Protrusive Dental Podcast

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.

Complete Dentures That Actually Work: Impressions, CR & Adaptation

You don’t have to suck at complete dentures — there’s a science to them, and an art you gather with experience.
Why do complete dentures feel so unpredictable — when a crown prep or an endo doesn’t?
What’s the number-one impression mistake dentists make — and the tissue-conditioning step most of us skip?
And when a new denture comes back painful — is it the extension, or the occlusion?
This one is a whistle-stop tour of complete dentures with Dr Leif Stromberg — a Dallas general dentist who learned removable prosthodontics directly from the legendary Earl Pound and has taught it for decades. Recently nominated for the Texas AGD’s 2026 Texas Dentist of the Year™ Award, Dr. Stromberg brings a wealth of clinical experience, leadership and mentorship to the profession.

Rather than drilling into a single appointment, Jaz put a stack of Protrusive Guidance community questions to him and covered the whole arc, from choosing the right patient to troubleshooting a painful denture at delivery. Expect breadth over depth — a lot of ground, a little from each stage — with plenty of technique, nuance and communication tips to take back to the chair.

Protrusive Dental Pearl: Pick the Patient Before the Denture

You don’t have to treat everyone. Before promising anything, work out whether you can meet the patient’s expectations — because you can build the world’s best denture and they still may not adapt to it. The single strongest predictor of success is the patient’s own adaptation, not the technical quality of the prosthesis.
So read the markers of adaptation. The patient who has worn a technically poor, flimsy denture happily for years — and only needs a new one because the old one is worn out — is a home run: improve the retention and stability and they’ll do brilliantly, because their neuromuscular adaptation is already proven. The patient who has hated every set they’ve owned is the warning sign. Assess adaptation right from the first appointment; it matters more than the articulator you own.

What You’ll Take From This Episode

Pick the patient, not just the denture — the markers of adaptation that predict success before you start.
Where the teeth actually go — Pound’s lingual control lines, and why “lingual” means stable.
The number-one impression mistake — coverage versus overextension, plus pre-impression tissue conditioning.
Records without the wobble — recording centric relation with a gothic arch tracer, and why the facebow ranks low.
A painful denture at delivery — how to tell overextension from occlusal overload, and what to do about each.

Highlights of This Episode

From the Guest

Dr. Stromberg teaches  the fundamentals of predictable complete dentures through a run of CE courses on Dentaltown — a five-part written series and a video series that walk through the exam, impressions, records, try-in and delivery.
👉  Stromberg’s “Keys to Complete Denture Success” CE courses on Dentaltown

Learn more at: https://www.strombergdentistry.com/articles

Want more?

If you enjoyed this episode, check out: Occlusion for Complete Dentures – PDP162

Tags

#PDPMainEpisodes #ProsthoPerio #Communication 

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.
This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcomes C
AGD Subject Code: 670 Removable Prosthodontics.

Aim & Learning Outcomes

Aim: To give clinicians a predictable, appointment-by-appointment approach to complete dentures — patient selection and adaptation, accurate records, functional tooth position, and troubleshooting at delivery.
Learning Outcomes — by the end of this episode, dentists will be able to:
1. Assess a patient’s suitability for complete dentures and their likely adaptation, and manage expectations before treatment begins.
2. Describe the sequence of clinical appointments for complete dentures and the key objective of each — impression coverage, recording centric relation and vertical dimension, and functional tooth position.
3. Differentiate the common causes of pain at denture delivery (overextension versus occlusal overload) and apply an appropriate method to identify and correct each.

Holistic, biological, functional — is there actually a difference, or is it all just marketing?
Are root canals really dangerous — or is that just what the algorithm keeps showing your patients?
When a patient wants their sound fillings out, do you test, reassure, or drill?
And how do you bring sleep, diet and blood tests into a dental appointment without it stopping being dentistry?
This episode sits down with Dr James Goolnik (https://uk.linkedin.com/in/james-goolnik)— clinical dentist, founder of the London holistic practice Optimal Dental Health, past President of the British Academy of Cosmetic Dentistry, and one of Jaz’s earliest mentors. James openly calls himself a holistic and biological dentist, which makes him the ideal person to separate the thoughtful, evidence-aware end of this world from the online extremism that gives it a bad name. Expect a balanced, honest conversation: some of it you’ll adopt tomorrow, some of it you’ll want to pressure-test — which is exactly the point.

Protrusive Dental Pearl: Dentistry Isn’t Just About Fixing Teeth

This one isn’t a clinical tip — it’s a sentiment that frames the whole episode. Dentistry isn’t just about fixing teeth; it’s about improving health. You don’t have to agree with every claim made in biological dentistry — but you will struggle to disagree that a patient’s diet, sleep, breathing, stress and inflammation all influence oral health.
So the pearl is simple: stay curious, stay open-minded — but stay critical, and never stop asking better questions.

What You’ll Take From This Episode
The holistic–biological spectrum — what each word actually means, and where thoughtful practice tips into online extremism.

Test or reassure? — the three-question filter for deciding whether any test earns its place before you order it.

Safe amalgam removal — the SMART protocol, and when a worried patient’s sound filling should be left well alone.

The mouth-body connection — how sleep, glucose control and systemic inflammation affect the mouth, and where to refer.

The balanced take on root canals and implants — whether root canals are dangerous, and titanium versus ceramic with metal-allergy testing.

Highlights of This Episode
00:00     Teaser
00:59     Holistic vs Biological Dentistry: What's the Difference?
05:49    Why Listening Beats Perfect Margins in Dentistry
10:29     Why Patients Started to Doubt Root Canal Treatment
12:09     Mercury Fillings: Should You Remove Amalgam?
14:09     The SMART Protocol for Safe Amalgam Removal
19:59     The Mouth-Body Connection: Sleep, Diabetes & Alzheimer's
24:59    How to Build Nutrition Into a Dental Practice
26:25     Midroll
34:01     Sleep Tests, Glucose Monitors and Blood Tests in Practice
38:21     Is Biological Dentistry Dangerous? The Extremist Problem
39:21     Are Root Canals Dangerous? A Balanced Take
41:51     Titanium vs Zirconia Implants and Metal Allergy Testing
46:51     When Removing a Healthy Tooth Becomes Negligent
50:56    What Diet Should Dentists Actually Follow?
53:41     How to Get Started in Holistic Dentistry
56:30    Outro

From the Guest

Dr James Goolnik is a clinical dentist and founder of Optimal Dental Health, a holistic practice in London built around integrating nutrition, sleep and whole-health screening into everyday dentistry. He is a past President of the British Academy of Cosmetic Dentistry, a member of the International Academy of Oral Medicine and Toxicology, and the author of “Brush” (profits to Dentaid) and the “Kick Sugar” cookbook (profits to his Rewards Project charity).
👉  Optimal Dental Health — monthly practitioner newsletter, and connect with James on LinkedIn

Want the Toolkit?

We’ve turned this episode into a practical Holistic Dentistry Clinical Toolkit — with quick-reference guides for whole-body assessment, testing, patient conversations, and navigating the holistic–biological spectrum.
Download the free toolkit at www.protrusive.co.uk/biological

References & Further Reading

Sources and further reading from this episode:
IAOMT — Safe Mercury Amalgam Removal Technique (SMART). The protocol for safely removing amalgam (rubber-dam isolation, adsorbent rinse, sectioning, high-volume evacuation) to minimise mercury exposure for patient and team. 
MELISA test. A validated blood lymphocyte-transformation test for type-IV hypersensitivity to metals including titanium and mercury — used to guide titanium-vs-ceramic implant decisions. 
Tests, devices & materials referenced — a home overnight sleep test, a phase-contrast microscope, a national blood-testing partner, point-of-care fingerprick analysers (CRP / HbA1c), a blood/hair/urine mercury panel, continuous glucose monitors, and Biodentine for vital-pulp therapy. 

Want more?

If you enjoyed this episode, check out: Implementing Sleep, Airway and Myo to Restorative Dentistry Part 1 — PDP262

Tags

#PDPMainEpisodes #Communication #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 Outcomes C.
AGD Subject Code: 150 Health, medicine and nutrition.

Aim & Learning Outcomes

Aim: To give dentists a balanced, evidence-aware understanding of holistic and biological dentistry — what the terms mean, how to integrate whole-health thinking and appropriate testing into practice, and how to navigate patient beliefs about root canals, mercury and metal-free dentistry without abandoning the evidence base.
Learning Outcomes — by the end of this episode, dentists will be able to:
1. Differentiate between holistic and biological approaches to dentistry, and articulate where evidence-based, minimally invasive care ends and unsupported claims begin.
2. Apply a structured decision filter to judge whether an additional test or intervention is justified — whether it will change treatment, provide a benchmark, or motivate the patient — while working within scope and referring appropriately.
3. Describe t...

Injection moulding is meant to save you time. Too often it hands you a mouthful of flash and a cleanup that swallows the chair time you thought you were saving.
Dr Sandra Hulac is a Clinical Instructor at the Kois Center in Seattle and an Accredited Fellow of the American Academy of Cosmetic Dentistry. She uses full-mouth injection moulding to road-test occlusions and stabilise breaking-down dentitions, and she teaches the technique hands-on.
In this episode she works through where the mess actually comes from, and how design, matrix strategy, careful PTFE and a simple cleanup protocol keep a case clean from the first injection.
This episode comes with an infographic: the whole no-mess workflow on one visual guide to keep beside you during design and cleanup. Download it at protrusive.co.uk/nomess. It is the fastest way to turn this episode into something you actually use at the chair.

What You’ll Take From This Episode

Most injection-moulding mess is prevented at the design stage, through thickness targets and clear lab communication, long before any cleanup.

The alternating matrix technique, injecting every other tooth, is the biggest single cleanup saver and cuts the PTFE you need.

Matrices cured in a pressure pot, with a spacer protocol, give even thickness and far fewer bubbles.

Thin, careful PTFE prevents distortion; bunching it interproximally creates the very excess you are trying to avoid.

An S-shaped motion with a Ceri-saw and several 12-plate blades clears resin while protecting the contact.

Good pre-treatment hygiene, using diluted hypochlorite or povidone-iodine rather than chlorhexidine, cuts bleeding and contamination.

Highlights of this episode:
00:00 Teaser
00:54 Introduction
02:17 Dental Pearl: Free Injection Moulding Infographic
03:17 Main Interview with Dr. Sandra Hulac
4:49 Innovations in Dental Education
07:26 The Mess Problem in Injection Moulding
15:38 Alternating Matrix Technique
18:18 Every-Other-Tooth Technique
27:54 Cleanup Instruments and Techniques
31:35 Handling Teflon and PTFE
36:41 Patient Oral Hygiene Tips
37:27 Dilution protocol:
39:24 Key Principles for Minimizing Mess
40:42 Matrix Fabrication and Spacer Protocol
43:55 Course Information and Conclusion
46:19 Outro

From the Guest

Master Full Mouth Injection Moulding in this exclusive two-day hands-on course!

📅 Dates: Feb. 26-27, 2027
📍 Location: Central London Venue (TBC)
🌐 Learn more & secure your spot: protrusive.co.uk/FMIM

Want more?

Learn to treat tooth wear with injectable composite in Injectable Composites in PDP081

Tags

#PDPMainEpisodes, #BreadandButterDentistry, #AdhesiveDentistry

Listen, subscribe, and earn CPD

Listen: Spotify, Apple Podcasts, YouTube, and inside Protrusive Guidance.
Earn CPD: This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.
Compliance: GDC Development Outcome C. AGD Subject Code 250 Operative (Restorative) Dentistry.

Aim & Learning Outcomes

Aim: To enable dental professionals to minimise cleanup during injection moulding by optimising design, matrix use, PTFE application, and interproximal finishing techniques.
By the end of this episode, dentists will be able to:

Explain how proper design and lab communication can reduce composite flash and cleanup in injection moulding.

Demonstrate the alternating matrix technique and the correct use of PTFE in minimising mess.

Identify and use appropriate instruments and techniques for efficient interproximal cleanup after injection moulding.