Very Clinical: The Crossover Incident

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[00:01:30] Welcome to the Very Clinical Podcast, brought to you by Zerk Dental Products. In about the time it takes to do an M.O. on three, we will entertain and enlighten you with tips and tricks for regular daily dentistry. Here's Kevin and Zach. This is a special episode of the Clinical Hacks Podcast. And it's special because it probably has some bad swears. You have been warned.

[00:02:00] Welcome to Clinical Hacks, where real working dentists talk real dentistry. Sit back, relax, tighten your toffelmeyer, and prepare to be clinically hacked. Bros, what is up? Welcome to the Working Interferences Podcast, a dental advice show. I am Kevin Fryer. And I am Zach Miners. And I'm Mack Jones. Guys, how the hell are you? Ah, you know, I've never been better. This is a great time in American history. What a time to be alive.

[00:02:29] I feel like we're basking in the glory of this COVID virus. Oh, yeah, absolutely. You've 10Xed your practice, Kevin. I know a lot of Invisalign starts. Eric, machine humming. It's all been going nonstop all week long. So guys, I have a hot take right from the start here. Have you noticed that we're saying COVID-19 lately and not coronavirus? And here's my hot take.

[00:02:52] I think that the Corona Beer Company, PR people, have taken over and they've decided to make us all say COVID instead of diminishing and demeaning their fine beer product. What do you think? What do you say, Matt? I can go with that. I can get behind that. That does sound like a good conspiracy theory there, Kevin. I appreciate that. That's good stuff.

[00:03:17] So I don't know what you guys have been doing, but we're kind of bored at our office. So we've been doing some spring cleaning and really doing some deep cleaning around the office. And I got to ask you guys something. A couple of years ago, did you guys get those potato chips from Densply Sirona? I did. Yes. I ate them. I did not record myself eating them in an ASMR fashion, but I did enjoy them. How about you, Matt?

[00:03:47] I did not get them. And let me tell you something. And I hope you're listening, Sirona. I was on the verge of pulling the trigger on a fucking CEREC. And I heard all my little buddies talking online about their fucking potato chips. And I did not get them. So fuck you, Sirona. So I did get the potato chips, but that was right when I started keto. Shout outs to the ketodontist Matthew Standridge. And they just sat in the back for a while. And I'm sure the team ate them.

[00:04:15] However, what you guys don't know, or maybe don't know, is a couple years prior to that, Sirona released some trading cards of dentists in sort of the same fashion. And here I am at my office. I'm going through stuff. I'm pulling out some jewel pods that I had tucked back in the back of a drawer. And there I see this pack of trading cards that was unopened. And I thought... I feel like I know where this is going, Kevin. I think you do. Tell me. We're going to do it. Was it a wax back? Are we?

[00:04:46] We're going to do a bit called Remembering Some Dentists. So I have the pack here right in front of me. And I have not opened this up. I have no idea how this is going to go. We'll just open it up and see who is in here. So a little Foley work here first. Let me get it open. Oh, man. All right. Our first card. Oh, my gosh. It's Gordon Christensen. Oh.

[00:05:16] Holy smoke. Does Gordon Christensen even know he's a trading card? That's the question. I have no idea. Let's look at his stats. Did you know that Gordon is a 1960 graduate of USC Dental School, University of Southern California? That's three years before I was born. Did you say 1960 or 1916? Ooh. Ooh. Savage there, Mac. So what's his war? Do they have that on there?

[00:05:46] Does he have like a dental war? I feel like it's got to be one of the highest ones in dental history. It doesn't really say that. Let me look at the back of the card. It lists his wife as Rubella, not Rella. Oh, typo. It must be a typo. Those cards are usually worth a lot more. That's a huge one. Good get. Do you think Gordon collected baseball cards as a kid? Oh, wow. He grew up in that era. I mean, for sure. No. I don't know.

[00:06:16] I'm going to go with yes. I bet he's opened some of those Topps packets with the delicious gum, the crunchy gum on the inside. Yeah, he's done that. No, no, no. Guys, I have... Gordon is so old. But his mom threw out his collection. Gordon is so old that Honus Wagner had Gordon Christensen's rookie card. Yes! Oh, that was funny. That's awesome. I really...

[00:06:41] I kind of have a vision in my mind of little Gordon sitting on the front steps of his home, opening up a baseball pack, a pack of baseball cards, and pulling out a Mickey Mantle rookie card, and just kind of looking at it and smelling it. And, you know, fond memory for Gordon there. All right, let's move on. Let me get the next card here. Oh, another star. Dr. Gina Dorfman. Whoa. What a pull.

[00:07:11] Who would have thought? Guess what, guys? She's also a graduate of the University of Southern California, the year 2000, when all the robots took over. Another Trojan. You guys have any good... Wow. You guys have any good Gina memories? Uh, I think Mac does. Pretty sure Mac Jones does, doesn't he? Maybe. Ah. I don't know. Gina was very good to us at VOD this year. Shout out to Gina. Yes. Yes, she was. Thanks, Yappy.

[00:07:40] Shout out to Gina and Yappy. Yeah, we all had a good time at VOD this year. She's pretty much a rock star in my mind. So that's a good pull out of this pack. All right, let me get another one here. Oh. Oh. Guys. Guys. Oh, man. I don't know if I can... Oh. Oh. I don't think I can do this. Oh, guys. I just don't think I can do this.

[00:08:10] Oh. I pulled out of... Let it out, Kevin. I pulled out of this pack Dr. Kenny... What the hell is this? No, no, no. Not going to do it. Who stole our bits? No. We know Kenny talk. What is happening? None of that. Lance, is this a very special episode? It's a special something. You remember that episode of... Steaming special. Yeah, of Blossom where Blossom got her period, I think. I think that was it. It reminds me of that. Very similar.

[00:08:38] This is a very special, as you can tell. This is... We call the virus time... We call that our experimental phase. I'm working in a Francis. There's a bit of that. Remember when the Beatles went to India for a while and just got really into the Maharaji? Yeah, yeah. That's this. This is our era of that. It's me on acid. Yes. We have a crossover show tonight, which all...

[00:09:07] That was kind of a big thing in the 80s. You guys remember in the 80s, crossover shows where the good times would come in with the Addams Family or some shit. Yeah, there we go. The Jetsons and the Jetsons. Different strokes. Exactly. And what was the one with the girls' school? Facts of Life. Facts of Life. Facts of Life. Facts of Life. Yeah, there we go. Yeah. So this is a crossover between the working interferences and the clinical hacks.

[00:09:32] Our good friends, Kevin Fryer, Mac Jones, Zach Miners, who you've been hearing them do some of our... I would say our most famous bits, but no one really knows any of our shit. So... Yeah, pretty much. I really did enjoy remembering some dental guys. I think Gordon's war has got to be like 78 to 80, somewhere in there. I mean, pretty high. I'd say Hall of Fame level war for Gordon.

[00:09:59] And Gina, I would love to have that signed Gina Dorfman rookie card. I mean, how amazing would that be? Jeez. And then, yeah, do you think they ever made a... Do you think Sirona actually made a Kenny card? That would be interesting. It had no bib on it. There was definitely no bib on that card. For sure. Well, guys, this is an advice show. It's a shitty one. So we're going to do a half of a shitty advice show and then a half of a clinical hacks,

[00:10:27] and we're going to meld them all together into some Frankenstein thing, and we'll see how it goes. It's like a Reese's peanut butter cup. Maybe it will mutate into a virus that will take over the world. I would love that. I've not had enough of that so far in March. So more of that would be great. We can name it the Sirona virus. We answer your questions. That oral... Oh! I don't know if they're going to like that. Yeah. That's exactly what I was just thinking today. I was like, man, DS World this year is going to be pretty lame because they are not selling

[00:10:57] any CEREC machines this year. No. And no Prime Mills are going to go out and no OrthoOffice CBCTs. It's going to be a lean one. Carrot Top might be your entertainment at DS World this year, along with the Jay Giles band headlining on main stage. It's going to be a wolf of a program this year. We answer questions we find in all those neat little dental Facebook groups. We answer questions from...

[00:11:27] Reddit! Reddit! Reddit! We strive to tell Dennis and Dental team members their own unique brand advice. So please, we need your questions. They are the... We crave. We crave. You can submit your questions to workinginterferencesatgmail.com. Now, we don't want just any question. Do we guys? Fuck no. Fuck no. Facts of Life mixed with the Cosby Show, where Bill Cosby put Mickeys in all of those girls

[00:11:56] from the Facts of Life strength is the greatest cross-ever episode of all time. We want the questions that Gordon Christensen cannot answer. So we're going to do one Reddit question tonight, and then we will do some clinical hack stuff. So this is from the subreddit of Dentistry. Reddit user, IamLostInPolyLand asks, Impact of adult pacifiers on teeth? Hello, lovely dentist. I have a question for you about using a pacifier as an adult.

[00:12:27] As a part of a lifestyle, I recently started using these adult pacifiers to soothe myself and occasionally fall asleep. What kind of impact and wear and tear should I expect to see? On my teeth. Have you guys ever heard of adult pacifiers? What is this lifestyle? That's what I want to know. Well, I think we're going to get into that in just a second. All right. Okay.

[00:12:55] I've never had a patient use a pacifier that was not a child. Is it an NTI, an adult pacifier? Sort of. That is a good point. I have an NTI that I wear at my desk when I'm stressed. So that means when I'm stressed. So I've had it in basically for the last two and a half weeks. So that's been a tough one. Any of you guys ever had an adult who had a pacifier habit? Not that they told me about. Not something people usually advertise. I do have an adult thumb sucker who admitted it.

[00:13:25] Oh, wow. Give me some demographics. Male, female? She's a female. And she's probably in her mid-30s, approaching 40. Interesting. And so she had a diastema between 9 and 10 or something like that. And it's like, hey, you want to do some Invisalign? I know this patient actually very well. She's a family member of a good friend of mine. And I said, hey, you want to do some Invisalign on that? We can close that space, make it look good. And she's like, I'd love to do that.

[00:13:54] But I still suck my thumb. And I tried to control my shock. So we talked about that for a little bit. But it is comforting to her. And she does it in her sleep. And you can't fight that. So no Invisalign for her. Does she have an open bite? Tough look for my girl. Yes, for a tough look for her. Does she have an open bite, Kevin?

[00:14:21] So she must put her left thumb in. You put your right thumb in, you take your right thumb out. She must put her left thumb in. Because it's on the left side between 9 and 10. So there is a little bit of an open bite on that side. But the rest of her occlusion is pretty good as far as I can remember. It's just, it's created a space there that is never going to close. That's crazy. I'm looking at this Amazon page because she linked these pacifiers.

[00:14:49] And there is a wide swath of adult sized pacifiers on Amazon. I mean, I'm talking at least two or three pages worth. So again... Are they shaped like those NUC ones to help develop the palate? Yeah. I don't know if I could tell you the difference, like spot from across the room. Like, oh, that's a NUC pacifier. I know my pacifiers. Are they ribs for her pleasure? You guys that have kids, maybe you guys could do that.

[00:15:19] Mack, Zach, you guys have been at least in that range in the past decade. So... I could tell you... I could spot a NUC from across the room. Yes. If I had to. Yes. Yeah. Honestly, my kids are so old now that that's such a dark time in my life when they were that age. I have blacked it out. It was a dark time. Yes. Yeah. Speaking of, they do have this really cool matte black, matte finish black adult pacifier.

[00:15:49] So if you... For very fashion dollars. If you saw a woman with a NUC like that, would you say, hey, look at the NUC on her? I think you might get slapped on that one. Yeah. Adult size pacifier. Do they have lights on them? No. So that's... You know, I think Zach had that thought, right? That this is a rave thing. Have any of you guys ever actually been to a rave at all? I have not.

[00:16:18] No, I'm too old. I'm too old. You seem like a raver. Yeah. Josh Austin, you've been to one. I know. So I've been to like a frack party that was billed as a rave, but I don't think it was like... You know, it was like a 60 mile an hour fastball as compared to like a real like German underground techno music kind of, you know, like where you don't...

[00:16:42] It's in some warehouse somewhere and you've got to know Tootsie, you know, is the code word to get in or something. Like I've never been to a rave like that, like an unadvertised, like thousands of people like that kind of deal. I've been to like a, you know, UT Fiji party that they billed as a rave, but like I don't think it was actually a rave. Was there rampant use of MDMA at this particular frat rave? All right. So because that's where this is going.

[00:17:12] Yeah. Which one's Molly and which one's Ecstasy? I think they're the same thing, aren't they? We didn't call it Molly when I was in college. We called it Ecstasy or E. X or X. Yeah. Are they the same? Sorry for my lack of knowledge of designer drugs. I will answer in the best way that I know how to answer without incriminating myself. Yes, there was Ecstasy there. Okay. Very good.

[00:17:36] So allegedly, that stuff makes you want to, you have like an oral fixation that you just gotta have. Like it just makes you want to like grit, grind, all that stuff. So I think the pacifier is to fulfill that part of the role, I guess, if you will. Well, this pacifier would help because it has, and I quote, an adult-sized teat and an extra large shield.

[00:18:06] So you gotta have that adult-sized teat. So. Yeah. Okay. All right. We know Max. According to the Wikipedia, Ecstasy and Molly are the same thing. Oh. Okay. Okay. That's good that we've got that established. Yeah. We know Max's love of nightguards from the Clinical Hacks episode. Would this qualify as something that you would not like, Max? I think I could get behind these. So I actually had a little different take on this.

[00:18:35] I saw this on an old TLC show or something, but there's a fetish out there. Paraphilic infantilism. You guys familiar with that? Sounds hot. Yes. Yes. Is that like wearing diapers and stuff? Yes. Where an adult dresses up like a baby, wears a diaper and a pacifier. Would that be considered a lifestyle? Hmm. I think it is. I think that's probably what we're looking at here.

[00:19:03] So can I offer a take on this, Josh? This is, you guys, I'm giving you the opportunity to patent this. This is along the same lines as the rose gold crowns, and I can't remember the other one that you guys patented. But, so this person was specifically asking about their effects on their teeth. Yeah. So Glidewell is missing the market here.

[00:19:24] They need like a tap three with like a, with the pacifier extension out of it. Yes. So like this person can like double up, you know, they can be, they can get their roll on and protect their enamel at the same time. Roll on. I like, I like the insider MDMA Molly X lingo going on here. That was awesome. So you get on that. There it is. Mike DiTola, please start pacifier. Zach, are you sure you're not going to a rave this weekend?

[00:19:54] Yeah. You know, this is not all that different from the Aveo last weekend. He's got nothing else to do. Yeah, that's true. That's true. These COVID raves are hot. This isn't all that different from the Aveo. Do you guys know what the Aveo is? Is that the tongue? Is that the one for like the edentulous? You stick your tongue in it, right? Yeah. It's like a rubber, like a suction cup for your tongue and it just pulls your tongue out. Yeah. Yeah. Yeah. Yeah. Yeah.

[00:20:27] That's two weeks. That's funny. Rouse talks about, you know, you got to have the tongue in the roof of your mouth to breathe and the tongue in the roof of the mouth develops the palate. And so that's why like he never pulls a pacifier out on a kid until they're ready for it. Yada, yada, yada. You know, maybe this is just helping her put her tongue in the roof of her mouth so she can maintain her airway. Ah. This is like an actual airway device, like Zach said. Or maybe we could utilize this, Kevin, for your Invisalign.

[00:20:56] So I know you're a big Invisalign guy. We could do that. It could help out with, you know, palatal expansion and all that sort of stuff. Yeah. And you could, if you put something in between the front teeth, I'm trying to figure out what that could do for you orthodontically. You could like alter the occlusal plane somehow with that, right? Well, you could possibly correct a deep bite, an anterior deep bite. Yeah. Right. Exactly. Yeah. So like cusp ramps or like turbos or bumpers or whatever, right? Right.

[00:21:26] Yeah, I'm digging that. So it's just a raving bumper, a raving deep bite turbo. I wonder, is there, on these adult pacifiers, can they have some sort of LED light component in it? That would be super cool. I was going to say, let's 10X this and turn this into a propel thing and also have it have light and vibrate. Yes. Now we can really 10X our movements on Invisalign. Love it. Can we put some CBD in there? We definitely need some CBD. Yeah.

[00:21:56] Flavor. Definitely. Yes. Yes. Yes. Absolutely. I kind of know some more about this person and I got to figure out more about this lifestyle. Um, okay. Here's the lifestyle. Because she has several posts and I'm assuming it's a woman. She has several posts in this subreddit of DDLG, which has 54,000 members.

[00:22:21] And it stands for Daddy Dom Little Girl BDSM. Oh, wow. Mac was right. Wow. Yeah. That's what it is. And I think we have a first on working interferences. Oh, wow. We have a nude in, uh, in previous posts. Oh. So, so Lance, we're probably gonna have to beep this, uh, this name here. Um, it's just one. We'll put that in the show notes.

[00:22:51] It looks like it's a subreddit of DDLG porn. Um, which. Uh, I gotta, wait a minute. I have an important question. WS? Question mark? Um, no. No? Not great. No. All right. No. No. Uh, and also very into stuffies. Um, which apparently is what this group of people calls. God. That's what my daughter calls stuffed animals too. Really? Oh, Mac. Max. Yes. Uh, Mac's right on on this. Well done, Mac. Yeah. I know.

[00:23:19] Mac has a huge collection of stuffies. Mac loves, Mac loves stuffies. This might be the title of this episode. Might be. Might be. Show us on the stuffy where Gordon touched you. Oh, God. Oh, God. Why did we end up here? I don't know. Because we have nothing else to do. When you're quarantined. Right.

[00:23:45] So there's, in, in the subreddit of little space, which is a subreddit for, uh, a place for littles, middles, caregivers, and anyone interested in CGL or ABDL relationships. Daddy takes me to a kink cafe. They had a menu for littles. I brought my favorite stuffy and we played Candylands. Smiley face emoji. There's a lot going on there to unpack. Yeah. This, this is Pandora's lives. Wow.

[00:24:14] We have delved into the weird, my friends. Oh, I think so. Creepy. I'm going to navigate away from all of those things before I end up on a list. Um, and before the feds show up. Another list? Another list for the feds show up at my house. Wow. Whoa. Um, yeah. Um, well we, we did our Reddit work tonight. Um, I think it's now time to turn it over to the, uh, clinical hack. Wait, before we go, Josh, uh, let's do some clinical hack. I'm behind you. He's peeking in your window.

[00:24:44] There he is. Pour yourself a glass of lemonade. I'll be right there. Hey, it's Kate, the assistant. And it's time to get very clinical in this episode's very clinical corner. Are you ready, Dr. Mead? I'm ready, Kate. Let's hear it. Dr. Mead, have you ever given your assistant the death stare when they leave the room mid procedure? Definitely. It totally disrupts the flow. They're probably off finding something that we need. I've been there.

[00:25:12] And it's usually because we're in a mad panic to find something that wasn't restocked or somebody forgot to move it from one room to another. My assistant tries to keep up with inventory, but it's tough. Exactly right. You can simplify material management with procedure tubs and central backstock location so we can avoid the mid procedure escapes, which means no more death stares. That sounds perfect. How do we make this happen? Well, you'll evaluate your clinical workflows.

[00:25:38] If your assistants are constantly leaving to grab materials, it's time for an upgrade. Check the show notes for links to upscale for your team. I don't know how I can talk about the crown prep thing after all that. Like, I mean, I guess let's I guess we'll bring it around. So, yeah. Welcome to the clinical hacks portion, the less entertaining portion of the of the show.

[00:26:02] So tonight we were going to discuss each each one of us have have a wildly different practice, do a wide range of stuff. But we're all all all GPs. And so we were going to discuss one of the most common procedures dentistry, the the crown prep and just get a pro tip from each one of us on efficiency and speed in your in your daily prep.

[00:26:25] And so I will start off with the let's I get let's start with Lance, because we talked about before the show. And I loved I love what you have to say. So one one to three pro tips, Mac. What do you are not? Sorry, Lance. What do you got for us? How do you do a crown prep faster? Well, what I found I've been helping out some other offices and it knocked me off my high horse a little bit, only in that where I knew that I could be quick and efficient in a different setting.

[00:26:54] I'm not nearly as quick and efficient. I found that I didn't realize I love my electric handpiece. And if I'm someplace else that's air driven with bad torque or something that would stall. So I'd sit there and just keep painting the the margins to try to finally get a margin and prep it down. So that slows me down right there. So nice, sharp burrs with a electric handpiece.

[00:27:19] Having the isolate was is able to allow me to just crank and not have to stop and pause and rinse and let them spit and come up for air, all kind of stuff. And by having a good scanner, I love my I got the I upgraded. I didn't realize how slow my iTero was until I got a new one. And the new one just so lightning fast that if I have an isolate, sharp burrs, electric handpiece and an iTero, I pretty predictably can do a crown prep in about 30 minutes. Take one of those away and suddenly I'm adding 10 to 15 minutes for everything I don't have.

[00:27:49] And when you say 30 minutes, Lance, are you talking about from numbing to them walking out the door? Yeah. Yeah, that's incredible. I got a lot of work to do. Well, part of that also is the temporization. If I can lock in 10 units for doing the Siltek shrink wrap type smile, I can do the same thing for a single prep. And so it only takes three minutes really to make a temporary if you're going to lock it in. Right. Now, it does mean I'm going to have to numb them up and cut it off. But I never get a phone call on the weekend with a temporary coming off.

[00:28:18] There's just a lot of advantages. It's not perfect. There's a couple downsides to it, but they're easily overcome. Can you floss a locked temporary? No. No. No. Okay. Okay. Thank you. I lost anyway. Exactly. Touche. Touche. All right. Mac Jones, give me an efficient crown prep tip of the day. So here's my tip. It's nothing real specific, but it also applies to how we should all approach our dentistry. If and when we ever reopen, don't. Yes. Don't dick around.

[00:28:48] That's my tip. Yeah. Just get in there, do the shit, grind the enamel down and get it done. Don't dick around. Josh Austin. I know that Mac is a big fan of reverse crown prep technique. And Mike Dettola, apart from Andrea and my family, is probably one of the most influential people in my life that I've ever met ever. And his reverse crown prep technique, I just think it really works well in my hands.

[00:29:16] And the funny thing was, I'd seen it presented. I'd seen him lecture three or four times before I ever really decided to try it. Because it's so easy to go see a lecture. I'm like, oh, that's cool. That sounds great. And then you just never do it. And so the third time I heard him speak, that's when I said, all right, I'm going to actually order some round diamond birds and try this. And really, I haven't looked back. That's basically the way I've read for the most part, almost all the way since then.

[00:29:44] And I just find it works really, really well for me. It may be that that particular system works well for me, or it may be just that I need a system. But we've talked about that before. Like Mac said, don't dick around. Have a system. Know what you're doing first, second, third, fourth, and do it that same way every time. And if you do it that same way every time, you're not going to miss things. I'm a big fan of the Comet deep purple birds. Very aggressive cutting. But we're not in dental school anymore.

[00:30:11] We don't need these super light cutting birds. I mean, you know what you're trying to do. You know what you're trying to prep. We're all doing all ceramics. So a more aggressive prep is indicated. Get in there and do it with a bird that can do it and do it quickly. The more aggressive the bird, the less heat that gets generated on the tooth, lowers the chance of endo that you're going to need. And it makes you faster. And so there's no reason why a dentist who's been practicing for a couple of years shouldn't

[00:30:35] be able to have a prep done in five to six minutes and be scanning in seven minutes, eight minutes after you start based on how you're managing the tissue, how long you're leaving your second cord in or your hemostatic retraction paste. And the third tip I have is a product by a company called Contact Easy. They're a great company that makes these really nice.

[00:31:02] They're known for their like IPR products and their interproximal strips, but they have a product called Prepture, which is a really nice reduction guide. You don't know how much you've reduced unless you check. And it's easier to tell on premolars. And first molars, it's really hard to tell on like number 15. And so, you know, I just don't know how much I've prepped unless I've used one of these Preptures and they come in one millimeter, 1.5 and two.

[00:31:27] Um, and if you can slide it through with it just dragging, then you know, you've got that amount. If it stops somewhere, then, you know, you have to, to catch it where it stops and, and reduce some more. Um, Dottola always says, how can you tell the difference between, you know, 0.6 millimeters and one millimeters, unless you have one of those Terminator eye implants, like you just can't. So that's what, what really helps me is, is the Prepture. I have them on every Crown Prep kit. Um, mostly I'm doing Zirconia. So I have a 1.5.

[00:31:55] Um, if I'm doing an interior one, I don't necessarily need, I can usually tell like, oh, there's 0.5 difference from the two. So I don't have all three of them out on every tray. It's mainly the red one. That's, that's 1.5. I can kind of gauge everything from there. So, um, no matter how many Crown Preps I cut, I still check every one to see if I've got the clearance that I need. You know, we should, we should put the, uh, the YouTube link to the reverse Crown Prep video in, uh, the show notes. If there is one thing that I wished I could have seen as a first year dentist or a fourth

[00:32:24] year dental student, it would be that video. I mean, talk about a life-changing video. Once I did see it, it was, it was good stuff. You know, it was good stuff for sure. Kevin Fryer, what do you got? All right. Well, um, as you guys know, I'm big into rubber dam isolation and really that's my, my first tip, uh, sort of along the lines of what Lance said with the ice light, just, uh, it allows me to just move without have the patient having to stop. Everything's really isolated.

[00:32:53] I often put a second clamp on the tooth that we're working on just to retract the gingiva and I can just blow through without interruption. And, um, I know that that seems maybe counterintuitive to a lot of people. And I know I've shown that on our Facebook page before, but it really just works for me. I hate tongues. They're always in the way they're always doing something that, uh, they shouldn't be doing.

[00:33:20] And so to be able to just, uh, go, uh, continuously and not stop is, is really beneficial. And the, the times that I can't use a rubber dam, because obviously that happens from time to time. I just think it's so annoying. It just, you know, it's in my head that, man, this is, this is really dragging on patient has to stop patient has to swallow all those things that just bog you down.

[00:33:45] Um, my second tip would be, uh, reduction, um, guides. Um, so, uh, on, on the occlusal in particular, kind of along the lines of what Josh was saying. I use the, um, I use the Misinger, uh, reduction burr, but I've also got some of the ones that, uh, Mac mentioned in our, uh, in our presentation at VOD.

[00:34:12] I've been trying those out too, but particularly for ceramic, I'm doing a lot of CEREC. I need at least, uh, 1.8 millimeters, which is really two millimeters. There's no way I can eyeball that. Those, uh, reduction guide burrs really help out a lot. Most of us under reduce, uh, the occlusal in particular. And, uh, even with those, sometimes I'm under reduced once I get to the scanned, uh, uh, the, you know, starting to design the crown.

[00:34:41] So, you know, I think that's, that's super important. If you're sending it to the lab, you, you won't know that, you know, I'll know it, you know, within, you know, a minute or so, and I can just go back in, reduce a little bit more and then rescan. But that has really, uh, helped out in, in terms of, um, you know, longevity of the restoration and just knowing that you have enough clearance. And so here, here's my, here's my couple. First of all, if, if, if it's a crown prep that, uh, you're going to schedule, it's not like a same day broken tooth type of thing.

[00:35:12] And you've got a patient with maybe suboptimal home care, uh, gingivitis, get them on some Paradex. If you get, get them on some Paradex a week or two before the prep, it'll make your life so much easier. Whenever I get in a habit of doing that. That's a great tip. Those, that, that, that, the, that tissue management is so much easier. And when I get out of the habit of doing that, I notice it because bleeding tissue sucks. So that's my other two tips for along the same lines in the reverse crown prep video.

[00:35:41] One of the most important parts of it to me is that once you break your contact, you're putting in that first cord to get a little bit of retraction and some, uh, hemorrhage control. And then you're kind of getting to see your margin better and smooth it out faster, quicker, easier, all that, that, that one tip, uh, changed. My preps a lot because before when I was packing my cord and then I'd pull the piece and then it's like, Oh, that's not a very smooth margin. Then you're, you're doing stuff after the fact. So that sucks.

[00:36:10] So the first piece of cord, if you're a cord, if you're a cord user in immediately is good. The third one is one I picked up from, from Lance. And that is, if you, if you didn't put them on the Paradex and you got a heavy bleeder, one of those gingival retraction pastes, uh, uh, Lance turned me on to, is it dry Z correct? Dry Z Lance. Is that right? The one you're using? Yeah. From Parkel. Did you ever try the blue version of that, by the way? Is it better or the same? I haven't tried the blue. You haven't tried the blue? Okay.

[00:36:39] Anyway, I use dries pretty consistently and the blue, um, is okay. Um, I went back to the regular ones. Um, I didn't find any huge advantage to using the blue, um, and actually found it to be a little harder to control. The tip on it is a little bit narrower, so it's hard to get as much of it out and it's, it's just stiffer. Um, so I, I think the regular one works better in my hands. Uh, but I'm a huge fan of, of, I call it dries. I don't know if it's dry Z or whatever, but. It is probably dries.

[00:37:09] Yeah. Yeah. So I, I like that as kind of as a, I'll either put it on, on top of a single cord or sometimes if it's a real bloody mess, it's, I put the both cords and, and still shoot that stuff on. And if you don't like those pace, then go back and listen to our episode with Ali Sergi. Yeah. Or he talks about the peroxide, which is another product. I think Lance, you put, you put all of it on, right? You do the dries, the peroxide, and then some unicorn tears, right? Or something. Zach. Yeah. And some, uh, John Hall. Zach, when you're putting this paste on, are you really trying to get it down in the sulcus

[00:37:38] or are you really just kind of squirting it all over everything? No, usually I, I, I don't really aim and just kind of go wherever it's just going to go. I, if it's a real gusher, then I'll probably do viscous stat first and, uh, get, get it slow down and then I'll put the dries on top. And, uh, most of the time, then I'm going to, um, I'll scan the opposing arch while that, uh, you don't want about three minutes on there. So it takes about those, well, my older iTero took about three minutes to get the other scan. Now it's so fast.

[00:38:07] I kind of have to stare at it and, and, and wish there was more time. Since Allie, if I get a squirter, I really just put on the, uh, hydrogen peroxide because it seems to control that best. It, it foams up like a mother though. It's awesome. It's super cool to see. It's like a chemistry experiment. Have you ever seen it where it kind of keeps foaming? Like even later on, if you've rinsed it all away, like you still get these little bubbles out of the sulcus. Sometimes.

[00:38:33] That's kind of like, wow, like I guess I didn't rinse all this away, even though I had water spraying on it for 30 seconds straight. Um, that's kind of, kind of scary, but, uh, yeah, it does work well. The great thing about that, that 35% hydrogen peroxide, it's like dirt cheap. Yes. Dirt cheap. Yeah. Yeah. Which is really nice. I still got a big jug in the back. I don't think I'll ever get out. I was going to say, I don't think it goes bad. I mean, I think it's like, it's like a case of amalgam in the last year, whole career. Uh-huh.

[00:39:00] Well, uh, thanks guys for the efficient crown prep tips that, that kind of wraps up the clinical hacks version of the show. So I'll, I'll kick it back over to, uh, Lance and Josh. All right. Hey, if you're, uh, if you enjoyed this show, why don't you go, uh, go over to iTunes or Stitcher or Spotify and, and why don't you give both working interferences and clinical hacks a rating? Zach, what's your favorite number? George Brett, number five. There we go.

[00:39:27] I was trying to think of a Kansas city chief number five, but, uh, go with the Royal Hall of Famer, man. Brett's, Brett's a good one. Brett's a really good one. I remember that guy. He, when we were at the Hall of Fame, they had on the big screen, uh, in one of the exhibits, the pine tar game. Uh, and, and when he goes nuts at Yankee stadium with that pine tar bat. So good. Uh, so that's how I feel, uh, when we could practice, that's how I felt every day in my office, putting out fires left and right.

[00:39:55] He's just running around like George Brett at the, after the pine tar call, um, iTunes, Stitcher, uh, Spotify, um, Google play, wherever you're listening to the show for flicking through pod bean, flick five stars, uh, hit us up on the web, working interferences.com. Hit us up on all the social bullshits. Bullshits, bullshits. Facebook, uh, working interferences with Josh and Lance, funny shit for dentists and dental team members and clinical hacks. Um, is there a password?

[00:40:24] I don't remember. Is there a, uh, how do you guys get into that? To get in, there are some questions you need to answer. You just need to make sure you're a dentist or a dental student. Okay. Any NDAs? There are no NDAs and, uh, yeah, we don't, uh, we don't, we don't do that. There's very little rules there, but we all get along there pretty well, don't we? Without the rules. It's amazing how that works. It's amazing. It is amazing. Weird. Hit us up on Twitter at winterferences. Hit us up on Instagram at winterferences. Do you guys have a clinical hacks Instagram?

[00:40:53] No, just head over just to the, all the dental hacks. Just look for dental hacks on all this stuff. It's all, we don't have our own branding. All right, cool. You can find Lance. We're the redheaded stepchild. That's all right. No one talks about any of the other stepchildren, just the redheaded one. So that's the one that gets all the pub. So that's the, that's the one you want to be. Um, you can find Lance on Instagram at drtimmerman dmd. You can find me on Instagram at joshwastondds. Boys, you want to plug your Instagrams? Uh, mine's... Uh, no.

[00:41:22] Mine's kwfryrdds, I think. It's just mainly all, uh, practice stuff. Nothing, you know, stuff from our practice. You can find me at, at, at, at macjones, I, I, I, I, or jones dental arts. Nice. And what about zam? What do you got, zam? Uh, I don't use Instagram a whole. I think it's miners dentistry. Okay. Um, but not, not too much. I'm not a heavy, sorry. I'm not a heavy user in that department. Zach, why don't you promote your MySpace page? Yes.

[00:41:50] Any of you got a Friendster account you want to plug? Yeah. MySpace, I think it's the, slash MDMA. I, uh... What's your, uh, instant messenger handle? Yeah, your AOL instant messenger. Let's hit that. Do you guys remember ICQ? Was that around? Do you guys remember that one? That was the first chat that I ever had, like, when I was a freshman in college. That was what all of us on the UT dorm were hitting up in 1997 when, uh, Ricky Williams was running around. Um, all right.

[00:42:18] So, who's gonna, we've got an interesting situation because normally our guest gets the song. Before we do that, I just want to say thank you, everyone. This is a dream come true. I had this idea in July of 2019 and it's taken a virus to slow all our lives down for us to be able to actually... A fucking pandemic. ...actually do this. So, I thank you. A virus and the Make-A-Wish Foundation who has generously agreed to make this happen for

[00:42:48] Kevin, who is unfortunately terminal, um, with the, with the COVID-19. We're sorry for your loss, Kevin. If I get the novel virus, coronavirus, COVID-19, and I die, my dreams have come true. So, thank you very much. Awesome. There we go. Shoot for the stars and if you wind up floating dead in space, well, eh, you know, you don't have to live with disappointment anymore. Um, normally we have the guest pick a song. This is the first time we've ever had three guests.

[00:43:16] So, um, I think you guys had some talks about how you guys were going to do this. So, so let us know, uh, how this is going to go. Go ahead, Mark. So, I think, I think I was nominated and, uh, it's a different world we're living in right now, boys. And, uh, coming up this weekend, we got the first weekend in April. And what does that usually mean for us? Masters. Baseball. Masters and the final fucking four. Oh, yeah, yeah, yeah, yeah. And that has been ripped from our lives.

[00:43:44] So, I'm sending you out today with one shining moment. By David Barrett. Okay, I was going to say Peebo Bryson, but you wanted which one? David Barrett. None of that Jennifer Hudson bullshit. They tried to give us a couple years ago. I was going to say, they're not all the same. No, the original, the original one shining moment. Okay. It's going to make me tear up listening to this, Mac. I'm really going to tear up. Would UNC have won the national championship this year if they would have had it? We, this is the first year, like in 35 years, we would not have made the tournament.

[00:44:13] It hasn't been that long, but it's been a long time. All right. So, it was a good year to have the Rona hit us. The streak is still alive, I guess. I'm still pissed off, yeah. Yeah. Nice. Well, enjoy one shining moment. Maybe one day we'll have one again. For Lance Timmerman and Zach Miners and Mac Jones and Kevin Fryer, I'm Josh Austin. Peace and stay fresh, cheese bags. See ya. Wakanda forever.

[00:44:58] The ball is tipped. There you are. You're a shooting star. All the years. No one knows. Just how hard you work. One shining moment.

[00:45:23] It's all a one shining time. Time is short. And the road is long. And it's done.

[00:45:47] Winds inside you decide. One shining moment. Give your heart. Feel the wind in your face.

[00:46:16] It's more than a contest. It's more.

[00:47:10] One shining moment.