How to Temporise Veneers Step by Step FULL GUIDE – PDP214

What is the best technique for fabricating temporary veneers?

How do you ensure they are retentive but not TOO retentive?

What’s the best way to shape, polish, and remove them efficiently?

In this episode, I’m joined by Aodhan Docherty—an absolute sensation in Sydney when it comes to veneers. He’s mastered the art, and today, he’s on a mission to share everything you need to know to get crisp, stable, and well-shaped temporary veneers every single time.

We break down different protocols, troubleshoot common issues, and, most importantly, make sure your temporaries stay put until it’s time for the final fit.

https://youtu.be/BI_xMlSXgvc

Watch PDP214 on Youtube

Protrusive Dental Pearl: Aodhan recommended a chlorhexidine-based mouthwash to reduce inflammation but advises using an ADS (Anti-Discoloration System) mouthwash to avoid staining. The ADS system helps maintain healthy tissue response, preventing bleeding and inflammation on the day of veneer placement while eliminating the discoloration commonly associated with standard chlorhexidine products.

Key Takeaways:

• Temporary veneers serve as a blueprint for final restorations.
• Facially driven smile design enhances patient satisfaction.
• Patient adaptation is key to successful cosmetic procedures.
• Oral hygiene is vital for maintaining temporary veneers.
• Effective communication with the dental team improves outcomes.
• Understanding patient biotype is essential for treatment planning.
• Stress management is a critical skill for dental professionals. Patient-centric approaches are essential in modern dentistry.
• The shrink wrap technique offers better control and aesthetics for temporaries.
• Effective communication with patients enhances their experience and satisfaction.
• Hands-on training is crucial for developing practical skills in dentistry.
• The importance of assessing temporaries before finalizing restorations cannot be overstated.

Need to Read it? Check out the Full Episode Transcript below!

Highlights of this episode:

• 01:17  Protrusive Dental Pearl
• 04:42 Welcoming Dr. Aodhan Docherty
• 06:30 Challenges and Rewards of Managing Practice
• 10:00 Facially Driven Smile Design
• 14:53 Temporary Veneers: Practical Tips and Techniques
• 20:51 Non-Staining Mouthwash
• 22:27 Temporaries: Pros and Cons
• 26:49 Proximal Papilla Care
• 31:14 The Trial Smile Approach
• 35:14 The Shrink Wrap Technique
• 39:41 Detailed Steps for Shrink Wrap Technique
• 40:56 Spot Etching & Bonding for Retention
• 43:08 Removing Temporaries Atraumatically
• 51:22 Porcelain Veneers Workshop: Course Overview
• 56:12 Learning from Failures

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes B and C.

AGD Subject Code: 780 ESTHETICS/COSMETIC DENTISTRY (Tooth colored restorations)

Aim:

Aimed to provide dental professionals with a comprehensive understanding of temporary veneers, covering techniques to improve their fit, durability, and aesthetics.

Dentists will be able to –

1. Implement predictable protocols for creating stable and well-shaped temporary veneers.

2. Apply the shrink wrap technique for improved aesthetics and retention.

3. Assess and adapt temporaries effectively before finalizing restorations.

Ready to take your veneer skills to the next level and create stunning, long-lasting smiles? Join the Exceptional Porcelain Veneers Workshop with Dr. Aodhan Docherty and Dr. Kamran Ashraf!

📍 2025 Course Schedule:
🦷 Sydney: March 8–9
🦷 Melbourne: May 3–4
🦷 Perth: July 26–27
🦷 Auckland: April 5–6
🦷 London: May 24–25

🚀 Upcoming Course:
🔹 Bulletproof Dentistry – The Foundations of Occlusion & Restorative Dentistry (April 25–26, Surrey, UK)
This two-day hands-on course is the ultimate foundation before tackling full-mouth rehabs and tooth wear cases. Join Jaz and Mahmoud to strengthen your force management, longevity strategies, and occlusion fundamentals.

🔗 Check out: bulletproofdentistry.com

If you love the idea of learning on the go while earning CE credits, consider joining a paid plan on Protrusive! It’s tax-deductible and offers incredible value for ongoing dental education. Plus, the full seven-episode series on VertiPreps for Plonkers is now available exclusively on the Protrusive Guidance App—don’t miss out! 🚀

Click below for full episode transcript:

Teaser: I use my temporaries in the protocol that we teach and in the protocol that I use every day. My temporaries are blueprint for my finals. They have to be so damn nice that the patient is going to be happy to wear them for three and a half weeks. This sort of high end dentistry is not about getting them in and out.

Teaser:
It’s about spending the time with them and you’re going to charge appropriately for that. And you need to give, like, for this cosmetic dentistry, it’s not like they’re coming in to get a tooth broke, that’s broken, fixed, or an endo done. It’s like they’re walking into Rolex and they’re buying Rolex. And the person, I hate this phrase, but like customer service, it has to be better than it ever has been.

Jaz’s Introduction:
This episode goes deep into temporary veneers. They can be really fiddly, they can be really stressful, and we discussed quite a few protocols that exist, but actually Aodhan Docherty here, he’s a sensation in Sydney, and he does so many veneers, he does them so well, I’ve been intrigued by social media, and I told him he’s got one mission today, and that’s to go really deep into temporary veneers, because like I said, they can be a real source of stress for us dentists.

The whole veneer process when we’re starting out can be quite stressful. But one thing I promise you today is that if you listen all the way to the end of this podcast, temporary veneers will become so much easier for you. We explore some different protocols that are out there. Some things that I’ve tried, something that he’s tried, but we’ll tell you the exact steps to make sure they get really nice, crisp, temporary veneers. How to get them to stay on, how to shape them, and then how to remove them when you’re ready to fit your veneers.

This episode is eligible for one CE credit or one hour of CPD. Protrusive is a PACE approved provider. As usual, you need to be on the Protrusive Guidance app. Head over to the website protrusive.app to get started. If you haven’t already, you need a paid plan to get CE, but the education otherwise is free. We’ve been giving free podcasts for six years now. But if you’d like to show your support, please do consider getting a subscription because that’s what allows us and the team to grow and make good content for you.

Dental Pearl
Every PDP episode, we give you a Protrusive Dental Pearl. And this pearl is taken directly from a really important thing that I learned from Aodhan. You see, it’s so important that at the fit visit of your veneers, that the tissues are absolutely perfect. You don’t want any inflammation. You don’t want any bleeding.

So whilst Aiden does cover which cleaning tools he recommends his patients to use. The thing that I took away I learned is the type of mouthwash to use because he’s found in his protocols that it does reduce inflammation. The pearl is to use something that’s chlorhexidine based, but I know what you’re thinking.

You’re thinking, okay, well, what about the staining? Well, turns out there are certain mouthwash brands like Curasept that are ADS, which is an anti discoloration system. For me, this makes absolute sense because you get all the benefits of a really nice tissue response. So you get no bleeding and no inflammation on the day of your veneer fits.

But again, you don’t get any of the nasty staining that you can get with chlorhexidine based products. So when prescribing or giving your patients a mouthwash to use in the interim as well as all the oral hygiene instructions, consider prescribing an ADS system, which is an anti discoloration system. So thank you Aodhan for teaching me that which I’m passing on to you and actually this episode is absolutely full of gems.

I’ll tell you something interesting guys. Just two days ago, I was diagnosed with a pneumothorax, a spontaneous pneumothorax. Essentially, my left lung is collapsed, and here I am doing this podcast. It was actually supposed to be yesterday, but I moved it today, and I thought, let me see how I feel.

And when I wake up this morning at around 5. 30 a. m. to record this podcast, because our guest is in Sydney, I was like, ooh, should I do this, should I not? I’m feeling a little bit short breath. But as soon as I sat down with Aodhan, And we just went all geeky, I absolutely forgot about everything. I feel great. And health comes first. Health is wealth.

So why am I sharing this with you? I’m sharing this with you because when you do something and it doesn’t feel like work, that is your true calling. Sometimes when I’m in the clinic, I’m just in the zone. I’m in the flow and I don’t feel like I’m working so this didn’t feel like work I had such a wonderful conversation with him and my shortness of breath considering I’ve just had a pneumothorax two days ago isn’t too bad. The worst thing about this pneumothorax is that we’ve had to cancel our family holiday.

I can’t fly. And I just feel so bad for my children because we were talking every day about how much fun we’re gonna have in Dubai and all the water parks we can go to. So I feel devastated for my boys. But health is wealth and there will be more holidays. And thank you so much, Protruserati, for all your messages of support on Protrusive Guidance when I told you guys this happened to me.

But as you can see, I’m fine. Thank you so much for your concern. Thanks to my wonderful wife and my family for looking after me so well. And thanks again to you guys for your support. Before we join the main episode now, don’t forget that in April, me and Mahmoud are bringing back the basics of occlusion two day live course.

We’ve actually rebranded it to Bulletproof Dentistry. We changed the name because delegates left with so much more than just occlusion. Yes, we had the nine hands on exercises and we had wonderful feedback, but delegates left with a set of protocols and philosophies for force management, for longevity, for how to make their dentistry bulletproof.

So it is an occlusion course. It’s really a foundations of restorative dentistry. That course is on April 25 and 26 in the UK in Surrey. Previously we’ve had delegates from all over the UK as well as Estonia and Libya, Italy. So wherever you are in Europe or the world would love for you to join me and Mahmoud to do the course that you should do before you ever do a full mouth rehab, before you do any tooth wear course.

This is the foundations of occlusion and restorative dentistry. Check out bulletproofdentistry. com That’s bulletproofdentistry. com to learn more about our two day course. Hope you enjoy and I’ll catch you in the outro.

Main Episode:
Welcome to the podcast, my friend. I’m very excited to do a deep dive into temporary veneers, right? And so let’s start with you said a little bit about yourself. Sometimes you work in Sydney, cosmetic dentist. Anything else that defines you that, why did you go into cosmetic dentistry? Why not oral surgery? What do you love about the field that you’re in? And it sounds like you own multiple practices. That sounds very stressful.

[Aodhan]
Yeah, it’d be very stressful. That’s dentistry though, isn’t it? Just a stressful career. Seriously, you can try all you want to implement practices, protocols, and levels to things in terms of checklists and stuff, but there’s always going to be that stress.

It’s a weird. I reckon dentistry is one of the strangest mixes of healthcare, business, and just this high level of work that you’re doing on a patient in their mouth, while they’re often, most often, conscious, right? Like, honestly, I don’t think there’s many other careers that juggle that sort of amount of variables.

Challenges and Rewards of Managing Practice
And when things go wrong, they can go wrong spectacularly and you have to be able to be able to back yourself. But also you have to be able to understand when you shouldn’t take a case on. I think that’s really important. And when to get help and when to ask for help. I do it all the time. If I need help with something or if I don’t feel like I can approach a case, I’d rather bring it to a group of my close colleagues.

And we discuss it. We have case discussions and that’s one of the great things about dentistry is. You are all in the trenches. I hate that phrase, but like you’re in the shit together and you just have to be able to pull together and help each other out. Like I spent the six, seven hours this morning with a group of four or five dentists and we basically went through our cases and we basically discussed the occlusion, how we’re going to combat people with parafunctional issues, occlusal dysfunction issues, constricted chewing patterns, and all this sort of stuff.

And I suppose, I feel like I have always been someone who likes to take on something that’s challenging and I love science and I love biology and I think dentistry for me was just the perfect fit and practice ownership is a stressful thing, but it’s so, so rewarding when you spend years and years building this practice and you have patients which come back to you and they feel like family, right? I think it’s just so rewarding.

[Jaz]
I think what I love you said about it is the community of practice that you need around you as well to help you thrive. It is a team thing, not only as a practice owner, but to be at the top of your game. Clinically, you can’t do it alone. You need to listen to others. So often, when I present a case that I’m stuck on someone, it’s like they show you your blind spot and say, oh yes, you know what?

I didn’t consider that. And that’s a great shout. Sometimes you just completely miss it, even though you knew it, you miss it. And so great. I love that you said that. I love that you spent the morning in that way. Just an interesting question before we dive into the temps, what do you find as the like peak stress being the practice owner or like doing the 0. 1 millimeter precision cosmetic dentistry on someone who’s got expectations and hopes and fears and that kind of stuff.

[Aodhan]
Ah, yeah, it’s not a good question. I always say it’s balancing the staff and the dramas and there’s always dramas. There’s always people that have something. I touch wood, I say this and then it’s all going to fall to shit. But right now is so golden for me. I’ve got a great front of house. My nurses are great. The team is like, do you know those times where you’re just like, I need to appreciate the times. And then like sometimes someone leaves or there’s a catalyst for something that goes on or something happens and there’s dramas and then you think, God, why am I doing this?

But at the moment, I think, for me having a good team, like what I’ve got right now is just allowing everything every day. I just love it. Absolutely enjoy it. But I think that’s one of the hardest things as being a dentist and a practice owner is managing staff, managing the team and challenging people.

And like this year, something different I did. And I know we’re not here to talk about this sort of stuff, but something different I did is I sat down with each person at the start of the year and I asked them, what is it that you want to achieve this year? And I said, where do you see yourself in the next few years?

Like, what can I do to help you? So my oral health therapist said, I want to get better at doing proximal fillings. And my front of house said, I actually want to pick up an extra day and I’d love to become a practice manager of one of the clinics. So if I don’t have that conversation, what will have happened to me previously is they will either leave or they will have job dissatisfaction or they won’t feel supported.

Facially Driven Smile Design
And that’s what, these days, that’s what it’s all about, really. You have to really support your team and make them feel empowered. It’s not like the old days where you just tell them to sit in the corner and do their job because they’ll just leave, especially in Sydney. There’s so many clinics and there’s a lack of staff since COVID. There’s just such a lack of staff and team. They’ll just walk around the corner and get another job in two seconds.

[Jaz]
I think that really highlights you, my friend, you as the captain of the ship, someone steering the way, the culture that you’re brewing. That’s so important. I read something recently that the success of your business is the most important metric to use is how your staff feel on Sunday night.

That is, if you’re led by that metric, then I realized that that was deep. So, already you gave us a little snippet about you as a practice owner as a someone who is going to help your staff to grow and be fulfilled. So I absolutely love that. Now let’s go to the meaty part, right?

Temporary veneers. Many years ago, when I was first learning temporaries, I don’t think it was specific to temporary veneers that this advice was given. But you’ve heard the saying that, if you make your temps really crap, then when the definitive comes. The patient will love it. Right. And I just don’t think that there’s a place for that in the veneers because when they’re playing so much money and they want the whole point of getting the veneers, is to look good.

Why would they accept looking like not so good in their temps, but there’s still, there’s that saying that, okay, maybe you do want your finals to be a level up. So how are you going to tackle that question? And how good should your temps be?

[Aodhan]
Well, this is an awesome question. Cause that’s what I was told as well, even in dental school as a laugh rat by the lecturers, but they were being serious. Now, I use my temporaries a bit differently, I suppose. I use my temporaries and in the protocol that we teach and in the protocol that I use every day, my temporaries are a blueprint for my finals.

They have to be so damn nice, that the patient is going to be happy to wear them for three and a half weeks. Because I do my temps, which I’m going to discuss with you different methods of that. But I do my temps, and then three to five days later, we do a review. The review is basically to ensure that we have completed a facially driven smile design because it is different these days.

It’s not like the old days where you send your alginate and you just write on your lab prescription one five to two five wax up. Totally different. These days we facially drive the design. So I send a facial photo and now as of six to 12 months ago, I send a full face scan. So I have a ray face and I actually send a scan of their whole head.

[Jaz]
And this is of them like while they’re at rest or while they’re smiling and you like overlay images, is that how it works?

[Aodhan]
Yeah, correct. Correct. So I’ll take different sets of images and I’ll do different sets of photographs. I’ll take the Emma photo. So the repose photo. So I tell the patients to either lick their lips and swallow, or I’ll tell the patient to say Emma.

And then I’ll take a photo, because we are able to set the maxillary incisal length based off that photo, either basing it on the canine being at zero, basically being right on the edge of the lip, as John Kois teaches, or as Frank Spear teaches, having two to three millimeters, depending on if you’re a male or a female.

Two to three millimeters of central incisors showing. For me, I think everyone looks good with about two to three anyway. A little more always looks nice, within limits. But I use those parameters to do facially driven smile design and we can basically drive the smile design so we don’t have canting and we can actually build out volume.

So I get a big Duchenne smile, like the biggest smile. So we’ve got an Emma smile, a  Duchenne smile, and a social smile, which is right in between. And that  Duchenne smile is crucial because if you get a social smile, you can’t pick up a lot of things like gingival tissue asymmetry. You can’t really appreciate canting. You need to get them laughing, smiling. And it’s the hardest thing to do in a dental setting, right? Because half the time people don’t want to be there, but in a veneer, in a cosmetic consultation bonding, everything like that, I do the same protocol for all of them. They’re excited to be there. They’re happy. And you get them chatting and you say things like, gimme an aha and then do it a photo and think, or whatever it is, and all that sort of stuff. I get my nurse to make awkward jokes.

[Jaz]
You feel like a photographer in the studio, like trying to say these remarks to make them laugh and get those emotions. But, one of the cool things I’ve seen is a video, right? You video it and then you get those still frames and that can help. The problem with that, I guess is compared to the sort of resolution of a DSLR or something, or a mirrorless, to get that highest resolution. You probably don’t get that with the moving images, but I think there’s a place for getting some video as well to use some stills to capture the wide array of emotions. How do you feel about that?

[Aodhan] Temporary Veneers: Practical Tips and Techniques
I use that especially for gummy smiles because for a gummy smile, they train themselves to not show the gummy smile. And they train themselves to have that lower lip sitting down. And then it’s so hard sometimes to get them to smile and to laugh and things like that.

You put the camera on and you just start chatting to them. You can take your photos above the camera, which is set below. And you don’t even have to have a, like some expensive sort of camera set up. You can just have a tripod and a camera and just set it on record and essentially just get chatting to them.

And as they warm up as well. That’s when you can get those. You might do it like you might not want to do those photos and records right at the start of the console. If you’re trying to like get a bit of rapport with the patient, you might do a little bit into the console, for example, but that’s a really good point. The video can be crucial to seeing that gummy smile, especially.

[Jaz]
And so, you’re doing facial driven, which is the whole point of getting the blueprint. And that blueprint is going to then dictate the shapes of your temps. And you said that once you place the temps, which will go into deep, you bring them back a few days later, and at that point, how long do you book? And I imagine you’re getting out the disc and the flowable and you’re trying to basically get it perfected. But what I’d love to know is, okay, how often do you need to do that? And how often the patients come and you know what, that what’s in my mouth now is exactly how I want it. Tell us about that.

[Aodhan]
I would say. Clinically, 7 out of 10 cases come in and they are loving it. And I’m going to obviously jinx myself saying that, but if you go through, like, if you have a good lab, you work with your lab and you guys are on the same wavelength in terms of smile design, and you have a really good technician that focuses on facially driven smile design and you give them good quality records, you’re probably going to get it pretty close with the mockup and the temporaries.

If they come back, what are they going to say? They may say, hey, I actually want to have these front teeth a little shorter. You get your red disc, you adjust them up by touch. Hey, can I actually have the lateral incisors a little bit shorter than my centrals or a little bit longer centrals? And I get my flowable and I add it. Can I get my canines rounder? Run it off with a disc, or pointier, because a lot of my patients love pointy canines. And I add the point a little bit more defined, and then I use a red disc. But if I see, for example, there’s a cant, or if I see that there’s a lack of fullness on the fours and fives, I’ll grab my flowable and I’ll build it out on the fours and fives. I’ll polish it. I’ll adjust it. How long does that appointment take? Probably half an hour. I don’t take any longer than that usually. If I was starting and I wasn’t doing this, I do this two, three times a day for the preps that I’ve done in the previous days, I’ll book off an hour.

I’m always an advocate for booking off more time than you need because it’s when you don’t book off enough time that as we were saying before, the stressful moments happen. Something goes wrong. You’re bleeding. The patient’s gums won’t stop bleeding. And that’s when the stress happens because you’re looking at the clock and that’s when things aren’t going to go right.

It’s always the way. It’s just Murphy’s Law. So I always book off a little bit of extra time. Even if I finish half an hour to 45 minutes early, I’d rather have that time to do my notes and to actually get the patient sitting, chatting, post op instructions and make sure they’re comfortable. For this sort of high end dentistry, it’s not about getting them in and out.

It’s about spending the time with them and you’re going to charge appropriately for that. And you need to give, like for this cosmetic dentistry, it’s not like they’re coming in to get a tooth that’s broken fixed or an endo done. It’s like they’re walking into Rolex and they’re buying Rolex.

And the person that I hate this phrase, but like customer service, it has to be better than it ever has been, and you have to train your team for that because otherwise, if you give subpar customer service, you’re not going to have a good name. So we’ve got all those protocols like we’re talking about to get that facially driven smile design, right?

So our temporaries look beautiful. Now they’re never going to look shiny and the same shade, but they should have the same shape, canting, everything. Like we want them to be beautiful. And that gives your patient then three weeks while your technicians make the veneers to adapt.

[Jaz]
Just to clarify, then when they come for that review appointment, three to five days later, by the time they come to you, the scan or the impressions have already been taken and sent to lab. So your labs already got the preps already. And what you’re doing either is from that appointment telling the technician, hey, the patient was already happy. I didn’t have to touch anything crack on, or actually I made a few tweaks. Here’s my impression of squint scan. Let’s do this together to get it right. Is that the way it’s going? Right?

[Aodhan]
That’s exactly it. Do you know what I’d rather not do? I’d rather not. Say to the technicians, hey, I want this done, this done, this done, this done, this done. Change my temps, change this, that and that. Because I can guarantee you, they may get four out of five. They’re not getting five out of five of those changes.

So just grab flowable and do it. Even if the flowable breaks off in those three weeks, it doesn’t even matter. But at least, like at the end of the day, it’s probably going to be fine. But if it chipped off, hey, it’s not the worst thing. Every little bit of stain happens. But if you’re able to make those changes, scan it.

And I take a full new set of records, right? New photos. And I take a new RAYFace as well. Then I can give that to my lab and facially driven small design. Like, hey, these days it’s amazing having this face scanner, but for the last 10 years, I haven’t used a face scanner or nine years before that for last year I have, but the nine previous to that, I didn’t, I always just used good photographs and either an alginate impression of my temps or a scan of the temps, which I’ve been doing for the last, say, six, seven years now.

[Jaz]
The only question I have on this, because I know someone’s going to mention it in the comments, is when you’re adding the flowable to, let’s say, lengthen the teeth. Are you aerobrading, bonding, and the flowable, that kind of stuff, or are you literally just drying and adding flowable and then curing and then maybe just disking off and the patient goes home?

[Aodhan]
Yeah, a little bit of bond. Just cure the bond, put the flowable done. Like we’re not aerobrading.

[Jaz]
Let’s not overcomplicate it.

[Aodhan]
Yeah, I’m not aerobrading and doing all that stuff. If the patient came back and there was plaque and there was crap all over the teeth, something’s wrong. Their oral hygiene instructions need to be very clear.

Non-Staining Mouthwash
I make sure that they have a clean at least two to three weeks prior to the prep visit. By the way, I make sure that they use a chlorhexidine mouth rinse for the week prior, and they use an anti discoloration mouth rinse, so they don’t get the staining that we see with, for example, Curasept or Savacol and their soft tissues need to be really really beautiful pink. They need to use interdental brushes in the lead up or floss. And I scared the life out of them if they don’t do it. Cause I say, we’re not prepping your teeth that day. And it would hurt me more than them because I book off three hours for my prep visit, but we’ve got a mutual understanding.

And the patient really wants to impress you at that stage and their soft tissue should be healthy. You don’t want to be like prepping teeth and there’s bleeding and you start finding subgingival calculus and all that sort of stuff. You want to be prepping and there’s no bleeding. You want to make it like a walk in the park.

[Jaz]
Absolutely. And you mentioned about a non staining mouthwash. Is that like a peroxide based mouthwash?

[Aodhan]
So it’s a chlorhexidine based mouthwash. You could try a peroxide based mouthwash. For me, my experience has mostly been with chlorhexidine based because I find it you can’t use it long term, but for a short term use of a week or two, the soft tissues react really nicely. Like they look beautiful after that. They’re primed for your prep visit.

[Jaz]
Okay, fine. So I think the staining worry that we usually have with clorhex, that comes for long term use. That’s why in the bottle it says avoid using for more than two weeks or three weeks.

[Aodhan]
The trick is don’t use chlorhexidine mouth rinse that is a discoloration branded one. So I should say I’m going to brand a discoloration, but there’s one that’s branded anti discoloration system.

[Jaz]
I didn’t know that. Okay.

[Aodhan] Temporaries: Pros and Cons
So, and the God, do you know, someone asked me this about a month ago and I looked up the science and now I’ve forgotten it, but basically. I don’t know if you guys have the brand Curasept.

[Jaz]
Yeah. Yeah.

[Aodhan]
So there’s Curasept that stains and God knows why they have that. Then there’s Curasept that isn’t a staining, like it doesn’t stain. So it’s called Curasept ADS and the ADS is anti discoloration system. And that doesn’t stain.

[Jaz]
I did not know that at all. So that is a pearl right there. So yeah, excellent. Love it. Thanks so much for sharing that.

[Aodhan]
Imagine you got them to use Curasept and they come in and their teeth are bloody brown and they’re all stained and then you’re trying to clean them and stuff like that, or God forbid the temps go brown because they will definitely go brown if they’re starting to rinse with too much chlorhexidine. So use the ADS one, the Curasept ADS.

[Jaz]
That is a top tip. Brilliant. And you mentioned about the importance of being able to clean around your temp. So let’s go into the different ways that we can do temps before we learn how you like to do them, how you and Cam, et cetera, like to do them. Just a little, take a step back and overview.

I’ll tell you a bit of a journey of me when I was learning temps and it kind of covers the entire spectrum. And then I’d like to see where you fall on this spectrum, or maybe you do it in a completely different way. So the first time I ever learned veneers was from a restorative consultant in the UK, and his argument was that because we are staying in enamel, that we don’t need temps.

So that was the most extreme view, right? Because we’re in enamel, we don’t need temps. Obviously, the downside of that is you’re not giving the patient that taste of what’s to come. You don’t get that constant validation like you do. Like, okay, is the shapes correct? Mr. Patient, are you happy with this kind of thing?

Right? So you miss out on that. But there is one argument that if you’re doing very minimal prep, there are some challenges actually in making veneers, like contact lens veneers, fine, but contact lens, thins, temps is a bit tricky before we move on. Any comment on that?

[Aodhan]
I agree. I’ve got this in some bloody slides for you coming up, but you’re doing all the slides for me.

[Jaz]
You know what? Okay.

[Aodhan]
I want to hear it because if there’s something that I don’t have in there, after this, I’m just going to open that and I’m going to add everything you said in.

[Jaz]
This is just what I’ve learned over the years. I just want to like do a little overview because I’m really, what I really want to know about is how you have found to do them.

[Aodhan]
Exactly. Like you’ve started at the right point. No temps, no tensive. It’s like, if you’re doing minimal preps, which we all claim we are, right. We’re all doing minimal preps or we’re trying to do minimal intervention dentistry. And when you’re not exposing dentine, so that’s critical. You can’t expose dentine and do not do temps.

Then no temps is a viable option. Why is that? What’s the biggest thing for no temps? Number one, soft tissues will inevitably be healthier. I guarantee you soft tissues will be healthier without temps. Even if you’ve got someone who is really good at cleaning their temps and really good with oral hygiene, the oral hygiene around something like a bisacryl or a temp material is never going to be as excellent because it’s more rough, it’s more plaque retentive.

But number two is what you said, they can’t visualize their smile. So that if they can’t visualize the end goal during the process, they can’t adapt to it. So my ideal is that by the time the veneers come to fit or issue, I like the patient is like, they look beautiful. Thank you. Let’s put them on. They’re actually jumping out of the seat when they see their temps initially.

And that’s actually the big excitement for me, like for the patient is when they see them in that stage, because that’s when they’ve got totally different teeth, but when they get their final teeth. The color is going to be nicer, the luster and the shine, but it’s the same design. And that’s where you’ve got the adaptation and you’re going to have, like for me, I find that for my cases, majority I’ve ever done, and I’ve done thousands of cases now and Cam that I teach with is done many, many thousands of cases, is that our cases with no temporaries, you’re going to have a risk that the patient then doesn’t potentially consent to cementation because they’re frazzled or they’re not used to it at that stage. Whereas if you give three weeks, like the three week rule, as we always call it, for them to adapt, they’re much more easy when it comes to the cementation as well.

[Jaz]
The word adaptation is a great one, Aodhan. The reason I love it is because some people might think, oh, it’s the occlusion or speech and all those things are important, but actually the adaptation is not for them. It’s for the people, their loved ones around them. Because I’m sure you experienced if you give someone, and I love what you’re saying, because you give someone their final smile without a dress rehearsal, without that prototype, then what they instantly need to adapt to is they paid their big bill.

Proximal Papilla Care
They’re now got these beautiful veneers, which is what they wanted. But then people are like, Oh, your teeth have changed. And sometimes they know it looks great, but that sort of is overwhelming for some personalities, right? And therefore, can be very messy. But if you give them time to adapt in the temps, it’s much better than actually getting to adapt in the defensive.

[Aodhan]
That’s going on the slide, I’m adding that. It’s so true.

[Jaz]
Let’s have a look at it, mate. Share your screen. Let’s bring the slides up. And for those on Spotify and Apple, we’re not going to do a dirty one on you. We’re going to pretend the slides aren’t even there. We’re just going to talk you through it like we are.

But for the people on Protrusive Guidance and YouTube, you get Aodhan’s got some lovely visuals and stuff. I’ve seen his work on social media. So I’m quite, he’s got beautiful dentistry. Gotta check him out. So to have some visuals for those on video, it’s totally cool.

[Aodhan]
So what we want to see when you’ve done temporization correctly is you actually want to see little spaces above the proximal papillas. And those little spaces are going to allow you to feed an interdental brush, such as a Pikster or any of the other interdental brush brands. But I use a Pikster. I don’t know if you guys have Piksters, but-

[Jaz]
It’s like a plastic plastic one, right?

[Aodhan]
Yes. It’s the smallest one. It’s a little interdental brush. And I use the smallest one interproximally. And when you’ve done your temporaries nicely, you should have a little space above, or incisal too, I should say, the papilla. And that’s your space that you can feed.

[Jaz]
Like a tiny black triangle.

[Aodhan]
A tiny black triangle. What happens if you don’t have any space? You’re going to have inability to clean proximally. And you’re going to have a nightmare for your issue appointment. Because one of two things will have happened. You’ll have crushed your papilla and you will actually induce necrosis and you will actually induce an actual black triangle. And also you’re going to have lots of bleeding, so it’s not good for anyone. So you want to actually see a little black triangle, the smallest black triangle, to feed an interdental brush through. And what will happen-

[Jaz]
And it’s particularly important, Aodhan, just to point out that those people with them a very thin biotype, right? Like even scarier to work on those patients, right? Because of the risk of recession. And you definitely want, don’t want to go anywhere near the soft tissues of those kinds of patients is, is less forgiving.

[Aodhan]
It is so much less forgiving. And that’s important. Like you have to, during your examination process really identify like we would go through a list of things as I’m sure everyone does, but we would identify the type of biotype and the type of tissue the patient has as well.

Because yeah, as you said, thinner biotype more prone to recession and that’s a worst case scenario is to come to the issue appointment and have margins exposed and then you’re re prepping as well. And you started exactly right, like the three main techniques would start with no temporaries where you’ve done minimal prep, you’ve got minimal dentine exposed, so minimal to no dentine, I would really say, so you’re not going to have sensitivity. And that’s going to be excellent for soft tissues, right? But, you’re not allowing the patient to test drive and really critique the final design. And-

[Jaz]
So as a percentage, how often in your patient base, cause it varies differently on where you are working in the world. I’m a huge believer in that your demographics will greatly change the kind of dentistry you are, have the permission to do on your patients. So, what percentage of our patients get a no temp approach because of their scenario that they’re in?

[Aodhan]
0. 0%.

[Jaz]
And that’s cool. It’s good that you decided that, okay, this is a way, but for the reasons that you’ve already explained very nicely that it’s not in tune with the way that you’d like to do things.

[Aodhan] The Trial Smile Approach
Agreed. And it really also comes down to the test drive for the patient, the critiquing, the smile design. Cause there’s only so much you’d like. The only other way you can do it really is and I was speaking to Michael Allen, who is an excellent dentist over in Austin, Texas. We have a little beef on Instagram.

If you’ve ever seen it, he’s a great guy. Like I was talking to him yesterday about his approach and his approach actually involves doing the trial smile, which I do as well for a patient, but he spends all of the time at the trial smile appointment with the patient, critiquing all of the factors that we spoke about, making sure that the incisal edges are at the level they need to be making sure there’s fullness, the shapes, the size, everything is bang on.

But you have got a one hour, whatever 40 minute appointment to do that. You don’t have any time for the patient to go home, start adapting, get any feedback as well. And everything like that. So that’s an approach you could use. That’s the other approach, but I personally prefer to use temporaries for every single patient.

[Jaz]
I like that.

[Aodhan]
Now there’s another approach and it’s the traditional approach and all of us will have done this because we were taught this at dental school. Like when you’ve done a crown prep, you use your putty key, you fill the material, you’ve probably put a little bit of glycerin or a bit of Vaseline on the tooth, you seat it, when it’s just about set you pop it off, then you use a disc to shape the actual temporary and then you cement it with some temporary cement.

Now you can do that for veneers as well. It’s a little bit more fiddly with veneers because They’re not full crowns, and the prep should be light. So it’s not the easiest thing to handle them and to adjust with a disc.

[Jaz]
Because it’s very flaky, very thin in my experience. And then, you’ve got to choose your path of insertion, because obviously with veneers, you’re going usually horizontally, like labially. Again, it’s very fiddly to take it off and insert it in that way. But yeah, it’s very much, you make a great comparison. That is how we are traditionally learn to do temps.

[Aodhan]
And that’s the way we all learn. And that’s the way I did it for years and years, because that’s all I knew. And what did I find happened? I found like the downsides. Number one, God knows I would always use a disc and over reduce around the margins. And I would then go to seat it, and I’ve got a deficiency, and then I’m trying to add flowable, and there’s flowable over the soft tissue, there may be bleeding, there’s different ways you can re add flowable to something you’ve over reduced, but it makes it very hard because the flowable can chip off at the margins in that few weeks that you’re waiting for the finals to get made.

I’d often either over or under reduce the interproximal. So I’d induce a very big black, like I’d create a black triangle in my temps that’s too big, or I would leave too much material interproximally. I would take it off and I would break a temporary, like you said, it’s super fiddly and super thin.

Or when I would cement the temps, I would have excess that went subgingival or interproximal that I struggled to get out. And then I’d induce bleeding and it would be a mess. Then when I took those temps off later, I’d see lots of interproximal temporary cement. And that was my experience with doing the traditional technique. And that’s why I don’t do that technique anymore. I really only do that technique for crowns.

[Jaz]
So this is another 0. 0.

[Aodhan]
Yeah. But it’s closer to that. I literally only do it when I do crowns, because I feel like I can manage the traditional technique with a crown well. And I can, and I’ll talk about the other technique we use, but I find it better than the next technique for a crown in particular. So if I’m going to do crowns on the posterior and veneers on the anterior, then I’ll do my crowns with the traditional technique and segmentally make some temporaries using the shrink wrap technique for the anteriors.

[Jaz] The Shrink Wrap Technique
And so the shrink wrap technique is the way that you like to do things, which you’re going to describe now, right?

[Aodhan]
Yeah. So the shrink wrap technique is essentially where we are shrink wrapping the temporaries onto the teeth with our stent. We remove the stent and we’re not removing the temporaries to polish them. We are basically gluing the temporaries to the teeth. And then when we take our stent off, the temporaries are still on the teeth.

Now, what are these questions going to be? Number one, how do you keep them on? Number two, don’t they just pop off when you take your stent off? Number three, isn’t that going to have lots of excess everywhere? Well, how do we get around that? I would say number one, you need an excellent stent. It’s not your single phase crappy medium body stent, it is going to be a light and heavy body stent, which is cut perfectly.

So when we actually, when we do our courses and things like that, we actually get the delegates. We show the delegates how to do this and we teach them so they can teach their nurses because it keeps your lab fees down.

And it’s really easy to do, to make a really good stent makes your life so much easier during veneers. And a really good stent is good for the shrink wrap technique or the traditional technique as well, just by the way. So use a light and heavy body stent and it needs to have little escape pathways interproximally and those escape pathways allow excess to come out and we need to scallop it with a fine blade.

Usually an 11 blade is the best. We scallop it around the gingival margins. So it sucks in and sits at that gingival margin really nicely. And that’s how you get crisp gingival margins for your temps. Using a shrink wrap technique.

[Jaz]
When you load up the stent and you deliver it and there is a temptation to start playing around how long do you wait in terms of nuance to actually wait for some of the initial set to happen before you start removing the the scallopy excess? Because if you remove that too soon that it might kind of disturb the rest of it.

[Aodhan]
Good question.

[Jaz]
You find that when you’re able to remove it, it kind of cleaves off at the right time, leaving the actual temp behind on the tooth.

[Aodhan]
So let me walk, how about I walk you through the technique? So step by step.

[Jaz]
Before you walk us through, I just want to just quickly mention a few other ways that I’ve done it or heard of actually. One is the direct composite veneer. So spot edge-

[Aodhan]
I’ve done that too.

[Jaz]
Yeah, I thought you would have, you’ve got to update your slides. So tiny spot edge and a direct composite veneer. Again, it’s using a lot of material. And again, you’re not being driven by the future shape. You’re just doing quick, quick composite veneers. And for a fussy patient, it’s difficult to get right. The other way, which I have used and probably is something that I’ve used the most is doing it your way, the shrink wrap way, okay, except the putty is cut at the just incisal to the papillae.

So basically two thirds of the tooth, okay, so the incisal two thirds of the tooth is exactly this way, and then the gingival third is with a composite veneer basically. So it’s like a hybrid. That’s what Jason Smithson taught me on his course years ago. And that works well again, when I did the Dawson Academy, Ian Buckle taught me your way.

So, I feel as though what I would do now, I mean, I’ve got an older patient base, I’m doing a lot more crowns, I’m doing veneers, but I do like the shrink wrap technique in terms of do it once, make it neat, make it nice, and you’re done rather than a two stage, but the reason I mentioned it is because I want to give everyone an idea of there are so many different ways to do it.

[Aodhan]
There’s many ways. And the way you learned with Jason and that I’ve seen Pascal Magne do it as well is by doing the gingival in composite. And it’s not to like say it’s a bad technique, right? But the idea you controlling where your margins are with composite and also controlling the interproximal in theory is a good idea.

However, if you have any bleeding around the gingiva, It can be a bit of a pain because you’re struggling to control bleeding while you’re trying to place a composite onto those areas and I feel like with the shrink wrap technique, the control we have with a really good stent is so much better than trying to place it by hand around the gingival margins, because the stent will crisply suck onto the gingival margins and hold your material there, while you actually use something to clear the interproximal. So you don’t need to rely on your manual. Like, manually working composite around those interproximals. So-

[Jaz]
Agreed.

[Aodhan] Detailed Steps for Shrink Wrap Technique
Essentially, what I do is we’ve got our preps done, we’ve done our scan, and we have our cord in. Okay? I take my cord out, I get the patient to rinse, and I take five minutes. Why? So, because you know when you take cord out, there’s always gonna be a little bit of bleeding, probably here or there.

[Jaz]
It’s that compression. It’s the release of the compression. People get worried, young dentists, when they remove the cord or the PTFE or whatever they’re using and they see that bleeding, they get very worried, but actually it’s to reassure everyone that this is a normal phenomenon due to this kind of decompression of the capillaries.

[Aodhan]
100%. It’s totally normal. We’re trying to reduce, basically, bleeding and gingival crevicular fluid with that. And it’s been in, usually we try and only, we limit it from 8 to 15 minutes, like in an ideal world. We all know we all do it longer than that, but like, that’s your ideal. You shouldn’t have caught in too much longer.

You’ve got a more, a higher risk of recession and things like that. But as soon as you pop that out, everything opens. You can get bleeding. I see the patient up, have a rinse, have a little chill, go on your phone. I say, you know, this stage, you don’t have any temporaries on. You’re probably not going to want to look at your teeth and start doing selfies or anything silly, but just take a few minutes.

Spot Etching & Bonding for Retention
So I just go and get a drink of water. That’s when I’m pretty tired at that point. And I, and I go and get a drink of water. I flipped through Instagram for a couple of minutes. I come back in the room and I’m ready to go. And I lie on the patient back and I’ve got my optrogate in or like whatever retractor you use.

And I spot etch the center of each tooth with a spot. And I’m talking about like, I put etch onto my glove, or my nurse puts etch on my glove and hands me a probe. And I dip the probe in etch, bop, bop, bop, bop, bop. And I add a little dot of etch into the center of each tooth. And that etch is then able to spot etch a certain area only.

So you’re not blanket etching the whole tooth. And then what I do is I actually pop Teflon strips interproximally. And that holds over the papilla and basically covers and protects your papilla. So these little Teflon strips, they’re actually the thickness of a bit of Teflon floss, like your Oral B glide floss.

You can use that as well. We actually place those over the papilla as a protection. And then I actually spot bond and what spot bond am I going to use? It’s a total etch adhesive, meaning it’s something like an OptiBond Solo Plus, which allows us to just spot bond that area. So don’t use a universal or something that goes everywhere.

Spot bond after you’ve spot etched with a total etch. So that means that you’re going to just etch the center of each tooth. And that is actually going to form a retentive bond to your temporary material. And that’s how we basically keep the temps on because it’s going to go, the temps are going to shrink wrap into all the nooks and crannies and basically hold in. But if you spot it should spot bond in the center of each tooth, then it’s going to give it that extra grab onto your actual preps.

[Jaz]
I was very scared of doing this years ago, but when Ian Buckle taught me on Dawson. It made so much sense, but initially I was like, Oh my God, why am I using bond? But, the other thing that, you do, obviously, you show us the photos and stuff is. I was taught to take a photo of exactly where you place the etch, so you know your plan of attack when you’re going to remove the temp. Usually you’re trying to do it in the middle anyway, but it’s, it’s nice to sometimes different shaped teeth and one might be, the abutment might be higher or lower.

Removing Temporaries Atraumatically
And so you know exactly where the etch is and you reference back to that photo so you know roughly where it’s the strongest bond. But I’d love to know, how do you actually come to remove it atraumatically before you put those veneers on.

[Aodhan]
Yeah, good question. I suppose in terms of removal, we’re going to use a carbide point and I section in between the facial surface, right down the midline of the tooth, across my spottage point, and I open the interproximals.

If I have got open interproximals, I opened those up with the carbide point, not a diamond ever because we don’t want to cut tooth, and you can’t cut tooth with a tungsten carbide point unless you’re doing something insane like you’re pushing it through the tooth. It’s going to hit the tooth and just spin otherwise, and you’ll smell it burning if as opposed to holding a diamond and just prepping straight through the temporary and through your prep.

So use a tungsten carbide, use it lightly. As soon as it hits the tooth, it’s going to stop. I do it right in the center. And then I do the interproximals. And then what I do is I get a flat plastic or a cord packer, and I actually just go through and I tell the patient, listen, you’re going to hear little pops here, little clicks.

And I go through pop, pop, pop, pop, and I pop them all off. And I use a scaler as well, especially on your premolars and I pull from the palatal cusp from that buccal cusp from the palatal aspect and I pull it forward and I just pop all the temps off.

[Jaz]
What about the residue, the common question is the residue of where you spot bonded? Is it a soflex disc? Because I quite like using soflex too. Just polish that away. But is there anything else that you use? Maybe you use attachment removal burs or?

[Aodhan]
I just run the tungsten carbide over the top of it. And I’m not changing the tooth anatomy doing that. And then I also air abrade, air particle abrasion it’s gone. So I actually don’t use a disc personally or any diamond at that stage, because I don’t want to change the anatomy and that intimate fit that he has. Even if it’s only a couple of millimeters, I want to keep the most intimate fit possible. And you can also change the optical perception of shade and value.

If you go too hard with a bur right in the middle, if you actually dish out because you’re going to have thicker cement layer, technically, especially if you use a white cement or a lighter colored cement. So that’s pretty critical, is to do the most atraumatic removal and keep your instruments away from the gingival margin.

But that gingival margin, those tissues should be pink and healthy. Why? Because using the spot etch and spot bond shrink wrap technique with something like Teflon is going to actually cover those proximal papilla and I’m holding my stent on and I’m actually allowing it to go tacky before I remove the excess.

Like you asked before, when do you remove the excess? I actually hold the stent and then I have a probe and I just check the excess every so often that forms just apical to the stent, like just under the lip there. And when it becomes tacky, I just flick it straight off. And if you’ve got a really nicely cut stent, the way it flicks off is you get little scallops and they all come off at one. Even if it comes off in a couple of pieces, it doesn’t-

[Jaz]
Very satisfying. It’s almost as satisfying as giant bits of calculus.

[Aodhan]
Because it’s comes off in a scallop and it doesn’t take if you’ve got a good putty key, this comes back to that light body and a really well adapted putty key. It doesn’t take from under your like beyond your margin.

[Jaz]
Cause you have a lovely tight seal. And so it kind of stops the material from being like a tablecloth being slipped under the, or your sort of a magic trick they do. It’s not going to be like that, where everything just gets sucked away. It’s a nice tight seal.

[Aodhan]
Definitely not. It’s nice tight seal. And the thing is just before you are like at that stage. Just before you remove that excess, I actually take all those Teflon pieces, because my nurse will have cut up 10, 12 X amount of Teflon strips, or Teflon floss, that is sitting in approximately