Podcasts about Spacing

This year has been one of major change. But what doesn't change here is talking about transit. It's the return of Tricia Wood (York University urban geography professor and Spacing contributor) and Matt Elliott(Toronto Star columnist and publisher of the City Hall Watcher newsletter). They help us unpack the state of public transportation in Toronto and the surrounding region, warts and all. We talk about restoring faith in the TTC, the battle of competing transit projects, the Federal budget, and why cars still take priority over transit in Toronto.

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This month’s podcast is from a Space Out, Outside featuring Bob Lukomski and David Mason. We played outside the Colorant Shop on Main Street in Beacon, NY as part of their 10th anniversary celebrations. This is one of my favorite Space Out, Outside recordings; it has the exact balance of the ambiance and The Ambiance … Continue reading Errant Space Podcast 128: Spacing Out, Outside Colorant →

Let's be honest – the occlusion after Aligner cases can be a little ‘off' (even after fixed appliances!) How do you know if your patient's occlusion after aligner treatment is acceptable or risky? What practical guidelines can general dentists follow to manage occlusion when orthodontic results aren't textbook-perfect? Jaz and Dr. Jesper Hatt explore the most common challenges dentists face, from ClinCheck errors and digital setup pitfalls to balancing aesthetics with functional occlusion. They also discuss key strategies to help you evaluate, guide, and optimize occlusion in your patients, because understanding what is acceptable and what needs intervention can make all the difference in long-term treatment stability and patient satisfaction. https://youtu.be/e74lUbyTCaA Watch PDP250 on YouTube Protrusive Dental Pearl: Harmony and Occlusal Compatibility Always ensure restorative anatomy suits the patient's natural occlusal scheme and age-related wear. If opposing teeth are flat and amalgam-filled, polished cuspal anatomy will be incompatible — flatten as needed to conform. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Common mistakes in ClinCheck planning often stem from occlusion issues. Effective communication and documentation are crucial in clinical support. Occlusion must be set correctly to ensure successful treatment outcomes. Understanding the patient’s profile is essential for effective orthodontics. Collaboration between GPs and orthodontists can enhance patient care. Retention of orthodontic results is a lifelong commitment. Aesthetic goals must align with functional occlusion in treatment planning. Informed consent is critical when discussing potential surgical interventions. The tongue plays a crucial role in orthodontic outcomes. Spacing cases should often be approached as restorative cases. Aligners can achieve precise spacing more effectively than fixed appliances. Enamel adjustments may be necessary for optimal occlusion post-treatment. Retention strategies must be tailored to individual patient needs. Case assessment is vital for determining treatment complexity. Highlights of this episode: 00:00 Teaser 00:59 Intro 02:53  Pearl – Harmony and Occlusal Compatibility 05:57 Dr. Jesper Hatt Introduction 07:34 Clinical Support Systems 10:18 Occlusion and Aligner Therapy 20:41 Bite Recording Considerations 25:32 Collaborative Approach in Orthodontics 30:31 Occlusal Goals vs. Aesthetic Goals 31:42 Midroll 35:03 Occlusal Goals vs. Aesthetic Goals 35:25 Challenges with Spacing Cases 42:19 Occlusion Checkpoints After Aligners 50:17 Considerations for Retention 54:55 Case Assessment and Treatment Planning 58:14 Key Lessons and Final Thoughts 01:00:19 Interconnectedness of Body and Teeth 01:02:48 Resources for Dentists and Case Support 01:04:40 Outro Free Aligner Case Support!Send your patient's case number and get a full assessment in 24 hours—easy, moderate, complex, or referral. Plus, access our 52-point planning protocol and 2-min photo course. No uploads, no cost. [Get Free Access Now] Learn more at alignerservice.com If you enjoyed this episode, don't miss: Do's and Don'ts of Aligners [STRAIGHTPRIL] – PDP071 #PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A and C. AGD Subject Code: 370 ORTHODONTICS (Functional orthodontic therapy) Aim: To provide general dentists with practical guidance for managing occlusion in aligner therapy, from bite capture to retention, including common pitfalls, functional considerations, and case selection. Dentists will be able to – Identify common errors in digital bite capture and occlusion setup. Understand the impact of anterior inclination and mandibular movement patterns on occlusal stability. Plan retention strategies appropriate for aligner and restorative cases. Click below for full episode transcript: Teaser: The one thing that we always check initially is the occlusion set correct by the aligner company. Because if the occlusion is not set correctly, everything else just doesn't matter because the teeth will move, but into a wrong position because the occlusion is off from the beginning. I don't know about you, but if half the orthodontists are afraid of controlling the root movements in extraction cases, as a GP, I would be terrified. Teaser:I don’t care if you just move from premolar to premolar or all the teeth. Orthodontics is orthodontics, so you will affect all the teeth during the treatment. The question’s just how much. Imagine going to a football stadium. The orthodontist will be able to find the football stadium.  If it’s a reasonable orthodontist, he’ll be able to find the section you’re going to sit in, and if he’s really, really, really good, he will be able to find the row that you’re going to sit in, but the exact spot where you are going to sit… he will never, ever be able to find that with orthodontics. Jaz’s Introduction: Hello, Protruserati. I’m Jaz Gulati. Welcome back to your favorite dental podcast. I’m joined today by our guest, Dr. Jesper Hatt. All this dentist does is help other dentists with their treatment plans for aligners. From speaking to him, I gather that he’s no longer practicing clinically and is full-time clinical support for colleagues for their aligner cases. So there’s a lot we can learn from someone who day in day out has to do so much treatment planning and speaking to GDPs about their cases, how they’re tracking, how they’re not tracking, complications, and then years of seeing again, okay, how well did that first set of aligners actually perform? What is predictable and what isn’t? And as well as asking what are the most common errors we make on our ClinChecks or treatment plan softwares. I really wanted to probe in further. I really want to ask him about clinical guidelines for occlusion after ortho. Sometimes we treat a case and whilst the aesthetics of that aligner case is beautiful, the occlusion is sometimes not as good. So let’s talk about what that actually means. What is a not-good occlusion? What is a good occlusion? And just to offer some guidelines for practitioners to follow because guess what? No orthodontist in the world is gonna ever get the occlusion correct through ortho. Therefore, we as GPs are never gonna get a perfect textbook occlusion, but we need to understand what is acceptable and what is a good guideline to follow. That’s exactly what we’ll present to you in this episode today. Dental PearlNow, this is a CE slash CPD eligible episode and as our main PDP episode, I’ll give you a Protrusive Dental Pearl. Today’s pearl is very much relevant to the theme of orthodontics and occlusion we’re discussing today, and it’s probably a pearl I’ve given to you already in the past somewhere down the line, but it’s so important and so key. I really want to just emphasize on it again. In fact, a colleague messaged me recently and it reminded me of this concept I’m about to explain. She sent me an image of a resin bonded bridge she did, which had failed. It was a lower incisor, and just a few days after bonding, it failed. And so this dentist is feeling a bit embarrassed and wanted my advice. Now, by the way, guys, if you message me for advice on Instagram, on Facebook, or something like that, it’s very hit and miss. Like my priorities in life are family, health, and everything that happens on Protrusive Guidance. Our network. If you message me outside that network, I may not see it. The team might, but I may not see it. It’s the only way that I can really maintain control and calm in my life. The reason for saying this, I don’t want anyone to be offended. I’m not ignoring anyone. It’s just the volume of messages I get year on year, they’re astronomical. And I don’t mind if you nudge me. If you messaged me something weeks or months ago and I haven’t replied, I probably haven’t seen it. Please do nudge me. And the best place to catch me on is Protrusive Guidance. If you DM me on Protrusive Guidance, home of the nicest and geekiest dentists in the world, that’s the only platform I will log in daily. That’s our baby, our community. Anyway, so I caught this Facebook message and it was up to me to help this colleague. And one observation I made is that the lower teeth were all worn. The upper teeth were really worn, but this resin bonded bridge pontic, it just looked like a perfect tooth. The patient was something like 77 or 80. So it really made me think that, okay, why are we putting something that looks like a 25-year-old’s tooth in a 77-year-old? But even forgetting age and stuff, you have to look at the adjacent teeth in the arch. Is your restoration harmonious with the other teeth in the arch, and of course is the restoration harmonious with what’s opposing it? Because it’s just not compatible. So part one of this pearl is make sure any restoration you do, whether it’s direct or indirect, is harmonious with the patient’s arch and with the opposing teeth and with their occlusal scheme. Because otherwise, if you get rubber dam on and you give your 75-year-old patient beautiful composite resin, it’s got all that cuspal fissure pattern and anatomy, and you take that rubber dam off and you notice that all the other teeth are flat and the opposing teeth are flat amalgams, guess what? You’re gonna be making your composite flat, whether you like it or not. You created a restoration that’s proud, right? That’s why you did not conform to the patient’s own arch or existing anatomical scheme. So the part B of this is the thing that I get very excited to talk about, right? So sometimes you have a worn dentition, but then you have one tooth that’s not worn at all. It’s like that in-standing lateral incisor, right? Think of an upper lateral incisor that’s a bit in-standing, and you see some wear on all the incisors, but that lateral incisor does not have any wear in it because it was never in the firing line. It was never in function. It was never in parafunction. Now, if you give this patient aligners or fixed appliances, you’re doing ortho and you’re now going to align this lateral incisor. So it’s now gonna eventually get into occlusion and it will be in the functional and parafunctional pathways of this patient. Do you really think you can just leave that incisor be? No. It’s not gonna be compatible with the adjacent teeth. It’s not going to be compatible with the opposing tooth and the occlusal scheme. So guess what? You have to get your bur out or your Sof-Lex disc out, and you have to bake in some years into that tooth. Or you have to build up all the other teeth if appropriate for that patient. You’ve just gotta think about it. And I hope that makes sense so you can stay out of trouble. You’re not gonna get chipping and you can consent your patient appropriately for enamel adjustment, which is something that we do talk about in this episode. I think you’re in for an absolute cracker. I hope you enjoy. I’ll catch you in the outro. Main Episode: Doctor Jesper Hatt, thank you so much for coming to Protrusive Dental Podcast. We met in Scandinavia, in Copenhagen. You delivered this wonderful lecture and it was so nice to connect with you then and to finally have you on the show. Tell us, how are you, where in the world are you, and tell us about yourself. [Jesper] Well, thank you for the invitation, first of all. Well, I’m a dentist. I used to practice in Denmark since I originally come from Denmark. My mother’s from Germany, and now I live in Switzerland and have stopped practicing dentistry since 2018. Now I only do consulting work and I help doctors around the world with making their aligner business successful. [Jaz] And this is like probably clinical advice, but also like strategic advice and positioning and that kinda stuff. Probably the whole shebang, right? [Jesper] Yeah. I mean, I have a team around me, so my wife’s a dentist as well, and I would say she’s the expert in Europe on clear aligners. She’s been working for, first of all, our practice. She’s a dentist too. She worked with me in the practice. We practiced together for 10 years. Then she became a clinical advisor for Allion Tech with responsibility for clinical support of Scandinavia. She was headhunted to ClearCorrect, worked in Basel while I was doing more and more consulting stuff in Denmark. So she was traveling back and forth, and I considered this to be a little bit challenging for our family. So I asked her, well, why don’t we just relocate to Switzerland since ClearCorrect is located there? And sure we did. And after two years she told me, I think clinical support, it’s okay. And I like to train the teams, but I’d really like to do more than that because she found out that doctors, they were able to book a spot sometime in the future, let’s say two weeks out in the future at a time that suited the doctors… no, not the doctors, ClearCorrect. Or Invisalign or whatever clear aligner company you use. So as a doctor, you’re able to block the spot and at that time you can have your 30 minutes one-on-one online with a clinical expert. And she said it’s always between the patients or administrative stuff. So they’re not really focused on their ClearCorrect or clear aligner patient. And so they forget half of what I tell them. I can see it in the setups they do. They end up having to call me again. It doesn’t work like that. I would like to help them. [Jaz] It’s a clunky pathway of mentorship. [Jesper] Yes. And so she wanted to change the way clinical support was built up. So we do it differently. We do it only in writing so people can remember what we are telling them. They can always go back in the note and see what’s been going on, what was the advice we gave them, and we offer this co-creation support where we take over most of the treatment planning of the ClearCorrect or Clear Aligner or Spark or Invisalign or Angel Aligner treatment planning. So we do all the digital planning for the doctor, deliver what we think would be right for the patient based on the feedback we initially got from the doctor. And then the doctor can come back and say, well, I’d like a little more space for some crowns in the front, or I would like the canines to be in a better position in order to achieve immediate post disclusion. And so we can go into this discussion back and forth and adjust the digital setup in a way that is more realistic and predictable and do it all for the doctors. So they, on an average, they spend four to six hours less chair time when they use that kind of service compared to if they do everything themselves. And on top of that, you can put your planning time. She was responsible for that and it works quite well. I still remember when we initially got on all these online calls and we would see fireworks in the background and confetti coming down from the top and all of that. [Jaz] Exactly. So excuse that little bit, but okay. So essentially what you’re doing is, for an aligner user myself, for example, you’re doing the ClinChecks, you are helping, supporting with the ClinChecks, the planning. And I’ve got a lot of questions about that. The first question I’ll start with, which is off the script, but there’s probably a hundred different mistakes that could happen in a ClinCheck, right? But what is the most repeatable, predictable, common mistake that you’ll see when a new user sends a case to you to help them with their planning? What’s the most common mistake that you will see in a setup? [Jesper] Two things, actually. The one thing that we always check initially is the occlusion set correct by the aligner company. Because if the occlusion is not set correctly, everything else just doesn’t matter because the teeth will move but into a wrong position because the occlusion is off from the beginning. And so we always check that as the first part. How does this— [Jaz] So let’s talk about that ’cause that might be confusing for a younger colleague because they’re like, hey, hang on a minute. I scanned the bite left and right. What do you mean the occlusion is wrong? Because surely that gets carried through into what I see on the ClinCheck. So what do you think is the mechanism for this to happen? [Jesper] Two different reasons. I’m from a time when I graduated in 2003, so that was before digital dentistry. So when I went to the Pankey Institute and learned everything about functional occlusion and all of that stuff, I also found out that most of my patients, when I put silicone impression material between the teeth and asked the patients to bite together, they would always protrude a little bit unless I instructed them to bite hard on the posterior teeth. And when we got the scanners, when we put a scanner into the cheek and pull the cheek, most patients, when we asked them to bite together to do the intraoral scan of the bite, they also protruded a little bit, not much, but enough to set the bite wrong. So that is the one challenge when the technicians of the aligner companies put the models together. The other challenge is that some of the aligner companies, they let the technicians set the models. We always, as the first thing when we see a case, we always look at the photos, the clinical photos. And that’s why the clinical photos have to be of great quality. So we look at the clinical photos of the patient— [Jaz] And also in those clinical photos, Jesper, you have to coach them correctly to bite. You have to notice if they’re biting wrong even in the photos ’cause then it just duplicates the error. And that’s why good photography and actually being able to coach the patient is so imperative. [Jesper] Yes, that’s correct. But we compare the two and usually if we see a difference, we ask the doctor, is what we see in the photo correct, or is what we see on the digital models correct? And because we don’t like differences. So that would be the first step to look for. And what’s the second? The second thing is that when you look at the setup, the anterior teeth are usually—I’m trying to show you—the anterior teeth are very, very steep. Typically with aligners it’s a lot easier to tip the crowns. So when you have a class II patient, deviation one, where the anteriors are in a forward position, proclined, and you have a lot of space between the anteriors of the maxilla and the mandible, then the easiest thing on a digital setup is to just retrocline the anteriors of the upper to make them fit the lowers, which you could then procline a little bit, but usually you have very steep relationships between the two and this— [Jaz] So you’re more likely to restrict the envelope of function, functional interference anteriorly. You are obviously reducing the overjet, but you may end up reducing like a wall contact rather than an elegant, more open gate. [Jesper] Yes. And there’s another dimension to this because when we work with orthodontics, one of the most important things to look for is actually the profile of the patient. Because let’s say I’m trying to illustrate this now, so I hope you get a 90— [Jaz] So describe it for our audio listeners as well. So we’re looking at a profile view of Jesper. [Jesper] Yes. So I’m turning the side to the camera. I hope you can see my profile here. So let’s say I had flared anterior maxillary teeth and I wanted to retrocline them. It would have an effect on my upper lip, so the lip would fall backwards if I just retrocline everything. And every millimeter we move the anteriors in the maxilla in a posterior direction, we will have a potential lip drop of three millimeters. In addition, if we don’t get the nasolabial angulation correct, we risk the lower face will simply disappear in the face of the patient. So soft tissue plays a role here, so we cannot just retrocline the teeth. It looks great on the computer screen, but when it comes to reality, we’ll have a functional challenge. We’ll have a soft tissue support challenge, and in addition we’ll have long-term retention challenges as well. Because when you have a steep inclination, the anterior teeth in the mandible, they don’t have any kind of support. They will not be stopped by anything in the maxillary teeth, which you would if you had the right inclination between the teeth, which would be about 120 degrees. So why do aligner companies always set the teeth straight up and down in the anterior part? We wondered about this for years. We don’t have a strict answer. We don’t know exactly why it’s like this, but I have a hunch. I think there are two things to it. First of all, the easiest thing to do with aligners is to move the crown, so we can just tip the teeth. You take them back, you make a lot of IPR, and then you just tip them so they’re retroclined. Secondly, all aligner companies, they come from the United States. And in the United States there is a higher representation of class III patients. Now why is that important? All our patients can be put into two different categories in regards to how they move their mandible. They are the crocodiles that only open and close, like move up and down, and then we have the cows. And then we have the cows that move the mandible around, or the camels. I mean, every camel, if you’ve seen a camel chew, it’s just moving from side to side. [Jaz] Horses as well. Horses as well. [Jesper] They kind of do that. [Jaz] But I’m glad you didn’t say rats ’cause it’s more elegant to be a crocodile than a rat. [Jesper] Exactly. And I usually say we only tell the crocodiles. So why is this a challenge and why isn’t it a challenge with class III patients? Well, all real class III patients act like crocodiles, so they don’t move them side to side. From a functional perspective, it’s really not a problem having steep anterior inclination or steep relationships as long as you have a stable stop where the anteriors—so the anteriors will not elongate and create the red effect. So they just elongate until they hit the palate. If you can make a stop in the anterior part of the occlusion, then you’ll have some kind of stability with the class III patients. But with class II patients, we see a lot more cows. So they move the mandible from side to side and anterior and back and forth and all… they have the mandible going all kinds of places. And when they do that, we need some kind of anterior guidance to guide the mandible. I usually say the upper jaw creates the framework in which the mandible will move. So if the framework is too small, we fight the muscles. And whenever we fight the muscles, we lose because muscles always win. It doesn’t matter if it’s teeth, if it’s bone, if it’s joints, they all lose if they fight the muscles— [Jaz] As Peter Dawson would say, in the war between teeth and muscles or any system and muscles, the muscles always win. Absolutely. And the other analogy you remind me of is the maxilla being like a garage or “garage” from UK, like a garage. And the mandible being like the car, and if you’re really constrained, you’re gonna crash in and you’re gonna… everything will be in tatters. So that’s another great way to think about it. Okay. That’s very, very helpful. I’m gonna—’cause there’s so much I wanna cover. And I think you’ve really summed up nicely. But one thing just to finish on this aspect of that common mistake being that the upper anteriors are retroclined, really what you’re trying to say is we need to be looking at other modalities, other movements. So I’m thinking you’re saying extraction, if it’s suitable for the face, or distalisation. Are you thinking like that rather than the easier thing for the aligners, which is the retrocline. Am I going about it the right way? [Jesper] Depends on the patient. [Jaz] Of course. [Jesper] Rule of thumb: if you’re a GP, don’t ever touch extraction cases. Rule of thumb. Why? Because it is extremely challenging to move teeth parallel. So you will most—especially with aligners—I mean, I talk with a very respected orthodontist once and I asked him, well, what do you think about GPs treating extraction cases where they extract, you know, two premolars in the maxilla? And he said, well, I don’t know how to answer this. Let me just explain to you: half of my orthodontist colleagues, they are afraid of extraction cases. And I asked them why. Because it’s so hard to control the root movement. Now, I don’t know about you— [Jaz] With aligners. We’re specifically talking about aligners here, right? [Jesper] With all kinds of orthodontic appliances. [Jaz] Thank you. [Jesper] So now, I don’t know about you, but if half the orthodontists are afraid of controlling the root movements in extraction cases, as a GP, I would be terrified. And I am a GP. So I usually say, yeah, sometimes you will have so much crowding and so little space in the mandible, so there’s an incisor that is almost popped out by itself. In those cases, yes. Then you can do an extraction case. But when we’re talking about premolars that are going to be extracted, or if you want to close the space in the posterior part by translating a tooth into that open space, don’t. It’s just the easiest way to end up in a disaster because the only thing you’ll see is just teeth that tip into that space, and you’ll have a really hard time controlling the root movements, getting them corrected again. [Jaz] Well, thank you for offering that guideline. I think that’s very sage advice for those GPs doing aligners, to stay in your lane and just be… the best thing about being a GP, Jesper, is you get to cherry pick, right? There’s so many bad things about being a GP. Like you literally have to be kinda like a micro-specialist in everything in a way. And so sometimes it’s good to be like, you know what, I’ll keep this and I’ll send this out. And being selective and case selection is the crux of everything. So I’m really glad you mentioned that. I mean, we talked and touched already on so much occlusion. The next question I’m gonna ask you then is, like you said, a common error is the bite and how the bite appears on the ClinCheck or whichever software a dentist is using. Now, related to bite, vast majority of orthodontic cases are treated in the patient’s existing habitual occlusion, their maximum intercuspal position. Early on in my aligner journey, I had a patient who had an anterior crossbite. And because of that anterior crossbite, their jaw deviated. It was a displaced—the lower jaw displaced. And then I learned from that, that actually for that instance, perhaps I should not have used an MIP scan. I should have used more like centric relation or first point of contact scan before the displacement of the jaw happens. So that was like always in my mind. Sometimes we can and should be using an alternative TMJ position or a bite reference other than MIP. Firstly, what do you think about that kind of scenario and are there any other scenarios which you would suggest that we should not be using the patient’s habitual occlusion for their bite scan for planning orthodontics? [Jesper] Well, I mentioned that I was trained at the Pankey Institute, and when you start out right after—I mean, I spent 400 hours over there. Initially, I thought I was a little bit brainwashed by that because I thought every single patient should be in centric relation. Now, after having put more than 600 patients on the bite appliance first before I did anything, I started to see some patterns. And so today, I would say it’s not all patients that I would get into centric relation before I start treating the teeth. But when we talk about aligner therapy and orthodontic treatment, I think it’s beneficial if you can see the signs for those patients where you would say, hmm, something in the occlusion here could be a little bit risky. So let’s say there are wear facets on the molars. That will always trigger a red flag in my head. Let’s say there are crossbites or bite positions that kind of lock in the teeth. We talked about class III patients before, and I said if it’s a real skeletal-deviation class III patient, it’s a crocodile. But sometimes patients are not real class III skeletal deviation patients. They’re simply being forced into a class III due to the occlusion. That’s where the teeth fit together. So once you put aligners between the teeth and plastic covers the surfaces, suddenly the patients are able to move the jaws more freely and then they start to seat into centric. That may be okay. Usually it is okay. The challenge is consequences. So when you’re a GP and you suddenly see a patient moving to centric relation and you find out, whoa, on a horizontal level there’s a four- to six-millimeter difference between the initial starting point and where we are now, and maybe we create an eight-millimeter open bite in the anterior as well because they simply seat that much. And I mean, we have seen it. So is this a disaster? Well, it depends. If you have informed the patient well enough initially and said, well, you might have a lower jaw that moves into a different position when we start out, and if this new position is really, really off compared to where you are right now, you might end up needing maxillofacial surgery, then the patient’s prepared. But if they’re not prepared and you suddenly have to tell them, you know, I think we might need maxillofacial surgery… I can come up with a lot of patients in my head that would say, hey doctor, that was not part of my plan. And they will be really disappointed. And at that point there’s no turning back, so you can’t reverse. So I think if you are unsure, then you are sure. Then you should use some kind of deprogramming device or figure out where is centric relation on this patient. If there isn’t that much of a difference between maximum intercuspation and centric— [Jesper] Relation, I don’t care. Because once you start moving the teeth, I don’t care if you just move from premolar to premolar or all the teeth. Orthodontics is orthodontics, so you will affect all the teeth during the treatment. The question’s just how much. And sometimes it’s just by putting plastic between the teeth that you will see a change, not in the tooth position, but in the mandibular position. And I just think it’s nicer to know a little bit where this is going before you start. And the more you see of this—I mean, as I mentioned, after 600 bite appliances in the mouths of my patients, I started to see patterns. And sometimes in the end, after 20 years of practicing, I started to say, let’s just start, see where this ends. But I would always inform the patients: if it goes totally out of control, we might end up needing surgery, and there’s no way to avoid it if that happens. And if the patients were okay with that, we’d just start out. Because I mean, is it bad? No. I just start the orthodontic treatment and I set the teeth as they should be in the right framework. Sometimes the upper and the lower jaw don’t fit together. Well, send them to the surgeon and they will move either the upper or the lower jaw into the right position, and then we have it. No harm is done because we have done the initial work that the orthodontist would do. But I will say when I had these surgical patients—let’s say we just started out with aligners and we figured, I can’t control this enough. I need a surgeon to look at this—then I would send them off to an orthodontist, and the orthodontist and the surgeon would take over. Because then—I mean, surgical patients and kids—that’s the second group of patients besides the extraction cases that I would not treat as a GP. ‘Cause we simply don’t know enough about how to affect growth on kids. And when it comes to surgery, there’s so much that is… so much knowledge that we need to know and the collaboration with the surgeons that we’re not trained to handle. So I think that should be handled by the orthodontists as well. [Jaz] I think collaborative cases like that are definitely specialist in nature, and I think that’s a really good point. I think the point there was informed consent. The mistake is you don’t warn the patient or you do not do the correct screening. So again, I always encourage my guests—so Jesper, you included—that we may disagree, and that’s okay. That’s the beauty of dentistry. So something that I look for is: if the patient has a stable and repeatable maximum intercuspal position, things lock very well, and there’s a minimal slide—like I use my leaf gauge and the CR-CP is like a small number of leaves and the jaw hardly moves a little bit—then there’s no point of uncoupling them, removing that nice posterior coupling that they have just to chase this elusive joint position. Then you have to do so many more teeth. But when we have a breakdown in the system, which you kind of said, if there’s wear as one aspect, or we think that, okay, this patient’s occlusion is not really working for them, then we have an opportunity to do full-mouth rehabilitation in enamel. Because that’s what orthodontics is. And so that’s a point to consider. So I would encourage our GP colleagues to look at the case, look at the patient in front of you, and decide: is this a stable, repeatable occlusion that you would like to use as a baseline, or is there something wrong? Then consider referring out or considering—if you’re more advanced in occlusion studies—using an alternative position, not the patient’s own bite as a reference. So anything you wanna add to that or disagree with in that monologue I just said there? [Jesper] No, I think there’s one thing I’d like the listeners to consider. I see a lot of fighting between orthodontists and GPs, and I think it should be a collaboration instead. There’s a lot of orthodontists that are afraid of GPs taking over more and more aligner treatments, and they see a huge increase in the amount of cases that go wrong. Well, there’s a huge increase of patients being treated, so there will be more patients, just statistically, that will get into problems. Now, if the orthodontist is smart—in my opinion, that’s my opinion—they reach out to all their referring doctors and they tell them, look, come in. I will teach you which cases you can start with and which you should refer. Let’s start there. Start your aligner treatments. Start out, try stuff. I will be there to help you if you run into problems. So whenever you see a challenge, whenever there’s a problem, send the patient over to me and I’ll take over. But I will be there to help you if anything goes wrong. Now, the reason this is really, really a great business advice for the orthodontists is because once you teach the GPs around you to look for deviations from the normal, which would be the indication for orthodontics, the doctors start to diagnose and see a lot more patients needing orthodontics and prescribe it to the patients, or at least propose it to the patients. Which would initially not do much more than just increase the amount of aligner treatments. But over time, I tell you, all the orthodontists doing this, they are drowning in work. So I mean, they will literally be overflown by patients being referred by all the doctors, because suddenly all the other doctors around them start to diagnose orthodontically. They see the patients which they haven’t seen before. So I think this is—from a business perspective—a really, really great thing for the orthodontists to have a collaboration with this. And it’ll also help the GPs to feel more secure when they start treating their patients. And in the end, that will lead to more patients getting the right treatment they deserve. And I think that is the core. That is what’s so important for us to remember. That’s what we’re here for. I mean, yes, it’s nice to make money. We have to live. It’s nice with a great business, but what all dentists I know of are really striving for is to treat their patients to the best of their ability. And this helps them to do that. [Jaz] Ultimate benefactor of this collaborative approach is the patient. And I love that you said that. I think I want all orthodontists to listen to that soundbite and take it on board and be willing to help. Most of them I know are lovely orthodontists and they’re helping to teach their GPs and help them and in return they get lots of referrals. And I think that’s the best way to go. Let’s talk a little bit about occlusal goals we look for at the end of orthodontics. This is an interesting topic. I’m gonna start by saying that just two days ago I got a DM from one of the Protruserati, his name is Keith Curry—shout out to him on Instagram—and he just sent me a little message: “Jaz, do you sometimes find that when you’re doing alignment as a GP that it’s conflicting the orthodontic, the occlusal goal you’re trying to get?” And I knew what I was getting to. It’s that scenario whereby you have the kind of class II division 2, right? But they have anterior guidance. Now you align everything, okay, and now you completely lost anterior guidance. And so the way I told him is that, you know what, yes, this is happening all the time. Are we potentially at war between an aesthetic smile and a functional occlusion? And sometimes there’s a compromise. Sometimes you can have both. But that—to achieve both—needs either a specialist set of eyes or lots of auxiliary techniques or a lot more time than what GPs usually give for their cases. So first let’s touch on that. Do you also agree that sometimes there is a war between what will be aesthetic and what will be a nice functional occlusion? And then we’ll actually talk about, okay, what are some of the guidelines that we look for at the end of completing an aligner case? [Jesper] Great question and great observation. I would say I don’t think there’s a conflict because what I’ve learned is form follows function. So if you get the function right, aesthetics will always be great. Almost always. I mean, we have those crazy-shaped faces sometimes, but… so form follows function. The challenge here is that in adult patients, we cannot manipulate growth. So a skeletal deviation is a skeletal deviation, which means if we have a class II patient, it’s most likely that that patient has a skeletal deviation. I rarely see a dental deviation. It happens, but it’s really, really rare. So that means that in principle, all our class II and chronic class III patients are surgical patients. However, does that mean that we should treat all our class II and class III patients surgically? No, I don’t think so. But we have to consider that they are all compromise cases. So we need to figure a compromise. So initially, when I started out with my occlusal knowledge, I have to admit, I didn’t do the orthodontic treatment planning. I did it with Heller, and she would give me feedback and tell me, I think this is doable and this is probably a little bit challenging. If we do this instead, we can keep the teeth within the bony frame. We can keep them in a good occlusion. Then I would say, well, you have a flat curve of Spee. I’d like to have a little bit of curve. It’s called a curve of Spee and not the orthodontic flat curve of Spee. And then we would have a discussion back and forth about that. Then initially I would always want anterior coupling where the anterior teeth would touch each other. I have actually changed that concept in my mind and accepted the orthodontic way of thinking because most orthodontists will leave a little space in the anterior. So when you end the orthodontic treatment, you almost always have a little bit of space between the anterior teeth so they don’t touch each other. Why? Because no matter what, no matter how you retain the patient after treatment, there will still be some sort of relapse. And we don’t know where it’ll come or how, but it will come. Because the teeth will always be positioned in a balance between the push from the tongue and from the cheeks and the muscles surrounding the teeth. And that’s a dynamic that changes over the years. So I don’t see retention as a one- or two-year thing. It’s a lifelong thing. And the surrounding tissues will change the pressure and thereby the balance between the tongue and the cheeks and where the teeth would naturally settle into position. Now, that said, as I mentioned initially, if we fight the muscles, we’ll lose. So let’s say we have an anterior open bite. That will always create a tongue habit where the patient positions the tongue in the anterior teeth when they swallow because if they don’t, food and drink will just be splashed out between the teeth. They can’t swallow. It will just be pushed out of the mouth. [Jaz] So is that not like a secondary thing? Like that tongue habit is secondary to the AOB? So in those cases, if you correct the anterior open bite, theoretically should that tongue posture not self-correct? [Jesper] Well, we would like to think so, but it’s not always the case. And there’s several reasons to it. Because why are the teeth in the position? Is it because of the tongue or because of the tooth position? Now, spacing cases is one of those cases where you can really illustrate it really well. It looks really easy to treat these patients. If we take away all the soft tissue considerations on the profile photo, I mean, you can just retract the teeth and you close all the spaces—super easy. Tipping movements. It’s super easy orthodontically to move quickly. Very easy as well. However, you restrict the tongue and now we have a retention problem. So there are three things that can happen. You can bond a retainer on the lingual side or the palatal side of the teeth, upper, lower—just bond everything together—and after three months, you will have a diastema distal to the bonded retainer because the tongue simply pushes all the teeth in an anterior direction. [Jaz] I’ve also seen—and you’ve probably seen this as well—the patient’s tongue being so strong in these exact scenarios where the multiple spacing has been closed, which probably should have been a restorative plan rather than orthodontic plan, and the retainer wire snaps in half. [Jesper] Yes, from the tongue. [Jaz] That always fascinated me. [Jesper] Well, you’ll see debonding all the time, even though you sandblast and you follow all the bonding protocol. And debonding, breaking wires, diastemas in places where you think, how is that even possible? Or—and this is the worst part—or you induce sleep apnea on these patients because you simply restrict the space for the tongue. So they start snoring, and then they have a total different set of health issues afterwards. So spacing—I mean, this just illustrates the power of the tongue and why we should always be careful with spacing cases. I mean, spacing cases, in my opinion, are always to be considered ortho-restorative cases. Or you can consider, do you want to leave some space distal to the canines? Because there you can create an optical illusion with composites. Or do you want to distribute space equally between the teeth and place veneers or crowns or whatever. And this is one of those cases where I’d say aligners are just fabulous compared to fixed appliances. Because if you go to an orthodontist only using fixed appliances and you tell that orthodontist, please redistribute space in the anterior part of the maxilla and I want exactly 1.2 millimeters between every single tooth in the anterior segment, six years later he’s still not reached that goal because it just moves back and forth. Put aligners on: three months later, you have exactly—and I mean exactly—1.2 millimeters of space between each and every single tooth. When it comes to intrusion and extrusion, I would probably consider using fixed appliances rather than aligners if it’s more than three millimeters. So every orthodontic system—and aligners are just an orthodontic system—each system has its pros and cons, and we just have to consider which system is right for this patient that I have in my chair. But back to the tongue issue. What should we do? I mean, yes, there are two different schools. So if you have, let’s say, a tongue habit that needs to be treated, there are those that say we need to get rid of the tongue habit before we start to correct the teeth. And then there are those that say that doesn’t really work because there’s no room for the tongue. So we need to create room for the tongue first and then train the patient to stop the habit. Both schools and both philosophies are being followed out there. I have my preferred philosophy, but I will let the listener start to think about what they believe and follow their philosophy. Because there is nothing here that is right or wrong. And that is— [Jaz] I think the right answer, Jesper, is probably speak to that local orthodontist who’s gonna be helping you out and whatever they recommend—their religion—follow that one. Because then at least you have something to defend yourself. Like okay, I followed the way you said. Let’s fix it together now. [Jesper] That’s a great one. Yeah, exactly. [Jaz] Okay, well just touching up on the occlusion then, sometimes we do get left with like suboptimal occlusions. But to be able to define a suboptimal occlusion… let’s wrap this occlusion element up. When we are completing an orthodontic case—let’s talk aligners specifically—when the aligners come off and the fixed retainers come on, for example, and the patient’s now in retention, what are some of the occlusal checkpoints or guidelines that you advise checking for to make sure that, okay, now we have a reasonably okay occlusion and let things settle from here? For example, it would be, for me, a failure if the patient finishes their aligners and they’re only holding articulating paper on one side and not the other side. That’s for me a failure. Or if they’ve got a posterior open bite bilaterally. Okay, then we need to go refinement. We need to get things sorted. But then where do you draw the line? How extreme do you need to be? Do you need every single tooth in shim-stock foil contact? Because then we are getting really beyond that. We have to give the adaptation some wiggle room to happen. So I would love to know from your learning at Pankey, from your experience, what would you recommend is a good way for a GP to follow about, okay, it may not be perfect and you’ll probably never get perfect. And one of the orthodontists that taught me said he’s never, ever done a case that’s finished with a perfect occlusion ever. And he said that to me. [Jesper] So—and that’s exactly the point with orthodontics. I learned that imagine going to a football stadium. The orthodontist will be able to find the football stadium. If it’s a reasonable orthodontist, he’ll be able to find the section you’re going to sit in. And if he’s really, really, really good, he will be able to find the row that you’re going to sit in. But the exact spot where you are going to sit, he will never, ever be able to find that with orthodontics. And this is where settling comes in and a little bit of enamel adjustments. [Jaz] I’m so glad you said that. I’m so glad you mentioned enamel adjustment. That’s a very dirty word, but I agree with that. And here’s what I teach on my occlusion courses: what we do with aligners essentially is we’re tampering with the lock. Let’s say the upper jaw is the lock. It’s the still one. We’re tampering with the key, which is the lower jaw—the one that moves—we tamper with the key and the lock, and we expect them both to fit together at the end without having to shave the key and to modify the lock. So for years I was doing aligners without enamel adjustment ’cause my eyes were not open. My mind was not open to this. And as I learned, and now I use digital measuring of occlusion stuff and I seldom can finish a case to get a decent—for my criteria, which is higher than it used to be, and my own stat—is part of my own growth that’s happened over time is that I just think it’s an important skill that GPs are not taught and they should be. It’s all about finishing that case. And I think, I agree with you that some adjustment goes a long way. We’re not massacring enamel. It’s little tweaks to get that. [Jesper] Exactly. I like the sound there because sometimes you hear that “ahh,” it doesn’t really sound right, but “tsst,” that’s better. [Jaz] That’s the one. You know, it reminds me of that lecture you did in Copenhagen. You did this cool thing—which I’ve never seen anyone do before. You sat with one leg over the other and you said, okay guys, bite together. Everyone bit together. And then you swapped the legs so the other leg was over the other and bite together. And then you said, okay, whose occlusion felt different? And about a third of the audience put their hand up, I think. Tell us about that for a second. [Jesper] Well, just promise me we go back to the final part because there are some things we should consider. [Jaz] Let’s save this as a secret thing at the end for incentive for everyone to listen to the end—how the leg position changes your occlusion. Let’s talk about the more important thing. I digressed. [Jesper] Let’s talk about the occlusal goals because I think it’s important. I mean, if you do enamel adjustments in the end—so when we finish the treatment, when we come to the last aligner in the treatment plan—I think we should start by breaking things down to the simplest way possible. Start by asking the patient: are you satisfied with the way the teeth look? Yes or no? If she’s satisfied, great. How do you feel about the occlusion? “Well, it fits okay.” Great. Now the patient is happy. There’s nothing she wants to—or he wants to—change. Then you look at the occlusion. Now, it is important to remember that what we see on the computer screen, on the aligner planning tools, will never, ever correspond 100% to what we see in the mouth of the patient. And there are several reasons for that. But one of the things that we have found to be really interesting is that if you take that last step and you say, okay, the occlusion doesn’t fit exactly as on the screen, but it’s kind of there… if you use that last step and you don’t do a re-scan for a retainer, but you use the last step of the aligner treatment as your reference for your aligner retainer… We sometimes see that over six months, if the patient wears that aligner 22 hours a day for another three to six months, the teeth will settle more and more into the aligner and create an occlusion that looks more and more like what you see on the screen. Which to me just tells me that the biology doesn’t necessarily follow the plan everywhere in the tempo that we set throughout the aligner plan. But over time, at the last step, if it’s just minor adjustments, the teeth will actually move into that position if we use the last stage as a reference for the retainer. Now, if we do a scan at that point and use that as a reference for creating an aligner retainer, then we just keep the teeth in that position. Now, if the teeth are a little bit more off— [Jaz] I’m just gonna recap that, Jesper, ’cause I understood what you said there, but I want you to just make sure I fully understood it. When we request, for example, Align, the Vivera retainer, it gives you an option: “I will submit a new scan” or “use the last step.” And actually I seldom use that, but now I realize you’re right. It makes sense. But then on the one hand, if the occlusion is—if the aesthetics are good and the patient’s occlusion feels good, what is your own judgment to decide whether we’re still going to allow for some more settling and occlusal changes to happen over a year using the Vivera retainers based on the ClinCheck last-aligner profile, rather than, okay, let’s just retain to this position? What is making you do the extra work, extra monitoring? [Jesper] To me, it’s not extra monitoring. It’s just basic. I mean, it’s just part of my protocol. I follow the patients. And honestly, to me, it’s just time-saving to just use the last step in the aligner. Because I mean, if the plan is right and if the teeth have been tracking well, they should be in that position. Why do I then need to re-scan for Vivera retainers or for other kinds of retainers? Now, if the occlusion is a little bit more off—and in a minute you’ll probably ask me when do I see which is which, and I can’t really tell you; it’s about experience—but that’s the beauty of this. If I see there’s a little bit more deviation and I like some teeth, the occlusion isn’t really good on one side compared to the other side, I would rather have a bonded retainer from first premolar to first premolar in the mandible, combined with a Hawley or Begg or something like that retainer for the upper. And you can order them with an acrylic plate covering some of the anterior teeth so they keep that position, but that allows the teeth to settle. And over three months you should see some kind of improvement. If you don’t see enough improvement and let’s say you still have a tendency for a kind of an open bite on one side, you can always add some cross elastics, put some buttons on the upper, on the lower, instruct the patient to use these, and then in three months you will have the occlusion you want. Now, once that is established—you have that kind of occlusion—you need to keep the teeth there for at least six months before you do some kind of equilibration or enamel adjustment. Because if you do the enamel adjustment right after you have reached your final destination for the teeth, the teeth will still settle and move. So you do the equilibration, two weeks later everything looks off again. You do the equilibration, two weeks later things have changed again. So I prefer to wait six months before I do the final equilibration. Now, in this equation what we’ve been talking about here, it goes from very simple to more and more complex. And then we have to consider, well, did I expand the mandible posterior segment? If so, I can’t just use a bonded retainer on the lower and I need to add something to keep the teeth out there in combination with whatever I want in the upper. Do I want to keep the Begg retainer or the Hawley, or do I want to change to something differently? So these kinds of considerations have to be there from the beginning of the treatment because, I mean, it costs additional money to order a Begg retainer compared to just an aligner. [Jaz] A Begg retainer is the same as Hawley? [Jesper] Well, no. It has a little different design. [Jaz] Oh, a Begg as in B-E-G-G? [Jesper] Yes. [Jaz] Yeah, got it. Got it. Okay. [Jesper] And then in Denmark we use the Jensen retainer, which is a Danish invention, which goes from canine to canine or from first premolar to first premolar but with a different type of wire which keeps the teeth more in place compared to a round wire. So there are different variations. The most important part here is it allows the posterior teeth to settle so they can move, which they can’t in an aligner to the same degree at least. Now, this is all really nice in teeth that only need to be moved into the right position, but most of our patients are adult patients, or they should at least be adult patients. Most of my patients were more than 30 years old. So if you have a patient with anterior crowding and you move the teeth into the right position where the teeth should be, the teeth are in the right position, but they still look ugly because they have been worn anteriorly by the position they were in when they were crooked. So when we position them, we still need to do some restorative work. Then what? We still need to retain those teeth. The patient wants to be finished now as fast as possible, so we can’t wait the six months to make the final touches. So we have to figure out: what do we do? And then we have to think of some kind of retention strategy to keep the teeth in place during that restorative procedure. And I mean, at the end of an aligner treatment or any orthodontic treatment, two days is enough to have relapse in some patients. Some patients it’s not a problem. The teeth are just there to stay in the same position for three months, and then they start to move a little bit around. But other patients—I mean, you just have to look away and then go back to the teeth and they’re in a different position. You can’t know what kind of patient you have in your chair right now. So you have to consider the way you plan your restorative procedure in regards to how you retain the teeth during that phase. So if you want to do anterior composites or veneers, do it all at once. Put in a bonded retainer, scan, and get your aligner retainer as fast as possible. Or use a Begg or a Hawley or something like that that’s a little bit more flexible. If you want to do crowns, then we have a whole different challenge and then we have to consider how do we then retain the teeth. [Jaz] Okay. Well I think that was lovely. I think that gives us some thoughts and ideas of planning sequence of retention, which is the ultimate thing to consider when it comes to occlusion. Okay, yeah, you get the occlusion, but how do you retain it? But in many cases, as the patient’s wearing aligners, the occlusion is embedding in and is fine. And you take off the aligners, the patient’s happy with how it looks. They bite together. It feels good. You are happy that yes, both sides of the mouth are biting together. Now, it might not be that every single contact is shim-hold, but you got, let’s say, within 20 microns, 40 microns, okay? Then some bedding happens. In that kind of scenario, would you be happy to say, okay, I’m gonna scan your teeth as they are because I’m happy with the occlusion, the occlusal goals are good, and they’re near enough the ClinCheck, and go for the retainers to that position? Or is your default preference as a clinician to go for the Vivera or equivalent based on the last aligner, on the ClinCheck projection? [Jesper] I would still go for the last aligner because I think the planning I’ve done is probably a little bit more precise than what I see clinically. However, I still expect that I will have to do a little bit of enamel reshaping at the end after six months, but that’s okay. I mean, the changes are so small, so you can still use the last aligner or the Vivera retainer that you already have ordered. So it’s not that much of a problem. [Jaz] Which goes back to your previous point: if it’s a big deviation, then you’ve gotta look at the alternative ways, whether you’re gonna go for refinement or you’re gonna allow some occlusal settling with a Hawley and a lower fixed-retainer combination, or the elastics like you said. Okay. Just so we’re coming to the end of the podcast—and I really enjoyed our time—I would like to delve deep into just a final thing, which is a little checklist, a helpful checklist for case assessment that you have for GDPs. [Jesper] Yeah, thank you. First of all, one of the big challenges in a GP practice is being able to take a full series of clinical photos in two minutes without assistance. I think most dentists struggle with that, but that is a foundational prerequisite to any aligner treatment. Once you have the photos, I would sit down with the photos and I would consider six different steps. One: is this a patient that I could treat restoratively only? Because that would be the simplest for me to do. Next, moving up in complexity: would be, do I need periodontal crown lengthening? Or next step would be: do I need to change the vertical dimension, or is there something about centric relation that I should consider? Moving up a little bit on the complexity: are there missing teeth? Do I need to replace teeth with implants? Next step would be orthodontics. So this is step five. The next most complex case we can treat is actually an aligner case—orthodontics in general. And the last part would be: are the teeth actually in the right position in the face of the patient, or do I need surgery to correct the jaw position? So these six steps, I think they’re helpful to follow to just think, how can I break this case down into more easy, digestible bits and pieces to figure out what kind of patient I have in front of me? Now, if you consider it to be an orthodontic case or ortho-restorative case, here comes the challenge: case selection. How do you figure out is this an easy, moderate, complex, or referral case? And here’s the trick: do 500 to 1000 treatment plans or treatments with clear aligners. And then you know. But until then, you really don’t. This is where you should rely on someone you can trust who can help you do the initial case selection. Because you can have two identical patients—one is easy and one is super complex—but they look the same. So it’s really nice if you have done less than 500 cases to have someone who can help you with the case selection. And I don’t say this to sell anything, because we don’t charge for that. Because it’s so essential that we don’t do something that is wrong or gives us a lot of challenges and headaches in the practice. I mean, the practice runs really fast and lean-oriented, so we need to make things digestible, easy to work with. And I think that’s really important. [Jaz] It goes full circle to what we said before about having that referral network, staying in your lane, knowing when to refer out, cherry-picking—it all goes back full circle with that. And not even orthodontics, but restorative dentistry—case selection is just imperative in everything we do. [Jesper] Yes. And there is—we always get the question when we do courses and we do consulting—can’t you just show me a couple of cases that are easy to start with? And it works with implants, kind of. But with orthodontics where we move—I mean, we affect all the teeth—it’s just not possible. I know the aligner companies want to show you some where you say, you can only just do these kinds of cases and they are really easy. The fact is they’re not. But they want to sell their aligners. [Jaz] I get it. They are until they’re not. It’s like that famous thing, right? Everyone’s got a plan until they get punched in the face. So yeah, it can seemingly be easy, but then a complication happens and it’s really about understanding what complications to expect, screening for them, and how you handle that. But thanks so much. Tell us—yeah, go on, sorry. [Jesper] There are three things I’d like to end on here. So, first of all, we’ve been talking together for about an hour about a topic that, if you want to take postgraduate education, it takes three years to become an orthodontist. And there is a reason it takes three to four years. However, I want to encourage the listener to think about this: Mercedes has never, ever excused last year’s model. Meaning that they always strive for perfection. So if we go into the practice and we do the very best we can every single day, there is no way we can go back and excuse what we

Join Mark and Tyler for a special Mailbag episode of The Hours podcast! Celebrating over 600 members in the Savvy Basketball community, they tackle listener-submitted "smart questions" that show effort and application. This episode dives deep into coaching philosophy, from youth development to high-level defensive strategy, emphasizing principles over prescribed plays and function over form.Get ready for an in-depth discussion on how to teach modern basketball, why reacting to your opponent means you've already lost, and how to improve shooting effectively mid-season.

In this episode, we explore the science of learning with leading experts Dr. John Dunlosky and Dr. Regan Gurung. They discuss common misconceptions in adult learning, the importance of self-regulated learning, and effective strategies for retention and application of knowledge. The conversation highlights the role of knowledge in the age of AI, the significance of interleaving and spaced practice, and the concept of priming in enhancing learning outcomes.Dr. John Dunlosky is a prominent Professor of Psychology and the Director of the Science of Learning Center in the Department of Psychological Sciences at Kent State University. He is a leading expert in cognitive science, human learning and memory, and effective study methods, focusing his research on metacognition and self-regulated learning across the lifespan.Dr. Dunlosky is recognized for his work on evidence-based learning strategies. A significant contribution is his 2013 review on learning techniques, which highlights the effectiveness of methods like practice testing and distributed practice. He is the co-author of the textbook Metacognition and has also written books for a general audience, such as Study Like a Champ and Teach Like a Champ.https://www.amazon.com/Study-Like-Champ-Psychology-Based-LifeTools/dp/1433840170Dr. Regan A. R. Gurung is a Professor of Psychology at Oregon State University and author specializing in social, health, and pedagogical psychology. He is a prominent figure in the field of teaching and learning in psychology.Dr. Gurung's research interests include social, health, and pedagogical psychology, and applying cognitive science to enhance student learning. He has authored or co-authored/co-edited 15 books and over 130 articles and chapters. His recent books include Study Like a Champ, Thriving in Academia, and Teach Like a Champ.https://regangurung.com/books/https://regangurung.wixsite.com/pip2022TAKEAWAYSLearning outcomes depend on what people do between sessions.Effective study strategies are critical for adult learners.Misconceptions about learning can hinder progress.Self-regulated learning enhances retention and application.Knowledge is essential, even with AI tools available.Interleaving and spaced practice improve learning outcomes.Priming can enhance memory retrieval during learning.Training should focus on transfer of knowledge to real-world applications.Learning is a process that requires effort and attention.Understanding individual differences can improve learning effectiveness.Chapters00:00 The Myths of Adult Learning00:17 Understanding Learning Science03:09 Misconceptions in Adult Learning05:57 The Importance of Self-Regulated Learning08:21 The Curse of Knowledge10:40The Role of Knowledge in the Age of AI13:09 Effective Retention Strategies16:01 Application and Transfer of Knowledge18:25 The Role of Trainers in Learning20:46 Designing for Transfer23:10 Interleaving and Spacing in Learning35:39 The Power of Priming in Learning

*President Trump is calling for an investigation of the meat packing industry.  *We are nearing an end to the government shutdown.   *West Texas A&M hosted a groundbreaking for their new research feedlot. *Corn is a major crop for the Texas High Plains region.  *Spacing and support are important when planting trees to enhance the value of rural property.  *Sometimes Bermuda grass stands slowly thin or die over time.  *Wildlife can be affected by the New World screwworm.  

EPISODE 65: UFDP talks with Emma Lehnhardt, former Program Planning and Control Manager for NASA's Gateway Program, about what she wishes writers knew about the science part of science fiction , and what's actually been going on at NASA in the wake of Trump and DOGE cuts.

Erwan et Thomas se penchent sur les Atlanta Hawks, et notamment sur l'arrivée de Kristaps Porzingis. Son intégration dans un roster déjà bien construit autour de Trae Young, notre Zaccharie Risacher et un Jalen Johnson de retour pourrait bien transformer Atlanta en véritable outsider. Spacing, équilibre, défense : les Hawks ont-ils enfin trouvé la bonne formule pour surprendre la ligue cette saison ? Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Send us a textMeal timing significantly impacts GLP-1 response, appetite regulation, and metabolic health, making strategic eating schedules as important as food choices for weight management and overall wellness.• Strategic meal timing optimizes metabolism, weight loss, and gut health while reducing sugar spikes• Spacing meals 4-5 hours apart naturally increases GLP-1 production and improves insulin sensitivity• Eating earlier in the day (front-loading calories) leads to better metabolic response than late-night meals• Avoiding food 2-3 hours before bedtime improves digestion and metabolic function• Meal composition sequence matters: protein first, followed by fats and fiber, then complex carbs• Quality protein at each meal reduces cravings and hunger spikes• Smart snacking requires protein-forward choices rather than simple carbs or sugary options• Many hunger signals are actually dehydration, boredom, or stress responses Support the showSponsor Affiliates Empowering Wellness Through Evidence-Based Education https://www.atecam.com/ Get YOUR Own Joburg Protein Snacks Discount Code: Damaris15 Or Damaris18 Feeling need to Lose Weight & Become metabolically Healthy GET METABOLIC COURSE GLP 1 REseT This course is designed for individuals looking to optimize their metabolic health through integrative and functional medicine approaches. Whether you're on a GLP-1 medication or seeking natural ways to enhance your metabolic function, this course provides actionable steps, expert insights, and a personalized roadmap sustainable wellness. Are you feeling stressed, tired, or Metabolism imbalanced? Take advantage of our free mindful steps to help improve your well-being.ENJOY ONE OF our Books Mindful Ways Health Wealth & Life https://stan.store/Mindfullyintegrative Join Yearly membership ALL IN O...

#gardening  Email your questions to Gardentalkradio@gmail.com Or call 1-800-927-SHOW  Segment 4: Garden questions answered   Sponsors of the show for 2025 Phyllom BioProducts of http://www.phyllombioproducts.comPomona pectin of https://pomonapectin.com/Dripworks of https://www.dripworks.com/Walton's Inc of https://www.waltonsinc.com/  Us code grow50 and save 10% off your order of $50 or more Natural green products of https://www.natgreenproducts.com/ use promo code freeship4meany size No More Bugs!Rescue of https://rescue.com/Jung Seeds of https://www.jungseed.com/category/talk-gardening use code 15GT25 to save 15% off ordersWind River Chimes of https://windriverchimes.com/Wisconsin Greenhouse Company of https://wisconsingreenhousecompany.com/Mantis of https://mantis.com/Summit Chemical of https://summitchemical.com/Iv organics of https://ivorganics.com/  Use radio10 to save 10% off your orderSoilmoist.com of https://www.soilmoist.com/products/soil-moist.phpDavid J Frank of https://davidjfrank.com/ Timber Pro Coatings of https://timberprocoatingsusa.com/products/internal-wood-stabilizer/Totally tomatos of totallytomato.com/category/talk-gardening use code 15GT25 to save 15% off ordersr.h.shumway https://www.rhshumway.com/category/talk-gardening  use code 15GT25 to save 15% off ordersVermont Bean https://www.vermontbean.com/category/talk-gardening use code 15GT25 to save 15% off ordersEdmunds Roses use code https://www.edmundsroses.com/category/talk-gardening 15GT25 to save 15% off orders https://www.azurestandard.com/  Use code Use Promo Code: JOEYANDHOLLY15 applied at checkout to get 15% off for new customers who open an account for the first time and place a minimum order of $100 or more, shipped to a drop location of their choice.Root and Rhizomes https://www.rootsrhizomes.com/category/talk-gardeninguse code 15GT25 to save 15% off ordersKarrikaid https://karrikaid.com/ Use Code Radio10 at checkout and get 10% your order  Tarps https://tarps.com/Sunwarrior https://sunwarrior.com/ Use code JOEYHOLLY25” that will get you 25% off all productsat checkout Grow Smart https://www.grosmart.com/  use code “radio” at check out and save 10% on your order Lawn symergy https://lawnsynergy.com/Azure Standard of https://www.azurestandard.com/ use code : Use Promo Code: JOEYANDHOLLY15 applied at checkout to get 15% off for new customers who open an account for the first time and place a minimum order of $100 or more, shipped to a drop location of their choice.Durable green bed https://durablegreenbed.com/Tree IV https://treeiv.com/Brome Bird Care https://bromebirdcare.com/en/Chip Drop https://getchipdrop.com/For Jars of https://forjars.co/  Use the code: forjars25 to get a 10% discount on your orderAzure https://www.azurestandard.com/ Use Promo Code: JOEYANDHOLLY15 applied at checkout to get 15% off for new customers who open an account for the first time and place a minimum order of $100 or more, shipped to a drop location of their choice.Corba head hand tools https://www.cobrahead.com/ use code soil for 10% your order at checkout valid once per customer Soil Savvy https://www.mysoilsavvy.com/Phyllom Bioproducts http://www.phyllombioproducts.com/home.htmlShore and Chore https://shoreandchore.com/Dig Defence of https://digdefence.com/Weed Wrench  https://www.weed-wrench.com/home us code weed at check out to save $10.00 on your order Milk weed balm of https://milkweedbalm.com/ Use code: gardening for 20% off your orderOne sweet earth of https://onesweetearth.com/

Send us a text If you've ever wasted time manually dragging pins around in Tailwind, this episode is going to make you so happy. I'm breaking down Tailwind's brand-new Pin Spacing Tool—how it works, why it matters, and how to customize it for launches or seasonal campaigns.This tool is a major time-saver for service-based business owners, helping you stay consistent, avoid spam triggers, and free up time to focus on creating content that actually converts.Shownotes (ALL THE LINKS): https://jenvazquez.com/tailwind-pin-spacing-tool-save-time-and-prevent-pinterest-spam-filters/

Rihanna's back-to-back pregnancies have sparked conversations about pregnancy spacing - how close is too close between births? In this episode, we break down what research says about short pregnancy intervals, the risks for mom and baby. Whether you're planning your next child or just curious about the medical facts, you'll learn what's recommended and why timing matters.

This week on the pod, Jen and Brett sat down with writer, producer, and newly published author David Meyer. They chatted about his new book Five Minutes From a Meltdown, and got to the heart of poetry, or something like that.David's Recommendations:- You Don't Have to Have a Dream by Tim Minchin- How to Be Perfect by Michael Schur- Egghead by Bo BurnhamThe Village Well Podcast is brought to you by Village Well Books & Coffee⁠⁠⁠⁠⁠⁠ in downtown Culver City, CA. Each episode, we interview authors and readers about books that capture our imagination. New episodes every Wednesday.If you'd like to get in touch, you can email us at ⁠⁠⁠⁠⁠podcast@villagewell.com⁠⁠⁠⁠⁠.If you love the show and want us to keep creating, please consider subscribing on YouTube or leaving us a review wherever you listen!

Check out The Basketball IQ Masterclass: https://www.visiondrivenbball.com/opt-in-801f8775-ceda-402f-9618-c6f4013d0f5bYou can be the most skilled player on the court… but if your spacing is off, you'll clog the offense, frustrate your coach, and miss easy scoring chances.In this video, I'll break down the exact spacing concepts and in-game situations you need to master so you're always in the right spot, creating opportunities, and making your teammates (and coach) love playing with you.Check out Basketball IQ Academy (The Elite Scorer Blueprint): https://www.visiondrivenbball.com/basketball-iq-academy

In this episode of Get It Seen: The Simplest Way to Accessible Design host Michelle Frechette and typography expert Piccia Neri discuss the vital role of typography in web accessibility. They explore how factors like font choice, size, alignment, kerning, and style impact readability and legibility for all users, including those with visual or neurological differences. The conversation highlights common pitfalls—such as using all caps, centered text, or decorative fonts—and offers practical tips for creating accessible, user-friendly content. Real-world examples underscore how thoughtful typography can improve user experience and even boost website conversions. The episode concludes with a preview of next week's focus on color and contrast.Top Takeaways:Typography Is More Than Just Fonts — It's a Core Element of Accessibility: Typography includes not only font choices but also layout, spacing, alignment, font weight, size, line height, tracking, and visual hierarchy. These elements together shape how readable and legible text is, directly affecting accessibility and user experience.Readability and Legibility Are Different, and Both Matter: Legibility is about how easily individual letters can be distinguished (e.g., clear letterforms, avoiding imposter letters like I/l/1). Readability refers to how easily blocks of text can be read and understood (e.g., proper line length, avoiding full justification, using appropriate spacing). Both need to be considered when designing for diverse users, including those with dyslexia or visual impairments.Alignment Strongly Impacts Usability and Conversion: Left-aligned text is significantly easier to read, especially online. Centered or poorly aligned text disrupts the reader's visual flow and can make content inaccessible.There Are No Universally "Perfect" Accessible Typefaces: Recommendations like "use sans-serif fonts" or “Arial is accessible” are oversimplified. Accessibility depends on how the typeface is used, whether it distinguishes similar characters clearly (e.g., capital I vs. lowercase L), and whether it's appropriate for your audience. Typefaces like Atkinson Hyperlegible are designed with accessibility in mind, but even these aren't universally preferred.Mentioned in the Show:Don't Make Me Think Book By Steve KrugAtkinson HyperlegibleSöhne Klim Type Foundry National Klim Type FoundryJosef AlbersAccessible typeface checklist – free resourceAccessible Typography 101 course – 30% discount code: PODCAST30Better Accessibility Through Typography Masterclass – 30% discount code: PODCAST30

Today, we are joined by Dr. Daniel Willingham.Daniel T. Willingham is a Professor of Psychology at the University of Virginia, known for his work applying cognitive psychology to K-16 education. He earned his B.A. from Duke University and his Ph.D. in Cognitive Psychology from Harvard University. Initially, his research focused on the brain basis of learning and memory, but he later shifted his focus to the practical applications of cognitive science in education. He is the author of several books, including Why Don't Students Like School?, When Can You Trust the Experts?, and The Reading Mind.In this fascinating conversation, we explore the science behind effective learning and memory. Dr. Willingham reveals why most adults never update their learning strategies from school, the dangerous myths that persist about memory and learning styles, and the evidence-based techniques that actually work.Key topics include:Why adults rarely update their learning approachesDebunking persistent myths about memory, learning styles, and "brain training"The illusion of knowing and why familiarity doesn't equal true understandingWhy rereading, highlighting, and copying notes are ineffectiveThe power of retrieval practice Spacing effects versus cramming When and how to use mnemonic devices like memory palaces effectivelyThe fundamental principle of matching study methods to desired outcomesWhether you're a lifelong learner, educator, or leader looking to enhance your own learning capabilities, Dr. Willingham's research-backed insights will transform how you approach acquiring and retaining new knowledge.Dr. Daniel Willingham's Books: "Why Don't Students Like School?" https://www.amazon.com/Why-Dont-Students-Like-School/dp/1119715660 "Outsmart Your Brain" https://www.amazon.com/Outsmart-Your-Brain-Learning-Hard/dp/1982167173 -Website and live online programs: http://ims-online.com Blog: https://blog.ims-online.com/ Podcast: https://ims-online.com/podcasts/ LinkedIn: https://www.linkedin.com/in/charlesgood/ Twitter: https://twitter.com/charlesgood99 Chapters:(00:00) Introduction(01:15) Tool: Dr. Willingham's Journey from Neuroscience to Education(04:25) Technique: Why Adults Don't Update Their Learning Software(05:35) Tip: Overcoming Learning Overconfidence and Illusion of Knowing(09:10) Tool: Debunking Learning Styles and Common Memory Myths(11:25) Technique: Thinking About Meaning vs Mindless Repetition(14:45) Tip: Why Retrieval Practice Reigns Supreme for Learning(16:00) Tool: The Power of Overlearning and Spacing Effects(20:25) Technique: When and How to Use Mnemonic Devices Effectively(24:15) Tip: Matching Study Methods to Learning Outcomes(25:00) Conclusion#CharlesGood #DanielWillingham #TheGoodLeadershipPodcast #CognitiveScience #LearningScience #MemoryResearch #EducationalPsychology #EvidenceBasedLearning #LearningMyths #RetrievalPractice #SpacingEffect #MemoryPalace #AdultLearning #EffectiveLearning #ScienceOfLearning #LearningStrategies #MemoryTechniques #CognitivePsychology #LifelongLearning #LearningMethods

Subscribe to the ⁠⁠⁠⁠⁠Idaho Basketball Coaching Podcast⁠ newsletter⁠⁠⁠⁠---We are fortunate to have Matt Fletcher on this episode.Fletcher is the head coach at Concordia St. Paul in Minnesota. The Golden Bears are coming off one of the most successful seasons in the school's season, finishing with a 22-9 record, a first-ever conference title and a trip to the NCAA Division II Tournament.---EPISODE BREAKDOWN1:30 - Enjoying the growth of a program3:15 - Coaching the program you have4:50 - Recruiting locally5:55 - Factors of adopting an uptempo style7:50 - Playing quickly, but not rushed9:35 - Shot selection as a team11:20 - Recruiting decision making12:10 - When teams try to slow down13:50 - Creating & maintaining good spacing15:20 - Perimeter spacing concepts16:50 - Using SSGs for teaching spacing18:00 - Developing practice plans & activities19:50 - Using your best player as a spacer21:50 - The big in early offense23:35 - Flow after the initial trigger25:15 - Replicating neutral situations after actions27:30 - Communication in a conceptual offense29:35 - Teaching the pace of actions31:40 - Adopting NBA concepts34:15 - Rebounding as a weapon

Hey Heal Squad! We're back with Part 2 of our conversation with integrative pediatrician Dr. Joel Warsh, where breaks down how to cut through the noise when it comes to prevention, toxins, and true immune support (especially for kids!). We continue the important conversation on vaccine schedules and also get into everything from gut health and inflammation to why so many people are experiencing chronic symptoms. He also shares simple tips that every family can start using today to feel better, boost resilience, and protect long-term health. PLUS, we explore the power of trust, intention, and listening to your intuition, especially when making decisions that impact your health and your kids. If you've ever felt confused about what wellness really means or what your next step should be… this episode will help you come back to your center. Tune in!! HEALERS & HEAL-LINERS Prevention Starts Before Symptoms. By the time symptoms show up, the immune system has already been compromised. Dr. Joel shares tangible ways to be proactive with health, like reducing toxic load and focusing on clean nutrition and lifestyle habits. Over-Vaccination: A Hidden Immune Disruptor. While vaccines have value, overloading the immune system too early can lead to dysregulation. Spacing out vaccines, detoxing post-injection, and supporting the gut and nervous system can make all the difference. True Health Isn't Just About Avoiding Illness. Dr. Joel emphasizes that wellness is not just the absence of disease—it's thriving physically, mentally, and emotionally. Real prevention means building resilience, not just reacting when symptoms arise. -- HEAL SQUAD SOCIALS IG: https://www.instagram.com/healsquad/ TikTok: https://www.tiktok.com/@healsquadxmaria HEAL SQUAD RESOURCES: Heal Squad Website:https://www.healsquad.com/ Heal Squad x Patreon: https://www.patreon.com/HealSquad/membership Maria Menounos Website: https://www.mariamenounos.com My Curated Macy's Page: Shop My Macy's Storefront Prenuvo: Prenuvo.com/MARIA for $300 off EMR-Tek Red Light: https://emr-tek.com/discount/Maria30 for 30% off Airbnb: https://www.airbnb.com/  Join In-Person Heal Retreat Waitlist! https://mariamenounos.myflodesk.com/heal-retreat-waitlist GUEST RESOURCES: Instagram: https://www.instagram.com/drjoelgator/  Website: https://integrativepediatricsandmedicine.com/about/  Book: https://go.shopmy.us/p-21314744  ABOUT MARIA MENOUNOS: Emmy Award-winning journalist, TV personality, actress, 2x NYT best-selling author, former pro-wrestler and brain tumor survivor, Maria Menounos' passion is to see others heal and to get better in all areas of life. ABOUT HEAL SQUAD x MARIA MENOUNOS: A daily digital talk-show that brings you the world's leading healers, experts, and celebrities to share groundbreaking secrets and tips to getting better in all areas of life. DISCLAIMER: This Podcast and all related content (published or distributed by or on behalf of Maria Menounos or http://Mariamenounos.com and http://healsquad.com) is for informational purposes only and may include information that is general in nature and that is not specific to you. Any information or opinions provided by guest experts or hosts featured within website or on Company's Podcast are their own; not those of Maria Menounos or the Company. Accordingly, Maria Menounos and the Company cannot be responsible for any results or consequences or actions you may take based on such information or opinions. This podcast is presented for exploratory purposes only. Published content is not intended to be used for preventing, diagnosing, or treating a specific illness. If you have, or suspect you may have, a health-care emergency, please contact a qualified health care professional for treatment.

Send us a message!In this episode we will be covering Facebook Live Questions 7/8-7/12/25  from Dana's free Facebook Group Registered Dietitian Exam Study Group with Dana RD!Get the free RD Exam Prep Masterclass here. Looking for additional tutoring service? Visit my website! Shop all recorded courses at https://danajfryernutritiontutoring.teachable.comJoin the RD Exam Prep Mastery Program for access to the Situational Practice Questions, Vocab Classes, Wed 8pest Group tutoring , study guides and a new trouble area video each week!

Episode #225. This episode of The Presentation Podcast dives deep into the role of typography in PowerPoint presentations. The hosts discuss font selection, line and paragraph spacing, alignment, visual hierarchy and more. Plenty of practical tips and frustrations of typography formatting within PowerPoint are shared, along with comparing PowerPoint's features to other advanced design and desktop publishing tools. Solutions to common text formatting challenges in PowerPoint are also a big part of the conversation…because effective typography is essential for clear, professional, and engaging presentations. Listen now! Full Episode Show Notes https://thepresentationpodcast.com/2025/e255 Show Suggestions? Questions for your Hosts? Email us at: info@thepresentationpodcast.com Listen and review on iTunes. Thanks! http://apple.co/1ROGCUq New Episodes 1st and 3rd Tuesday Every Month

Welcome to episode 183 of Growers Daily! We cover: garlic rust and what to do about it, how to tell if your soil is healthy, and it's feedback friday! We are a Non-Profit! 

"If you don't cultivate other interests or travel or spend time with friends, this and that, you don't have anything to write about," says Dane Huckelbridge, author of Queen of All Mayhem (William Morrow).Dane returns to the show to talk about his latest book, but also a smattering of other juicy writer topics such as: Procrastination Writing around the uncertainty Not having much of a routine Spacing out Niche hobbies And staying motivatedDane can be found at danehuckelbridge.com and on IG @huckelbridge.This episodes opens with an audio excerpt of The Front Runner, read by Roger Wayne.Order The Front RunnerNewsletter: Rage Against the AlgorithmWelcome to Pitch ClubShow notes: brendanomeara.com

In this podcast episode, Cynthia Donovan and Stephanie Lauri discuss the critical role of nutrition during pregnancy. They explore the gaps in prenatal nutrition education, the importance of balanced meals, and how to manage food aversions and nausea. Stephanie shares practical tips for expecting mothers to optimize their nutrition while maintaining a realistic and flexible approach to eating. Cynthia and Stephanie emphasize the importance of hydration, managing constipation, and the need for a balanced diet. The conversation also touches on the significance of trusting one's body during pregnancy, especially regarding weight management and the individual nature of pregnancy experiences. Practical tips for symptom relief and meal planning are provided, making it a valuable resource for expectant mothers.Takeaways:Nutrition is often overlooked in prenatal care.Many women have questions about nutrition during pregnancy.Balanced meals and eating frequently help with nausea and energy levels.Full-fat products are important for nutrient absorption.Different nutrients are important at different pregnancy stages.Food aversions are common and can be managed.Comfort foods can be made more nutritious.Smoothies are a great way to add nutrition.It's important to focus on what to add, not restrict. Constipation is common in pregnancy due to slowed motility.Hydration is crucial, but can be challenging due to nausea.Spacing out water intake can help reduce nausea.Trial and error is essential for symptom management during pregnancy.Leaving snacks at bedside can help with morning nausea.Slowly increasing fiber intake is important for digestion.Movement, like walking, can aid in digestion and bowel movements.A variety of foods should be incorporated for balanced nutrition.Trusting your body is vital during pregnancy and postpartum.Weight gain varies greatly among individuals and does not determine baby health.Apply for coaching w/Cynthia:  https://0u8h3wddwmr.typeform.com/StrategyCallDiscover the truth about HA:  click the link to download Cynthia's fact sheet that debunks common myths and misinformation! Website: https://www.periodnutritionist.comInstagram: www.instagram.com/period.nutritionistFor the full show notes - please visit my website: periodnutritionist.com

How much space should you leave between deck boards? It depends on the material, the climate, and the tools you're using. In this episode, Shane and Wade break down the ideal spacing for pressure-treated lumber, cedar, composite, and PVC boards. They also cover the best tools to get it done right and explain what happens when you get it wrong. Whether you're a DIYer or a seasoned builder, this episode helps you build smarter, one board at a time.

In this episode, Paul was asked a question about where to find the 2 foot – 4 foot and 5 foot – 12-foot rules for receptacle spacing in the NEC, and why they do not see the 4 foot, or 12 feet mentioned. We also answer a question on do standalone sprinkler systems have to have a dedicated circuit and all the labeling requirements of a fire alarm system per NEC 760.41(B). Well, we have the answer for you on this episode so enjoy.Listen as Paul Abernathy, CEO, and Founder of Electrical Code Academy, Inc., the leading electrical educator in the country, discusses electrical code, electrical trade, and electrical business-related topics to help electricians maximize their knowledge and industry investment.If you are looking to learn more about the National Electrical Code, for electrical exam preparation, or to better your knowledge of the NEC then visit https://fasttraxsystem.com for all the electrical code training you will ever need by the leading electrical educator in the country with the best NEC learning program on the planetBecome a supporter of this podcast: https://www.spreaker.com/podcast/master-the-nec-podcast--1083733/support.

In this episode, Paul was asked a question about where to find the 2 foot – 4 foot and 5 foot – 12-foot rules for receptacle spacing in the NEC, and why they do not see the 4 foot, or 12 feet mentioned. We also answer a question on do standalone sprinkler systems have to have a dedicated circuit and all the labeling requirements of a fire alarm system per NEC 760.41(B). Well, we have the answer for you on this episode so enjoy.Listen as Paul Abernathy, CEO, and Founder of Electrical Code Academy, Inc., the leading electrical educator in the country, discusses electrical code, electrical trade, and electrical business-related topics to help electricians maximize their knowledge and industry investment.If you are looking to learn more about the National Electrical Code, for electrical exam preparation, or to better your knowledge of the NEC then visit https://fasttraxsystem.com for all the electrical code training you will ever need by the leading electrical educator in the country with the best NEC learning program on the planetBecome a supporter of this podcast: https://www.spreaker.com/podcast/electrify-electrician-podcast--4131858/support.

In this episode, Paul was asked a question about where to find the 2 foot – 4 foot and 5 foot – 12-foot rules for receptacle spacing in the NEC, and why they do not see the 4 foot, or 12 feet mentioned. We also answer a question on do standalone sprinkler systems have to have a dedicated circuit and all the labeling requirements of a fire alarm system per NEC 760.41(B). Well, we have the answer for you on this episode so enjoy.Listen as Paul Abernathy, CEO, and Founder of Electrical Code Academy, Inc., the leading electrical educator in the country, discusses electrical code, electrical trade, and electrical business-related topics to help electricians maximize their knowledge and industry investment.If you are looking to learn more about the National Electrical Code, for electrical exam preparation, or to better your knowledge of the NEC then visit https://fasttraxsystem.com for all the electrical code training you will ever need by the leading electrical educator in the country with the best NEC learning program on the planet.Become a supporter of this podcast: https://www.spreaker.com/podcast/ask-paul-national-electrical-code--4971115/support.

Joist spacing might not be sexy, but it's what keeps your deck from bouncing like a trampoline. In this episode, Shane and Wade break down everything you need to know about joist sizing and spacing: 12" vs 16" on center, when to use 2x8s vs 2x10s, span rules, structural pros and cons, and how it all affects your budget and your build. Whether you're planning your first deck or dialing in your crew's standards, this is a must-listen for getting framing right.

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In Hour 3 of Willard and Dibs, Mark & Dan talk about if there's an added pressure to Brock Purdy now that he's officially their franchise qb after signing a 5 year extension. Plus, Willard gets into some sound from Denver Nuggets forward, Aaron Gordon, who suffered a hamstring injury (similar to Steph Currys) and decided to play game 7 of the NBA semifinals in a loss to OKC. Should the NBA consider spacing out playoff games to give guys less of a chance of getting injured?

Welcome to the 77th edition of the Coach's Corner Round Table on the Hoop Heads Podcast. Each episode of the Coach's Corner Round Table will feature our All-Star lineup of guests answering a single basketball question. A new Coach's Corner Round Table will drop around the 15th of each month.May's Round Table question is: What are the key principles you teach to ensure spacing and timing on offense?Our Coaching Lineup this month:· Erik Buehler – Arapahoe (CO)High School· Chris Delisio – Olmsted Falls (OH) High School· Stephen Halstead – Grace College· Dave Hixon – Amherst College· Chris Kreider – Rice University· Bob Krizancic – Mentor (OH) High School· Josh Merkel – Randolph-Macon College· Don Showalter - USA Basketball· John Shulman – University of Central Arkansas· Joe Stasyszyn – Unleashed PotentialPlease enjoy this Round Table episode of the Hoop Heads Podcast and once you're finished listening please give the show a five star rating and review after you subscribe on your favorite podcast app. Be sure to follow us on twitter and Instagram @hoopheadspod for the latest updates on episodes, guests, and events from the Hoop Heads Pod.Visit our Sponsors!Dr. Dish BasketballOur friends at Dr. Dish Basketball are here to help you transform your team's training this off-season with exclusive offers of up to $4,000 OFF their Rebel+, All-Star+, and CT+ shooting machines. Unsure about budget? Dr. Dish offers schools-only Buy Now, Pay Later payment plans to make getting new equipment easier than ever.The Coaching...

Waukee NW Head Coach Brett Watson is back to help us kick off our summer coaching series! In this episode, we dive into the art of offensive spacing—how to create gaps through smart positioning and movement. We also explore what it means to play with “JAZZ”—free, instinctive basketball with rhythm and flow. Whether you coach high school, AAU, or youth, this one's for you. Stick around to the end where Coach Watson drops his 3 essential keys for youth coaches looking to build a strong foundation.

Spacing out a bit in a tumultuous market? Here's why Andrew Chanin, CEO of ProcureAM is looking for otherworldly innovation in stocks like Rocket Lab and ASTS, even in a risk-on investing environment. But it's not all about being starry-eyed: Chanin explains why other space-related names could see a rougher time ahead. Learn more about your ad choices. Visit megaphone.fm/adchoices

This week host @Jackgreenstalk (aka @Jack_Greenstalk on X/instagram backup account) [or contact via email: JackGreenstalk47@gmail.com] is joined by panel with @spartangrown on instagram or X f.k.a. Twitter at https://x.com/grown43626 or email spartangrown@gmail.com for contacting spartan outside social media, any alternate profiles on other social medias using spartan's name, and photos are not actually spartan grown be aware, @TheAmericanOne on youtube aka @theamericanone_with_achenes on instagram who's amy aces can be found at amyaces.com and @NoahtheeGrowa on instagram, ... This week we missed @Rust.Brandon of @Bokashi Earthworks who's products can be found at bokashiearthworks.com Matthew Gates aka @SynchAngel on instagram and twitter @Zenthanol on youtube who offers IPM direct chat for $1 a month on patreon.com/zenthanol , @drmjcoco from cocoforcannabis.com as well as youtube where he tests and reviews grow lights and has grow tutorials and @drmjcoco on instagram, and and @ATG Acres Aaron The Grower aka @atgacres his products can be found at atgacres.com and now has product commercially available in select locations in OK, view his instagram to find out details about drops!

The ladies discuss Blue Origin's all-girl space mission, whether we should be rethinking ADHD, and the vibe shifting against the right.

The Take Dat With You crew are joined by Ben and Skin of Poor Spacing to preview the Mavericks play-in match up against the Sacramento Kings. The guys where the Mavs advantages are in this game and what they will need to focus on to slow down the Kings. The crew also takes time to recap Luka's return to Dallas.

The Take Dat With You crew are joined by Ben and Skin of Poor Spacing to preview one the biggest Mavericks regular season game with Luka's first game back in Dallas. The guys break down the emotions they will feel broadcasting the game along with how Anthony Davis and Luka Doncic will feel facing their former teams. They also take a deep dive into the play-in race and what the Mavs will need to do to clinch the 9th spot to get a home game.

From witnessing craft up close to a string of abductions, Dave Scott has experienced alien life in many forms. Join hosts Jeni Monroe and Tressa Slater as they talk triangles, cylinders, and smart watches. Alien Species, Canadians, and Spacing Out - Monsters Lounge Podcast Dave Scott's links: https://spacedoutradio.com/ https://www.youtube.com/c/spacedoutradio https://apple.co/3xlo2z3 Find all Monsters Lounge info and links here:  https://www.monstersloungepodcast.com/ https://linktr.ee/monsterslounge (and while you're there, RATE, REVIEW, SUBSCRIBE AND FOLLOW) Join us, and spread the word about the Cryptid Womens Society! https://cryptidwomenssociety.com/cws-tressa/ -Credit and a warm thank you to Jay Juliano for original theme music: Enter The Monster's Lounge -Special thanks to Dave Schrader and The Paranormal 60 network Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Caitlin Massone, ultra-runner, mountaineer, neurologist, and first-time author, sharing the story of her 14-year battle with eating disorders, and how she recovered in an unconventional way through finding endurance sports and nature. Her book, "Running from Perfection," comes out this spring (April 26th 2025).  Part memoir, part neuroscience, her story delves into the neurobiology of eating disorders, how our brains form habits and addictions, and how nature and exercise can help us heal from mental health disorders such as eating disorders, anxiety, and depression. Since regaining her health, Caitlin has run numerous marathons and ultramarathons, including a 50 mile race on the Mountains-to-Sea trail, and recently completed the Wonderland Trail around Mount Rainier (93 miles in three days). She has also embraced mountaineering, summiting Mount Rainier and Mount Baker, and is planning to climb Denali in 2026. Her story is about perseverance, overcoming mental health obstacles, and finding passion in sports that have transformed her from a 100-pound girl with anorexia to a strong, 150-pound athlete who is ready to take on new challenges!  Trigger Warning: This episode contains discussions about eating disorders, mental health challenges, and recovery. Please listen with care, and reach out for support if needed. *** Catch the latest episodes of the Tough Girl Podcast, dropping every Tuesday at 7 am UK time! Don't forget to subscribe so you won't miss the inspiring journeys and incredible stories of tough women.  Want to play a part in uplifting female representation in the media? Support the Tough Girl Podcast on Patreon! Your generosity helps shine a spotlight on female role models in the world of adventure and physical challenges. Join us in making a positive impact by visiting www.patreon.com/toughgirlpodcast. Thank you for your amazing support! *** Show notes Who is Caitlin  Being based in New Jersey Working as a practicing neurologist Working 7 days on and 7 days off Developing new interests, in running, hiking, backpacking and mountaineering  Writing about her long term eating disorder and how she found ultra endurance sports What a neurologist does  How her working schedule came about Her path from medical school, to residency, and completing her fellowship Her early years growing up in New Jersey Loving soccer (football) from 5 years old and playing varsity  Losing her love of sports and nature at 16 Nature and nurture in the formation of eating disorders  Being abandoned by her father Little Miss Perfect…. Dealing with pressure Type A personality and how they turned against her What people don't know about eating disorders Starting to binge eat  Balancing it out with exercise  Taking a job in Colorado  Being exposure to nature at it's best Quitting cold turkey Doing short hikes and runs outdoors Getting to the top of her first 14,000 ft Seeking professional help and working with a therapist Keeping her eating behaviours very private Good or bad habits… Habit formation in the brain and the role that exercise plays  Exercise junkie  Not being preoccupied with food  Having a better outlook on it  The battle going on inside your brain Primitive urges and self talk Mantras - Powerful and perseverance  Running her first half marathon while in medical school Her running journey being slow and gradual Starting running ultra marathons in 2020 Race strategy and getting use to time on feet and breaking it down into small chunks of time Spacing out nutrition throughout the race Fuelling and attitude to food during races Working with a running coach for the past 2 years Trying to keep things easy  Getting into mountaineering International Mountain Guides  Planning to climb Mt Denali The use of oral contraceptive pills past the age of 35 Building the mental resilience  Eating Disorder Survivor Symbol  Getting her tattoo done  Social media…. Not being hugely active  Women in Mountaineering  Sunny Stroeer New book goes live April 26th 2025 Final words of advice  Finding someone to listen The power of talking and opening up to people   Social Media Book: Running from Perfection: My Journey from Eating Disorders to Endurance Sports--And the Neuroscience Behind It   

In this episode of 'Moments with MamasteFit,' we delve into optimal spacing between pregnancies and its impact on pregnancy and birth outcomes. The discussion covers research and professional experiences regarding interpregnancy and birth-to-birth intervals, especially in the context of vaginal birth after Cesarean (VBAC). Key recommendations include a minimum of 18 to 24 months between pregnancies to reduce risks such as uterine rupture, maternal mortality, and infant complications. The episode also emphasizes the importance of preconception counseling for effective family planning.00:00 Introduction to Interpregnancy Intervals01:26 Understanding Interpregnancy Intervals02:29 VBAC and Interpregnancy Intervals05:09 Optimal Spacing Between Pregnancies10:03 Preconception Counseling and Planning15:37 Risks of Short and Long Interpregnancy Intervals18:21 Conclusion and Recommendations20:17 Prenatal and Postpartum Support Programs21:28 Sponsor Message: Needed Prenatal Vitamins——————————Get Your Copy of Training for Two on Amazon: https://amzn.to/3VOTdwH

NasCardRadio Episode 228: The guys review last week's winners from Phoenix Raceway: Aric Almirola in the Xfinity Series, and Christopher Bell in the Cup Series. They also discuss the highest finishing rookies, including Taylor Gray and Shane van Gisbergen, along with their first trading cards. In the next segment a few Panini Instant card print runs have been reviled along with last week's Parkside Pronto Week 1 checklist. Next the guys circle back about the 1983 UNO back border spacing and show some examples along with last week's Kings Court entry that sparked this review. Logan talks about Driver inscriptions in light of the Dale Earnhardt Jr Sports Illustrated article and tweet. Finally, the guys end the show with some sweet eBay racing card auctions in ‘The Kings Court'. #thehobby #tradingcards #panini

Every other week I'm republishing one of my most popular or impactful episodes and adding an update, new insight, or context that will help you benefit from it even more. This week I'm highlighting Episode 113, which is all about third spacing and fluid shifts. Full Transcript – Read the article and view references LATTE Method Template – Download the free LATTE Method Template so you can streamline how you study and focus on what a nurse needs to know.  FREE CLASS – If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES…you can thrive in nursing school without it taking over your life! Study Sesh – Change the way you study with this private podcast that includes dynamic audio formats that help you review and test your recall of important nursing concepts on-the-go. Free yourself from your desk with Study Sesh!  Med Surg Solution – Are you looking for a more effective way to learn Med Surg? Enroll in Med Surg Solution and get lessons on 57 key topics and out-of-this-world study guides. 

Do you want more plants than you technically have room for? We're sharing where you can bend the rules a bit and ignore the plant tag. Featured shrub: Stonehenge yew.

Mentioned during podcast:- “Deep Nutrition: Why Your Genes Need Traditional Food” by Catherine Shanahan M.D. - https://amzn.to/419tqBH- Episode 106: “Young Christian Couple's Convictions on Family Planning and Birth Control” - https://www.nowthatwereafamily.com/podcasts/now-that-we-re-a-family-10/episodes/2147567944- Episode 185: “Things We've Changed Our Minds About // Birth-Control, Alcohol, Eschatology . . .” - https://www.nowthatwereafamily.com/podcasts/now-that-we-re-a-family-10/episodes/2147824607- Episode 293: “Is Family Planning Wrong?” - https://www.nowthatwereafamily.com/podcasts/now-that-we-re-a-family-10/episodes/2148659968

In this episode of the Chasing Giants podcast, hosts Terry and Don discuss their recent experiences, including health challenges, community support, and a successful fundraising event for families navigating breast cancer. They share insights from Don's consulting adventures in property management and the upcoming Ship Shawana show, highlighting auction details and vendor participation. The conversation also delves into the impact of cell phones on hunting practices, weighing the pros and cons of technology in the field. In this episode, Don and Terry engage in a lively discussion about various aspects of deer hunting and management. They address listener questions, including the use of grain sorghum versus switchgrass for bedding, the differences between timber harvest and timber stand improvement, and the importance of edges in food plots. They also share insights gained from years of experience with captive deer and discuss the controversial topic of high fences in hunting. The episode concludes with a look ahead to upcoming events and consulting plans. Chasing Giants and Lester's Feet Merchandise can be purchased at: https://morancreekoutdoors.com Our Sponsors of Chasing Giants TV: Asio Camo Gear - www.asiogear.com Midwest Land Group - www.midwestlandgroup.com Victory Auto Group - www.victorykc.com 360 Hunting Blinds - www.360huntingblinds.com Real World Wildlife Products - www.realworldwildlifeproducts.com Mathews Archery - www.mathewsinc.com Gingerich Tree Farms - www.gingerichtreefarm.com Brenton USA - www.brentonusa.com Vortex Optics - www.vortexoptics.com Any use of reproduction without the expressed written permission of Chasing Giants TV LLC is strictly prohibited. #mathewsarchery #mathews #liftx #foodplots #archery #whitetailhabitat #giantbuck #chasinggiants #liftx

Today we talk to Dallas Taylor, host of the most popular sound podcast on the planet, Twenty Thousand Hertz. I like to think our show sounds pretty good, but Twenty Thousand Hertz is next-level audio production, some of the very best in the podcasting business. And Dallas prides himself on making a podcast for absolutely everyone. As he told me, he tries to make a show that's just as mainstream and approachable as a true crime show.  We start off with a chat about Dallas's background in music, how he entered the world of sound design, what inspired him to start the podcast, and how he was discovered by Roman Mars of the legendary design podcast 99% Invisible.  Then we jump into the nuts and bolts of how he and his team make Twenty Thousand Hertz. Dallas was kind enough to share the stems for my favorite episode, titled “Space,” so we will do a Song Exploder-like anatomy of that episode before listening to the full episode in the second half of the show. Today's show was edited by Craig Eley with additional help from Ravi Krishnaswami. Our Production Coordinator and transcriber is Jason Meggyesy Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

Welcome back to Just Alex! In today's episode, we're talking about fertility after giving birth and trying for baby #2. This week we learned we need to be managing screen time for our 3-month-old (WHO KNEW?!). And I'm dealing with some serious nanny guilt (plus, guilt if I'm not being productive enough while the nanny is here (make it make sense!!!!)). We also talk betting markets again (I'm still so confused that you can bet on ANYTHING) - the TikTok ban, the U.S. possibly buying Greenland, and you can finally bet on the U.S. annexing Canada. OK - Love you guys! ---------------------------------------------------------------- Timestamps: 00:00:00 Welcome back to another episode of Just Alex! 00:02:54 How old were you when you realized you didn't have a good voice? 00:05:40 Nanny guilt 00:11:08 Betting on the Tik Tok ban 00:16:00 The US is now buying Greenland?! (AND Canada?!) 00:20:45 Managing screen time for a 3 month old?! 00:24:45 Smart phones vs. flip phones 00:28:25 Getting pregnant after giving birth (trying for baby #2!) 00:33:55 Spacing your kids 00:40:54 What's going on with Mark Zuckerberg?! 00:47:35 The little white lies we tell our kids 00:51:40 LOVE YOU GUYS! #justalexpod ---------------------------------------------------------------- Thank you to our sponsors this week: - Boll & Branch: Now's your chance to change the way you sleep with Boll & Branch. Get 15% off, plus free shipping on your first set of sheets at https://www.BollAndBranch.com/alex. - Me Undies: This Valentine's Day, give the gift that'll always have them thinking of you and get 20% off your first order, plus free shipping, at https://www.MeUndies.com/alex, enter promo code alex. ---------------------------------------------------------------- Listen to the pod on Spotify/Apple Podcasts: https://open.spotify.com/show/7BxuZnHmNzOX9MdnzyU4bD?si=5e715ebaf9014fac https://podcasts.apple.com/us/podcast/just-alex/id1737442386 Follow Just Alex Pod: Instagram | https://www.instagram.com/justalexpod/ TikTok | https://www.tiktok.com/@justalexpod Follow Alex: Alex's Instagram | https://www.instagram.com/justalexbennett Alex's TikTok | https://www.tiktok.com/@justalexbennett Follow Harrison: Harrison's Instagram | https://www.instagram.com/harrisonfugman Harrison's TikTok | https://www.tiktok.com/@harrisonfugman ---------------------------------------------------------------- Powered by: Just Media House -- https://www.justmediahouse.com/ ---------------------------------------------------------------- Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode features a takeover of our popular weekly live Q&A session on Instagram, called Ask a Flower Farmer. It was guest-hosted by Dave Dowling of Ball/ColorLink, a former flower farmer and the instructor for our online course: ⁠⁠⁠Flower Farming School Online: Bulbs, Perennials, Woodies, and More⁠⁠⁠. Dave is always happy to share his knowledge with our listeners! Topics Covered Caring for dahlias in high heat Growing ranunculus, daffodils, & tulips for a spring wedding Overwintering snapdragons Growing ranunculus in tunnels Beginner-friendly fall-planted flowering bulbs Storing daffodil bulbs prior to planting Growing ornamental kale Ranunculus post-harvest care Grow lights for home gardeners Allium preferred growing conditions Spacing for planting peonies Episode originally aired 9/25/24 on Instagram. Join Lisa and her guest hosts Wednesdays at 12:30PM Eastern time to get your cut flower growing questions answered by the experts! Mentions Dave Dowling on social: Facebook, Instagram Dave's Online Course: Bulbs, Perennials, Woodies, and More! Val Schirmer's Online workshop: Forcing Glorious Blooms for the Holidays & Beyond Discover our online courses! ⁠Shop the TGW Online Store for all your seeds and supplies!⁠ ⁠Sign up to receive our Farm News emails!⁠ The ⁠Field and Garden Podcast⁠ is produced by Lisa Mason Ziegler, award-winning author of ⁠Vegetables Love Flowers and Cool Flowers⁠, owner of ⁠The Gardener's Workshop,⁠ ⁠Flower Farming School Online,⁠ and the publisher of ⁠Farmer-Florist School Online⁠ and ⁠Florist School Online.⁠ Watch ⁠Lisa's Story⁠ and connect with Lisa on social media!

Nekias Duncan and Steve Jones Jr. catch up on the latest news around the (W)NBA & Unrivaled, then answer questions from the Dunker Spot mailbag.To send NBA or WNBA questions for future mailbag episodes, email us at dunkerspot@yahoo.com.If you'd like to join our Dunker Spot online watch parties and watch hoops with us -- they're free, and easy to sign up for -- you can do so here: https://www.playback.tv/thedunkerspotIf you plan on purchasing NBA League Pass and haven't yet, do so through our affiliate link: https://nba.sjv.io/Wqxvn3TIME STAMPS0:45 -- WNBA coaching news (Sparks/Dream)5:00 -- Unrivaled rosters revealed7:15 -- NBA injury update (Luka Doncic, Kevin Durant/Bradley Beal, Paul George and more)11:45 -- NBA All-Star update13:45 -- Mailbag, beginning with Cavs-Celtics confidence meter18:15 -- League trend that's caught our eye + favorite lineup(s)25:00 -- Evaluating rookie highs & lows29:30 -- Spacing deep dive + potential Angel Reese usage37:30 -- Diving into Giannis' season43:00 -- Are the (healthy) Kings primed for contention?48:15 -- Exploring the Grizzlies' pace50:45 -- Donovan Mitchell or Jalen Brunson?52:30 -- Power ranking the Celtics as screeners1:01:30 -- Deni Avdija thoughts1:07:30 -- Player we'd want to watch film with1:11:00 -- Free ThrowsSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.