Protrusive Dental Podcast

Patient has patchy white spots after braces — do you really whiten, or will that just make the spots stand out more?

Tetracycline staining darker than your darkest shade tab — is bleaching even worth attempting, or is it veneers by default?

A single dark, root-filled central incisor — can you fix it without picking up a drill at all?

And how do you talk a patient through weeks, shades and cost so they actually consent to the slow, non-invasive route?

This is Part 2 of the trayless whitening series with Dr Wyman Chan — inventor of trayless teeth whitening and the Get2Smile system — and Dr Elvis Law, who now runs around 90% of his whitening trayless. Part 1 covered the science and the everyday protocol; this part applies it to the three cases dentists find hardest, with the costing and consent conversations that make them work.

https://youtu.be/1PyL-dXRVHo

Watch PDP278 on YouTube
Protrusive Dental Pearl: Treating Family and Friends

Almost every clinician has a story about a case that went wrong on a family member, a friend, or a loved one. It’s not a random fluke. When we treat someone we love, we put our guard down — we relax the checklist, skip a step, get driven by emotion, and lose our judgement.

So if you must treat family and friends, stay razor-sharp and treat them exactly as you would a stranger. Be extra vigilant, extra hot on your protocols, and take the emotion out of it. If that tooth needs a root canal, it needs a root canal — don’t bend the plan to preserve pulp vitality that was never the right call. The best pearl is not to treat loved ones at all; the real-world one is to not lose your judgement when you do.

What You’ll Take From This Episode

The frosted glass model — a patient-ready way to explain white spots: enamel is clear glass, dentine is a yellow sponge, and acid has turned the glass frosty.

A two-stage white spot protocol — remineralise and condition the gums first, then whiten trayless, and why a dirty tray would have sabotaged the result.

Whitening tetracycline staining — realistic timelines, why darker teeth lift faster, and how to frame it honestly against veneers.

The non-vital tooth without a drill — whiten every tooth to target, then paint the single dark tooth to match, and why leakage (not the bleach) causes rebound.

Costing and consent — charging “almost by time,” staged reviews, and matching invasiveness to the mouth in front of you.

Highlights of This Episode

00:00     Teaser

01:05     Trayless Whitening Part 2: Recap of Part 1

03:55     Protrusive Dental Pearl: Treating Family and Friends

06:55     Whitening White Spot Lesions After Orthodontics

11:55     Whiten First or Restore First? Cavitated Anterior Caries

18:35     The Frosted Glass Analogy: Explaining White Spots to Patients

21:05     A Two-Stage White Spot Protocol: Remineralise, Then Whiten

32:57     Midroll

36:23     Whitening Tetracycline-Stained Teeth

40:03     Costing and Consent: Bleaching vs Veneers

46:23     Whitening a Non-Vital Yellow Central Incisor

47:43     Why Root-Filled Teeth Rebound After Bleaching

53:13     Trayless Single-Tooth Whitening Without a Drill

1:00:43   How to Access Trayless Whitening and Training

1:03:40   Outro

From the Guest

Dr Wyman Chan is the inventor of trayless teeth whitening and the Get2Smile system, with a PhD in the efficacy and safety of teeth whitening and a whitening clinic in London’s West End. Dr Elvis Law trained in safe dental bleaching under Dr Wyman Chan and now runs the majority of his whitening trayless.

Start Offering Trayless Whitening for Your Office

UK Dentists:

In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes.

Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses.

At checkout, use code: DOCSUMMER20

The Trayless whitening system is called Get2Smile.

International Dentists wishing to offer Get2Smile, please enquire from Dr Chan’s website. The international version uses 10% formulation applied for 15 minutes, twice daily.

📌 Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026.

Saturday 5th September London, UK CPD EVENT:

👉Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases.

📍 Royal Asiatic Society, London NW1 2HD

The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases.

Want more?

If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all..

Tags

#PDPMainEpisodes

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C

AGD Subject Code: 780 Esthetics/Cosmetic Dentistry.

Aim & Learning Outcomes

Aim: To give dental practitioners a practical, non-invasive approach to three difficult whitening presentations — post-orthodontic white spot lesions, tetracycline staining, and a discoloured non-vital tooth — together with the expectation-setting and consent conversations that make treatment succeed.

Learning Outcomes — by the end of this episode, dentists will be able to:

Describe how enamel demineralisation produces white spot lesions and explain, in patient-friendly terms, why a repair-then-whiten sequence addresses both the surface and the underlying tooth colour.

Apply a staged, non-invasive protocol to manage white spot, tetracycline and non-vital discolouration cases, selecting an appropriate route by matching invasiveness to the individual patient.

Articulate realistic expectations on shade, timeline and cost, and use them to obtain informed consent for an extended, reviewable whitening course.

What if the tray is the reason your whitening results are inconsistent?

Why would a dentist who owns a whitening lab — and holds four patents on making bleaching trays — tell you to skip the tray?

Trayless whitening does not mean strips. It means the patient puts in a retractor and paints the gel directly onto the teeth, twice a day, for half an hour. No impression, no lab bill, no two-week wait, and no soft plastic reservoir quietly absorbing your peroxide.

This is Part 1 of a two-part conversation with Dr Wyman Chan and Dr Elvis Law, recorded live in their central London whitening practice. Wyman has done nothing but whitening since 2002, has a PhD on the efficacy and safety of whitening processes, and — despite owning the lab that makes the trays — now does most of his cases without one. Elvis trained under him and reckons around 90% of his own cases are now trayless.

Part 1 is the mechanism, the protocol and an honest list of who it doesn’t suit. Part 2 takes it into the hard cases.

https://youtu.be/aAAoUxTIkxo

Watch PDP277 on YouTube
Protrusive Dental Pearl: Let the Patient Pick the Shade

Most of us ask “how white do you want to go?”, get a laugh about Hollywood white or Simon Cowell white, then hold a B1 tab against the canine and call that the destination. Try flipping it.

Under corrected light, record where the patient is now. Then hand over the whole shade guide, arranged by value, and let them choose the tab they want to reach. Photograph both.

This is the VITA Shade guide arranged by value:

B1 → A1 → B2 → D2 → A2 → C1 → C2 → D4 → A3 → D3 → B3 → A3.5 → B4 → C3 → A4 → C4

Two things change. You now know the target precisely instead of inferring it, and you can track progress against a fixed reference. Most patients land on B1 — it’s the last shade before the bleach range, and it reads natural rather than veneered. Some will point at 0M1 and that’s a different conversation, which is exactly the point.

Because whatever they choose dictates how many weeks, how much gel and how many reviews the case needs — and therefore what it should cost. A single flat whitening fee assumes every case takes the same work. They don’t. Someone starting at C4 who wants a bleach shade can get there, but it takes more gel, more time, more reviews and probably a protocol change along the way. Price that honestly.

Only you can decide what the tiers look like in your practice. But it might be worth sitting down as a team of dentists and therapists and asking: how are we delivering whitening? Two tiers? More? Based on what?

What You’ll Take From This Episode

Conscious bleaching — why an awake patient with an open mouth is a completely different chemical situation to a sealed tray worn overnight, and what that does to sensitivity.

The formulation constraint — peroxide needs acid to stay stable on the shelf, which is why pre-mixed products lean acidic and why two-component gels exist at all.

The full trayless protocol — wear schedule, spacing, patient positioning, review intervals and what to troubleshoot first when a case is behind.

Who it doesn’t suit — an honest contraindications list, including the one objection patients raise most often and the answer to it.

Tray hygiene as a clinical instruction — the reason results vary so much between patients using the identical gel.

An A3.5 to B1 case — start to finish in three weeks, with the review points and the maintenance plan.

Highlights of This Episode

00:00     TEASER

01:05     Trayless Teeth Whitening Explained

03:40     Protrusive Dental Pearl: Let Patients Pick Their Whitening Shade

06:05     Meet the Guests: A Career Built on Teeth Whitening

10:27     What Is Trayless Whitening? (It’s Not Whitening Strips)

13:44     Why Whitening Trays Waste Your Bleaching Gel

15:37     Are Whitening Strips Acidic? Gel Formulation Explained

19:17     Conscious Bleaching and Whitening Sensitivity

24:43     When NOT to Use Trayless Whitening

29:05     The Trayless Whitening Protocol: 30 Minutes Twice a Day

32:55     Midroll

42:45     How to Clean Whitening Trays Properly

50:02     A3.5 to B1 in Three Weeks: A Case Walkthrough

56:16     Tooth Porosity and the 45-Degree Recline Rule

1:02:09   Whitening Top-Ups and the Five-Year Guarantee

1:06:49   How to Price Teeth Whitening and Let Patients Pick the Shade

1:07:45   OUTRO

1:12:56   What’s Coming in Part 2

Start Offering Trayless Whitening for Your Office

UK Dentists:

In the UK you need the Get2Smile Kit which is 6% formulation applied twice daily for 30 minutes.

Head to directoralcare.com and register for a free professional account. Approval unlocks the full shop, pricing, offers and their upcoming educational courses.

At checkout, use code: DOCSUMMER20

The Trayless whitening system is called Get2Smile.

International Dentists wishing to offer Get2Smile, please enquire from Dr Chan’s website. The international version uses 10% formulation applied for 15 minutes, twice daily.

📌 Want to learn directly from Dr Wyman Chan? Join him for Redefining Early Caries Management and Aesthetic Dentistry in Shanghai, China, on 20–21 October 2026.

Saturday 5th September London, UK CPD EVENT:

Join Dr Wyman Chan for an exciting event focused on redefining the management of dental plaque-induced oral diseases.

📍 Royal Asiatic Society, London NW1 2HD

The session will include a live lecture, clinical demonstration, and the opportunity to take part in practical, hands-on training. Dr Wyman Chan will be joined by Dr Niki Shah and Dr Elvis Law, who will also showcase their clinical cases.

Want more?

If you enjoyed this episode, check out: MAGIC Teeth Whitening with Dr. Wyman Chan – PDP245 — Wyman’s first Protrusive episode, covering whitening myths, sensitivity, and whether in-office lights do anything at all.

Tags

#PDPMainEpisodes 

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C.

AGD Subject Code: 780 Esthetics/Cosmetic Dentistry.

Aim & Learning Outcomes

Aim: To give dental practitioners a mechanism-led understanding of external tooth whitening delivered without a tray — how gel containment and contact time influence sensitivity and efficiency, how formulation constrains the delivery method, and how to select, sequence and price a whitening case around the patient’s chosen target shade.

Learning Outcomes — by the end of this episode, dentists will be able to:

Describe how containment and contact time influence bleaching sensitivity, gingival irritation and the proportion of active gel that reaches the tooth.

Apply a structured protocol for tray-free external whitening, including wear scheduling, patient positioning, review intervals and technique troubleshooting.

Differentiate between patients suited to tray-based and tray-free delivery, and justify a fee structure derived from the patient’s target shade rather than a flat rate.

Just qualified — so why does it feel like the learning is only just beginning?

What should you actually focus on in year one: the flawless dentistry on your feed, or something far less glamorous?

How do you tell a patient their nerve might die — without it sounding like YOUR fault?

And when a patient says “just do whatever you think” — what do you say back?

This is the conversation every new dentist needs and every experienced one recognises. Our guest is Dr Emma Hutchison — a former dental nurse who trained at the University of Glasgow, and has been the face of the Protrusive Students series across her studies. We recorded in her final weeks of dental school, right on the threshold of practice, and talked through everything the syllabus skips: the safe-beginner mindset, what to learn (and what to ignore) early on, how to protect your standards under time pressure, which cases to take on, and how to talk to patients about risk, cost and consent so the words actually land. If you’re fresh out, this one hits hard. If you’re an oldie, it’s a trip down memory lane — and a reminder of how far you’ve come.

https://youtu.be/gjJiDVP4w-4

Watch PDP276 on YouTube
Protrusive Dental Pearl: Predict the Complication Before It Happens

A communication pearl for every deep restoration. When a filling sits close to the nerve — a big cavity, a crack — name the likely complication before it happens. Show the patient the images, then tell them what to expect: a twinge to cold or hot that can linger a few days, so keep taking painkillers and keep the area clean. And warn them what a red flag looks like: a severe throbbing ache keeping them up at night, or pain out of the blue without eating or drinking, means the nerve is struggling and they should call you.

Do this and, if the complication ever arrives, you look like the expert who called it — not someone something went wrong for. Skip it and reception fields the panicked calls instead. It reassures the patient, lowers your callback rate, and quietly reduces your risk profile. Obvious, easy to forget, and worth saying out loud every single time.

What You’ll Take From This Episode

The safe-beginner mindset — why qualifying is the driving licence, not the destination, and how the happiest dentists keep getting 1% better.

Just-in-time learning — study for the cases actually in your diary, not the obscure pathology you won’t meet for years.

Get good before you get fast — master the bread and butter, protect a little extra time early, and reflect on every procedure.

Clever hacks vs cutting corners — how to tell the difference, and why every shortcut quietly rewires the habit.

Consent that works — getting patients to own the problem, and giving a clear recommendation instead of a fifteen-item menu.

Highlights of This Episode

00:00  Teaser

01:05  The Things Dental School Doesn’t Prepare You For

03:05  Communication Pearl: Predict the Complication Before It Happens

05:35  Life as a Final-Year Dental Student on Outreach

09:55  Why You’re Only a “Safe Beginner” When You Qualify

13:45  Master Bread-and-Butter Dentistry Before the Fancy Stuff

16:05  Just-in-Time Learning: Study for the Cases in Front of You

18:05  Get Good Before You Get Fast (and Protect Your Time)

19:45  Clever Hacks vs Cutting Corners: Don’t Lose Your Standards

24:14  Midroll

27:46  The Skills to Nail in Your First Year as a Dentist

30:11  Which Cases to Take On — and Learning From Mistakes

35:46  How to Explain Risk and Get Patients to Own the Problem

41:26  When Patients Refuse the Ideal Treatment: Start With Their Goal

44:26  Treatment Planning Without the Overwhelm: Loom & “Guess Who”

47:36  Claim Your CPD & Become the Next Protrusive Student

47:38  Outro

Dr Emma Hutchison came to dentistry the long way round — from a dental nursing background into dental school at the University of Glasgow, with final-year outreach on the Kintyre peninsula in Campbeltown. She has been the face of the Protrusive Students series throughout her studies, and this episode marks her crossing from student to newly qualified dentist. On behalf of the whole Protruserati: we’re proud of you, Emma.

Become the next Protrusive Student: with Emma qualifying, we’re looking for the next keen student who wants part-time work, an income while studying, and to contribute to Protrusive — or a nudge if you know one. DM the team inside the Protrusive Guidance app.

Resources & Mentions From This Episode

Quick & slick rubber dam — the in-app video series on quadrant isolation, for building the rubber dam habit from day one.

21-Day Photography Challenge — the in-app challenge that walks you through capturing every clinical photo, including the dreaded occlusal shots, in your first three weeks.

Loom School — in-app training on async, Loom-video treatment planning (roughly 90 minutes of CPD across around 15 bite-sized lessons).

Access the above masterclasses and more when you subscribe to the Ultimate or Infinity plan.

Want more?

If you enjoyed this episode, check out: Periodontics for Beginners – PS008

#PDPMainEpisodes #CareerDevelopment #Communication 

Listen, Subscribe, Earn CPD

Listen: Subscribe to the Protrusive Dental Podcast on Spotify, Apple Podcasts, or YouTube.

This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes A and D.

AGD Subject Code: 770 Self-Improvement 

Aim & Learning Outcomes

Aim: To give early-career dentists a practical framework for the transition from dental school to independent practice — how to keep developing, how to protect clinical standards under time pressure, and how to communicate risk and treatment options as part of valid consent.

Learning Outcomes — by the end of this episode, dentists will be able to:

Apply a “just-in-time” approach to continuing development, prioritising the competencies relevant to the cases in front of them over isolated advanced techniques.

Differentiate time-saving efficiencies from quality-compromising shortcuts, and describe strategies to maintain clinical standards early in practice.

Apply structured communication techniques to explain procedural risk, establish a patient’s treatment goal, and make a clear, defensible recommendation as part of valid consent.

Your patient brushes well, avoids sweets — and still keeps getting decay. What if the answer isn’t in their mouth at all?

What if two inexpensive finger-prick tests told you more about a patient’s gum disease and implant prognosis than anything on the radiograph?

And here’s the uncomfortable one: if the science is this clear, is not checking starting to look like a medico-legal risk? Especially for imlpant surgery!

This is a conversation with Dr Tif Qureshi — the dentist who changed how the profession thinks about the lifelong patient, the envelope of function, and Align, Bleach, Bond. He’s gone down a new rabbit hole: metabolic health. In general practice he’s now doing blood tests — HbA1c and vitamin D — and making the case that the mouth isn’t connected to the body, it is the body. This isn’t about becoming a “biological dentist” (as you’ll hear, Tif is refreshingly blunt about the wilder end of that world). It’s about respecting the biology, screening sensibly, and helping patients where we’re genuinely placed to help.

https://youtu.be/mt1MXLFCTp0

Watch PDP275 on YouTube
Protrusive Dental Pearl: Test Yourself First

Before you even think about introducing blood tests for your patients, ask whether you’re checking your own biomarkers at a sensible interval. The deepest way to understand this topic is to learn it on yourself and your family first — run your own HbA1c, vitamin D, iron, and liver and kidney markers, and see what the data tells you.

Start quarterly, like hygienist visits, then stretch to six-monthly or annual once things look good. Getting invested in your own numbers is what makes better food and lifestyle choices actually stick — and it’s the honest starting point for ever offering this to a patient.

What You’ll Take From This Episode

The metabolic lens — why one disordered glucose-and-insulin system sits under so much chronic and dental disease, and why dentistry is well placed to act on it.

Sugar, redefined — why patients who avoid sweets still get decay, and how frequency of starchy carbs drives the problem.

The two biomarkers that matter most — what HbA1c and vitamin D each tell you about caries, perio and healing.

How to run it in practice — finger-prick logistics, what to test, and how to raise it on the medical history form.

The medico-legal case — why documenting these markers can protect you before implant, graft and perio work.

Highlights of This Episode

00:00  Why Dentists Should Care About Blood Tests

06:00  Metabolic Disease: The Root Cause Dentists Miss

13:00  Why Starchy Carbs Cause Decay, Not Just Sugar

15:50  HbA1c and Caries: What the SHIP Study Shows

21:00  Insulin Resistance: The Hidden Driver of Gum Disease

26:00  How to Talk to Patients About Diet Without Scaring Them

31:00  Why Vitamin D Deserves a Place in Dentistry

34:00  Vitamin D, Implant Failure and Perio Risk

37:00  Blood Tests as Medico-Legal Defence

42:00  What Dentists Should Test: HbA1c and Vitamin D

44:00  How In-Practice Blood Testing Actually Works

50:00  The Mouth Is the Body: Screening, Not Diagnosing

51:00  Is This Biological Dentistry? An Honest Answer

57:00  How to Learn Blood Testing for Your Practice

From the Guest

Dr Tif Qureshi qualified from King’s College London in 1992 and is a Past President of the British Academy of Cosmetic Dentistry. He is Founder and Clinical Director of IAS Academy, best known for pioneering Align, Bleach, Bond and Progressive Smile Design, and as a teacher of the Dahl concept. His current focus is metabolic health in general practice.

👉  IAS Academy — Align, Bleach, Bond, the Dahl concept, and blood-testing / metabolic health training

Coming soon: Join Dr. Tif in one-day metabolic health programme. He has spent years connecting the dots between what’s happening in the mouth and what’s happening in the body. The results are undeniable: better outcomes, stronger case acceptance, and a rock-solid medico-legal position.

This one-day course will change the way you practise. For good.👉Metabolic Health in Dentistry

References & Further Reading

Studies and sources referenced in this episode:

Song I-S, et al. Severe Periodontitis Is Associated with Insulin Resistance in Non-abdominal Obese Adults. J Clin Endocrinol Metab, 2016;101(11):4251–4259. Insulin resistance as an independent risk factor for severe perio in normal-weight adults.

Botelho J, et al. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients, 2020;12(5):1471. Vitamin D across caries, periodontitis, orthodontic and surgical outcomes.

Schmolinsky J, Kocher T, Rathmann W, Völzke H, Pink C, Holtfreter B. Diabetes status affects long-term changes in coronal caries – The SHIP Study. Sci Rep. 2019 Oct 30;9(1):15685. doi: 10.1038/s41598-019-51086-z. PMID: 31666549; PMCID: PMC6821733.

Want more?

If you enjoyed this episode, check out: Why do some Dentists find Dahl Distasteful? – PDP016. 

#PDPMainEpisodes #BeyondDentistry #Communication

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 and A.

AGD Subject Code: 730 Oral Medicine, Oral Diagnosis, Oral Pathology

Aim & Learning Outcomes

Aim: To help dental practitioners understand the link between metabolic health and oral disease, and to evaluate whether simple in-practice biomarker screening has a place in their care of patients.

Learning Outcomes — by the end of this episode, dentists will be able to:

Describe how disordered glucose and insulin metabolism relates to caries, periodontal disease and healing outcomes, and explain what HbA1c and vitamin D each indicate.

Apply a structured, non-alarmist approach to discussing diet and biomarker screening with patients, within the professional boundary of screening rather than diagnosing or prescribing.

Evaluate the clinical and medico-legal case for documenting relevant biomarkers before periodontal and surgical treatment, and identify when to refer to a medical colleague.

Filling, stainless steel crown, pulpotomy or extraction — how do you actually decide on a deciduous tooth?

Why is the lower first primary molar the one that always seems to flare up?

When should you reach for silver diamine fluoride instead of the drill — and when is a child’s cooperation telling you to change the plan entirely?

And how do you actually do a pulpotomy, step by step, without it blowing up under the crown?

This is a paediatric dentistry masterclass with Dr Nidhi Kotak — “The Baby Tooth Dentist,”. It’s built for the general dentist who treats children and wants clearer rules: when to fill versus crown, how to read the radiograph, silver diamine fluoride, local anaesthetic and behaviour guidance, isolation, and a full pulpotomy and stainless steel crown technique. The through-line is simple — in children you decide fast, protect the airway, and treat for predictability rather than heroics.

https://youtu.be/3OscfwF7SIQ

Watch PDP274 on YouTube
Protrusive Dental Pearl: Strategic Flexibility

You cannot be rigid when treating children. The mindset shift is to stop asking “what should be done for this child?” and start asking “what can be done for this child?” With children you have to be fast and efficient, and curveballs are constant — sometimes the parent is harder to manage than the child. So the plan has to bend.

The worked example: you planned a conventional prepped stainless steel crown, but cooperation drops mid-appointment. Rather than abandon the visit, switch to a no-prep whole-crown approach and protect the tooth anyway. It stays in the child’s best interest — and it’s far kinder to your own mental health. It’s a mindset worth carrying into all of dentistry, not just children’s.

What You’ll Take From This Episode

When to fill vs crown — the surface rule for baby molars, why crowns are so predictable in children, and where composites still work.

The “D” devil tooth — why the lower first primary molar flares up, and why mesial caries on a D is an automatic crown.

Pulpotomy indications — the signs that say vital pulpotomy, the ones that say extraction, and why a pulp exposure in a primary tooth is an automatic pulpotomy.

SDF, sedation and isolation — arresting decay without drilling, matching sedation to the child, and protecting the airway.

The pulpotomy technique — a full step-by-step from caries removal to cementing the stainless steel crown, including the modern medicament choice.

Highlights of This Episode

00:00  TEASER

00:59  Pediatric Dentistry for GDPs: The Strategic Flexibility Mindset

07:24  Why GDPs Struggle Treating Children

08:19  When to Fill vs When to Crown a Baby Tooth

12:18  Class II vs Stainless Steel Crown: The Surface Rule

13:41  Reading Pediatric Radiographs & When to Take Bitewings

19:15  SDF vs Fluoride Varnish: When to Use Each

22:37  Resin Infiltration (Icon) for Children’s Teeth

25:15  Pulpotomy in Primary Teeth: When It’s Indicated

26:19  The “D” Devil Tooth: Why Mesial Caries Means a Crown

27:31  Hall Crowns and the Modified Whole Crown Technique

27:48  Midroll

38:39  Local Anaesthetic & Behaviour Guidance in Children

40:38  Sedation Options: Oral, Nitrous & Intranasal

46:22  Rubber Dam vs Isolite: Isolation for Kids

48:59  How to Do a Pulpotomy: Step-by-Step Technique

58:03  OUTRO

Dr Nidhi Kotak is a dual US and Canadian board-certified paediatric dentist — a Diplomate of the American Board of Pediatric Dentistry and a Fellow of the Royal College of Dentists of Canada. 

Follow Dr. Nidhi for more paediatric dentistry tips 👉  @babytoothdentist on Instagram

Want more?

If you enjoyed this episode, check out: Zirconia vs Metal Hall Crowns vs Conventional with Dr Tim Keys – PDP227

#PDPMainEpisodes #EndoRestorative

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: 430 Pediatric Dentistry.

Aim & Learning Outcomes

Aim: To give dental practitioners a clear, decision-led approach to restorative paediatric dentistry — how to choose between filling, crowning, pulpotomy and extraction, how to manage caries conservatively, and how to carry out a pulpotomy and stainless steel crown safely.

Learning Outcomes — by the end of this episode, dentists will be able to:

Differentiate the presentations that indicate a direct restoration, a stainless steel crown, a vital pulpotomy, or an extraction in the primary dentition, using clinical and radiographic findings.

Describe minimally invasive and behaviour-management options in children — silver diamine fluoride, fluoride varnish, resin infiltration, local anaesthesia, sedation and isolation — and select them appropriately for the individual child.

Apply a step-by-step technique for a vital pulpotomy and stainless steel crown in a primary molar, including the current choice of medicament and cementation.