I agree with the info...I think the reason us dentists in the US are seen by the rest of the world as over-treating is in part because a patient with good oral hygiene, diet, and hygiene appointment attendance is very rare. It's pretty rare that I see a completely arrested lesion...a patient in the US who has susceptibility to caries, even on a better than average diet usually has much more sugar in their diet than ideal from the perspective of the ability to propagate a cavity.
Hi Jaz , I just want to say that I've watched this episode before and once more today ! ( I've watched many of your episodes more than once btw ) May his soul rest in peace 🙏🏼 was such an amazing dentist. To drill is such a big decision, I always think not only once but 10 times before I cut a tooth . Yesterday I had 2 early teens patients with leasions that are " borderline!" and before I submit the treatment plan , I needed that reassurance that I am doing the right thing. It is very appreciated to have such a valuable bank of information from the best in the field to make our daily dental life easier. Thank you again 😊 On a different note, I am interested in the RBB lecture / notes you've mentioned at the start of the episode, kindly let me know how to access it , if still available. Thank you 😊
you are so caring and judicious - your patients are lucky. RBB masterclass can be purchased from rbbmasterclass.com OR it's part of the ultimate education plan on Protrusive Guidance App
As a patient, I would rather have my dentist leave it up to me. If I come back every 4 months for a cleaning anyway, I don't see any harm in waiting. It's always suspicious when someone goes to a dentist for the first time, and the guy immediately finds a cavity.
I moved practice after COVID to be closer to family. I will ask the new Dentist there whom I have a good relationship with! I now work in a practice where my (now retired) predecessor was watching such lesions for up 30 years and I am proudly managing such lesions preventatively
I understand, many thanks for the answer! I am also curious about your opinion, would you consider applying silver diamine fluoride on such a lesion to raise the chances of arresting the progression? (if the black staining was not bothering the patient). @@protrusive
@@user-pp3qc4xx7c so my wife wrote an essay as part of her MSc about this - Fluoride has LONG TERM data and does not cause the staining. SDF is brilliant and the data thus far suggests a very strong ability to arrest (perhaps moreso than F-) but the black stains are the biggest downfall
Please do not try any of these tips and tricks if you work in a busy NHS practice and you don’t know your pts and your pts don’t follow diet and oral hygiene advice and routines . If however your pts are regular and they follow your advice then a lot of what has been said is applicable . Bearing in mind that dentists are often swayed by the type of renumeration they get . If the dentists are remunerated by a strong hygiene department ie income from hygienists working and they get on capitation ; fixed income per head - it is less likely that you will want to fill early lesions .
I agree - poor oh and diet is not suitable for this management (but it begs the question: should we even be restoring?) - also agree how remuneration will affect management plans. This is true in any field of work and in all walks of life - thanks for your valuable comments
from my understanding (and how I have used it) is that CDD is applied to an open cavity - I'm not sure if it would penetrate as suggested? I'm open to input from the community!
Wow. Interesting to hear another point of view. I’ve been practicing 45 years and use a microscope for diagnosis and treatment. Gotta say I totally disagree with you and your approach.
Helps a great deal! Appreciate it a lot 🙏🏾
I agree with the info...I think the reason us dentists in the US are seen by the rest of the world as over-treating is in part because a patient with good oral hygiene, diet, and hygiene appointment attendance is very rare. It's pretty rare that I see a completely arrested lesion...a patient in the US who has susceptibility to caries, even on a better than average diet usually has much more sugar in their diet than ideal from the perspective of the ability to propagate a cavity.
appreciate your comment and I want to take this opportunity to apologise to my US colleagues for the generalisation!
Keep up the good work
Great program!
thank you again :) What was your stance on this debate?
Thank you so much for this channel
Thank you Dr Ola!
Hi Jaz ,
I just want to say that I've watched this episode before and once more today ! ( I've watched many of your episodes more than once btw )
May his soul rest in peace 🙏🏼 was such an amazing dentist.
To drill is such a big decision, I always think not only once but 10 times before I cut a tooth . Yesterday I had 2 early teens patients with leasions that are " borderline!" and before I submit the treatment plan , I needed that reassurance that I am doing the right thing.
It is very appreciated to have such a valuable bank of information from the best in the field to make our daily dental life easier. Thank you again 😊
On a different note, I am interested in the RBB lecture / notes you've mentioned at the start of the episode, kindly let me know how to access it , if still available.
Thank you 😊
you are so caring and judicious - your patients are lucky. RBB masterclass can be purchased from rbbmasterclass.com OR it's part of the ultimate education plan on Protrusive Guidance App
Could you do something related to tips/demonstrations for class II restorations (if not done already)? Thankyou again
Id have been picking up the high speed every time for these cases. Great lecture... in the right patient watch them and "get the balloons out" :)
Thanks James!!
Jaz Gulati loving the podcasts mate. Some really great people you’ve had on.
As a patient, I would rather have my dentist leave it up to me. If I come back every 4 months for a cleaning anyway, I don't see any harm in waiting. It's always suspicious when someone goes to a dentist for the first time, and the guy immediately finds a cavity.
Very helpful! Would be interesting to know how that case has turned up since then, did you end up restoring it?
I moved practice after COVID to be closer to family.
I will ask the new Dentist there whom I have a good relationship with!
I now work in a practice where my (now retired) predecessor was watching such lesions for up 30 years and I am proudly managing such lesions preventatively
I understand, many thanks for the answer!
I am also curious about your opinion, would you consider applying silver diamine fluoride on such a lesion to raise the chances of arresting the progression? (if the black staining was not bothering the patient). @@protrusive
@@user-pp3qc4xx7c so my wife wrote an essay as part of her MSc about this - Fluoride has LONG TERM data and does not cause the staining. SDF is brilliant and the data thus far suggests a very strong ability to arrest (perhaps moreso than F-) but the black stains are the biggest downfall
Please do not try any of these tips and tricks if you work in a busy NHS practice and you don’t know your pts and your pts don’t follow diet and oral hygiene advice and routines .
If however your pts are regular and they follow your advice then a lot of what has been said is applicable .
Bearing in mind that dentists are often swayed by the type of renumeration they get .
If the dentists are remunerated by a strong hygiene department ie income from hygienists working and they get on capitation ; fixed income per head - it is less likely that you will want to fill early lesions .
I agree - poor oh and diet is not suitable for this management (but it begs the question: should we even be restoring?) - also agree how remuneration will affect management plans. This is true in any field of work and in all walks of life - thanks for your valuable comments
Would it help to use a Caries detection dye before drilling?
from my understanding (and how I have used it) is that CDD is applied to an open cavity - I'm not sure if it would penetrate as suggested? I'm open to input from the community!
Pascal Venuti believes the detection dyes don’t signify anything . I’m not sure what his actual wording was when he said this in a presentation.
Wow. Interesting to hear another point of view. I’ve been practicing 45 years and use a microscope for diagnosis and treatment. Gotta say I totally disagree with you and your approach.