to finally come on my Podcast….I also managed to get him over in November 2020 for his signature 2 day occlusion program! The event was rearranged from May 2020 to November 2020 due to Covid-19 - therefore new tickets will be added. Check out Occlusion2020.com for tickets. I present my first ever Video Podcast below – but as always, the audio version is available by direct download above, or from iTunes, Apple Podcasts, Google Podcasts, Spotify etc. This episode’s Protrusive Dental Pearl is shared by one of the talented Dental Technicians I use, Hit Parmar – how can we give our patients the experience of what a splint might feel like, as if to test tolerance and compliance? “How will I know I will not gag or be able to wear one in my sleep?” – a common and valid concern. Listen to the audio podcast to find out how you can manage this and test the waters! (within the first few minutes of the introduction to the episode) In this fun and informative episode, we discuss: – What is the point of using a Facebow and Articulator? (you may be surprised by his answer..!) – Are we really designing Occlusal schemes for optimum function (spoiler – we’re not!) – Why is our understanding of Occlusion…’sub-optimal’ once graduating? – Which is the best Occlusion camp? Dawson? Pankey? Kois? LVI? – Which is the ‘best splint’? – We discuss his upcoming 2-day Occlusion in Everyday Practice program in Heathrow 27th and 28th November 2020 Do join us in November for occlusion and lamb chops at Occlusion2020.com You will never find a better value Occlusion or even Michael Melkers course ever again! https://www.youtube.com/watch?v=UpQQg9daDak

This week in Dental news to Abuse I discuss changes with coding occlusal night guards and how to bill them and make sure you get reimbursed for these little critters. In addition, I discuss the ins and outs of emailing patient dental records and making sure you protect Patient Healthcare information or PHI. I also discuss six patient retention strategies and how to use social media to find your next hire.

In this special edition of The Dental Practitioner podcast series, ADA NSW takes you to the University of Sydney's Oral Rehabilitation Symposium, held in honour of Professor Iven Klineberg's retirement from the School of Dentistry last year. In this third episode, we feature a lecture from Professor Sandro Palla titled ‘Adaptation and maladaptation to occlusal changes: the role of cortical reorganisation and signal amplification'.

Dr. Arthur (Tony) Tomaro, a graduate of The University of Michigan, School of Dentistry, where he also completed his Master’s of Science, and Bachelor of Science.  Prior to his relocation to Las Vegas, Nevada, Dr. Tomaro enjoyed 26 years of private practice in Grand Rapids, Michigan. Dr. Tomaro is previous Director of Clinics at Las Vegas Institute for Advance Dental Studies. He maintains a private practice, Arthur Tomaro Exceptional Dentistry, in Las Vegas, Nevada. As a member of Catapult Education, Dr. Tomaro teaches hands on courses, as well as peer lectures to dentists nationally and internationally. His teaching focuses on techniques related to General Dentistry (Tooth Colored Fillings & Crowns), Full Mouth Reconstruction, Diagnosis, Business of Dentistry, Cosmetic Dentistry, The Art of Smile Design, Treatment of Headaches, and Occlusal  Procedures that are used in daily patient care.    Dr. Tony Tomaro is a published author and a consultant for dental laboratories and manufacturers, and a current contributing author to national dental publications and dental laboratory publications on several topics.  He is affiliated with the following prestigious organizations: ADA - American Dental Association, MDA - Michigan Dental Association, NDA - Nevada Dental Association. He can be reached at 702-533-3336 or via email at atomaro@ameritech.net   www.DrTomaro.com

Dr. B was interviewed on the Healthy Mouth, Healthy life Podcast by Ms. Carrie Ibbetson who is an oral health coach and patient advocate. Carrie is a hygienist who has been in dentistry for over 20 years and has a podcast for the general public about oral health care. She also helps people with oral conditions that are complicated from the point of view of the public. In short, she helps people make choices with their oral health decisions. She uses patient language to explain the conditions in patients' mouths and in even simpler terms becomes a non-biased bridge between dentists and patients. Carrie wanted to talk with Dr. B regarding the language of occlusal splints (better known as Occlusal guards or bite Guards). Dr. B makes quite a few occlusal Splints and charges over $1000 for each. But can only do so because of the specific language he uses with patients.

Today I brought in my friend Dr. Bilal Saib, DDS (Pronounced Bill-Al) aka Dr. B to talk about what a “night guard” does, why a good fitting guard is so important, what to expect in the impression and placement process and what to look for in a dentist who is recommending one, when you decide it’s time to invest it’s important to know what can happen in the mouth if someone decides to wear a “night guard” (both good and bad). Thankfully Dr. B walks us though the differences. Protecting your teeth from the strong forces of grinding may be important if you are trying to avoid teeth that break, crack, become sensitive, prematurely yellow or gums that recede. Also, much of the pain and destruction in the muscles of the head, neck and jaw joints can change when wearing a properly fitted guard, but can be worse if the guard isn’t properly fitted to your mouth, and adjusted as the muscles relax and begin to change. Dr. B and I spend a lot of time talking about this! As a travelling hygienist, I’ve had the opportunity to work in hundreds of offices, which means I’ve seen thousands of people that have night guards, yet they don’t wear them due to discomfort or even feeling like it makes them grind more. Fortunately, I’ve also worked in offices where I have seen correctly fitting guards change people’s lives and provide comfort from pain and destruction of the mouth. That’s what drew me to Dr. B. He’s one of those dentists who “get it”, and I am so thankful that he sat down today to give us some insight about why not all night guards are created equally. The ones I’ve seen work most often are like the ones Dr. B provides his patients and advocates for. These guards are meticulously created and adjusted for the patient as their muscles relax, and their bite changes. They often are more expensive, but by the end of today’s episode I hope you will have a better understanding as to why, and you’ll be wanting to seek out a dentist that thinks this way too for yourself. When Dr. B isn’t being interviewed for podcasts, he’s busy interviewing people for his own podcast “The Passionate Dentist”, or changing lives and smiles in his dental practice Chapel Hill Advanced Dentistry in Chapel Hill, North Carolina. Guards are called by many names. Occlusal guard, night guard, mouth guard for teeth grinding, dental guard, nocturnal bite plate and bite splint are the most common terms used. There are many different reasons that someone may be needing a guard, but the bottom line is you want to make sure that the person performing the service is someone that is looking at all the pieces to the puzzle of why you need one. Thanks Dr. B for your insight, we appreciate you! You can learn more about Dr. Bilal Saib at: Chapel Hill Advanced Dentistry The Passionate Dentist

On this podcast episode, I talk with Christin Lincoln, RDH about the different types of hygienists you may find in every day offices, and things you can use to tell if a dental office is one that you want to invest in.  We piggy back on last week’s episode where Cindy Johnson and I talk about interviewing a health care provider to determine if they are the right fit for you and your values as a patient or employee. We explore why oral health matters and how hygienists and oral health coaches help guide you to better overall health…not just oral health. Christine talks about her website that is also designed for the consumer population and bacteria that triggers disease in the body, and the podcast she cohosts with a friend and fellow “momgienist”. We discuss how someone’s bite can lead to gum disease (periodontal disease) and why it’s important to look at both gum disease and bite when it comes to having dental work performed or repaired.We talk Pankey dentistry, its benefits, and the oral systemic link. This episode helps both the consumer and clinician alike. Listening to Christine will leave you feeling like you’ll want to find someone help you make sure your mouth is healthy for years to come. Please visit Oral Health Coaching once you’ve heard her tell you why it’s the best investment you can make for your health!! http://www.oralhealthcoaching.com/   Links: Christine’s links: http://www.yoursmilinghygienist.com/ http://www.momgienists.com/ Bacteria in the mouth and what happens to the body: Sabotage: How Oral Bacteria Hijacks the Immune System What the Heck is Inflammation? It's Okay to Strive for ZERO Bloody Prophy’s: Occlusal disease issues: Fremitis: How the bite effects the gums/bone:   Our mutual hygiene crush and overall badass human, Cyndee Johnson, RDH : http://www.scaler2schedule.com/ The Pankey Dentist that changed my life! http://www.spiritofcaring.com/public/287.cfm

A dentist requests an occlusal splint. Originally aired on Chairside Live episode 14

More than one-third of patients are ideal candidates for occlusal splints due to bruxism, clenching or post-operative situations. In this video, Dr. Michael DiTolla discusses the ways in which the uncomfortable splints of the past have been replaced with patient friendly, comfortable soft/hard occlusal splints. Also discussed is how to take impressions for splints, bite splint fabrication, and bite splint delivery. Plus, Dr. DiTolla stresses the importance of early diagnosis of bruxing and clenching, one night of which Dr. Gordon Christensen equates to 100 days of normal wear.

The aim of this clinical-morphological study was to investigate the effects of dental probing on occlusal surfaces by scanning electron microscopy (SEM). Twenty sound occlusal surfaces of third molars and 20 teeth with initial carious lesions of 17- to 26-year-old patients (n = 18) were involved. Ten molars of each group were probed with a sharp dental probe (No. 23) before extraction; the other molars served as negative controls. After extraction of the teeth, the crowns were separated and prepared for the SEM study. Probing-related surface defects, enlargements and break-offs of occlusal pits and fissures were observed on all occlusal surfaces with initial carious lesions and on 2 sound surfaces, respectively. No traumatic defects whatsoever were visible on unprobed occlusal surfaces. This investigation confirms findings of light-microscopic studies that using a sharp dental probe for occlusal caries detection causes enamel defects. Therefore, dental probing should be considered as an inappropriate procedure and should be replaced by a meticulous visual inspection. Critical views of tactile caries detection methods with a sharp dental probe as a diagnostic tool seem to be inevitable in undergraduate and postgraduate dental education programmes. Copyright (c) 2007 S. Karger AG, Basel.

Because of different measurement techniques and the easier design of the CRM prototype, this in vitro study aimed to compare the diagnostic performance and reproducibility of two electrical methods (Electronic Caries Monitor III, ECM and Cariometer 800, CRM) for occlusal caries detection, and to evaluate the effect of staining/ discoloration of fissures on diagnostic performance. Hundred and seventeen third molars with no apparent occlusal cavitation were selected. Six examiners inspected all specimens independently, using the CRM, and a subgroup of 4 using the ECM. Histological validation using a stereomicroscope was performed after hemisectioning. Intra- and interexaminer reproducibility was assessed by Lin's concordance correlation coefficient (CCC) and Bland and Altman analysis. Diagnostic performance parameters included sensitivity (SE), specificity (SP) and area under the ROC curve (A(z)). The CCC yielded an intra- and interexaminer reproducibility of 0.69/0.62 (ECM) and of 0.79/0.74 (CRM). The mean intra- and interexaminer 95% range of measurements (range between Bland and Altman limits of agreement) given in percentages of the instrument reading were 67%/65% for the ECM and 28%/33% for the CRM. A(z) at the D3-4 level was 0.74 (ECM) and 0.78 (CRM). The CRM showed at least equivalent diagnostic performance to the ECM. However, improvement is still desirable. Diagnostic performance appeared to be enhanced in discolored lesions; however, this may be related to sample lesion distribution characteristics. Copyright (C) 2006 S. Karger AG, Basel.