Last month, I wrapped up another wonderful session of E-School LIVE, my hands-on dental training course, and it inspired me to document the successes of the weekend.
E-School LIVE is a 4-day in-person CE event where dentists who have finished my online E-School with Coaching course come to my practice for some guided, hands-on endo practice. I bring in live patients, and my students refine their root canal skills over the course of the event. They get to try out my equipment and tools, and we provide $50,000 in free dental care to the greater Charlotte community!
The next session of E-School LIVE will go on sale soon, so join the waitlist now to be the first to grab your seat.
What I love most about the event is Day 3. At this point, the students’ nerves start to settle, and there is an air of confidence that fills the operatories. The students go from hands shaking on Day 1 and totally unsure of what to do, to more confidence and more consistent and predictable outcomes on Day 3.
There is no doubt that this is a tough hands-on dental 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 worse than no knowledge at all, so I take you to your limits while I have you in person with me!
Warm Vertical Condensation
Just like with any fresh skill, it’s common to struggle with something that’s new to you. I actually really love that we ran into some issues and struggles at the most recent E-School LIVE, because my students were able to fix them in real time and get some real hands-on learning.
A consistent struggle I have noticed is warm vertical condensation. It seems many people are afraid to do warm vertical condensation. 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 higher 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 people can back out of a problem when they get home and have to do it on their own! If everything goes perfectly during the weekend, there are not that many takeaways to take home.
Nonetheless, it did help this 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.
You can see how beautifully #6 was treated. That fill is so homogenous, right? That was our favorite word this weekend, hah!
And #7 was going real smooth… that is, until the downpack.
Teachable Moments from our Hands-On Dental Training
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 made 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. They still happen to me all the time. We learn really well 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, in-person, in real-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!!
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.
Another Tricky Case
Here is another example of a successful case, but it took some work. 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 viola! 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. I feel confident that they can take these experiences back home to their practice to create more efficiencies in their practice flow.
Three Takeaways for You
I think there’s a lot to learn from these hands-on dental training tooth stories, but I’d love for you to take away three big lessons from this blog post.
First, perseverance is key! If you don’t like your obturation, or you run into issues with your backfill, or any other challenge you might run into… 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 about your mindset. 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, so he 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 sure I’m 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, things 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 to see 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.
There’s a bonus fourth takeaway, which is get a trusted mentor to help you enhance your learning. If you’re interested in expanding your endodontic knowledge, I invite you to join the E-School LIVE waitlist! You’ll be the first to know when I offer future sessions. I’d love to have the chance to mentor you in person, so you can ask all your questions in real-time!