Random Rantings from a wet -fingered dentist

Using Forms to make life easier

laser_dentist@icloud.com (Ashley Watson) — Mon, 26 Jan 2026 07:51:08 GMT

Computers were supposed to make our lives easier. Some days, they do. Other days, they feel like passive-aggressive filing cabinets with a superiority complex.

Why I’m Obsessed with Custom Forms

Since computers infiltrated dental practices, we’ve reclaimed entire walls of filing cabinet space and spared our staff the soul-numbing task of note retrieval. We’ve also gained the ability to store far more information—hello, “enhanced customer experience.”

Gone are the days of scribbling “PCO Pn UL6, poss #, PA, AB’s TCA XLA.” There’s a certain purity to that shorthand, but now we’re expected to document everything from the patient’s new granddaughter to their house move—before we even get to the clinical bit.

Detailed notes aren’t just good practice—they’re a medico-legal necessity. So why not make your life easier with custom screens and forms?

Custom Screens: Your Clinical Cheat Sheet

Attach them to specific services to act as an aide-memoire. They prompt you to ask the right questions, record the right details, and avoid the “I meant to write that down” regret.

Forms: The Unsung Workflow Hero

Forms are brilliant for collecting and distributing information. Once created, they can be reused endlessly, filed automatically, and emailed to everyone who needs them. Most platforms generate non-editable PDFs, which are perfect for compliance and record-keeping.

In my implant workflow, I use forms to:

Assess patients
Report on radiographs
Prep the team for surgery
Log post-op activity

I also use forms for:

CPD tracking
Pain assessments
Medical histories
Patient satisfaction surveys

If I’m repeating a process more than once, I build a form for it. It’s that simple.

My Platform of Choice: Wufoo

You’ve probably filled out a Wufoo form without even realising it. It’s flexible, intuitive, and powerful. You can:

Trigger conditional questions based on previous answers
Set passwords and CAPTCHA checks
Limit submissions per device
Schedule cut-offs for completion

It’s ideal for preventing misuse and keeping your data clean.

Try This

Check out the generic x-ray reporting form I’ve built. It might just save you time, improve your documentation, and streamline your communication.

The 7 Habits

Sun, 25 Jan 2026 15:54:23 GMT

Routines, Risk, and Radiographs: Building a Framework for Stress-Free Implant Dentistry

The Seven Habits of Highly Effective Implant Dentists (Sort Of)

Why Protocols Reduce Stress—And Improve Outcomes

One of the best ways I’ve found to reduce stress in clinical practice is to build routines and protocols for the day-to-day stuff. That way, when things get challenging, it’s more fun than frantic.

I’m not talking about becoming an automaton—carrying out treatment without thought or nuance. I mean having a framework that reduces the number of decisions you need to make on the spot. It frees up cognitive space for the real challenges.

Stephen R. Covey’s The Seven Habits of Highly Effective People is one of the best reads for any professional. You’ll hear people refer to its principles in everyday conversation. Dentistry isn’t so different. So I’ve borrowed the title—loosely—to outline the habits I believe every implant dentist should adopt.

The Core Principles of Implant Care

Let’s call these the “seven-ish” habits:

Risk Assessments
Patient Expectations
Clinical Considerations
Implant Placement
Restoration
Design & Planning
Contemporaneous Log of Treatment
Audit & Review

Okay, I know that’s not exactly seven—but close enough.

Habit 1: Risk Assessments Should Be Methodical

I use a custom screen on Exact. And no—it’s not prefilled. Every data field must be clicked for a response, or it stays blank. Atul Gawande’s The Checklist Manifesto was clearly written with me in mind.

If you don’t have a custom screen, the ITI’s SAC assessment tool is a good start. It’ll give you a sense of case complexity and can be saved as a PDF in the patient’s notes. But remember: complexity is just one piece. A comprehensive assessment of patient expectations and clinical considerations is essential. If you’re unsure what that means, the ITI has excellent CPD resources.

Habit 2: Plan from the Final Restoration Backwards

All implants should be planned based on the final restoration. Radiographic imaging—especially CBCTs—should relate directly to the guides you’re using. Guesswork isn’t good enough.

You don’t need the latest digital intraoral scanner to do this. A denture with a radio-opaque tooth before the x-rays, converted into a guide, can be nearly as effective.

Habit 3: Guided Surgery Is No Longer Controversial

Guided surgery is definitively more accurate than freehand placement. The closer you get to fully guided, the better. Good planning at the beginning prevents amplified mistakes later. Your lab will thank you, and your implants will suffer less inflammation and infection.

Do not accept poor-quality guides from a lab—no matter how experienced they claim to be. A guide that isn’t stable is stressful and poor value. And having a guide is not a defence for poor placement.

Habit 4: Keep a Log—Or Don’t Place

If you’re not keeping a log of treatment—including types, makes, and serial numbers of implant hardware—you shouldn’t be placing. It’s your moral duty to ensure the product is traceable and replaceable with minimal stress. That includes choosing suppliers who won’t vanish overnight.

Habit 5: Follow-Up Is Your Responsibility

Checking that the patient is maintaining their implants is your responsibility—even if you delegate it. Referrers and auxiliaries need to know what failure looks like and report it early.

Habit 6: Audit and Reflect Honestly

Audit your success annually—or per implant. It’s the only way to improve your technique. “Sharpening the saw,” as Covey would say, requires total transparency and honest self-reflection.

Habit 7: Mentoring Starts with a Foundation

Whenever someone asks me about mentoring, I want to know these principles are already in place. They’re the minimum standard for implant treatment. Without them, we’re not building—we’re guessing.

Whenever someone asks me about mentoring I like to know that the above principles are in place before we start, I think they have to be regarded as the basic minimum when it comes to implant treatments.

Why Won’t You Do What I Ask?

Sun, 25 Jan 2026 15:29:15 GMT

Why Won’t You Do What I Ask?

Dentistry Isn’t Retail—It’s Healthcare

Why Won’t You Do What I Ask?

Dentistry Isn’t Retail—It’s Healthcare

In a world Seth Godin might describe as long-tail chaos—where you can have whatever you want, whenever you want, in whatever god-awful colours you like—dentistry hasn’t kept up. Why?

Because it’s still healthcare.

After spending three months on sabbatical (most called it Lockdown 1.0), I was repeatedly asked by patients whether we’d be locking down again for version 2.0. It reminded me: dentistry is not non-essential retail. It’s not entertainment. It’s not paraffin hand waxing with Botox on the side.

Yes, I hear you chanting, “But there was a time…” And yes, we’re still punting tooth whitening thanks to innumerable lionate influencers. But occasionally, we must remind ourselves—and our patients—that we are healthcare providers, dedicated to improving dental health within our flock.

The Illusion of Choice

Patients don’t always help. Since Harold Shipman and the rise of the CQC, we’ve shifted from telling patients what they need to offering options. We say things like, “They’re your teeth, and it’s your health—I can’t force you.” And rarely does the threat of imminent sepsis or death make them any less attached to their favourite putrid molar.

Informed consent is essential. But once patients feel educated, some start offering “novel” solutions with Trump-like confidence. That’s when you need to shut it down—before you start believing miracles could happen.

You’re the One Wearing the Boots

It’s easy to forget, but you’re the one with the boots in the relationship. Patients will ask you to ignore worsening hygiene and bone levels because they’re scaler-phobic. Until you tell them they need ten teeth removed and only a denture is possible, they’ll cling to their refusals. Suddenly, their fears vanish when they realise how much they could make suing you for their future fated all-on-four treatment.

One patient I inherited reminded me of this when I informed him his failing implants needed removal. He was dumbfounded that I wouldn’t supervise his neglect for another few years and threatened to travel abroad for his care. Result!

Evidence-Based Dentistry Is Your Shield

Believe in the force of evidence-based dentistry. Fight back with your best sensible solution—or say goodbye. Your defence organisation will back you: if a patient refuses to take your advice, you’re within your rights to refuse to treat them.

We’re not here to entertain. We’re here to care.

How AI Is Transforming Dental Note‑Taking: Why Kiroku Is Saving Clinicians Hours Every Week

Sun, 25 Jan 2026 15:01:05 GMT

“From late‑night typing to instant, intelligent notes — the future of dental documentation has arrived.”

The Rise of AI in Dental Note‑Taking: How Kiroku Is Giving Clinicians Their Time Back

For as long as dentistry has existed in its modern form, clinicians have wrestled with the challenge of keeping accurate, contemporaneous notes. They’re essential for medico‑legal protection, continuity of care, and professional accountability. But let’s be honest: they’re also one of the most time‑consuming, mentally draining parts of the job.

We’ve moved from paper files to practice‑based software to cloud platforms—but the real revolution is happening right now, with the arrival of AI‑assisted dental note‑taking .

And few platforms embody this shift better than Kiroku .

The Problem: Notes That Eat Into Your Life

Every dentist knows the feeling. You finish a long clinical session, remove your gloves, and glance at the clock. You should be heading home, but instead you’re staring down a backlog of notes that need to be typed, formatted, and cross‑checked.

Even with modern software, the process can feel like a second job. Templates help, but they still require endless clicking, editing, and mental effort. Multiply that by dozens of patients a day, and you’ve got hours of admin that nobody trained for at dental school.

Enter Kiroku: AI That Actually Understands Dentistry

Kiroku didn’t just digitise note‑taking—it reimagined it.

Instead of typing out every detail, clinicians can now speak naturally , or select from intelligent prompts, and the AI generates structured, accurate, medico‑legally sound notes in seconds. It understands workflows, treatment sequences, and clinical terminology. It even adapts to your personal style over time.

The result is a set of notes that are:

Consistent
Comprehensive
Clear
Ready instantly

And crucially, they’re produced without the cognitive load that usually comes with end‑of‑day admin.

How Much Time Does It Actually Save?

Let’s put it plainly: hours .

Most clinicians report saving 30–60 minutes per day , sometimes more depending on the complexity of their cases. That’s not just time saved—it’s energy reclaimed. It’s the difference between finishing the day feeling drained versus feeling like you’ve actually completed your work.

For associates, it means fewer late nights.
For principals, it means a more efficient team.
For patients, it means better‑documented care.

And for everyone, it means less stress.

From Templates to Intelligence: A Shift in Mindset

When digital note templates first arrived, they felt revolutionary. But they still required manual input, and they were only as good as the time you invested in building them.

AI flips that model.

Instead of you adapting to the software, the software adapts to you.

Kiroku learns your phrasing, your treatment patterns, your preferences. It becomes a genuine assistant rather than a digital filing cabinet. And once you’ve experienced that shift, going back feels unthinkable.

The Ripple Effect Across the Practice

The benefits extend far beyond the clinician:

Reception teams spend less time chasing missing notes.
Compliance officers sleep better knowing documentation is consistent.
Patients receive clearer treatment summaries.
Principals gain a more efficient, less burnt‑out workforce.

It’s not just a tool—it’s a cultural shift.

Looking Ahead: The Future of Dental Documentation

If this is where we are now, imagine what’s coming.

AI‑assisted note‑taking is only the beginning. Soon, we may see:

Real‑time clinical transcription
Automatic coding and charting
Predictive treatment planning
Seamless integration with imaging and diagnostics
Entirely hands‑free workflows

And perhaps one day, the keyboard will become as obsolete as the manila file.

Final Thoughts

The advent of AI in dental note‑taking isn’t just a technological upgrade—it’s a restoration of time, focus, and sanity for clinicians. Platforms like Kiroku are leading the charge, proving that admin doesn’t have to be the tax we pay for delivering great dentistry.

For the first time in decades, the paperwork is finally working for us—not the other way around.

The Evolution of Dental Record Keeping: From Paper Mountains to Cloud-Based Efficiency

Sun, 25 Jan 2026 14:40:12 GMT

The Evolution of Dental Record Keeping: From Paper Mountains to Cloud-Based Efficiency

Why Good Records Matter More Than Ever

Accurate, concise, contemporaneous notes have always been the backbone of safe and effective dentistry. They protect clinicians medico‑legally and allow us to deliver better, more consistent care—without drowning in administrative overload.

The Early Days: A Room Full of Billy Bookcases

When I began practicing in 1993, the practice I joined had an entire room dedicated to record storage. Billy bookcases bowed under the weight of manila files stuffed with biro‑scribbled hieroglyphics, decades of notes, and the occasional x‑ray. Some even contained dentures or toothbrushes to prevent them from going astray.

Every morning involved pulling the day’s cards from the archive and forcing the previous day’s notes back into the labyrinth. Emergencies had to wait until someone could brave the paper maze to locate the right file. It was a system held together by habit, hope, and a lot of elbow grease.

The First Wave of Digital Dentistry

By the mid‑1980s, Customer Relationship Management (CRM) software began creeping into dental practices. Early platforms like Clockwork were text‑based and rudimentary, but they marked the beginning of a digital shift.

For many clinicians over the last decade, Exact by Software of Excellence became the standard. It offered powerful features and add‑ons, but as time went on, it grew increasingly clunky. The core issue was its architecture: locally installed software requiring constant hardware upgrades, network tinkering, and hefty backup solutions. I remember spending entire weekends upgrading versions, genuinely excited by even the smallest new feature.

The Cloud Arrives: Dentally Changes the Game

Then came Dentally , a cloud‑based platform that redefined what dental software could be. Remote login, instant updates, and near‑limitless scalability made it a breath of fresh air.

Initially, many clinicians resisted the shift—understandably attached to the familiarity of practice‑based systems. But Dentally’s intuitive interface and flexibility quickly won over the market. SoE eventually absorbed Dentally, recognising the direction the industry was heading.

The Only Real Challenge: Letting Go of the Old

Switching systems always comes with growing pains. Customising new software and saying goodbye to years of templates and workflows can feel daunting. But with a bit of focused onboarding—often done remotely—you’ll soon be generating bespoke treatment plans in seconds.

And if Dentally’s AI note‑taking continues to evolve, it may well rival platforms like Kiroku and reshape how we document care entirely.

Looking Ahead: A Future Beyond the Keyboard

The pace of change in dental technology is accelerating. Cloud platforms, AI‑assisted notes, and automated workflows are already transforming the way we practice. Who knows—perhaps in the not‑too‑distant future, we won’t need to tap a keyboard at all.

If you’d like, I can also craft an SEO‑friendly introduction or conclusion tailored to your target audience, or help you optimise image alt text for your comic strip.

Keep Calm and Carry On with the Carry On! - Dealing with a power outage

Mon, 27 Sep 2021 06:49:30 GMT

There are plenty of things you can do without power, and I don’t mean just handing out antibiotics because the guidelines have been relaxed to meet the need of the current government failings!

My trip to Ghana with 30 undergraduates taught me this.

Prepare yourself for action:

1. Buy a head torch and a really good hand torch that your nurse can hold

2. Stock up on cotton swabs

3. Make sure you have a go to temporary filling material that is sedative where possible

4. Don’t back yourself into any corners you can’t retreat from

When your dental unit stops working the most annoying thing to fail is not the chair or the handpiece, its not even the suction, because even if you get the last wheeze of air from your compressor, if you can’t see what you are doing it is useless. I found that a head-torch or better still your loupes with a light are a dentist’s best friend in these situations. Because head torches were designed for making a cup of tea in a tent, if your nurse can hold a good quality hand torch as well this helps.

Moisture control need not be an issue if you have enough sterile swabs and cotton rolls and you are a master in the art without suction. Saliva is easily soaked up or spat into a spittoon and in the worst scenario where a patient is bleeding, pressure and a reassuring manner can slow even the most persistent sites. It’s unlikely that you are going to be worrying about keeping patients waiting so you have all the time in the world to look after the patient in the chair.

Whenever you work, you will have an end goal in mind, but remember your training and don’t cut away all your options too early in the preparation. It’s much easier to put on a temporary crown with two interproximal slices rather than just the occlusal reduction, so rethink your protocols, and build in some provision for temporisation at every stage. Even if you are in the middle of an extraction you don’t have to finish if you have an emergency power outage.

I often think dentists make a mistake spending hours trying to find a root tip or chasing a brittle, dilacerated monster. If you give up after a maximum of 20 minutes, the patient rarely gets as much pain healing if you leave them alone, than if you successfully retrieved the root. After six weeks the gum would have healed over so a grateful surgeon can go in retrieve the last bit and will have some tissue to raise a flap and cover it all up again afterwards. So, in summary, when an extraction doesn’t go your way; drain any infection, remove all the irritating sharp supragingival dentine and then give up!

I have had to escort a patient from the chair midway through an implant procedure and dump them on the gilded streets of London because of a fire alarm and evacuation, but thanks to a neat flap and plenty of swabs this wasn’t a problem.

Keeping calm in the weirdest situations can almost be amusing for you and the patients. The patient in the chair will appreciate that you are doing your best in difficult times, and the patients waiting will understand as long as they are kept informed. The most important thing is that you have a plan which will keep you calm and the patients will feel reassured they are in the right place. Don’t be too quick to send everyone home either, you’ll be surprised how much you can do for someone in pain even without power, and it won’t be long before the power comes back on!

Know if you have reached you level of competance

laser_dentist@icloud.com (Ashley Watson) — Tue, 01 Dec 2020 08:00:02 GMT

The "Peter Principle"

The Peter Principle: A Revelation in Incompetence

I’ve just finished reading a book that blew my mind. Written in 1969—just a year after I was born—it was originally intended as satire. But readers found it so uncannily familiar that it evolved into a serious, highly regarded text. Today, it remains a cornerstone of organisational insight.

The book is theological in tone, but its wisdom translates effortlessly into any mature organisation—and, frankly, into the human condition itself.

The central idea? The Peter Principle: that people are promoted until they reach their level of incompetence. It’s a brutal truth, elegantly delivered. The authors propose clever ways to avoid this fate—if you’re self-aware enough to recognise where your true competence lies.

For business owners, it’s a revelation. It explains why your enterprise might stall, why productivity grinds to a halt, and why the most efficient person in the room often ends up alienated. It lays bare why tasks are delayed into oblivion, why incompetence floats to the top, and why frustration festers in silence.

Reading it felt like being admitted to a secret society. Like Neo in The Matrix, watching the numbers fall into place. I’ve achieved a zen-like calm—at least for a week—and I’ve ordered five copies to distribute among the quietly disenfranchised or anyone who shows even a flicker of workplace frustration.

Before you call the Samaritans—read this book.

�� Peter Principle on Wikipedia
�� Buy it on Amazon

"Just" patients

laser_dentist@icloud.com (Ashley Watson) — Thu, 12 Nov 2020 17:44:50 GMT

If you hear the word “just” before a treatment request,

cancel lunch and brace for impact.

“It Just Needs a Simple…” — The Patient Who Thinks Dentistry Is a Quick Fix

The ‘Just’ Patient: A Masterclass in Misunderstanding Dentistry

Every dentist knows the type. They call during your lunch break, charm your receptionist, and arrive late with a heroic tale of dental survival. They hate forms, love drama, and always end with:
“It just needs a simple…”

You can finish the sentence:
“…tighten.”
“…recement.”
“…filling.”
But never the one that’s most accurate:
“…gun to the head.”

What Is a ‘Just’ Patient?

A ‘Just’ patient is someone who believes their dental issue is a quick fix—despite all evidence to the contrary. They’re occasional visitors who think they need a tweak, a tighten, a recement… and they’ll tell you so with theatrical flair.

They charm your receptionist during your lunch break, arrive late, scoff at forms, and announce their dental trauma like they’re auditioning for a BAFTA. Their story always ends with:
“It just needs a simple…”

Why They Drain You

These patients are energy vampires. They forget who did the original work, where it was done, or what it involved. They’ll have you hunting for implant screws like a postgraduate researcher on lockdown.

They rarely bring records. They often bring drama. And they always bring a sense of entitlement that’s inversely proportional to their dental insight.

The Value Disconnect

I learned this early in my NHS year. After diagnosing a patient with a list of necessary treatments, he returned a week later with a DIY filling made of solder.
His explanation?
“That’s only what you do after all!”

Patients can be forgiven for receiving bad care. But some actively choose it—by being bad patients. And once you learn to spot the ‘Just’ tic, your practice becomes a much happier place.

How to Spot and Stop Them

They call during lunch and become best friends with your receptionist
They arrive late and resist paperwork
They downplay their issue with “just” language
They expect heroics for minimal effort

Final Advice: Just Avoid Them

Your time, your team, and your sanity are worth more than a soldered molar and a Friday afternoon drama. Dentistry is complex. Patients who don’t respect that don’t deserve your chair.

"What lab do you use?"

laser_dentist@icloud.com (Ashley Watson) — Tue, 13 Oct 2020 18:00:02 GMT

“Ask a dentist what lab they use and you’re not making small talk—you’re poking the beehive.”

Choosing a Dental Lab: Why the Question Matters More Than You Think

Every dentist has been there. You’re at a CPD event, chatting politely, when someone inevitably drops the conversational grenade:

“So… what lab do you use?”

It sounds innocent enough, but the motives behind it can vary wildly:

They genuinely want a good recommendation and value your opinion
Their own lab has pushed back and they’d rather switch than reflect
They’re quietly judging your clinical standards based on your lab choice

It’s a contentious topic for many—but for me, the answer is surprisingly simple.

What Makes a Good Lab? Four Non‑Negotiables

1. Mutual Respect for Each Other’s Craft

Both clinicians and technicians have difficult, emotionally charged jobs. A good lab understands this. And yes—sometimes they’ll ask for another impression. If it’s reasonable, explain it to the patient. It elevates your service, not diminishes it.

They’re looking at your work under magnification on a stone model. You’ve told them to flag anything that needs redoing. No patient can argue with that level of accuracy.

And if you truly can’t retake the impression, ask the lab to finish the restoration as best they can and take responsibility for the outcome. It’s rare, and often the crown fits beautifully—or at least well enough to serve as a temporary.

2. Clear, Detailed Communication

You can’t expect excellence from a lab if you don’t give them the information they need.

Send accurate impressions
Don’t accept poor margins or unstable materials
Provide proper shade information and photos
Write more than two words on the lab sheet

We use an intraoral camera for most single units—quick, simple, effective. Shades come from a Vita EasyShade, so I’m not spending my life deciphering mamelons and ochre. The lab gets the photos and does what they do best.

If you struggled clinically, tell them. If they could have done better, explain why—constructively. And if they make a mistake, help them fix it so it doesn’t happen again.

Visit your labs. Put faces to names. Understand their environment. You rely on them more than your family.

3. The Right Tools for the Job

If you want high‑end CAD/CAM zirconia work, your lab needs the compatible software and hardware. Many labs claim they can do everything, but not all have the resources.

A great lab will admit limitations and offer to outsource responsibly. A poor one will hope you don’t notice. That’s how inconsistency creeps in—and how responsibility evaporates.

4. A Pricing Structure That Makes Sense

Your lab fees should roughly mirror your own pricing philosophy. As a rule of thumb, lab costs should sit around 25% of the total treatment fee .

It’s neither ethical nor sustainable to:

Use a lab you can’t afford because “everyone who’s anyone” uses them
Use a bargain-basement lab that represents a tiny fraction of your fee

You know when you’re short‑changing patients—or yourself.

Why Your Lab Choice Matters

You are responsible for the work you fit. That work reflects directly on you in your community.

Great labwork:

Makes your team proud
Makes your patients delighted
Makes your recalls less stressful
Makes your reputation grow

It’s one of the most powerful marketing tools you have.

In Short: Don’t Choose a Lab Based On…

Cost (high or low)
Advertising
Peer pressure

Instead:

Pick up the phone. Better yet—visit them.

Tell them how you like to work. Ask whether they have clinicians with similar expectations. If they do, they’ll be eager to show you their workflow, their communication style, and the technicians behind the scenes.

A good lab doesn’t just make teeth.
A good lab makes your dentistry better.

Logging Your Implant Experiences

laser_dentist@icloud.com (Ashley Watson) — Tue, 29 Sep 2020 18:24:10 GMT

If you’ve trained formally in implant dentistry, you already know: logging every procedure isn’t optional. It’s your clinical safety net, your CPD tracker, and your medico-legal parachute. But how you log it makes all the difference.

Why I Built My Own Implant Logging System

In implant dentistry, documentation is everything. Whether you're replacing a restoration and need to know the exact components used—or facing a patient who has no idea what’s in their mouth—having a clear record saves time, stress, and reputation.

From a medico-legal standpoint, if you can’t demonstrate your experience, you’re skating on thin ice. Logging every procedure and every bit of training protects you. It’s not just compliance—it’s clinical self-defence.

But compliance is a burden. So why not make it easy?

Take Control of Your Data

I recommend using a custom database with a simple input method. This keeps your data secure and accessible—without relying on third-party platforms that might vanish overnight.

Just a word of caution: if you’re handling patient data, you’re responsible for it. Stay up to date with information governance, register with the Information Commissioner’s Office, and only collect what’s necessary. More data isn’t always better—and it’s definitely not always legal.

Lessons from Experience

I once used an online database provided by a respected implant association. It was brilliant—until it wasn’t. The subscription model collapsed, the platform was pulled, and my data disappeared.

Luckily, I’d backed everything up:

A custom screen in my practice management software
A written log with implant stickers
(Almost) an implant passport for patients

That redundancy saved me. And it taught me to build systems that I control.

My Current Setup

I now use a simple database accessible via phone or web. It allows me to:

Input data from anywhere
Customise fields to suit my workflow
Add photos and x-rays directly
Avoid typing serial numbers manually

The form is easy to teach to staff, so I can delegate without losing control.

Once the data’s in, I can sort, audit, and generate reports. I can even email a personalised implant passport to the patient or send a summary to the practice.

Who Benefits?

Patients – They get clarity and continuity of care
Practice – They get clean records and reduced liability
You – You get protection, proof, and peace of mind

Bonus Tip: Use Smart Forms

You can create a form that emails you, the practice, and the patient when submitted. Add a shortcut to your desktop, phone, or website. As long as you have internet, you’re good to go.

I use this for CPD logs, x-ray reporting, and more. I’ll dive deeper into custom screens, websites, and e-forms in future posts.

If you’re on our mentee program, these forms are available to you.
And if you’ve built your own system—or want to improve mine—I’d love to hear about it.

I can also turn this into a visual explainer or a carousel post to help your mentees adopt the system more easily. Just say the word.

Hands-Free Flap Retraction

laser_dentist@icloud.com (Ashley Watson) — Tue, 22 Sep 2020 18:13:09 GMT

When I’m performing a dental procedure, I want to see what I’m doing—and so do my nurses. That’s why I’ve fallen in love with Optragate. Some tools you stumble across and instantly know: this changes everything.

Why I’m Obsessed with Optragate

“But I’ve got great retraction already…”

You might say,

“My nurse is a legend at retraction, and when she’s off, I use autoclaveable devices.”

Brilliant—carry on.
But for everyone else: this is the secret to keeping lips open and cheeks retracted without extra effort or extra staff.

How to Place It Like a Pro

It takes about 30 minutes to learn how to size and place an Optragate.
Top tip: ask the patient to lick their lips just before placement.
Get the sizing right, and it rarely flies out when they bite down or swallow.

Bonus: play “Guess the Phrase” with your team while they wear it. You’ll bond and learn.

When We Use It

We reach for Optragate whenever we need an extra pair of hands:

�� Photography
�� Intra-oral scanning
��️ Restorative work (when rubber dam isn’t an option)
�� CBCT scans
�� Oral surgery (yes, with caveats)

Surgical Use: Let’s Talk Sterility

Yes, it’s not sterile.
Yes, you can soak it in CHX.
And yes, the access it gives often outweighs the risks—especially when the alternative is collapsing tissues or a sweaty nurse.

Suturing improves dramatically when you can see what you’re doing.

Implant Example: 20 Minutes, Start to Finish

Raise a small flap.
Place a holding suture.
Insert the Optragate.

We even trap the suture tails between the Optragate and the patient—creating soft tension that keeps the flap retracted. If you’re using surgical guides, this prevents the flap sneaking under the guide hole and getting chewed up by twist drills.

Final Thought

Optragate isn’t sterile—but imagine if someone made a sterile version.
We’d use it for everything.

I’d love to hear your thoughts, hacks, and whether you think someone should start manufacturing a surgical-grade version.

Spot the screw-access

laser_dentist@icloud.com (Ashley Watson) — Tue, 15 Sep 2020 18:08:05 GMT

Screw-down restorations: the holy grail of retrievability, the darling of the literature, and—let’s be honest—the bane of aesthetic perfection. But what if I told you the magic trick to make that access hole vanish?

The Magic of Screw-Retained Restorations

We all know screw-down restorations (SDRs) are the gold standard, right? The research keeps nudging us toward them, and for good reason. But let’s not pretend they’re flawless.

Mechanically, SDRs can be more temperamental than cementables. And cosmetically? That access cavity is a nightmare to hide. Cementables, on the other hand, offer a smoother fit appointment, often cost less, and make it easier to nail the aesthetics—assuming you don’t leave a cement buffet in the sulcus.

Still, I’m a die-hard SDR fan. I rarely reach for cementables unless I’m absolutely sure I’ll never need to remove the restoration. Even then, I use Tempbond—and still end up with a hammer in hand and a patient wondering if they’ve wandered into a blacksmith’s forge.

So yes, I screw everything down.

Back in the day, you could complain about screw loosening, fractures, and porcelain chipping around the access channel. But modern connections are robust. If you follow a few key rules, your restorations will behave beautifully.

Rules for Screw-Retained Success

1. Plan the Screw Channel Exit

Think ahead. Avoid placing the screw channel in working-side contacts. It’ll save you from porcelain fractures and premature wear.

2. Use Genuine Compatible Parts

Copyright and patents mean knock-offs don’t fit microscopically. That leads to wear, instability, and the dreaded tulip fracture. If you break the implant itself, good luck recovering.

3. Torque the Torque or Walk the Walk

Ignore engineering advice at your peril. Use a calibrated torque device and know your system’s specs. Screws should be genuine, colour-coded, and catalogued like your life depends on it—because sometimes, it does.

4. Ask for a One-Piece Screw-Down Crown

Keep it simple. Skip the abutment unless absolutely necessary. Fewer margins = fewer bacterial hideouts.

5. Embrace Zirconia

If you haven’t yet, prepare to be impressed. Zirconia offers translucency, strength, and wear resistance. Paired with a variobase (tibase), your lab can mill a pre-drilled block with a long access hole that lets light pass through the occlusal two-thirds. Translation? Even if you botch the shade of the filling material, it still looks natural.

No more hunting for opaque fillers to mask the dark cylinder inside a metal restoration. Yes, the abutment height might make you nervous, but trust the engineers. Zirconia can handle the stress—unlike eMax, which had its share of failures.

Just remember Rule 2: Use Genuine Compatible Parts or prepare for disappointment.

If your lab is forward-thinking, they’ll welcome this approach. It might even streamline their workflow—no need to pour or print models, and you could supply the parts yourself. That’s leverage with your implant supplier and a win for everyone.

Getting the best from your lab takes effort, but that’s a topic of another blog.

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