The Dr. Phil Klein Dental Podcast

Are you a dental hygienist wondering whether a periodontal specialty practice is the right career move — and what it actually looks like day to day compared to general dentistry?
Cheryl Calmis, RDH, BS, MEd, brings over 30 years of clinical dental hygiene experience with deep expertise in periodontics and diode laser therapy. She holds a Bachelor of Science in Dental Hygiene from the University of California, San Francisco, a Bachelor of Science in Biology from San Jose State University, and a Master of Education in Instructional Design from Western Governors University, where she graduated with highest honors. Cheryl has conducted pilot research for a major dental laser company, serves as a professional educator for a leading oral irrigation brand, delivers continuing education lectures on contemporary hygiene topics, and has authored articles for multiple dental publications including Today's RDH.
This episode draws a detailed clinical and professional comparison between working as a dental hygienist in a general practice versus a periodontal specialty office. Cheryl shares her own 9-year journey through general dentistry before transitioning to a perio practice, offering an honest and practical roadmap for hygienists considering a similar move. The conversation covers patient demographics, appointment structure, clinical protocols, laser use, chemotherapeutics, and the mindset required to thrive in a perio environment. For hygienists in GP settings, Cheryl also outlines how to advocate for — and build — a stronger in-house periodontal program without ever leaving their current office.
Episode Highlights:
Periodontal specialty patients differ significantly from the general practice population. Most patients referred to a periodontist are adults, often in their 50s or older, presenting with advanced bone loss, refractory periodontal disease, recession, or implant-related maintenance needs — with approximately 70% of patients having at least one implant in the mouth.
Periodontal charting is performed at every single appointment in a perio practice, not just annually. This continuous data collection allows the hygienist and periodontist to track pocket depth trends, bleeding scores, and disease stability over time — with patients often actively tracking their own numbers visit to visit.
Diode lasers are used by dental hygienists in California — and in most states — for laser bacterial reduction within periodontal pockets. This application is typically performed during non-surgical periodontal therapy or during maintenance appointments when a pocket shows signs needing additional intervention, and at the low energy levels used for bacterial reduction, tissue heat generation is not clinically significant.
Re-educating patients about the nature of bone loss is a core communication skill in periodontal practice. Patients referred from GP offices often feel demoralized after previous treatment did not reduce their pocket depths; the key clinical reframing is that bone loss represents history that cannot be reversed, and that stabilization — not resolution — is a clinically meaningful and realistic success outcome.
Hygienists in GP offices can proactively build periodontal program depth without changing jobs. By initiating a conversation with the practice owner about improving periodontal diagnosis, implementing consistent full-mouth charting, and expanding non-surgical therapy protocols, a GP hygienist can gain the clinical exposure needed to evaluate whether a specialty perio career is the right fit.
Perfect for: dental hygienists at any career stage considering a move into periodontal specialty practice, hygienists in GP settings looking to elevate their clinical role, and dental residents or students exploring the range of hygiene career pathways.
If you've ever wondered what it would feel like to do deep, focused periodontal work every single day — this episode gives you the clearest picture of what that career actually looks like from someone who's lived it.

What if you could hand a patient their finished crown before they even leave the chair — and it cost you $22 to make? Chairside 3D printing is no longer a future concept; it is happening right now in high-volume practices, and it is reshaping how dentists think about same-day restorations.
Dr. Michael Erdos is a general dentist and co-owner of Tawil Dental, a Brooklyn practice with nearly 50 years of history in cosmetic, restorative, and implant dentistry. A Columbia University College of Dental Medicine graduate and former Chief Resident at Mount Sinai Hospital, Dr. Erdos has built his clinical focus around the intersection of aesthetic dentistry, prosthodontics, and digital workflows. Over the past several years, he has worked directly with Shining3D to test, refine, and optimize in-office digital printing workflows at scale, with a particular emphasis on making AI-driven design and chairside printing practical for everyday clinical use.
In this episode, Dr. Erdos walks through a complete chairside 3D printing workflow — from intraoral scan to cemented restoration — and explains exactly how a general dentist can deliver a crown, veneer, onlay, or pediatric crown in a single visit using a compact, countertop printer that weighs under five pounds and requires nothing more than a standard wall outlet. He compares chairside printing directly to milling, discusses the ceramic-infused resin materials now cleared for permanent restorations, and shares his honest assessment of where the aesthetics stand today versus lithium disilicate. This is one of the most clinically detailed and financially transparent conversations about chairside 3D printing available to the dental profession.
Episode Highlights:
The complete chairside workflow from scan to cemented restoration can be completed in approximately 30 minutes, with a significant portion delegable to a trained assistant. The process involves scanning the full arch and bite pre-operatively, scanning the preparation, uploading to a cloud-based platform, and using AI design software to generate a restoration proposal — typically within one to two minutes — before sending directly to the printer in a single click.
Ceramic-infused resin materials now cleared for permanent restorations contain over 50% ceramic filler content, including ceramic compounds such as lithium disilicate and zirconia variants, which meaningfully increase strength and aesthetics compared to earlier-generation printable resins. While these materials do not yet rival the optical properties of pressed lithium disilicate or full-contour zirconia, post-cure staining, glazing, and nitrogen-atmosphere curing can significantly enhance final appearance and surface quality.
The additive nature of 3D printing allows for margin and contour accuracy that can surpass subtractive milling in certain applications, particularly for thin restorations such as veneers, where burr diameter in milling limits the fineness of internal line angles and margins. For no-prep or minimal-prep veneer cases, printed restorations can be bonded over natural tooth structure with minimal or no enamel reduction, then refined chairside after cementation.
From a financial standpoint, the per-restoration material cost using sealed single-use resin capsules is approximately $22, and a single capsule can accommodate multiple restorations of the same shade printed simultaneously — including up to six veneers or a three-unit bridge. At a practice fee of $750 per printed resin veneer, a four-veneer case generates approximately $3,000 in production at a material cost of $22, with the hardware investment in the printer recoupable within a single week of focused use.
Chairside printing opens a clinically and financially accessible pathway for pediatric white crown restorations as a direct alternative to stainless steel crowns, allowing the printed crown to be fabricated during the same appointment while other restorative procedures are completed. The same workflow applies to budget-conscious adult patients currently treated with direct composite bonding, converting them to indirect printed resin veneers at a price point that improves case acceptance without competing directly with laboratory-fabricated porcelain veneer cases.
Perfect for: General dentists exploring same-day digital workflows, prosthodontists integrating in-office printing, pediatric dentists seeking aesthetic alternatives to stainless steel crowns, and dental residents building their understanding of AI-assisted restorative design and chairside digital technology.
If you have been waiting for 3D printing to become fast enough, affordable enough, and simple enough to work in a real practice — this episode will show you it already has.

Are you treating patients with dental implants the same way you treat natural teeth — and could that approach be putting those implants at risk?
Dr. Jon Suzuki is a Professor of Microbiology and Immunology in the School of Medicine and Professor of Periodontology and Oral Implantology in the School of Dentistry at Temple University, where he also serves as Chairman and Program Director of the Department of Periodontology and Oral Implantology and Associate Dean for Graduate Education. A former Dean at the University of Pittsburgh and CEO of the University faculty practice plan, Dr. Suzuki holds a D.D.S. from Loyola University of Chicago, a Ph.D. in Microbiology from the Illinois Institute of Technology, an N.I.H. Fellowship in Immunology from the University of Washington, a Clinical Certificate in Periodontics from the University of Maryland, and an MBA from the Katz Graduate School of Business. He is a Diplomate of the American Board of Periodontology, a Diplomate and Board Examiner of the International Congress of Oral Implantology, a Boarded Specialist Microbiologist, a Fellow of the American and International College of Dentists, former Chairman of the FDA Dental Products Panel, and former Chairman of the ADA Council on Scientific Affairs, with over 150 published papers, chapters, and symposia and a textbook in Medical Technology.
In this episode, Dr. Suzuki joins Dr. Phil Klein to deliver a comprehensive, evidence-based framework for managing peri-implant health in the general dental practice. The conversation spans the biological reasons implant disease progresses faster than periodontal disease around natural teeth, the emerging concern of titanium corrosion and its potential systemic implications, and the practical protocols hygienists should follow at every implant maintenance visit. With 5 million implants placed annually in the United States, this discussion is immediately relevant to nearly every dental professional seeing patients today.
Episode Highlights:
Because dental implants lack a periodontal ligament, they have no PDL-associated vascularity, diminished local immune response, and only an epithelial soft tissue collar rather than a full gingival fiber complex. These anatomical differences mean peri-implant disease can progress significantly faster than periodontitis around natural teeth, making early detection and intervention critical to implant survival.
Probing depths of three to five millimeters are considered within normal limits around implants due to the nature of soft tissue adhesion, but pockets deepening to five to six millimeters, combined with erythema and bleeding on probing, represent clear red flags for peri-implant mucositis or early peri-implantitis. Hygienists should use a plastic or resin probe rather than a stainless steel probe during implant assessment to avoid scratching the titanium surface.
Titanium corrosion from dental implants is an emerging area of clinical concern supported by parallel literature in orthopedics and obstetrics-gynecology. Corrosion risk increases once implant threads become exposed to the oral environment — accelerated by pH changes from plaque, dietary factors, and occlusal loading — and the potential for systemic distribution of corrosion byproducts warrants continued research and clinical vigilance.
Approximately 80 to 85 percent of patients do not floss consistently, and implant patients are no exception. Power brushes, interproximal irrigating devices, and antimicrobial mouth rinses used selectively — particularly for two to three weeks following a surgical or maintenance appointment — represent practical, compliance-friendly strategies for reducing peri-implant biofilm in the home care setting.
Smoking lowers sulcular oxygen tension, promotes pathogenic anaerobic bacteria, suppresses neutrophil response, reduces salivary flow, and diminishes secretory immunoglobulin A — all of which increase peri-implantitis risk. While smoking is not an absolute contraindication for implant placement, dental offices should offer a tiered cessation approach including community counseling, nicotine-containing lozenges and gums, nicotine patches, and — with significant caution given documented psychiatric adverse effects — prescription cessation medications.
Perfect for: general dentists and restorative dentists managing implant patients, dental hygienists performing implant maintenance, periodontists, implant surgeons, and dental residents seeking evidence-based protocols for peri-implant disease prevention and early intervention.
If you place, restore, or maintain implants — or if you have patients who do — this episode gives you a clinical framework you can apply at your very next appointment.

What does it take for a general dentist to stop dreading pediatric appointments and actually start enjoying them? The answer may involve improv comedy, a safari in Kenya, and a few well-chosen words about a dolphin tail.
Dr. Nidhi Kotak is a dual American- and Canadian board-certified pediatric dentist, certified lactation counselor, and internationally recognized dental educator with over 14 years of clinical experience across five countries spanning North America, the Middle East, and Africa. A former Chief Resident at Temple University Hospital and former faculty member at the University of British Columbia, she has led hands-on continuing education courses for general dentists across Canada and is widely published with research in laser dentistry and infection control. Dr. Kotak is a recipient of the Lucy Hobbs Woman to Watch Award, and her unique career arc — from general dentist to pediatric specialist — gives her a rare dual perspective that resonates deeply with the GP audience.
This episode explores Dr. Kotak's unconventional path from near-burnout as a general dentist to becoming a passionate pediatric specialist, with a pivotal turning point during a dental outreach camp in Kenya. She delivers highly practical, immediately applicable guidance for general dentists who see children in their practices, covering behavior management, isolation strategies, caries management without anesthesia, and how to set boundaries with parents in the operatory. The conversation is grounded in clinical reality, acknowledging the common anxieties GPs face when treating young patients and offering concrete techniques to address each one.
Episode Highlights:
Stainless steel crowns are frequently underutilized by general dentists treating children, often replaced with multi-surface composite restorations that are a less durable and more technically demanding choice. For primary molars with extensive decay, the stainless steel crown is considered one of the most straightforward and reliable procedures in pediatric dentistry once a clinician has performed even a handful of them.
Silver diamine fluoride combined with a glass ionomer restoration represents a highly effective caries management strategy for young or anxious pediatric patients, particularly when conventional preparation under local anesthesia is not feasible. Applied at one visit and followed by a glass ionomer restoration two weeks later, this protocol — sometimes coded as caries control — can serve as a definitive restoration rather than merely a temporizing measure, especially when decay does not extend interproximally.
Isolation device selection significantly impacts procedural success and airway safety in pediatric dentistry. A suction-based isolation device that retracts the cheek, tongue, and lips while providing a throat barrier is the preferred choice for the majority of posterior procedures, while rubber dam with floss ligatures remains the gold standard for anterior restorations with subgingival or interproximal caries involvement.
Nitrous oxide is a valuable adjunct for pediatric patients in the general practice setting, but its appropriate use requires understanding its limitations. It is most effective for patients who are mildly anxious but motivated to cooperate, and works particularly well for longer procedures such as quadrant or full-arch dentistry — it is not a reliable tool for managing severely uncooperative or highly anxious patients.
Behavior management in pediatric dentistry is substantially enhanced through improvisation-based communication techniques, including sustained narrative distraction, tell-show-do framing, and creative language that transforms clinical tools into familiar, non-threatening objects. Establishing clear parental boundaries prior to the appointment — not during it — is equally critical, as it allows the clinician to maintain full focus on the child during treatment without reactive conflict in the operatory.
Perfect for: General dentists who see pediatric patients and want to build confidence and clinical skill, dental residents entering pediatric rotations, and any dental professional looking to improve behavior management techniques and caries control strategies for young patients.
If you have ever felt uncertain, stressed, or underprepared walking into a pediatric appointment, this episode will give you the tools and the mindset to change that.

What if your dental practice could detect cardiovascular risk, catch uncontrolled diabetes early, and reduce adverse pregnancy outcomes — all before a patient ever sees their physician?
This episode is hosted by Dr. Phil Klein, DMD, endodontist, and founder of Viva Learning LLC — the largest dental continuing education platform in the world with over 460,000 dental professionals in its user base. Dr. Klein earned his DMD and Post-Doctorate specialty degree in Endodontics from the University of Pennsylvania School of Dental Medicine, holds three dental patents, and brings over 40 years of experience spanning private practice, research and development, and dental education. As host of one of dentistry's most widely followed clinical podcasts, Dr. Klein is uniquely positioned to translate complex evidence into actionable clinical guidance.
In this episode, Dr. Klein delivers a comprehensive, evidence-based deep dive into the mouth-body connection — one of the most clinically significant and underutilized frameworks in modern dental practice. He explores the biological mechanisms linking periodontal disease to type 2 diabetes, cardiovascular disease, respiratory illness, and adverse pregnancy outcomes, and explains how chronic oral inflammation functions as part of a larger systemic inflammatory burden. Importantly, he also addresses how dental professionals can communicate these associations accurately and ethically — without overstating the science — in ways that build patient trust and drive case acceptance.
Episode Highlights:
The relationship between periodontal disease and glycemic control is bidirectional. Uncontrolled blood sugar impairs immune function and accelerates gum disease progression, while chronic periodontal inflammation elevates systemic inflammatory markers that increase insulin resistance — making it harder to stabilize blood glucose in diabetic patients.
Periodontal pathogens entering the bloodstream are associated with arterial plaque formation and elevated C-reactive protein levels, both of which are recognized contributors to cardiovascular risk. While causation has not been firmly established, the evidence is strong enough that periodontal health management may be a meaningful component of a patient's broader cardiovascular risk reduction strategy.
Aspiration of pathogenic oral bacteria — particularly during sleep and in patients with accumulated dental plaque — is a well-documented mechanism behind aspiration pneumonia and COPD exacerbations. Improved oral hygiene protocols have been shown to meaningfully reduce respiratory complication rates, especially in elderly and institutionalized patient populations.
Multiple studies have identified associations between periodontal disease and adverse pregnancy outcomes including preterm birth, low birth weight, and preeclampsia, with inflammatory cytokines and bacterial byproducts entering systemic circulation as the proposed mechanism. The American College of Obstetricians and Gynecologists recommends dental care during pregnancy, underscoring the role dentists and hygienists play in maternal and fetal health.
Transitioning a practice to a whole-body health model requires consistent, updated medical history documentation, early periodontal screening, comprehensive biofilm management including scaling and root planing when indicated, and active interdisciplinary collaboration with endocrinologists, cardiologists, and primary care providers. This framework not only improves clinical outcomes but drives patient trust, loyalty, and sustainable practice growth through differentiated care.
Perfect for: general dentists and dental hygienists looking to integrate a systemic health perspective into daily clinical conversations, as well as dental residents, periodontists, and any dental team member involved in patient education and preventive care protocols.
If you've ever wanted clinical language to explain the mouth-body connection to patients in a way that is accurate, compelling, and practice-building — this episode is exactly what you need.