Podcast Reflection - 09/12/2020

Updated: Sep 13, 2020

Dentistry Uncensored

Dr. Careen Young Shares Her Prosthodontic Wisdom

A Beverly hills prosthodontist and doctorated member of the dental profession, Dr. Careen imparted some actionable tips throughout the podcast. As always, Dr. Howard Farran is a gem of a host; a virtuoso at the intersection of entertainment and healthcare in my opinion. Balancing professional expectations, while engaging the audience with entertainment and charm, Dr. Farran has solidified his place within this niche.

Key takeaways

  • Patient preferences dictate where the appointment goes. Few younger patients want a shade darker than A1, while older patients will not go lighter than an A1. This pertains to the Beverly Hills demographic.

  • On comparison of the US vs. Canadian dental system - much of the Canadian system is also fee for service, while LA is highly insurance driver. There are advantages to the US system in that it is easier to find the right practitioner and get procedures conducted in a timely manner.

  • The industry is moving towards specialization. An example given was how some optometrists only treat patients with diabetes associated glaucoma. Is the super-GP a possibility post-graduation? Is the next thing a one stop shop dental office?

  • The podcast made me think about what procedures I’d like to focus on (most of the Dentistry Uncensored podcasts have pushed me in this direction). Hone your skills, then add something on is the general advice.

  • It’s becoming a trend for orthodontists and pediatric dentists to work together. Likewise, prosthodontists and periodontists are joining forces. What is the next logical dental symbiosis?

  • Presenting cases is one of the most underrated, underappreciated and creative parts of an appointment. You have to make sure you are confident, understand the patient and make sure they interpret things properly. They need to be on board. They need to agree with you and see what you see.

  • Minimum ferrule is 1mm and anything above that is better. To navigate complications, you can do crown lengthening, add a pin if a wall is missing or add a post to secure a buildup. Posts are prone to fracture and some dentists just avoid them at all costs. Extrusion usually involves premolars and anterior teeth. Best prognosis is on long, straight roots.

  • Aligning the bite and subsequent prosthodontic work go well hand-in-hand.

  • Abfraction causes include bruxism or toothbrush abrasion. These spots are great for food compaction and prone to decay.

The grey area

  • Learn from patients you don’t treat. For example, some patients choose to keep baby teeth if they are missing a permanent tooth and the baby tooth lasts decades. The key takeaway is that EVERY patient is different.

  • If it defect/anomaly starts small and is not changing, don’t do anything. If a patient’s face is changing, jaw is sore or they are experiencing headaches, it will dictate that something needs to be done. Intervene in the start with an occlusal guard.

Triple tray vs. articulator vs. scanning

  • Triple tray is good for single units, one quadrant, patients with stable occlusion and vertical dimension, stable vertical stop and a tripod stop

  • Articulator and VPS for full mouth reconstruction as research suggest scanner is not as good for this

  • Scanner could be good for alignment and smaller unit

More on scanners

  • She likes iTero intraoral scanner (linked to Invisalign)à merger with Zimmer

  • Straumann owns clear correct à may

  • ACE clear aligner is another company (created by a USC graduate)

Interesting facts:

  • There are over 40,000 health journals in the USA and 12 dental specialties.

  • Implantology and clear aligners are going up in double digits, everything else in dentistry is going with the market/economy rate

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