Very Dental Student: Back to School with Zach and Kevin!

[00:00:01] This is a production of the Very Dental Podcast Network.

[00:00:09] It's time for a Very Dental Podcast just for students and new dentists.

[00:00:14] Welcome to the Very Dental Student Podcast. And now here's your host, Mohamed Aboubasha.

[00:00:20] Very Dental Student listeners and Very Clinical listeners, I have a very cool announcement for you.

[00:00:27] So if you listen to the whole feed where you listen to all the different shows that we put out here at the Very Dental Podcast Network,

[00:00:33] you know that The Very Clinical Show is our Tuesday show. And it features Dr. Kevin Fryer and Dr. Zach Miners as the hosts.

[00:00:42] This has been going on for years, years and years. And then more recently in the last couple years,

[00:00:47] we also have a show called The Very Dental Student Podcast, which features our host, Mohamed Aboubasha.

[00:00:54] He's currently a third year student at Oklahoma in dental school.

[00:00:58] So each of these shows kind of has their own sort of way of doing things.

[00:01:04] I've had the honor of being on both shows multiple times in a lot of different capacities.

[00:01:09] But what's interesting is, is Zach and Kevin and Mo, I don't think have ever podcasted before now.

[00:01:16] So what we have is this epic crossover between Very Clinical and The Very Dental Student Podcast.

[00:01:23] And today, today and tomorrow, actually, you're going to hear kind of like two sessions worth of that, of that interaction.

[00:01:32] And they talk a little bit about dental school and it's very cool.

[00:01:34] It's really exciting to hear all three of these guys.

[00:01:36] Because maybe at some point, the four of us can get on an episode and I don't know, do like dental jeopardy or something like that.

[00:01:45] That would be epic.

[00:01:46] In any case, you have a lot.

[00:01:48] Actually, they have multiple episodes that they've recorded.

[00:01:51] Then, like I said, the next two days, you'll be hearing from them.

[00:01:55] So I'm just going to put it in one day is going to be very dental student episode.

[00:01:59] The next day will be very clinical, but they'll be kind of consistent.

[00:02:02] There's a sort of one after the other.

[00:02:03] So don't be too surprised by that.

[00:02:05] And so with that, I give you the Very Dental Student and the Very Clinical Podcast.

[00:02:10] Hello, everybody.

[00:02:11] Welcome to another episode of the Very Dental Student Podcast.

[00:02:14] I'm your host, Muhammad Abu Basha.

[00:02:16] And I'm coming at you with Dr. Kevin Fryer and Dr. Zach Minor.

[00:02:22] So these are both the very clinical guys on the podcast.

[00:02:26] So if you guys tune in on Tuesdays, you might have heard their voices before.

[00:02:30] Kevin and Zach, how are you guys doing today?

[00:02:32] I'm doing great.

[00:02:33] Super.

[00:02:34] I'm doing great.

[00:02:35] I can't speak for Zach because he's been banished outside of his house, living like a homeless person.

[00:02:40] Yeah.

[00:02:41] It's 70 degrees outside.

[00:02:43] I actually feel great sitting out here.

[00:02:44] And the Chiefs are 7-0.

[00:02:46] So my world's pretty good.

[00:02:48] Oh, stop this!

[00:02:48] Yeah!

[00:02:50] 7-0.

[00:02:52] Yeah.

[00:02:53] I know.

[00:02:53] Yeah.

[00:02:54] Yeah, that's good.

[00:02:55] Using Cleveland Browns rejects as starting running backs.

[00:02:58] You didn't even want the dude.

[00:03:00] That's right.

[00:03:01] Yeah.

[00:03:02] Anyway.

[00:03:02] So all is well here.

[00:03:04] Awesome.

[00:03:05] Yeah, I can't relate.

[00:03:06] No pro football team here in Oklahoma.

[00:03:08] So it just all goes over my head in the talk.

[00:03:13] Most people here are Cowboys fans or Chiefs fans though.

[00:03:16] So I'd say most people are pretty happy.

[00:03:17] All right.

[00:03:18] Well, half of them are fine.

[00:03:19] Yeah.

[00:03:21] Yeah.

[00:03:23] So one thing we wanted to kind of go over with the very clinical guys, Kevin and Zach, is I thought it would be a good idea to go over kind of some clinical protocols.

[00:03:33] This is definitely something they've done in the past on their segment, but maybe you need to just get a little bit of an update to that.

[00:03:39] But before we get into that, I wanted to pick their brains on some good and bad memories from dental school.

[00:03:46] I thought it would be a good throwback.

[00:03:47] So, whichever you'd like to start, let's start with the good memories.

[00:03:52] Zach, you go first.

[00:03:53] Okay.

[00:03:54] I know I've had much better memories than I do.

[00:03:55] So, for the very dental student listeners, I am a University of Missouri, Kansas City grad from 2001.

[00:04:03] At the time we had what was called a six year combined BADDS program.

[00:04:08] So I like fast tracked from high school to college through dental school in six years, which is pretty cool.

[00:04:15] Tarun Agarwal also was in that program two years ahead of me.

[00:04:18] So pretty cool alumnus from that.

[00:04:21] And I would say one of my best memories from dental school was that you could get little like side gigs within the dental school.

[00:04:33] And I had an upperclassman hook me up with the gig where I taught or helped teach dental anatomy and like some lab based things to both the dental hygiene classes and the dental assisting classes.

[00:04:54] Nice.

[00:04:54] So lots of chicks.

[00:04:56] Lots of chicks.

[00:04:58] And I have, I hooked two buddies up with their wives.

[00:05:01] Oh, wow.

[00:05:01] Their current wives.

[00:05:02] They're still married to.

[00:05:03] So, yeah.

[00:05:05] So I met a lot of girls.

[00:05:06] I did not, you know, end up with a hygienist, but I did hook some of the boys up with them.

[00:05:13] So Zach, you're a matchmaker.

[00:05:14] Indeed.

[00:05:15] Indeed.

[00:05:16] That's a pretty neat story actually.

[00:05:18] Yeah.

[00:05:18] How about you, Kevin?

[00:05:19] You got anything?

[00:05:20] Did you make up anything yet?

[00:05:21] I didn't make, I'm not, this is actual truth.

[00:05:24] Believe it or not, I was a bit of a class clown in school all the way from middle school on.

[00:05:32] But so some of my favorite memories were impersonating my dental school instructors and, you know, generally making people laugh and cutting up in class, saying inappropriate things and getting away with it.

[00:05:49] And I did an impersonation of our dental, our anatomy professor, Dr. Ho.

[00:05:57] And he caught wind of it.

[00:05:59] So he was a really cool guy.

[00:06:02] And one of the funniest things he ever said to me personally was, can I do the voice?

[00:06:09] I don't know if this is politically correct anymore.

[00:06:12] So I'm not going to do it.

[00:06:14] But he said, Friar, I hear you do an impersonation of me.

[00:06:19] And I said, yes.

[00:06:21] And he brought me in front of the class and he said, do it.

[00:06:24] So I did an impersonation of him in front of the class, in front of him.

[00:06:28] And then his good sport he is.

[00:06:30] He said, now I'm going to do an impersonation of you doing me.

[00:06:35] And then he proceeded to do that, which was very funny.

[00:06:39] So that's pretty good.

[00:06:40] That's a good memory.

[00:06:41] Awesome.

[00:06:41] Yeah.

[00:06:41] Those are both pretty awesome stories.

[00:06:44] And now I'd hate to make you guys remember the bad memories, but what is one of your worst memories from dental school as well?

[00:06:51] Oh, all right.

[00:06:51] I got this one.

[00:06:52] So the very first rotation I got assigned to third year was oral surgery, which on one hand should have been good because you get a whole bunch of shots in before you get through your operative reps.

[00:07:08] But I didn't know how to take out a tooth.

[00:07:10] I had no idea.

[00:07:12] I barely knew how to hit a block.

[00:07:13] And the very first individual patient they sent me up with was a 300 plus pound, strong African American man to take out to 32.

[00:07:26] I don't think I would do the tooth now.

[00:07:29] Right.

[00:07:29] I mean, I don't remember what the roots looked like.

[00:07:31] Of course, we didn't have we have cone beam or anything like that.

[00:07:33] I don't.

[00:07:33] But I mean, there's no way I would take one look at the guy and pass on that now.

[00:07:37] So I I didn't get him numb.

[00:07:40] I fiddled around the tooth for a while and then I had to bail out.

[00:07:43] Let me but let me tell you that set me up.

[00:07:45] That set me like you talk about a confidence killer right out of the gate.

[00:07:49] Who's tough to get it back.

[00:07:50] I'd be honest with you didn't didn't like going up to oral surgery much after that.

[00:07:54] So that was my bad memory from dental school.

[00:07:58] Yeah, I can imagine that.

[00:07:59] I mean, I had my oral surgery rotation.

[00:08:01] I can imagine that being my first patient.

[00:08:03] They gave us no good.

[00:08:04] They gave us really easy ones to start.

[00:08:07] I didn't have a chance at this tooth.

[00:08:08] And I don't think I'd have one today.

[00:08:10] So there's that.

[00:08:13] All right, Kevin, what do you got?

[00:08:15] Just a general bad memory.

[00:08:18] We were our class was in the transition period between like regimes, I guess.

[00:08:25] That's the best way to say it.

[00:08:26] Like regimes, Dean, and the restorative.

[00:08:30] They like wiped out the restorative people and brought new people in.

[00:08:34] So they were just like there.

[00:08:36] It was just different.

[00:08:37] What we were learning was completely different than the people you're ahead of us.

[00:08:42] So and so it just seemed like they were changing the rules all the time.

[00:08:48] And that was really frustrating to me, you know, in terms of how many requirements you needed, what classes you needed to take.

[00:08:56] And, you know, you get to a certain point, you know, Muhammad, your third year, you just want to be done. Right.

[00:09:02] So I just wanted to be done third and fourth year.

[00:09:05] But when someone is changing the rules on you on what you need to graduate, just really frustrated me to the point where I think, you know, Zach and I have talked about this through the years.

[00:09:17] And I think that's behind the scenes, just, you know, kind of changed my personality, not for the best.

[00:09:22] So, you know, I still, you know, I like to make jokes and stuff, but I think that dental school took a little bit of my soul.

[00:09:30] And I will add this, you know, I did go to the Ohio State University who, you know, we're not seven and oh right now.

[00:09:40] We're five and one. So there's that, Zach.

[00:09:45] There you go.

[00:09:45] But anyway, you know, my son went there also and I was visiting him one weekend and we were walked by the dental school.

[00:09:55] And back in the day, you know, 30 years ago, you could pull on this one door a certain way and break into the dental school, which we used to do on weekends to get our lab work done and stuff.

[00:10:04] It was like an unwritten rule.

[00:10:06] But anyway, I walked up to the door thinking 30 years later, you could just pull on this door like nothing had ever changed.

[00:10:12] And of course, it was locked.

[00:10:13] But then someone walked out.

[00:10:16] So the door opened and we walked in.

[00:10:18] And I immediately got this feeling in my stomach, like I would imagine a child who returned to a house where they were abused in feels like Charlie is like, are you okay?

[00:10:30] And I'm like, yeah, this just didn't feel right.

[00:10:34] Anyway, I don't want to, you know, make it that dramatic, but I'm glad I'm done.

[00:10:40] I don't envy you, Muhammad.

[00:10:42] Yeah, I think I think what you guys had to go through in dental school is definitely exponentially worse than what it is now.

[00:10:51] I mean, it still sucks.

[00:10:53] It definitely has its days, but I can't imagine.

[00:10:57] I don't know, back before political correctness, and back before everybody was easy to report issues and stuff.

[00:11:04] I can't imagine how it would have been back then.

[00:11:06] Oh, yeah, it's different, different game for sure.

[00:11:08] Different.

[00:11:09] And Kevin, I think at a different game than I did.

[00:11:11] Yeah.

[00:11:12] Because you graduated what 90, 89?

[00:11:15] Yeah.

[00:11:16] Wow.

[00:11:16] What year were you born, Muhammad?

[00:11:18] Yeah.

[00:11:18] Yeah.

[00:11:19] So, I was actually born about 10 years later in 99.

[00:11:23] Yeah.

[00:11:23] 99?

[00:11:24] Yeah, I was a sophomore in dental school in 99.

[00:11:27] So, yeah.

[00:11:28] Yep.

[00:11:30] All right.

[00:11:32] Well, I imagine you guys are definitely not still practicing the way that you were taught in dental school.

[00:11:38] But let's talk just briefly on what you guys were doing in terms of posterior restorations in dental school.

[00:11:46] In dental school?

[00:11:47] Yes.

[00:11:47] I'll go first since I'm the older statesman here.

[00:11:51] I'm the oldest.

[00:11:52] You have to respect me for that.

[00:11:55] Okay.

[00:11:57] We did amalgams.

[00:11:59] And then we did more amalgams.

[00:12:03] We're talking direct restorations?

[00:12:06] Yeah.

[00:12:06] Did I tell you that we did amalgams?

[00:12:09] That's what we did.

[00:12:10] No direct gold at all?

[00:12:13] Was that the...

[00:12:14] There was some direct gold, but that was an elective.

[00:12:17] Okay.

[00:12:17] I did not do that.

[00:12:19] Although, one of my good friends, to pass the board, instead of doing a cast gold inlay, did a gold foil on a tooth.

[00:12:26] He had never done a gold foil before except on his board exam.

[00:12:29] That is legendary.

[00:12:31] But yeah, only amalgam and then some more amalgam.

[00:12:36] Did...

[00:12:37] Were you using a lot of Copalite?

[00:12:39] Yes.

[00:12:40] Yes.

[00:12:40] Oh, he just brought back another great dental school memory.

[00:12:44] We had this one guy, I won't mention his name in case he's listening, which you know he's not.

[00:12:48] But anyway, he was a little bit of a gunner.

[00:12:51] And you know, you had to get each step checked off, including the Copalite step.

[00:12:57] You had to get the Copalite step checked off?

[00:12:59] Yes.

[00:12:59] That's some micromanaging.

[00:13:01] He skipped past that and like filled the tooth or whatever.

[00:13:04] And this nerdy operative instructor said, what if you skipped the Copalite step?

[00:13:10] And this guy, I'll say his first name.

[00:13:12] His name is Dan.

[00:13:13] He said, what were you going to smell it?

[00:13:16] Like...

[00:13:16] Do you even know what Copalite is?

[00:13:19] So that's what I was going to ask is what is Copalite?

[00:13:22] It's a cavity varnish, I guess.

[00:13:25] What did it actually do?

[00:13:26] Was it a disinfectant at the end of the day?

[00:13:28] I don't know.

[00:13:29] A waste of time.

[00:13:30] It was magic potion.

[00:13:33] It was weird.

[00:13:33] Yeah, that's a good band name.

[00:13:35] We're the Copalites.

[00:13:36] Yeah.

[00:13:37] It just doesn't...

[00:13:39] So anyway, I just did amalgams.

[00:13:41] Okay.

[00:13:42] Kevin, if you did a posterior crown, was it gold?

[00:13:45] Yeah.

[00:13:45] Or had you gotten to PFM for poster?

[00:13:48] We could do PFMs.

[00:13:49] Okay.

[00:13:50] On certain teeth, we could do PFMs.

[00:13:52] The lab made those, but I made all of my own gold crowns.

[00:13:55] Every single one of them.

[00:13:56] Oh, you had to wax them and everything.

[00:13:59] Wax them, invest them.

[00:14:00] Cast them?

[00:14:01] Cast them.

[00:14:03] Holy smoke.

[00:14:04] Did you ever have to do that, Zach?

[00:14:05] I had to wax and I had to do one crown.

[00:14:08] I had to make one gold crown and that was it.

[00:14:10] We were a little bit off topic.

[00:14:11] Yeah.

[00:14:12] We can talk about that later.

[00:14:13] Right.

[00:14:13] But I got some great casting your own gold stories.

[00:14:16] Okay.

[00:14:17] Yeah, we'll definitely save that for that episode.

[00:14:21] So, we also, all class twos were in amalgam for sure.

[00:14:28] They would let us do a few class ones because they taught us sealants, of course, which sealants suck.

[00:14:35] I hate sealants.

[00:14:36] And so, we were able to do some occlusal resins.

[00:14:43] Although, typically, I feel like I ended up doing more of those on classmates or some of the hygiene students that they would let us get away with a little bit more on a student than they would one of the general patients.

[00:14:59] So, and Prime and Bond was the bonding agent of the time.

[00:15:05] We were sort of, it was a fifth generation bonding agent.

[00:15:08] It was fairly new.

[00:15:08] And I remember the composite was TPH.

[00:15:12] Good old dense supply TPH was the resin we used.

[00:15:16] Were you allowed to etch the Denton?

[00:15:21] Everything was on total etch at the time.

[00:15:25] But was the etch allowed to touch the Denton?

[00:15:27] Oh yeah, for sure.

[00:15:28] Yes, everything was on total etch.

[00:15:31] That was not allowable for me and the anterior tooth.

[00:15:34] Oh, okay.

[00:15:35] Etching the Denton causes a lot of problems, Zach.

[00:15:38] I don't know if you know that.

[00:15:40] Well, let me tell you, in an era where we did not have any gluma and we probably weren't very good about the time, the etch times, there is for sure way more sensitivity than there ever should have been.

[00:15:56] Let me tell you, one of the very first like self etching things they came out with that we got to play with, we got samples of, was that Prompto pop stuff.

[00:16:05] Yeah, those were, those sucked.

[00:16:07] Which were horrible.

[00:16:08] Yeah.

[00:16:09] They even, they got nicknamed at some point like Prompto fail or something like that.

[00:16:12] It was, you know, it was, it was terrible.

[00:16:15] So all those failed rapidly.

[00:16:18] You know, some of my replacements instantly.

[00:16:21] Here's what I'm thinking about now.

[00:16:21] For our dear friend, Mohamed, he's going to go through some sort of era of something like that, that is going to cause failures, you know, like crap tech or something like that.

[00:16:30] Yeah.

[00:16:31] But anyway, you got to be, beware.

[00:16:34] So, Mohamed.

[00:16:36] Pay attention to materials class.

[00:16:38] Let me say that.

[00:16:38] Yeah.

[00:16:38] Pay attention to materials class.

[00:16:40] Pay attention.

[00:16:41] Most of your listeners are students, right?

[00:16:44] Yeah.

[00:16:44] That's kind of, it's directed towards mostly students and also some young ducks.

[00:16:48] No, I just, I think Zach has good advice there.

[00:16:52] Pay attention to materials class and, you know, don't fall victim to some of the garbage that I had to correct over time.

[00:17:01] But anyway.

[00:17:01] And also there's, there's nothing wrong with stuff that was made 10 and 20 years ago.

[00:17:06] Also like, don't, you know, the newest Chinese product that your rep brings around to you is not the best product almost always.

[00:17:15] You know, you, they want you to be a beta tester.

[00:17:17] Don't, don't do that.

[00:17:19] You know, do it in dental school, play with anything they got while you're there.

[00:17:22] But like, once you get out, don't do that.

[00:17:25] It just causes agony and redos.

[00:17:28] Those are expensive.

[00:17:30] Yeah.

[00:17:30] I think, um, a lot of what we get, we get to use in dental school is kind of the older stuff.

[00:17:36] I don't think they like to give us the newest stuff anymore.

[00:17:39] Maybe, maybe they used to experiment more and then they had a record of failure.

[00:17:44] So then they decided to just stick to what, to what they know.

[00:17:47] So this is your show.

[00:17:48] Let's, let's pick your brain.

[00:17:49] What are they actually teaching for, for posterior restorations?

[00:17:53] What do you, what do you use?

[00:17:55] What do you, what, what kind of a technique are you taught?

[00:17:58] Yeah.

[00:17:59] So we're still being taught in terms of like preparation design.

[00:18:02] We're still being taught the GV black principles.

[00:18:05] Okay.

[00:18:05] I went to school with him.

[00:18:06] Yeah.

[00:18:07] I actually, no, I forget what.

[00:18:12] That was an age joke on Kevin's.

[00:18:15] Kevin's throwing himself under the bus.

[00:18:16] No.

[00:18:17] Okay.

[00:18:18] Solid one, Kevin.

[00:18:19] Points.

[00:18:20] That's good.

[00:18:21] I got it.

[00:18:22] You gotta be careful cracking jokes with me.

[00:18:24] Cause I can, if I get tickled, I'll go into a 10 minute laughing.

[00:18:26] Perfect.

[00:18:27] You just challenged me.

[00:18:29] All right.

[00:18:29] So GV black preps.

[00:18:30] And then like, yeah.

[00:18:31] And our first, our first restorations were in amalgam in the preclinic.

[00:18:35] Um, and then when it comes to treatment planning on our actual patients, uh, we get taught composites

[00:18:43] obviously as well.

[00:18:45] And, um, our protocol for composites, um, we have a total edge technique is what we're

[00:18:51] taught and we're using OptiBond solo plus.

[00:18:53] Oh yeah.

[00:18:54] And there's good.

[00:18:55] Like it's supposed to be a chlorhexidine step in between there as well.

[00:18:59] Um, which is very frequently skipped if I have to be honest.

[00:19:04] Um, but then we, we get taught to use packable composite.

[00:19:08] We don't have like any like sure fill or anything like that, that we use for like a, like a bulk

[00:19:15] fill type thing.

[00:19:15] We don't, we don't do anything like that.

[00:19:17] So we're taught to use packable packable in layers, two millimeter layers.

[00:19:21] Um, what resin is the school pushing on you?

[00:19:24] Um, I honestly don't even know the brand.

[00:19:27] Okay.

[00:19:28] Probably not the best, but, um, yeah, it comes in little compules.

[00:19:33] Yeah.

[00:19:33] Um, yeah, that's all I know.

[00:19:35] Okay.

[00:19:35] Rubber dam.

[00:19:36] Do they, they have you having you put rubber dams down?

[00:19:38] Let's talk about isolation.

[00:19:39] Yeah.

[00:19:40] So in preclinic, they made it seem like we weren't going to be allowed to do any posterior

[00:19:45] composites without rubber dam.

[00:19:47] Okay.

[00:19:47] But in the clinic, if they're pretty comfortable letting you work with just an iso vac.

[00:19:54] Oh, okay.

[00:19:55] Like an isolate type.

[00:19:57] Yeah.

[00:19:57] The same thing.

[00:19:58] Interesting.

[00:19:59] Um, Zach, how do you feel about rubber dams right now?

[00:20:02] I'm a big fan.

[00:20:04] Yeah.

[00:20:05] Yeah.

[00:20:05] How did you feel about rubber dam and dental school?

[00:20:09] Uh, why I had, I had to use it.

[00:20:12] And so, but I did, it's hard to put on a rubber dam by yourself.

[00:20:16] Yeah.

[00:20:16] And I don't know if you guys get assistance or it's hard, but with a second person involved

[00:20:21] that knows what they're doing.

[00:20:23] And if you're prepared and you gotta, it's not, it's not a big event then, you know?

[00:20:29] Yeah.

[00:20:30] We have, uh, I'm going to go on a little rant here.

[00:20:35] Rant up.

[00:20:35] Let's do it.

[00:20:37] Let me, uh, take over your podcast, Muhammad.

[00:20:40] Um, so Zach, did you go through a period of time when you first graduated?

[00:20:44] You're like, Oh, that rubber dam.

[00:20:46] That's not for me.

[00:20:47] 100%.

[00:20:47] I, I didn't, I didn't recommit to the rubber dam until probably 10 years in.

[00:20:52] All right.

[00:20:52] Why?

[00:20:54] Uh, bad memories.

[00:20:55] That's all.

[00:20:56] The only reason was bad memories.

[00:20:57] And I hadn't like, I hadn't like refreshed my technique or looked into like better rubber

[00:21:01] dams or I hadn't, hadn't done any of the work.

[00:21:04] I just didn't think I needed it.

[00:21:06] You know?

[00:21:08] So as our listeners know, I'm a big rubber dam fan.

[00:21:12] I think that the, for your student listeners, the enemy of good dentistry is tongues and spit.

[00:21:20] Saliva.

[00:21:21] 100%.

[00:21:21] Tongues and saliva.

[00:21:22] If you can eliminate that as a factor, then you're rocking.

[00:21:26] Now, I did, uh, let me amend this.

[00:21:30] I'm a believer in isolation.

[00:21:32] Isolate, Isovac, that's great.

[00:21:34] Rubber dam, even better.

[00:21:35] I do almost all of my restorative work under rubber dam, including crown preps, which Zach

[00:21:41] and I have talked about in the past.

[00:21:43] It just makes everything easier.

[00:21:45] So step one, in my opinion, is some sort of isolation.

[00:21:50] And, um, I'm a big rubber dam fan.

[00:21:53] Okay.

[00:21:54] So you don't have an issue with Isovac slash Isolate.

[00:21:57] You think that's adequate?

[00:21:59] I think it is.

[00:22:00] It just really bothers my hearing.

[00:22:03] Oh, okay.

[00:22:04] I've never, I've never worked with one.

[00:22:06] So I, I only know, I only know rubber dam and then like, uh, like triangles and good

[00:22:12] assistant work and all that.

[00:22:13] Like those are my two choices.

[00:22:15] Cotton rolls and dry angles for posterior composite.

[00:22:19] It's just not going to work.

[00:22:20] You think it's going to work and it's just not.

[00:22:23] I don't argue that it's okay for some maxillary, um, uh, operative, especially the closer you

[00:22:31] get to the front of the mouth, but on the mandible, the dam is going on.

[00:22:36] Damn it.

[00:22:37] You know, that's just all there's to it.

[00:22:39] Yes.

[00:22:40] Yeah.

[00:22:40] No, that makes perfect sense to me.

[00:22:42] Yeah.

[00:22:42] I, uh, I actually wish I would, I would be using it more, but we like you guys mentioned,

[00:22:47] we don't have assistance and, uh, sometimes we feel like our, like our clamps.

[00:22:52] Honestly, I just feel like they really suck and we don't have the right, like, I don't

[00:22:57] know if it's just that they've been used so much and they're like not sturdy anymore,

[00:23:01] but they just always pop off.

[00:23:03] Like no matter.

[00:23:05] Yeah.

[00:23:05] So for sure.

[00:23:06] So that I, I agree with you on that, Muhammad.

[00:23:08] Like it wasn't until I invested in some like decent clamps and had like clamps for some,

[00:23:13] a lot of different scenarios, short teeth, rounded, you know, that it wasn't how invested in

[00:23:20] that and invested in better than like the, the green hygienic rubber dam that, uh, that

[00:23:26] they, that they have at the school.

[00:23:27] I invested in a little better rubber dam tech, watched a few YouTubes on it.

[00:23:32] That, that changed everything for me for sure.

[00:23:36] Awesome.

[00:23:37] All right.

[00:23:37] Well, I would love to get into what you guys are doing now in terms of posterior restorations

[00:23:42] direct.

[00:23:42] Oh, Muhammad.

[00:23:43] Wait, wait, wait.

[00:23:44] I got one more for you.

[00:23:45] Okay.

[00:23:45] Are they teaching you guys, uh, sectional matrices as opposed to Toffelmeyer's for like your

[00:23:50] class twos?

[00:23:52] Okay.

[00:23:52] Yeah.

[00:23:52] We are using, um, I believe it's the Paladent system.

[00:23:56] Okay, great.

[00:23:57] Super.

[00:23:57] That's good.

[00:23:58] That, that we are supposed to not have that.

[00:24:00] So that was a big neg for sure.

[00:24:03] And you did.

[00:24:03] We do have talk.

[00:24:04] We do have something that goes on to the Toffelmeyer carrier that's designed for composite.

[00:24:09] I don't know what brand it is, but it's kind of like a greater curve type thing.

[00:24:13] Oh yeah.

[00:24:13] Oh, okay.

[00:24:13] If you know about that.

[00:24:14] So we have one of those for situations where for whatever reason, the Paladent isn't working,

[00:24:19] but they really would prefer that we use the Paladent with the ring and all that.

[00:24:23] Sure.

[00:24:23] Sure.

[00:24:25] Absolutely.

[00:24:25] All right.

[00:24:26] Perfect.

[00:24:27] So, um, yeah, let's get into it.

[00:24:28] So we can start with Kevin.

[00:24:30] Kevin, what are you doing nowadays?

[00:24:32] Um, in terms of your posterior direct restorations?

[00:24:36] You want my real answer or?

[00:24:38] No, don't give me the real answer.

[00:24:40] Cause you can't cop.

[00:24:41] You prep them and walk out.

[00:24:42] I don't even do them, bro.

[00:24:43] You're like, don't give me that.

[00:24:44] You have to do it like as if you had to do the restoration yourself.

[00:24:48] Okay.

[00:24:48] Cause I had to do one yesterday for real.

[00:24:50] There it is.

[00:24:50] See that one.

[00:24:51] I had to do that one yesterday.

[00:24:53] Okay.

[00:24:54] Um, yeah.

[00:24:56] So rubber dam isolation and I'm using, uh, uh, for my adhesive, I'm using brush and bond

[00:25:04] from Parkel and I'm using a modified, I don't know what you would call this sack, the bio clear

[00:25:12] technique, except I'm not using bio clear.

[00:25:15] So I'm putting, um, uh, flowable in the box.

[00:25:21] You sure.

[00:25:22] Right.

[00:25:23] Yeah.

[00:25:23] Um, and then putting, uh, Phil tech Supreme on into that.

[00:25:31] So it's like pushes it into all the, Oh, you, you're a snowplow guy, snowplow guy.

[00:25:36] Yeah.

[00:25:37] Okay.

[00:25:37] It's Cleveland.

[00:25:38] We get a fair amount of snow.

[00:25:40] Okay.

[00:25:41] So we have to plow it now and then.

[00:25:43] Um, and that I'm just doing that to fill the box and then that all gets cured.

[00:25:49] And then now I've just turned it into a class one and I will, uh, fill that, uh, accordingly.

[00:25:57] And then I am using, um, sectional matrices, the ultra dent, whatever those are called triodent

[00:26:06] ones.

[00:26:07] I ultra triodent is the same as paladent, which is the same as there's like, there's a lot

[00:26:13] of versions of the same thing that are sold under different names.

[00:26:17] Okay.

[00:26:18] And then, uh, polish that up and you're done.

[00:26:23] I do have, I do have one question.

[00:26:25] Is the bonding system that you use, is it a two step or one step?

[00:26:29] One step.

[00:26:30] Okay.

[00:26:31] Self-etching, self-priming.

[00:26:33] There's no edge.

[00:26:34] It is the etch and bond all in one.

[00:26:38] Okay.

[00:26:39] Okay.

[00:26:39] Brush and bond.

[00:26:40] Yeah.

[00:26:41] And that has.

[00:26:42] You scrub in one coat, dry it and cure it?

[00:26:46] Yeah.

[00:26:47] I scrub.

[00:26:48] No.

[00:26:48] Apply.

[00:26:49] Yes.

[00:26:50] We.

[00:26:51] Well, okay.

[00:26:52] Yeah.

[00:26:53] Got it.

[00:26:54] Just brush.

[00:26:55] No scrub.

[00:26:56] Just brush.

[00:26:56] Okay.

[00:26:58] Okay.

[00:26:59] Awesome.

[00:27:00] Right on.

[00:27:00] What about you, Zach?

[00:27:01] What are you doing?

[00:27:02] Okay.

[00:27:02] So I have used the, I've used the same bonding agent since 2005.

[00:27:08] I've, I've used Danville zests.

[00:27:12] I used to be Danville zest bottom.

[00:27:14] It's called Prelude SE.

[00:27:16] It is a self-etching primer.

[00:27:18] So I don't do a, I don't do an acid etch.

[00:27:21] I do a, I use the self-etching primer to 10 second scrub.

[00:27:24] Then there's a bonding agent, 10 second scrub cure.

[00:27:29] Um, and, uh, I use a couple, Kevin's pretty good at just having like one composite, one

[00:27:36] technique for, for everything, which is great.

[00:27:39] Uh, I mess, I'm a little more nuanced and I mess around with some things a little bit

[00:27:43] more.

[00:27:44] So I've got, um, depending on the situation I'm dealing with, if it's like a, the average

[00:27:50] cavity, I'm probably going to use show fill, uh, show foods, beautiful too, which is a,

[00:27:54] uh, it's a resin that releases some fluoride and I've had really good long-term results

[00:27:59] with that.

[00:28:00] However, if the person's like a heavy, heavy grinder, or if I'm doing maybe a larger composite,

[00:28:06] I'll probably use a micro, uh, a, uh, micro hybrid called Z two 50.

[00:28:11] Uh, I'm, I'm apt to use that one.

[00:28:13] Um, and then if it's a real pain in the butt patient where I'm trying to get out of the

[00:28:17] situation as quickly as possible, I will use a total fill bulk fill material called bulk easy

[00:28:23] plus.

[00:28:24] And that's just a, you squirt it in, just fill the thing up, let it set cure for 90 seconds

[00:28:29] and then you finish it.

[00:28:31] Um, and that's a good material too.

[00:28:33] So I've used a guy, you have three different resins depending on how I'm feeling that day,

[00:28:37] which is bad.

[00:28:38] I've heard you guys talk about bulk easy before.

[00:28:41] Is it, and it's dual cure, correct?

[00:28:44] Uh, it's more, I would call it more self cure.

[00:28:47] You are supposed to let it set up completely on its own.

[00:28:51] Then you like your to just like, uh, you know, get the, uh, oxygen inhibited layer cured at the

[00:28:57] very top.

[00:28:58] Okay.

[00:28:59] So, and that's a, the, the generation one of that material, uh, didn't have the greatest

[00:29:06] wear characteristics after about year four or five, but then they came out there plus version

[00:29:11] that's been around for a couple of years now.

[00:29:13] I think the wear is going to be way better on it.

[00:29:15] It's, it has a way harder, way harder set.

[00:29:17] Um, and I think it's going to be, I think it's going to be a winner, but I'm, I'm not,

[00:29:22] I'm not pushing it as hard right now cause I don't have the longterm on it yet.

[00:29:25] But it's, it's, it's a, it's a very interesting material that we have a lot of, a lot of colleagues

[00:29:29] and friends using for sure.

[00:29:32] Okay.

[00:29:32] Interesting.

[00:29:33] So, and then what, um, I don't, what matrix system do you use?

[00:29:38] I'm using one of the knockoffs of, of Paladent.

[00:29:41] Um, there's one made by a company called Pacdent, which is like I matrix.

[00:29:47] It's basically Paladent except for like a third of the cost.

[00:29:50] That that's one of my sticks is, uh, finding things that are, you know, I, I, my, even I, I said, I

[00:29:58] used Prelude technically.

[00:30:00] I Prelude has been cloned.

[00:30:01] It's been around for so long.

[00:30:02] It's been cloned and it's, I buy the best choice version of, of that as well.

[00:30:07] So, uh, same, same manufacturing, same everything.

[00:30:11] Yeah.

[00:30:11] I'm sure.

[00:30:12] Yes.

[00:30:12] That.

[00:30:14] I've definitely heard you guys talk about it before, um, that you tend to go for the, the

[00:30:18] cheaper options.

[00:30:19] I am a, I'm a, I, if it's the same, I guess that I looked, I, I, I put a lot of effort

[00:30:26] into finding out where these things are sourced and made and make sure it's going to actually

[00:30:31] work before I, uh, you know, save that money.

[00:30:35] Perfect.

[00:30:35] I do have to ask, do either of you guys carry amalgam anymore?

[00:30:39] Yes, I did.

[00:30:40] I did an amalgam today.

[00:30:42] Yeah.

[00:30:43] Okay.

[00:30:43] Awesome.

[00:30:43] Talk to me about when you'll decide to actually pull that out.

[00:30:47] There are some situations where it is impossible to keep the area isolated.

[00:30:53] And if we go back to the way we started this, isolation is key.

[00:30:57] So those, those situations may be a kid or some weird lingual on a posterior tooth on

[00:31:08] an older person.

[00:31:10] That's, that's the last one I did that I remember.

[00:31:13] So I keep it handy in case we need to do something like that.

[00:31:18] So I probably do less than 10 a year, but you know, the, the minute I said that last

[00:31:24] year, I think January 2nd or 3rd, I placed an amalgam for, so I don't remember the reason,

[00:31:29] but I'm like, Oh, that's, that's one for the year.

[00:31:32] But, um, I'm going to let Zach answer.

[00:31:36] Then I want to circle back to that.

[00:31:37] Okay.

[00:31:37] Um, I, I also, I probably only do 10 to 10, 12 amalgam.

[00:31:43] It's like a once a month thing.

[00:31:44] It's like, Oh, this is the amalgam scenario.

[00:31:47] Some of those are like an endo was done through a gold crown.

[00:31:50] I'm not going to patch that with composite.

[00:31:52] I'm going to use amalgam on that.

[00:31:54] Um, okay.

[00:31:55] I know it's, uh, not advised to patch crowns, but sometimes I do.

[00:32:00] And if the crown's a metal based crown, I'm probably going to use a, an amalgam to, you

[00:32:06] know, patch the crown.

[00:32:08] Um, there's just some scenarios like that.

[00:32:10] Now here's the other, the other thing though, I use a whole bunch of glass ionomer in situations

[00:32:18] where Kevin might choose to use amalgam cause he doesn't have GI the, like the rubber dam doesn't,

[00:32:24] is not going to stay on this tooth.

[00:32:26] I do a lot of class ones and class five types of restorations, especially on molars in like

[00:32:33] an, in, in equia forte.

[00:32:35] A lot.

[00:32:36] I, that material gets used multiple times every single week.

[00:32:39] And so that's every scenario where a dentist would be like, Oh God, I, I, this just isn't

[00:32:44] going to bond here.

[00:32:45] I need to use an amalgam.

[00:32:47] I'm using that, uh, glass ionomer set.

[00:32:49] I don't know if they, are they teaching you glass ionomer all in school, Muhammad?

[00:32:52] Uh, we get taught it and we actually do have it available in the course.

[00:32:55] Clinics.

[00:32:56] You will say though, learn to use that.

[00:32:58] It is a great, great material that you will be proud of your results five to seven years

[00:33:03] down the line with that material where composites will fail.

[00:33:07] Do you, are the glass ionomers that you use?

[00:33:09] Are they true glass ionomers or are they?

[00:33:11] Yes.

[00:33:11] I do not use any RMG.

[00:33:13] I have, I only have a pure equia fortes, a pure glass ionomer.

[00:33:16] I, I have nothing against the people who's like, uh, Mac Jones used to do the show with

[00:33:21] us loves Fuji two, which is a resin modified glass ionomer.

[00:33:25] That's a wonderful material.

[00:33:26] Also.

[00:33:26] I just, for inventory sake, I stock one thing.

[00:33:29] So it's like, I either use composite or I use the glass ionomer.

[00:33:34] So.

[00:33:34] Got you.

[00:33:35] Now, Kevin, you were getting ready to come back to amalgam.

[00:33:37] So like.

[00:33:38] Yeah.

[00:33:38] So I've just had this thought recently and I, you know, I'm just going to throw this

[00:33:42] out here that, um, I think that the transition through, through the nineties and the two thousands

[00:33:52] to posterior composites, you know, there was this real anti-amalgam sort of, um, sentiment

[00:34:01] amongst our colleagues.

[00:34:03] And I understand why, you know, back then I was like, I'm putting this silver thing in

[00:34:09] someone's tooth.

[00:34:10] That's not really restoring it.

[00:34:12] Like if you were going to restore a classic car, you wouldn't put up a quarter panel that

[00:34:17] was a different material or different color than what you're restoring.

[00:34:22] I get all that.

[00:34:23] But I think as time has gone on, I, I don't think that that material is holding up in general,

[00:34:32] not just my own, but the ones that come through from other offices, both like they look great

[00:34:38] when you place them.

[00:34:39] But as the wear goes on, um, you know, I just don't think it, it holds up that great.

[00:34:46] So I think, you know, class one, that's different story than the class two.

[00:34:51] Uh, but a three surface composite over a long period of time on, I just, or rebuilding a cusp, just

[00:35:00] don't love it.

[00:35:00] I'm more apt to jump to a crown than, you know, some of these scenarios where you're kind of playing

[00:35:10] hero with this material.

[00:35:12] That's my opinion.

[00:35:15] Perfect.

[00:35:16] Uh, I do have kind of a follow up question kind of on that is, do you think that a lot

[00:35:20] of direct restorations, um, kind of with the improvement in 3d printing technology, do you think that we're

[00:35:29] going to be seeing a lot more inlay type things where we print it and that might hold up better than our, um, our

[00:35:38] current direct composite?

[00:35:39] Well, having a period of time where I was trying to mill inlays with my CEREC, I'm going to tell you that

[00:35:48] that's more difficult than what it appears to be.

[00:35:50] So you're seeing some of these people on Instagram, that's good for them, more power to them.

[00:35:56] But I just don't, right now, I just don't see that that's, um, a viable option.

[00:36:04] And, um, I do think that's an emerging technology and I don't want to, you know, what I just said,

[00:36:11] I don't, that would be like someone in 1992 saying, there's no way you can place a posterior composite

[00:36:19] or etch the Denton or whatever crazy things I was told back then.

[00:36:25] It probably will in your career be a thing.

[00:36:29] I'm just saying that, uh, printing an inlay or milling an inlay is way more difficult than what it appears

[00:36:35] in terms of getting it to fit.

[00:36:37] That, that's my prediction as well.

[00:36:39] I think in your career, Muhammad, I think that's what you're going to be doing.

[00:36:44] Yeah.

[00:36:44] Someday.

[00:36:45] But like, I don't think it's gonna, I don't think Kevin will, is going to do that in his career.

[00:36:49] Unless he's practicing in his, into his eighties.

[00:36:52] I don't think he's going to do that.

[00:36:53] And honest to God, even I'm in my late forties.

[00:36:56] I, I don't know if, I don't know if I will do it because by the time someone has it down and they're like,

[00:37:03] okay, this really genuinely works.

[00:37:05] And then I see, and then I see those, like, does it work for 10 years?

[00:37:09] Then I'm going to be done too.

[00:37:10] So I don't think it's gonna, I don't think I'm going to see it either.

[00:37:13] Not printing, you know, for sure.

[00:37:15] It's a fit issue.

[00:37:16] Really?

[00:37:16] Yeah.

[00:37:18] Yeah.

[00:37:19] It's also, I think it's a wear issue as well.

[00:37:21] I don't know if they have a material that's durable enough.

[00:37:23] Exactly.

[00:37:23] So yeah.

[00:37:24] So no, I, I think that's a-

[00:37:27] Actually that, that part will be, that part will overcome, I think.

[00:37:30] I think the, the, the wear factor will, won't be a factor, but, um, anyway, it's more

[00:37:37] of a trick than what it appears to be.

[00:37:39] Not, not any time.

[00:37:41] I don't, I just don't see it, you know, not, not this decade, you know, for sure.

[00:37:47] Not, not for, not for like genuine run of the mill usage.

[00:37:52] That's good to know.

[00:37:53] Cause I have heard a few people mention it.

[00:37:55] I obviously have no idea, I have no experience with it.

[00:37:58] So I thought I would just, just ask you guys to get a kind of, kind of, one of those things

[00:38:01] that, that, that's on the, the, the same line as be careful about in, you know, investing

[00:38:07] anything brand new out of the gate or that's even like kind of new, you know, there's a

[00:38:13] reason they have you using OptiBond Solo plus, which has been around since probably 2000.

[00:38:18] Um, then, uh, you know, some eighth generation, you know, thing that was developed in the last

[00:38:25] five or six years.

[00:38:27] So, yeah.

[00:38:28] And I bet you anything, once you figure out what composite you use, I bet it wasn't created

[00:38:31] in the last 10 years either.

[00:38:33] Yeah.

[00:38:34] Fair.

[00:38:34] I think I just remembered, I think it was spectra.

[00:38:37] Okay.

[00:38:37] That that's a, that's, that's TPH as well.

[00:38:40] That's just TPH is updated product.

[00:38:42] So there you go.

[00:38:43] Yep.

[00:38:44] Perfect.

[00:38:45] All right.

[00:38:46] Well, I think that just about does it.

[00:38:48] Any final remarks on posterior direct restorations?

[00:38:52] Um, do them if you have to.

[00:39:01] You know, here's, here's, here's my final thought.

[00:39:05] Here's my final statement.

[00:39:06] So, Muhammad for better or for worse, the almost running of like groups, group messages,

[00:39:14] message groups that Kevin and I are involved in almost a running joke of a, this is a, not

[00:39:19] a good joke, but it's a running joke.

[00:39:21] Yeah.

[00:39:21] Nonetheless, that like, if you hire someone out of dental school in their first few years,

[00:39:27] you're going to have to redo half their composites before the, even the, like, you know, the insurance

[00:39:32] allows you to get paid for redoing them.

[00:39:35] Um, so my plea would be, you know, it's not the sexiest thing to do CE on, but the good

[00:39:43] news is that most of the good CE are a lot of the good CE for composite.

[00:39:47] It's just on YouTube these days.

[00:39:48] Like you can, you can learn a good technique for a rock solid composite on YouTube for

[00:39:55] $0.

[00:39:57] And, um, I just, you're going to be doing a lot of fillings.

[00:40:01] You might as well have them work and not be sensitive.

[00:40:04] Uh, that sensitive fillings are a huge practice killer and, you know, a smooth filling experience

[00:40:11] is a, is, is a good thing for a potential employer and certainly for a patient base.

[00:40:17] So, you know, get good at them.

[00:40:19] Really glad you said that Zach, it is a running joke in our groups.

[00:40:25] Um, so I hate that it's a running joke.

[00:40:27] It shouldn't be, you know, I'll, I'll second, I'll say the best CE you have right now is

[00:40:32] you're in school.

[00:40:33] Just do it.

[00:40:35] Don't cut corners.

[00:40:36] You can't cut corners with the filling.

[00:40:37] You just can't do it.

[00:40:39] Can't cut corners with a lot of stuff, but especially that, especially if you're new out

[00:40:43] of school, I think a lot of people have problems preparing and filling class twos.

[00:40:50] I don't understand why.

[00:40:51] Just get good at it.

[00:40:53] And consistent, um, read your directions on your bonding agents.

[00:40:59] Read there.

[00:41:00] Even if you think you know the directions, reread the directions on the bonding agent,

[00:41:04] watch a YouTube on, on someone who's using that and how they scrub it in and how they

[00:41:09] do it.

[00:41:09] Like, you know, read, read your stuff and keep it isolated and you will have, it'll solve

[00:41:17] a lot of problems for you.

[00:41:18] I, I did badly with, with the poster residence at first cause I didn't do any of the things

[00:41:23] I just advised.

[00:41:25] There were also no podcasts for me to learn about that kind of stuff either.

[00:41:28] So, or YouTube, none of those.

[00:41:31] So take advantage of those free resources like podcasts.

[00:41:33] What we should have done isn't done at YouTube.

[00:41:36] Yeah.

[00:41:37] Then I wouldn't be here and you wouldn't be, none of us would be here.

[00:41:39] We'd all be on the beach.

[00:41:40] So, yeah, perfect.

[00:41:43] I think that's all a good advice and I hope, um, that the students out there listening

[00:41:47] or even any of the young doctors, um, were able to extract some wisdom from that.

[00:41:52] Um, and then I think we'll be on next week with another, uh, with another episode talking

[00:41:58] about, what are we talking about next week?

[00:41:59] And here you say, and here, yeah, or, or maybe something different.

[00:42:04] If Kevin doesn't like that idea, who knows?

[00:42:06] All right.

[00:42:07] All right.

[00:42:08] We'll catch you guys next week.

[00:42:10] See ya.