Protrusive Dental Podcast

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What do you say when a patient comes in wanting one tooth fixed, but you can see eight more heading the same way?
How do you tell a patient who has had a scale and polish every six months for twenty years that they now need something deeper without making it sound like you’re suddenly trying to sell them more dentistry?
Is there a magic sentence that makes patients say yes to comprehensive care?
And why can the patient you’ve known and liked for six years sometimes be harder to move forward with than a complete stranger?

This is Part 1 of a two-part communication series with Dr Zak Kara — co-founder of Smile Stories in Bournemouth, and the most-returning guest on this podcast. It’s also our first-ever call-in episode: the questions came in from the community as voice notes, and this episode answers two of them. Part 2 takes on the awkward stuff — discussing fees, and communicating risk without frightening people off.

Protrusive Dental Pearl: Reactive or Proactive Associate?

When the diary goes quiet, what do you actually do? Wait for the practice to work some magic and fill it — or go and fill it yourself? The mentality of “the clinic supplies the patients, I just treat them” is worth a hard look. The strongest associates pull their weight: writing, school visits, social media, and simply having conversations out in public that bring people through the door.
The logic behind it runs straight into the rest of this episode. You never get to do the clinical dentistry unless your communication is good — and you never get to communicate at all unless there’s someone in the chair.

What You’ll Take From This Episode

The two ladders of readiness — clinical readiness and interpersonal readiness rise separately, and a plan gets declined when they’re badly out of step.
Why “I’ll think about it” usually isn’t distrust — and the co-diagnosis move that stops you hearing it so often.
The conversation circle — open on goals rather than symptoms, and close the visit by tying the recommendation back to the patient’s own words.
Words that change the meeting — inflammation score instead of bleeding score, and why one word can decide whether a patient feels blamed or informed.
How to present a five-figure plan — when to name the number, and what to do in the silence afterwards.
Chairside scripts you can use tomorrow — permission questions, spot-the-difference, and the line that flips a treatment plan into something the patient avoids rather than buys.

Highlights of This Episode
00:00     TEASER
00:51     How to Talk to Patients Who Only Want One Tooth Fixed
03:45     Protrusive Dental Pearl: Reactive or Proactive Associate?
09:27     The First Protrusive Call-In: Your Communication Questions
13:40     Why There Is No Magic Sentence for Case Acceptance
15:58     Co-Diagnosis: How to Make It the Patient's Own Idea
22:36     The Conversation Circle: Start With Goals, End With Goals
26:58     Why "Inflammation Score" Beats "Bleeding Score"
30:50     The Peak-End Rule: What Patients Actually Remember
34:46     How to Ask Permission Before You Educate a Patient
39:32     Scale and Polish vs Deep Clean: Explaining the Difference
39:41     Midroll
44:54     How to Introduce Full Mouth Rehab Without Overwhelming
48:39     The Ladder of Readiness: Where Is Your Patient?
55:02     Two Ladders: Clinical and Interpersonal Readiness
59:23     How to Pre-Qualify Patients Before They Reach Your Chair
1:11:32   How to Present a Five-Figure Treatment Plan
1:20:26   OUTRO

Communication course — waiting list: Zak has a communication course in preparation. Protrusive is supporting it with a 90-day accountability group inside the app for anyone who enrols, plus retained lifetime access to Loom School. 
The waiting list is at protrusive.co.uk/conversations.

Find Zak Kara in Instagram (@zakdentalkitchen) and Facebook (Zak Kara).

References & Further Reading

The behavioural science referenced in this episode:
Norton MI, Mochon D, Ariely D. The IKEA effect: When labor leads to love. Journal of Consumer Psychology, 2012;22(3):453–460. People value what they helped build — the mechanism underneath co-diagnosis.
Bem DJ. Self-Perception Theory. Advances in Experimental Social Psychology, 1972;6:1–62. People infer what they believe partly from observing what they themselves say and do.
Kahneman D, Fredrickson BL, Schreiber CA, Redelmeier DA. When more pain is preferred to less: Adding a better end. Psychological Science, 1993;4(6):401–405. The healthcare application is Redelmeier DA, Kahneman D, Patients’ memories of painful medical treatments, Pain, 1996;66(1):3–8.

Want more?

If you enjoyed this episode, check out: Think Comprehensive – Communication Gems with Zak Kara – PDP010. The episode that started it all.

Tags

#PDPMainEpisodes #Communication

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.
This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcomes A.
AGD Subject Code: 550 Practice Management and Human Relations.

Aim & Learning Outcomes

Aim: To improve dental professionals’ ability to communicate the need for comprehensive or more extensive treatment to patients who present with single-tooth expectations, using structured, permission-based and goal-led conversation rather than persuasion.
Learning Outcomes — by the end of this episode, dentists will be able to:

Describe how a patient’s readiness for comprehensive treatment can be assessed along two parallel dimensions — their understanding of their own clinical need, and the strength of the working relationship — and identify where an individual patient sits on each.

Apply permission-based and question-led techniques that help a patient identify disease for themselves, so that a recommendation is understood and owned rather than imposed.

Dif...

Ever wondered what it’s really like to study dentistry abroad?

How different is it to train in Bulgaria, Slovakia, or Valencia compared to the UK?

And what happens when it’s time to come back home — can you easily register with the GDC and start practicing?

Dr. Hugo Medd joins Jaz for an honest and insightful conversation about taking the path less traveled — studying dentistry in Bulgaria after not securing a UK dental school place.

They dive into the realities of living and learning abroad, including language barriers, different teaching styles, and how much clinical experience international students actually get. Hugo also shares how he navigated GDC registration, what it’s like finding work after graduation, and why he has no regrets about choosing this unconventional route.
Highlight of this episode:
00:00     TEASER
01:21     Introduction
02:49     Meet Dr. Hugo Medd: A Journey to Bulgaria
06:09     Financial Considerations and Support Systems
09:56     Why Bulgaria? DMD vs BDS explained
13:13     Language Barriers and Communication Skill
17:47     Tuition Fees, Cost of Living, and Financial Realities
20:47     Navigating Post-Graduation and GDC Registration
23:23     Accredited EU Universities and Recognition Rules
25:09     Social Life, Culture, and Student Experience
28:14     Midroll
34:47     Differences in Teaching Styles Abroad
40:54     Navigating the UK Dental Job Market
43:03     Advice for New Graduates
50:24     Pursuing a Master's in Oral Surgery
54:45     Final Thoughts and Contact Information
57:11     OUTRO

Inspired to study abroad? Study Medicine Europe helps you land top dentistry and medicine placements in Europe and guides you from application to graduation.

If you enjoyed this episode, check out “The American Dental Dream – PDP002”

This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan.

#InterferenceCast #CareerDevelopment

Have you ever removed plaque using a scaler or ‘air-polisher’ and notice that the demineralised enamel flaked away?
Scaling and polishing is a routine part of preventive dental care — but could some of our traditional cleaning methods be doing more than we realise? A whitening specialist who works without a drill, scaler or air polisher argues that some approaches to cleaning may affect the enamel, and that hydrogen peroxide gel can remove plaque without touching the tooth surface.
Dr Wyman Chan has done nothing but tooth whitening since 2002, when he closed his general practice for a dedicated whitening centre, and he developed the chemical-polishing gel which is at the centre of this episode. He is joined by Dr Niki Shah, a UK general dentist and practice owner whose company distributes the product in the UK, and who now runs most of his hygiene this way.
In this episode, they explain which patients they believe may benefit most, walk through the full chairside protocol, and discuss the limitations of the approach and where it may not be appropriate.

Protrusive Dental Pearl: Manicuring Worn Lower Incisors

Worn lower incisors sit sharp against the upper teeth, concentrating stress. Take a Sof-Lex disc and manicure them, rounding the edges from pointed to smooth. Show the patient in the mirror first and, borrowing Dr Michael Melkers’ framing, ask if you can make their teeth look a little younger. It is surface topography, changed for force management, and the patient feels it with their tongue.

What You’ll Take From This Episode

On sound enamel, prophy paste and air polishing are low-risk; on demineralised enamel hidden under plaque, the same abrasion can flake the surface.

Chemical polishing does not lift calculus; where calculus is present, ultrasonic or hand scaling is still required.

Dr. Wyman Chan offers a 3% hydrogen peroxide gel as a plaque and biofilm adjunct, not a replacement for oral hygiene instruction.

The strongest cases for this are anxious, paediatric, orthodontic, special-needs and geriatric patients who tolerate scraping poorly.

The chairside protocol runs about twelve minutes and still ends with manual agitation using a single-tufted brush.

No published evidence supports the product’s clinical claims yet; Dr. Wyman Chan describes studies in progress.

Highlights of This Episode
00:00     Teaser
01:21     Rethinking How We Polish Teeth
03:36     Protrusive Dental Pearl: Manicuring Worn Lower Incisors
05:23     Meet the Guests: From Whitening to Chemical Cleaning
12:10     What Is Chemical Polishing? Prophylaxis, Not Whitening
20:05     Is Traditional Polishing Damaging Teeth?
21:54     How Abrasion Harms Demineralised Enamel
25:30     The Strongest Case: Anxious Patients
29:09     Children, Adolescents and Orthodontic White Spots
29:49     Midroll
35:22     Managing Pericoronitis and Gingival Abscess
38:15     Special Needs, Geriatric and Post-Surgery Care
40:43     Where Is the Evidence? Studies in Progress
43:59     The Cost and Business Case for Chemical Polishing
50:16     The Chemical Polishing Protocol: Step by Step using Magic3
53:14     Why Manual Agitation Still Matters
57:58     How It Changed a Working Day
1:00:35   Outro
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Want more?

New to Dr Chan’s work? Start with Trayless Whitening Technique Part 1 with Dr Wyman Chan - PDP277, on his whitening approach, sensitivity and how to let patients pick their target shade.

Tags

#PDPMainEpisodes

Listen, subscribe, and earn CPD

Listen: Spotify, Apple Podcasts, YouTube, and inside Protrusive Guidance.
Earn CPD: This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.
Compliance: GDC Development Outcome C. AGD Subject Code 490 Periodontics.

Aim & Learning Outcomes

Aim: To give a mechanism- and evidence-aware view of chemical polishing as an adjunct for plaque and biofilm removal: where mechanical polishing can harm demineralised enamel, which patients the approach suits, how the chairside protocol runs, and the limits of the current evidence.
By the end of this episode, dentists will be able to:

Describe how the abrasivity of prophylaxis pastes and air-polishing powders interacts with sound versus demineralised enamel.

Identify the patient groups for whom a non-mechanical approach to plaque removal is most appropriate, and the situations, such as calculus, where it is not.

Evaluate the current evidence base for a 3% hydrogen peroxide chemical-polishing protocol, and apply appropriate attribution and consent where the evidence is not established.

Full mouth reconstruction — is the aim really the flawless before-and-after you scroll past on Instagram, or is that a trap?
How do you actually know you’re ready to step up from single teeth to a whole mouth?
And when your comprehensive treatment plan keeps getting declined — psychologically, financially — is that the patient’s problem, or yours?
This one is a “your questions answered” episode: the community sent in far more FMR questions than we could cover, and we put the best of them to two prosthodontists who literally wrote the book on it.
This is a full-mouth reconstruction deep dive with Prof Riaz Yar and Dr Łukasz Lassmann — co-authors of the new Quintessence textbook Full-Mouth Reconstruction (foreword by Jeffrey Okeson). We cover screening before you commit, knowing when you’re ready, getting big plans accepted, choosing materials, setting the bite in centric relation, sleep apnea, and the honest truth about “perfect” versus “acceptable.”

Protrusive Dental Pearl: Always Present the Best Advice

When you present a complex case, offer three tiers. Best advice — take time and money out of the equation and describe the ideal: what would truly get this patient to the right result (gum grafting, orthodontics, the lot). A compromise — a good result without the parts the patient won’t consent to or can’t fund. And the minimum — the least that still helps, with the non-negotiables named.
The most important of the three is the best advice. It’s tempting to self-censor — to decide a plan is too elaborate or too expensive and quietly leave it out. But if you never present the best option, you’ll never get to do those cases. Present the ideal option first, then offer the compromises. Don’t limit the patient — or yourself.

What You’ll Take From This Episode

Screen before you plan — a green / orange / red system that sorts patients before treatment planning even starts, so you know which cases are yours.
How to get big plans accepted — why case acceptance is a confidence problem before it’s a skills problem, and how to present the best advice, compromise and minimum.
Choosing materials — why it’s the case, not the material: repairability vs aesthetics vs durability, and why erosion changes the answer.
Setting the bite — why centric relation is the reference position, what a night guard can do to it, and how sleep apnea changes the plan.
Perfect vs acceptable — defining success and failure honestly, and knowing when you’re actually ready to take a full-mouth on.

Highlights of This Episode
00:00     TEASER
00:53     Full Mouth Reconstruction: Your FMR Questions Answered
05:08     What Actually Counts as a Full Mouth Reconstruction?
10:48     Screening Patients for Full Mouth Rehab: Green, Orange, Red
18:48     Is Perfect the Goal of Every FMR? Success vs Failure
26:53     How Do You Know You're Ready for Full Mouth Dentistry?
36:23     Is the Dahl Concept a Good Segue Into Full Mouth Rehab?
38:50     Midroll
42:49     How to Get Patients to Accept Full Mouth Treatment Plans
49:34     Best Advice, Compromise, Minimum: Presenting the Options
55:04     Give Yourself Permission to Fail in Big Cases
56:14     FMR or Selective Restorations? Where's the Line on Tooth Wear?
58:49     interjection 1
1:04:52   Composite, Ceramic or Zirconia? Choosing FMR Materials
1:09:53   interjection 2
1:12:40   Centric Relation, Sleep Apnea and Setting the Bite
1:17:25   Anteriors or Posteriors First in a Full Mouth?
1:26:00   Does DTR Change How You Finish an FMR?
1:27:35   The Full-Mouth Reconstruction Book & Where to Learn More
1:30:37   OUTRO

From the Guests

Prof Riaz Yar is a specialist prosthodontist and Visiting Professor in Prosthodontics, with a 25-year focus on TMD, occlusion and full-mouth dentistry. Dr Łukasz Lassmann is a prosthodontist (DDS, PhD) whose PhD is in occlusion and the temporomandibular joint; he focuses on tooth wear, TMD and full-mouth rehab and founded Lassmann Education, whose multi-day “summer camp” FMR/occlusion course runs in Poland.
Interested in Full Mouth Reconstruction? Check out their book: 

Full-Mouth Reconstruction (Lassmann & Yar, Quintessence Publishing, 2026; foreword by Jeffrey Okeson) — a general-practitioner workflow from screening through orthodontics, perio, preparation, and cementation. 

References & Further Reading

Sources and further reading from this episode:
Lassmann Ł, Yar R. Full-Mouth Reconstruction. Quintessence Publishing, 2026 (foreword by Jeffrey P. Okeson). ISBN 978-1-78698-153-0.
Lassmann Ł, Calamita MA, Blatz MB. The “Smile Design and Space” (SDS) concept for altering vertical dimension of occlusion and esthetic restorative material selection. J Esthet Restor Dent. 2025;37(1):56–67.
Loomans B, Opdam N, Attin T, et al. Severe tooth wear: European consensus statement on management guidelines. J Adhes Dent. 2017;19(2):111–119.
Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig. 2008;12(Suppl 1):S65–S68.
Okeson JP. Management of Temporomandibular Disorders and Occlusion. Elsevier (8th edition) 

Want more?

If you enjoyed this episode, check out: https://protrusive.app/posts/free-podcast-videos-pdp225-occlusion-myths-and-red-flags-with-lukasz-lassmann

Tags

#PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative
Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.
This episode is eligible for 1.5 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcomes C.
AGD Subject Code: 610 Fixed Prosthodontics.

When you walk through the door after work, are you actually present or are you still running the day’s to-do list in your head?
Is there ever a “good” time to have a baby in the middle of specialist training and how do you fund it?
How do the best dentist-parents you know protect time with their kids without their careers stalling?
And can technology actually give you hours back — or is that just another thing to feel guilty about?
This is one for the dads. In this Interference Cast episode, Jaz sits down with Dr Sunny Marwaha — a dentist completing part-time specialist training in prosthodontics at Guy’s, who became a father right in the middle of it. It’s not a clinical episode. It’s an honest conversation about doing the hardest career stretch (training, buying practices, building a name) at the exact same time you’re raising young children — the sleep, the money, the guilt, and the strategies that actually help. Two dentist dads, comparing notes.

What You’ll Take From This Episode

Priority management, not time management — Decide what this season of life is for, and protect it; priorities shift as the kids grow.
Leave the day at the door — both directions — The driveway is dad mode, the clinic is showtime; you can’t take work home or home to work.
Run the family like a small business — Regular family meetings and a “mind like water” system can help carry the load without living in your head.
Use AI to buy back time — Make use of dictated notes, auto-drafted letters, and turning papers into audio for the commute. This is leverage, not cheating.
Specialise or self-direct? — An honest filter for whether a structured training pathway or private courses and mentorship suits you better.

Highlights of This Episode

00:00     Teaser
00:42     Daddy Dentist: Balancing Fatherhood and Dentistry
03:42     Should You Specialise or Learn Through Private Courses?
10:12      How to Time Having Kids Around Specialist Training
13:32     Paternity Leave for Dentists: What's Realistic?
16:42     Funding Specialist Training With a Young Family
20:02     Why Family Support Is a Privilege, Not a Given
22:57     Time Management vs Priority Management
23:42     The Two Moments With Your Kids That Matter Most
29:12      Protecting Sleep, Fitness and Your Mental Health
30:13     Midroll
39:03    Top Tips for Dentist Dads
41:53      Using AI to Buy Back Time for Your Family
45:53     Run Your Family Like a Small Business
53:33     How to Cut Kids' Screen Time (and Make It Stick)
59:23     Life After Specialist Training: A Shorter Week
59:57     Outro

From the Guest

Dr Sunny Marwaha is a dentist completing part-time specialist training in prosthodontics at Guy’s (King’s College London). He’s passed the MProst (Royal College of Surgeons), with his final MClinDent and GDC specialist listing still ahead. He became a dad to son Kabir midway through training; his wife Amrit is also a dentist.
👉  Follow Sunny on Instagram: @dr_marwaha

References & Further Reading

Listed for reference (mentions, not endorsements):
NotebookLM — Google’s AI research tool; can turn a source document (e.g. a paper) into an audio, podcast-style discussion for the commute.

Trello, Inkpad Notepad, and Google Calendar — The “mind like water” offload system. 

Loom — screen/video-message tool, mentioned as an alternative to written tooth-by-tooth reports.

Want more?

If you enjoyed this episode, check out: [Screen Times and SmartPhones for Children – Best Practices – IC061]. The screen-time reset comes up near the end of this chat; that episode goes deeper. 

Tags

#InterferenceCast #CareerDevelopment #BeyondDentistry

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.
This episode is eligible for 1.0 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcome B.
AGD Subject Code: 770 Self-Improvement.