Not so long ago, I wrapped up another wonderful session of E-School LIVE, my hands-on endo CE course, and it inspired me to document the many successes that came out of the weekend.
If you didn’t know, E-School LIVE is a 4-day, in-person, hands-on dental training that covers even the trickiest root canals. In real-time. On real patients.
This event is where dentists who have finished my online E-School with Coaching course come to my practice in North Carolina for some guided, real-life endo practice. I bring in live patients, and dentists arrive to refine their root canal skills over the course of four wonderful days. They get to try out my equipment and tools, and we provide $50,000 in free dental care to the greater Charlotte community! Plus, their assistants come, too!
Talk about a good time!
The next session of E-School LIVE is open now, so find out more here. I like to keep these groups small, so everyone can get personalized attention from my team and me—so don’t wait!
My favorite day of E-School LIVE is the third day. At this point, the students’ nerves start to settle, and there is an air of confidence and excitement that fills the operatories. The students go from hands shaking and totally unsure of what to do (Day 1 for sure!), to confident and consistent (that’s Day 3 territory!).
There is no doubt that this is a tough and immersive CE training experience. It’s made to push you to think critically and to really apply what you learn in E-School with Coaching. Let’s face it, knowledge without application is useless, so I take you to your limits while I have you in person with me!
What Can You Learn from a Hands-on Endo CE Course? Let’s Start with Warm Vertical Condensation.
It’s common to struggle with any skill that is new to you! I actually really love that we ran into some issues and struggles at the recent E-School LIVE because my students were able to fix them in real-time and get some real meaningful practice.
A consistent struggle I have noticed in my many years of providing hands-on dental training is warm vertical condensation. It seems many people are afraid to do it! They love doing a single cone technique because it is so easy. So one thing that I want to make sure every student takes away from the weekend is a greater comfort level with warm vertical condensation.
Why? Because it doesn’t matter what size your canal is, small or wide, you can predictably fill it with warm vertical condensation.
Let me walk you through some examples.
We were doing teeth #6 and 7 on this patient. Tooth #6 was a breeze, and there were no hiccups.
To be honest, that kind of disappointed me, because I always want to turn those hiccups into lessons so that this hands-on endo CE course is seriously hands-on and offers dentists lots of insight on how to navigate similar problems when they’re back in their own practices! If everything goes perfectly during the weekend, there are not that many takeaways too, well, take away.
Nonetheless, this case did help a dentist gain some confidence in doing root canal therapy since she had never done one before.
Both teeth were very sensitive to cold but had no pain to percussion. The diagnosis: Symptomatic Irreversible Pulpitis and Normal Apical Periodontium for teeth #6 and 7.
Teachable Moments from our Hands-On Dental Training
You can see how beautifully #6 was treated. That fill is sooooo homogenous, right? That was one of our favorite words that weekend, hah!
And #7 was going real smooth… that is, until the downpack.
The backfill gave us some trouble, with a bubble in the final fill. So, I had my student try to redo it.
And she did, and it actually ended up making it worse.
I know she was frustrated, but this is the kind of real-world problem that occurs in the operatory, and we need to learn how to fix it when these things happen. Seriously. This stuff still happens to me all the dang time. And it is so important to learn from teachable moments like this!
Now, my students are rock stars, but part of the benefit of E-School LIVE is I’m there as their mentor. Standing right by their side the whole time.
So, I instructed her to remove the coronal gutta percha, and then take her backfill unit (aka gutta percha gun) and place it right on top of the downpack. I advised her to leave it there for a few seconds to warm up the top of the gutta percha. Then I asked her to extrude about 2mm of gutta percha at a time and condense each increment with a plugger. By the way, using a 25 gauge obturation needle with light body gutta percha would also help prevent this from frequently happening.
And the result? She did it!! And she totally nailed it! She once again got a nice homogenous fill.
I was super proud of her and her perseverance. And now I am confident that she can back herself out of one of the biggest root canal obstacles that any dentist can face. Talk about a confidence boost!
Yet Another Tricky Case
Here is another example of a case that turned out successful, but definitely required that we do some serious endo work to get to that outcome.
The tooth had no pain to percussion and felt cold with no lingering pain. The diagnosis: Asymptomatic Irreversible Pulpitis and Normal Apical Periodontium.
His instrumentation was smooth, but then when I asked him how he liked his obturation, I could tell he was disappointed. So, I had him downpack again and see if he could advance the gutta percha on the mesial and make the distal a bit more homogenous (there’s that word again!).
And violà! Look how well he condensed the fill!
I think the final result was absolute perfection!
I am so happy my students were able to work out their root canal struggles in real-time and gain the confidence they need to keep rocking their endo back home. I am certain that they will use this knowledge to create more efficiencies in their practice flow.
Three Takeaways for You
I think there’s a lot to learn from the tooth stories that came out of this one-of-a-kind, 4-day, hands-on endo CE course. Even though I could probably write a book about this (and I mean, I guess I have written a book on tooth stories like these!) I’ll limit myself to my top three lessons.
First, perseverance is key! If you don’t like your obturation, or you run into issues with your backfill, or anything else comes up… take a deep breath and refocus. Most of the time, you can give it another shot. Endodontics is delicate work, so take it slow, steady, and easy.
Half the time, assuming you already have the knowledge and skills, overcoming challenges in the operatory is more about your mindset than your cold hard skills. You can help shepherd more cases than you think to a successful outcome.
Second, trust your gut. Like my student who didn’t love his obturation and decided to do something about it, pay attention to that little voice in the back of your mind. The one that says, “That could probably be better,” or “I’m not totally happy with that.”
I know he and his patient are both grateful he decided to downpack again. And I sure was proud of him for his decision to address what was nagging him, as well as the beautiful final result!
Third, never underestimate the benefit of learning opportunities. We all mess up, both in our work and in life. We’re only human, after all. And sometimes, mess-ups aren’t even our fault. I know I’ve faced my fair share of tricky cases. But this entire blog is dedicated to the lessons I’ve learned in navigating them.
Next time something goes wrong in one of your patient cases, take some time to reflect on it and discover what you could have done differently, and what you’ll do better next time. If we don’t take the time to learn from our experiences, we can’t grow as clinicians and people.
Here’s a bonus fourth takeaway, which is: to get a trusted mentor to help you enhance your learning. If you’re interested in expanding your endodontic knowledge, I invite you to join E-School LIVE! I’d love to have the chance to mentor you in person, so you can ask all your questions in real-time!
How did the second student re do the downpack? Did he remove the gp completely? What did he do differently the second time to make the filling more homogenous? Thanks!
I made him re-downpack again. He did not have to take the entire thing out, all he had to do was heat it back up and not be afraid to condense it a bit harder and look at how nice it came out. He really learned a ton in that case!
I am interested in course. Thank you
Lal, please send an email to firstname.lastname@example.org and my team will help you get registered.
Do you use the Endo sequence blend ?
Sorry I do not. Do you have any other specific questions?