Fix Up, Look Sharp! With Shiraz Khan
This week’s guest is winner of the Fast Track 4 award for future leaders in dentistry. But this conversation proves that dentistry’s best-dressed Shiraz Khan is leading the way in so many ways right now.
Dentist, lecturer and trainer Shiraz reveals how he went into a high profile role almost fresh from dentistry school and talks life on the lecture circuit (and the nerves that go with it).
Shiraz also weighs in on the porcelain vs composites debate.
“On my composite courses, I show the first-ever composite I ever photographed. And the reason I love doing that is that it brings me back to level pegs.” – Shiraz Khan
In This Episode
01.06 – Backstory
09.26 – On dancing
15.13 – First job & inspirational mentor
16.41 – Lecturing & training
28.48 – Documenting cases
33.31 – Blackbox thinking
39.18 – Working with Koray Feran
47.00 – Composite Vs porcelain Vs edge bonding
57.53 – Putting training into practice
01.03.20 – The patient journey
01.08.34 – Consumer ortho, AI and Turkey Teeth
01.15.15 – Last days and legacy
About Shiraz Khan
Shiraz Khan graduated from Birmingham Dental School in 2013 and trained in restorative dentistry at Croydon University Hospital and Guy’s and St Thomas’.
He is a prolific lecturer whose achievements include speaking at EXCIDA’s 75th national congress in Tehran.
In 2017, Shiraz was named Best Young Dentist at the Dentistry Awards and took the Rising European Star in Dentistry title in 2018. In 2019, Shiraz won the best restorative category at the Aesthetic Dentistry Awards. He is also winner of the Fast Track 4 award, which recognises potential future leaders in dentistry.
Shiraz is director of the Young Dentist Academy and a trainer with IAS Academy. He practices at Devonshire Place clinic in Chelsea and Fulham.
[00:00:00] Here’s the thing. Not once, not once did I ever think, nor do I think, no, actually that would be fortunate enough to be working where I was. I had no dream of. I want to be working on Wimpole Street at one point in my life. I want to share a podium with X. I didn’t even really know about lecturing very much. I didn’t know about awards very much. All I said to myself was, write the best version of yourself, whatever it takes, drive to that. Just drive to that. Don’t worry about what other people keep an eye on on the sphere of the industry. What people are doing. Give yourself some inspiration to try and achieve certain things. Absolutely. But focus on the inner. The best version of you that you can be.
[00:00:48] This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts Payman Langroudi and Prav Solanki.
[00:01:06] It gives me great pleasure to introduce probably someone who I’d consider to be the best dressed man in dentistry, always standing out when he’s lecturing on the street and puts most of us blokes to shame. Dr Shiraz Khan, who’s also an instructor and an incredibly talented dentist. Shiraz We normally start these podcasts by just asking a little bit about your backstory where you grew up. What school was like and generally your upbringing. So do you want to just give us a bit a bit of background information about yourself? Sure.
[00:01:41] Hi, guys, hope you. Well, thank you for inviting me along to do this lovely webinar podcast. Yeah, so my name’s Shiraz Khan. I qualified in dentistry in 2013, but I’m from the west of London. So bitter backstory. My father worked at Heathrow and he has done for his whole life and we’ve lived pretty close to Heathrow, which incidentally later on in life turned out to be a fantastic thing anyway. But I went to school local the areas known as Hounslow or Felten, where I went to school. And yeah, from very, very a working class family, humble beginnings. My parents worked as hard as they could to get me and my brother and my sister through education, but education was really important to them. So I went to school in Elsworth and Zone, and that was a boy school, which is basically slightly towards huge, costly type area. That’s fantastic school. Probably quite a challenging school because while there were people that were very, very high achievers, there were also people that weren’t. And the paradigm of those two in the same place can be sometimes a bit challenging. And then, yeah, then I went off to University of Birmingham to study medical sciences first because I knew something medical was what I wanted to do, but wasn’t quite sure where I would go with it. So I did three years. Medical science worked out the dentistry, what I wanted to do and build 2021. A few pandemics later. We’re here.
[00:03:08] Sure, I just just take take you back to growing up. Really? What was your childhood like you mentioned? Obviously, you came back came from humble beginnings. Education obviously featured quite heavily in terms of your influence from your from your folks. What was that like was it was the pressure on you to to sort of perform well at school? And what type of a student were you? Were you in that camp that was a natural high achiever? Or were you someone who had to really work hard to pursue exams?
[00:03:37] Yeah, definitely the latter. I mean, I think with my parents so quite openly, you know, my father works as a cargo supervisor for for Kuwait Airways at Heathrow, and he wanted to study to be an architect in his early years. But his familial situation didn’t actually allow for further education to be a prospect. So he had to get work, and he had to provide income for the house to keep the house running. In essence, obviously got married to my mum and just continued on working since so a lot of doors were closed for my parents in the sense of this was what was required at the time. I never really have been a natural high achiever or naturally gifted or naturally intelligent in any way, shape or form. One thing that I’ve certainly learnt from my parents, particularly my father as well, is the work ethic and hard work, you know, grinding hours in putting time in putting effort energy in to achieve something. And you know, my father, having worked nights, full days, double shifts over time, all of the above really put into place a mindset mindset or a mind frame where you want to try and emulate that whatever it is that you’re doing, if that makes sense. So yeah, definitely pushed it to work hard, but not in a not in a inflammatory way, if that makes sense.
[00:05:01] No, totally. Totally. Get it, mate. And just so I mean, some things resonate with me there. I mean, my my dad, you know, when we were younger, did everything from working in the factory to drive in taxis to, you know, running a corner shop. And one of the messages that I got from him was that the reason I’m working so hard is I don’t want you to do what I’m doing, right? You know, an education was a huge thing and always gave us the freedom and the space to study. And I feel very grateful for that. And was it similar for you in the sense that, you know, your dad saw what he was doing and he wanted something better for you, wanted you to progress? And was it the same for you? I know you’ve got a brother if you’ve got any other siblings you’re at. Yeah, I’ve got a
[00:05:51] Brother and a sister.
[00:05:53] We were all pushed in in the sort of direction of towards education. I don’t mean pushed. Like you said in the inflammatory way. That was a big sort of core family value in that sense.
[00:06:06] Yeah, it was. It was, and I wouldn’t say that I was given ultimate freedom as to exactly what I’d want to achieve. That wasn’t exactly what it was what. As long as it was something professional based, my parents were happy. But there was an ultimate driving force that was, you need to achieve X. And to do that, you need to do this. And the reason that we’re working so hard is that you don’t have to live this life. And, you know, an incredible background to who you are as a person because you don’t forget things like not being able to, you know, maybe have not so new clothes or trainers as kids do in schools. And well, now it would be the latest iPhone or whatever. But that wasn’t something that I ever aspired to have, either, you know, so.
[00:06:57] Mm hmm. And those so, so fast forward. You went on to do do medical sciences and then dentistry. What was your Dental inspiration? Was that was there a moment or someone you went to do some work experience with where you thought, You know what? This is what I want to do? Or was it part of this whole journey of becoming a professional individual?
[00:07:22] No. So once I finished medical sciences, my parents were quite quite keen for me to do medicine because it seems like the logical step, obviously. And that’s something that I feel that if you’re going to commit your life to, you need to give your your life to it. You need to be committed to it. You know, if you’re if you’re protecting people’s lives, you need to want to be there for sure. And I must admit that my my aspiration for for life wasn’t necessarily drawn to that. If I was fortunate enough to to have done it, I think I I’d apply myself as best I can, but that’s not where my heart was. So as part of me being who I am, I decided right only I know health care science is where I want to go. The only way I’m really going to tell is by doing all of the work experiences. So I did optometry. Physio Pharmacy did my medical work experience again. I worked in a lab to see if a PhD is something that I wanted to do, so I did all these things compared to back to back and dentistry. Just dentistry was the one because you were establishing relationships with people for years to come. You were able to be manually dextrous and creative with your hands. The job was what it felt like was a nine to eight where I used to work anyway. But it was you finished work, pretty much. You go and all of a sudden and there was all these multiple facets within dentistry. So if you really like surgery, that door can open up if you really like aesthetic. Dentistry wasn’t necessarily a big push in 2007, but if that was something you were into, you could push down that road. And it was the sheer variability, the sheer ability to establish relationships over a long period of time and there being a manually created part that stood out to me was like, Whoa, this is this answers all the boxes in a way. And so then so then I applied 2007 2008. I started and fortunately made it through with quite a lot of work.
[00:09:17] So where did you where did you go to Dental school?
[00:09:21] Birmingham as well, incidentally, University Birmingham. Ok.
[00:09:26] Cool. What was what was university life like for you, because obviously just checking out your Instagram and stuff, you’re always throwing shapes and moves and dancing and mixing that up with with your thing. And I’m just envious of how you can balance on on one hand and hold your body in that position, right? But is that something was that was that like a childhood thing that you just grew up with? And I’m assuming it was with your brother as well? Right? Because he’s he’s he’s quite quite a mover as well, right?
[00:09:57] Yes, he is. He’s quite a competitive chap as well. No. So putting it putting it in perspective, I hadn’t ever danced, ever moves around, never done any form of shows or anything until about 2007. So I went to university or just before university muscle, some local guys doing some doing some stuff, and I was like, Oh man, I mean, you know, it was, it was. It was purely the curiosity of it all. It was like, Sure, how where do you learn to do that? It’s not like, it’s not like you’ll go to like, you know, this syllabus or a curriculum or, you know, like what we’re used to is that this is this is really out there. And the physical element was really amazing. And I thought, not, what would you? So then I started researching locally in Birmingham. At the time, I found the classes went to a couple of classes and then just got immersed and I loved it. I loved it from the beginning. And having had no experience in dance or anything like that before, I mean, it just it just opened your eyes to a whole new side of the world because where we’re, as you can hear from, actually, I was always into sport. So, you know, it’s cricket quite a lot. Football. Basketball. Reasonably competitive. Local club type level. And then you go to university. And yeah, patterns probably change a little bit, don’t they? And I don’t really want to compete at the level because it’s quite serious at university level. But I was still in search of something and then this came along and I thought, Wow. And I just entered as deep as I could. I was like, Yeah, let’s go for it. Let’s let’s learn this craft and then you make it your own, don’t you? Then it’s a form of expression. And for someone who’s doing work science, medical type related life, it’s a really nice getaway. You know, it’s a completely parallel universe to to to the medical world.
[00:11:58] So, you know, I see it seems like when I was about to ask you the question like, you know, some people when they want to switch off from the stress of work, they go, meditate or go for a run or whatever. Is that your thing to just escape? And yeah. Do your own thing, and it seems like, you know, when you’re posting your videos and stuff of just little snippets of what you do, right? It almost seems like you are escaping and you just getting yourself into another world, right? You know, you know, I see that, you know, if I go while ago, go, Yeah, yeah, absolutely. Yeah, yeah, really. And so do you compete now in in that arena dancing? And how did your brother get involved? Was it around the same time or a little bit later?
[00:12:46] Yeah. So me and my brother are, I mean, we’re pretty much joined at the hip. Anything that I’ve done, he’s done anything. He’s done, I’ve done. We’ve all kind of stayed on the same vibe for many, many years. We basically just carbon copies of each other. I mean, he’s infinitely more handsome and probably in better shape than I am. But other than that, where I was the test dummy, he’s the two point, oh, isn’t it? So. That’s right. But when we started, we started. We started together, we started together and he was training. When I was at university, we were training together and competition was was where where it was at. This sort of two ways you can take dance, really start either performing and, you know, pretty little talent or that type of style of thing or theatre performance type stuff, which we’ve actually done as well, funnily enough. Or it’s the competitive side, and it was always the competitive side. Maybe. Driven by my nature as a person. That was what I was really, really attracted to. I like the idea of bringing your straight stripes to the table and just seeing how you fare. I love that side. Obviously, last year and a half, two years, it’s probably gone, gone down a lot because travel has been significantly inhibited. All these other things. But at the same time, I think it’s been a it’s been an incredibly, incredibly eye opening opportunity. And you know, this is the thing that I said before was all someone else Prav that if when you stand up on the line, your name gets called or whatever, you could be standing opposite a painter, a barber, a policeman, a teacher. A student, a kid, and it’s nothing to do with your CD. It’s about in that moment on the moment who had more stripes, and that thing is a thing that takes me away from this very insular profession that we’re in, actually, isn’t it? And sure, it gives you a bit of humility as well.
[00:14:46] So, yeah, it’s brilliant. Was brilliant. And so do you still compete?
[00:14:52] I haven’t recently, but me and my brother actually just talked about one that’s coming up in October. So I’ve still been training reasonably, reasonably, regularly, probably not as bad shape as I’ve been in my, in my career or my life, but definitely want. I think the competition side keeps you pushing to to want to stay in shape as well. So, yeah, I’m going to we’re going to be entering that, hopefully in October.
[00:15:13] Wicked, wicked. Let’s move. Let’s move back to dentistry. So you you qualified from Birmingham? And then what was your first job? What where did you work and who
[00:15:24] Did you work? Qualified in 2013. I was very fortunate to work for. A colleague was akin to Corrie in Gravesend, which is in Kent. So I live on the west of London and I got a job in the east of England almost, and it was a bit of a commute. But the person I work for was so, you know, you talked at the beginning with the people who inspired you or people who have been considerable to your career. This individual ActionScript was an absolute gem. He saw what I wanted to do. He saw what aspirations I had, and you really tried to allow me to be as free as possible. He realised that, you know, I’m not someone who’s just going to throw, you know, throw myself around and do inappropriate type things. But we did sit there and say to himself, Actually, look, do you know what? Yes, you want to try this? Go for it. You want to do this. Go for it. You want to learn this through it and really gave me. I suppose freedom is not the right word autonomy to make my own decisions and referred to when I need advice. And that was a fantastic year. Really, that was a fantastic year for us. He he still keeps in touch. We still speak. And he was a great man. He’s a great. He’s a great individual, really helped me during my foundation year as well.
[00:16:41] And so how did you how did your career progressed from there? Sure. So, you know, you qualify for Birmingham, you do your first year and your foundation year. And then, you know, fast forward a few years later, you’re speaking on the international stage, you’re passing on your skills and you know, you’ve recently started teaching, you know, a range of courses, but you know, alongside the likes of Tift Qureshi as well, you know, on composite dentistry, how do you get from there to there? And you know, also, you know, you’ve managed to secure some pretty cool jobs as well, working in some pretty prestigious practises with some with some high flying dentists or some well-respected dentists in the industry. So how do you do that? How do you go from like qualifying to say, did you have an ambition and say, Look, I want to work for Kerry or I want I want to be mentored or, you know, work alongside these individuals. What was your journey and what was your thought process along that journey?
[00:17:43] You know, no one’s really ever asked it to me like that actually Prav. So thanks for the question. It’s quite insightful because you don’t even think about yourself. Sometimes you just always looking forwards, and sometimes you don’t really get the chance to look back. So when I finished, I ended a year in hospital because I wanted to have more exposure to surgical side of the industry and very specialisms. I got offered the next year to do DK2, which was it was called at the time, which basically meant another year in hospital. I decided to get married that year and the thought of staying in dorms with my my lady probably wasn’t what I was aspiring for. So it was a purely social reason why I decided not to pursue further hospital engagement and and training, really. So then I got a job in London. And here’s here’s here’s the thing. Not once, not once did I ever think. Nor do I think, no, actually, that would be fortunate enough to be working where I was. I had no dream of. I want to be working on Wimpole Street at one point in my life. I want to share a podium with X. I didn’t even really know about lecturing very much. I didn’t know about awards very much. All I said to myself was write the best version of yourself, the best version of yourself, whatever it takes. Drive to that. Just drive to that. Don’t worry about what other people keep an eye on on the sphere of the industry. What people are doing. Give yourself some inspiration to try and achieve certain things.
[00:19:10] Absolutely. But focus on the inner the best version of you that you can be. And I can promise that I never thought about working. I never even knew that like teaching was a thing. I never knew that. You know, choro would be looking for an associate. I never even I never even thought about those things. Teaching opened up when the first opportunity for that was my educational supervisor, what they call training programme director. So there are people that run your scheme in foundation training. Sure. He said. I’d love for you to come back and share with the colleagues, your your juniors from your year as being a foundation trainee in camp and tell them what you did. And you know, I think they’ll learn a lot from you. Was that his name should be a fantastic, wonderful head of white hair. Very charming man, but also is able to identify those who want to achieve anything specific, just achieve as a blanket point. Sure. So he’s the first person who gave me my first opportunity to speak, and it went down really, really well. The people got the feedback. They were like, That’s the best thing we’ve had and edited it or whatever. And I don’t often like referring to myself in that context, but whatever. And he then said, Right, so everyone enjoyed it so much. I think we should get you back to the whole scheme, not just our group. So it went from 12 DFIs, then the next one was, I think, 90 FTEs. And they were like, Share, just like that you’re doing at the moment.
[00:20:52] Let me ask you a quick question there, you know, standing up in front of, let’s say. A hundred people and lecturing, talking, sharing your story, whatever it is, did you at any point find that nerve wracking or did it just come naturally to you because you were used to performing and all the rest of it that actually getting up there and speaking and sharing your story was? Was it easy
[00:21:19] At that point? It was still OK? I mean, this probably comes down to underlying personality traits of you as who you are as a young kid. But even when you do, you know, assemblies at school, you know, when you, you know, you act basically do a theatre show for school. I was always the narrator, but I didn’t realise that I wanted to do that. I just always was naturally the narrator. So there was always this natural ability to be able to share or learn or speak or whatever. But you didn’t really have a chance to put it into practise, I guess, right? Because where are you going to do that? And then the doorway opens and you realise, Oh, I’m actually really relatively comfortable. It did get nerve wracking, though, because after that I got the call for the BDA. So there was a few things on on the way. And then I got the call for the BDA to do it. The BDA conference in Manchester. Twenty. There I was that and I was like, OK, this is like national scale and clinical work is going to go up and there’s going to be people that are junior to. They’re going to be people that are senior to you. And it’s all out there. And it was it was lovely. It was. It was a pleasure, and not one part of me ever felt like that was ever owed to me. It was always a privilege. It was always a privilege to share. And to be able to talk and to inspire those that really want to chase what they want to do. I didn’t realise there were so many people that were like me that really wanted to do something, but really struggled because they didn’t have the energy or effort or whatever. And yeah, that was nerve wracking, but there’s been nerve wracking steps along the way as well since.
[00:22:53] Sure. And I guess as you progressed to different levels, the intensity steps up, I guess. But you know, it’s interesting because they’re a big team, the narrator right at school because, you know, when I first stepped in front of however many people it was and gave my first talk, I absolute inside. I was shaking like a like a dog, go into the toilet, mate. I was really nervous, right? And if I compare that to my daughter who who would get up in front of all the kids at assembly and wax lyrical and not even bat an eyelid? Yeah, it’s almost like that that getting up in front of people, there’s no fear ingrained in it because she’s used to doing that now. As a kid, I never did that as a kid, and I think that probably stands. You in good stead should just have that, just that confidence. You know, there’s several elements to public speaking. Part of it is, you know, people are going to look at my stuff and think it’s shit, right? Or people are going to fall asleep or some people not going to listen to me. And there’s all these different, you know, conversations you have with yourself. But in addition to that, there’s there’s there’s the fear of just getting up there and presenting yourself, right? That’s that’s the other thing. And I guess you don’t have that because you’ve done that as a kid, right?
[00:24:12] But I think there’s another facet to that, actually Prav. I think the other facet is if definitely if you have, you have certain genetic traits that are just predisposed for you to be the way you’re going to be. My daughter is two years old and she will get angry in a second. She has not learnt that from someone that is just ingrained to. She is going to be for the rest of her life, you know? But the other the other side of that is if you’re just working honestly for bettering yourself at all stages, not trying to cut corners, not trying to expose yourself, not trying to overly market yourself. If you’re just trying to be the best version of yourself, what do you really have to be scared about? Because immediately, if you if you’re trying to be the best person of your version of yourself, you’re doing that for yourself. And if you’re up there, once you’re sharing to others, you’re doing it for you. So actually, it’s not really about necessarily wanting to impress anyone else. It’s just about sharing your journey. And I think provided you’re not doing anything hugely incompetent or whatever or pretending to be someone you’re not, and I think that’s another important thing. I think there’s nothing to be scared about. It’s just you’re sharing your journey, and some people might really enjoy it. Some people might really not. And it’s just being okay with that flavour of the month, I think.
[00:25:34] Sure, sure. So having the opportunity to get up and teach and share your work, does that make you up your game in the clinic? I mean, knowing that you’re going to be sharing that with other dentists, does does that help you take things up a notch? You kind of like, you know, when you surround yourself in an environment with with high performers, you naturally elevate or levitate towards that level, right? Because you’re surrounding yourself, by those people, by getting up there and sharing your work is, you know, when you get in the clinic, are you doing work where you think I want this? To share with my colleagues, and so I’m going to raise my standards or does that just happen anyway because you want the best for your patients, because I’ve spoken to some lecturers and funnily enough, some will say I’m doing a portfolio piece for my lecture. Yeah. And some people just show everything right and it’s funny. So I’ve had numerous conversations with TIFF and whether TIFF’s going to photograph a piece for a lecture he’s giving or whether he’s just doing that in clinic and he’s in, he’s never going to see the light of day. The standard of work is always the same. Yeah, there’s no sort of two standards or whatever, whereas some lecturers, they create the piece to show to others. What’s your take on that?
[00:27:02] I’m going to turn again. I’m going to send the hourglass upside down. And I’ll say, rather than it being you wanting to showcase your work, it’s the fact that you’re documenting it to a certain standard. That means that you get to reflect on the work and then drive your standard up. So it’s kind of an it’s tomato tomato a little bit, but it’s kind of like because you’re taking the time to document on that level. Yeah, you’re seeing all of your imperfections and you sit there and say, Alright, for the next one, I’m going to make sure I don’t do that and I can, you know, on my composite courses and whatever I show the first ever composite I did, I show it. Because what? No, no, that’s not. That’s not strictly true. The first composite I ever photographed. Okay. Sure. And the reason I love doing that because it brings me back to level pegs, but also it’s like, Okay, whether you think the work is a good stand or a bad standard, there’s no denying that there’s progress along the way. And it’s the fact that there’s progress that allows you to share more openly. Personally, I’m very much against the idea of trying to create showcase pieces for lectures. If you’re doing it for an award or a publication or something like that, maybe slightly different, maybe slightly different. But I want this general standard of my work to be at a level that you see on the screen, and I’m quite happy to share ideas. I’m quite happy to share. If things didn’t quite work out why they didn’t work out, what did I do wrong? What did I do to correct them? Because rather than just showing a portfolio of your holiday snaps that show the day to day, you know of how it works, I’m I’m in complete agreement with you should push your standards up so that anything you photographed you could share.
[00:28:48] Brilliant. And so what are your top tips to somebody who is, you know, because I speak to a lot of dentists and in the marketing arena, documenting your work is really important as well, not just so that you can learn and progress from it, but so that you can demonstrate to patients. This is what I’m capable of, even if it’s just during a consultation and you’ve closed that central diastole for a patient and someone walks in for a central day with a central to when you say, Look at this, I did this two weeks ago, two months ago, whatever. I’m confident and you can give that patient that confidence, right? There’s several reasons for documents and but dentists on the whole, in my experience, are very poor at documenting their work. Yeah. What are your sort of top tips on on advising dentists on how to get started on, on on documented their work?
[00:29:46] I mean, I think, you know, I probably agree with you, Prav, because fortunately, we may only have access to three percent of the profession. There’s 97 percent that are generally not doing it or not document on a regular basis. I think not everyone wants to lecture, so you don’t take photos for that. Everyone does want patients to see that they can help them. So my advice would be get yourself a get yourself on a course, right? So get yourself on a course that teaches you the bread and butter basics of this is a camera. This is how you change aperture. This is the mirrors that you need. This is the equipment that you need and just start taking photos. There’s lots of online versions of that. You can do it online, one to start with just so that you know the brief idea. Then get yourself a hands on one where you actually just taking photos and most of the day, because what that will do is then it will translate everything you know, theoretically. And if there’s a the greatest thing that I find about hands on stuff is if there’s a problem that you get, you troubleshoot it on the spot, you’re going to find yourself being a lot more successful in that discipline or practise because you’ve worked out what the issue was going to be already.
[00:31:00] So having hands on support and troubleshooting and taking shots and small things like where you stand with the patient, which positions you hold your mirror, how is your assistant going to help you and getting the photos? All those little nuances, once they’re tapped in, you know, you’ll start doing a full set of clinical photographs for orthodontic or restorative records three minutes, four minutes Max. Wow. Yes, there might need to be some post-processing to straighten the images and all this other stuff. But if you can get into the habit of doing that for most patients, you’ll be you’ll be laughing. And I think the key is I understand that there’s going to be limitations within certain health care systems and so on. But I think the key is to be photographing as regularly as possible to make it so part of your day to day that you won’t ever not pick up your camera. So that makes sense. And then it becomes second nature.
[00:31:52] I’m going to give you a little plug here because you’ve been so humble about this, but you have got an online photography course and this is hosted by the IS Academy. But I know several dentists who have given so much positive feedback about that course because they can jump on pay fifty nine quid, which is an absolute bargain and get access to everything that you’ve just said there. How the settings on your camera, how to hold it, the angle, where to put the mirror and all of that. And I always say to my clients, you know, the best piece of education that you can get if you haven’t already had it, it’s just learn how to hold this camera and show your work off, even if it’s just for reflecting back and saying, Oh, I did this case before, but this is how I’m going to do it better, I think.
[00:32:45] Yeah, thank you. Thank you for suggesting that Prav. I mean, you know, I’m I’m quite open and I think there’s lots of people that do let us do great work so you can find whatever suits you, whatever suits you. But at the same time, I think there’s an opportunity for things to be broken down in a relatively simplistic way. You know, and in a way that’s digestible, and it’s not not trying to show that, oh, guess what, you can do this. It’s more just like, look, guys, take photos or make your practising life a lot easier. And ultimately, everyone wants pictures for their cases, for their website. You know, it’s something that patients go to. Instagram is on such a rise. It’s a photographic social media platform. So it just it just seems to make so much sense for a lot of people.
[00:33:31] Sure. And we spoke about mistakes, right, so you say you can look back at your photography and see your work and stuff like that. And one of the questions we ask and is, you know, what was your biggest clinical mistake if you reflect back on your on your what is a short career, what would you say your biggest clinical mistake was?
[00:33:56] That’s an interesting question. Probably have an answer that in a while, probably my biggest clinical mistake is OK. So I had a patient who had some crowns on their front teeth. And one of them had chipped. I think one of them are chipped and we’d gone through the process, and it seemed like replacement of the crowns was the ideal method to do so. Please, the crowns made contemporaries and this is relatively early in my career, and I hadn’t really quite estimated how much preparation would be required because they had crowns before and I hadn’t done a wax up his. Here’s the key I hadn’t done a wax up and so I took the cards off, used this index to make the new crowns, and the cement I used was temp bond, which is yellow in Q OK. So then I polished them as best as I could. Similarly, the one and they were these big circular yellow spots on the front of this patient’s crowns like massive. I mean, it was like you saw two in a big yellow because obviously I’m prepared enough or whatever and patient sat up and he’s like, Oh, is that what crowns? Yeah, the crowns. We’ve got some more work to do and is that but these are these look really bad and when you’re when someone’s facing you saying that? You sit them really question whether what you’re doing is the right thing or the wrong thing, you just question it all, don’t you like, do I know? Do I know? What’s the right thing? Is this the best thing to do anyway? So it turned out that I was getting lab made provisionals meat, which ended up looking much better.
[00:35:43] We cemented them two weeks later. But that moment in my life, that moment in my life, I was like, Okay, so what? What went wrong here? You thought you knew what you were doing, but you didn’t. You didn’t have a lab man made wakes up, you didn’t have a guy to know how much preparation was needed. The patient set up and could see it wasn’t what they were hoping for. Did I manage the expectations correctly on the discussions beforehand? Listen, you’re going to have some temporaries. They’re not going to look great. But the idea for them is to build you to the next phase so that we can get the trial made, sheepmeat cetera. Had I had that conversation and it’s moments like that where I was like, Wow, well, you know, you really get put on the spot as a clinician. Sure. And I vowed to myself, look right. So the standard that I’m going to push for the Stanley I’m going to push for is going to be beyond what most patients will be able to see. Necessarily standard I’m going to go for is to the standard that I would want them done. And then that just changed. That changed my career. That was that was a pretty big moment, a hairy moment where I was like, Oh, no, no, no.
[00:36:46] And more importantly, how did you handle that conversation with the patient? Because there’s that moment of embarrassment, right, where the patient says, Geez, what the hell have you done to me, right? I don’t like this. You kind of know what the hell have I done to you? I didn’t know what I was doing or it was. I went beyond my knowledge or whatever, right? And from that point on, you decided to get educated or whatever and take things to the next level. But there was that moment where you kind of just step a little bit beyond your capabilities. But more importantly, how do you handle that conversation with the patient? Because I think personally put the mistake to one side. The more important thing is that communication with the patient now, right? You know,
[00:37:34] It’s kind of like you need your head, your eyes in the headlights before you really see if that makes sense. And you need to be put into that position to say to yourself, I really wouldn’t like to be in that position again. During the conversation, it was more of a discussion about actually, we all know that this is a temporary phase. The temporaries are often not as realistic or mimic the nature that we’re going to do because I’m going to make you love me temporaries, which I had thought about that will give you an open opportunity or open arms to allow us to trial the new shape of the teeth. So whilst it looks like this now, I’m very, very confident it will look better in a couple of weeks time. And lo and behold, the new technologies go on and it’s like, Oh my God, you’ve changed me, you know? So I think it’s just about being quite clear and quite quite open and saying, Well, actually, these aren’t. This isn’t exactly how I would have wanted the temporary look as well. And if I thought about it a bit more, I would have used unclear, which is a clear cement, not a yellow basement, which wouldn’t have made it look as bad. You reflect on these things as you, as you, as you grow. But just knowing that you’ve got certain things, I think we’re in a day and age of, you know, patients are very aware. Social media has made patients extremely aware and potentially, you know, there’s there’s opportunities for people to see you down a path or patients to you down a path. And actually, I think it’s about remaining confident in your skill set. And if there’s things that you want to do, appropriate training and education and support and mentoring and from whatever to get yourself up to that position, don’t feel compelled to provide that earlier outset. That makes sense.
[00:39:18] So then how did you get the job, Cory’s place? How did that come about? You know, probably one of the most prestigious practises in the country, but more importantly, we’ve we’ve had him on this show. And my God, you know, if after listening to it, if I wanted a check-up and if I wanted to know what was going on in my mouth, there is no way of the dentist that I would go to because I know he would look at absolutely every little detail. Yeah. And you know, it blew me away, just just listening to the process he went through, right? So he must be pretty picky. In terms of, you know, who he allows to comment and, you know, see his patients, so to speak or patients under his umbrella, right? How did that opportunity come about?
[00:40:11] So, so this is I’m not sure how many people know about this, but this would be really insightful for a lot of people on a number of levels. So 2017 Corey Farran puts up a job up job advertisement in Facebook and in typical Quora fashion, you know, it’s it’s like a 5000 word job description.
[00:40:30] Of course,
[00:40:32] Of of the things that you need to have what you what you need to do, how you need to aspire and whatever all these things. So the type of person I am is like, I’m definitely not getting this, but I’m just going to throw it in anyway, way I’ll throw my CV in. I think he was asking at the time he’s asking for five years experience, at least one teaching master’s degree, copious employment experience. I mean, the list went on and on and on, and I submitted my CV and I think quite a few people did in that in that ring. And I got called in for an interview and I was like, Oh, yeah, OK, great, let’s just go along to the interview. So I went along to the interview and the first stage, by the way, first stage is that you meet each other, you talk about things and you need to present some cases to him. And I was like, Oh, well, I’m sort of presenting quite regularly. I think especially go, all right. Like, yeah, obviously not compared to some of the other people that are probably applying, but let’s go for it. Did it go along like a house on fire myself, his practise manager at the time and cry, and he was blown away by some of the case and documentation, which for me was the biggest comeback from that was getting approval from someone who is so incredibly well known in that way. And then I went to the second stage. So let’s go. Let’s let’s take the journey back to the beginning.
[00:41:58] Sure. I’m going to throw in my CV because I’m blatantly not going to get this job. Oh my God, I got an interview. Oh my God, I’m into the last three. That’s the that’s the journey. Anyway, so there were two other individuals that were that were shortlisted with me to be the final stage. I went through a planning exercise. That’s when I knew I was out of my depth because the level of intensity of planning and occlusion and all that stuff was knowledge I didn’t have. So I fell short at that stage and knew at that point, probably I was too junior for the role. So at that point, I was three years qualified. Right? Mm hmm. And that was on the Monday night, Friday night. I get a call. I sure as hope you well. I didn’t want my PA to call you and I didn’t want you to get any. I wanted to speak to you in person. And by the tone, I was like, Oh, it’s not. I didn’t. I didn’t get it right. And he was like, The reason I wanted to call you is because I think you’re a fantastic young man with an incredible future, and I’m not going to offer you the job yet. That was his words. Uh huh.. And you know, you know, like, it’s a funny, emotional, emotional cauldron, isn’t it? It went from I’m not bothered to then when you get to the final stage, you’re almost starting to plan your route to work kind of change. Your human mind is unable to remain an emotionally engaged, right?
[00:43:26] You know?
[00:43:28] And all of that then dropped as as a heavy weight on your chest. And I was like, Oh, and he’s like, I’m following everything you’re doing. I just want you to know you impressed me. Incredibly so golf. I was extremely distraught because despite knowing it probably wasn’t right for me, you’d really hoped it. You could, because I know the sort of person I would make whatever I could to learn as much as I could, so I wasn’t concerned about not knowing it. I was concerned about having the opportunity to grow and learn. And you know, when someone tells you bad news, the best way to do it is sugarcoat it at times, right? So I thought, Oh, you’re saying all of this just because he’s not giving me the job and all this stuff. And afterwards, so all being that, I was like, I’d love to come in shadow. You want to see how you do things. I’ve not got the job. Yeah, and I’ve gone into shadow. It stayed there for a day and I was like, Wow, the level that he’s working to or the patients and the demands and the expectations on you, I probably would not be able to do okay. Fast forward two years to 2019 December, we exchanged a few messages. I was like, Can I call you on a Sunday morning? I was like, Yeah, go for it.
[00:44:41] So I’d love for you to come work with me. Was that what is that? If you remember, if you remember the call? I said, I’m not offering you the job yet. And I was like, You did say that to me. And he’d been following everything that I was publishing and presentations. I was. He was keeping an eye on the sorts of work I was doing. And yeah, he decided to give me the job, which was incredible. I didn’t expect it. I hoped for it, I suppose, but I finished my masters at that point in 2019 as well. And yeah, it just seemed to gel as a perfect match. And having worked there for the last coming up, it’s nearly two years, really, you know, at the end of 2021, just coming up to two years. I very much agree and stand by the process that he puts in place because I understand the fallback if they’re not done, if that makes sense. And I’m the sort of person who wants to learn all of the rules to start with to know when it’s appropriate to not have to follow every single step of the rules, not just no rules one, five and seven, no one to 10 and then know that you need to only choose one, five and seven. That makes sense.
[00:45:49] Absolutely. Was there any communication between 2017 and 2019? We are in touch or was just silently stalking you or just seeing what you were up to? Yeah, we.
[00:46:03] Well, he probably was certainly stalking me, to be fair. But we did go. We would go for dinner once in a while because me, him and Dr. Nassif chat to another fantastic gentleman who’s also part of that is can be what an absolutely the most charming gentleman I have ever met in my life and myself. Life and career would go to dinner once every so often to just catch up, talk, you know, have a chat about the world, everything really sure. And I made that thing. He would say that let’s go, let’s go for dinner together. And you know, it wasn’t me trying to impose myself into his world. I was very much of the vein of I’d love to spend time with you if it suits you, not please meet me, you know? Yeah. And I think eventually over time that you can tell that, can’t you? Really? Yeah.
[00:46:54] Brilliant. Lovely story. Lovely story.
[00:46:57] Yeah. So despite not getting the job, you all of a sudden did.
[00:47:00] Yeah. Yeah, it’s brilliant. It’s brilliant. I want to. I want to dig more into sort of your overall philosophy in dentistry, your teaching and stuff like that. And I just want to start off with, you know, you run, you run a composite veneer course, nail a composite course, not a composite veneer course. That’s a whole different topic altogether. And actually, let’s go there. Ok? What are your thoughts on composite veneers versus porcelain and then composite veneers versus edge bonding? What your your overall thought on that on that piece?
[00:47:37] So for me, composites an incredible material. It has come along leaps and bounds over the last decade, particularly maybe two decades, and the ability to mimic nature is incredible. It’s unreal. It is still a far inferior material compared in terms of biomechanical properties, structural rigidity, strength aesthetics compared to porcelain. Okay. The disadvantage with porcelain is in thin section. Invariably it’s going to fracture. So you can do this veneers and they last very well. If they’re bonded very well, but extremely thin section they can, they can fracture. Okay, so there needs to be some form of margin. Sometimes you have to do some form preparation. So my point here is is okay with composite veneers, you’re still araby the service. You still etch the surface. Okay, you’re probably air the surface with porcelain. Maybe you need to have a bit more thickness of porcelain material, but the outcomes long term of the porcelain veneer are going to be far better than the composite veneer. So when it comes to post composite hand on heart, porcelain will win every time over the longer period. The conversation about edge bonding versus composite veneers is a very, very close one tomorrow. And as you know, I’m sure it’s got a very strong point on this. We haven’t spoken about it actually in too much detail, but I’m pretty sure I know what his view is on it. At the end of the day, if you are going to volumetric it and adhere to the whole surface of the tooth to mask your ability. I don’t think that’s the right thing. I think there is a place and I do composite veneers, by the way I do them. I think there is a place for composite veneers. There is certainly a place, but every case does not need to be a composite veneer case if you have good bonding protocols, if you have strong material, if you have measured the occlusion appropriately, if you’re not creating large overhangs, if your error of reading the surface pre treating, if you’re doing all of these things.
[00:49:44] Edge bonding can last an incredibly long time, and I think we are taught in dental school that not one size fits all. So not everyone needs be there. In fact, more people than not will need aligning their teeth to a certain degree, get the constricted envelope of function improved. So there’s a more harmonious sliding sliding pathway create cani guidance and edge bond. And all of a sudden you have got a case that you’ve done what’s in the best interest of the patient. They’re delighted because they think it looks great. And guess what? Adding to it is so simple. I’m sure you haven’t. But if anyone has tried to remove a composite veneer in the past, it is an absolute travesty. It’s so stressful that last layer that you’re removing, you’re like, OK, stop, let me have a look. Change your view. Look at with your light. Turn your light off. Comes it light on? I’ve tried to it. Yeah, there’s a little bit there. Correct stop. It is so complicated, Prav. And you know, if you’re if you’re truly trying to do what’s best for the patient, obviously, you know, if everyone can just take a know, fattest big Bertha, you take it all off. Loads of all got sucker as well. I’m not a fan of that. So my view on edge bonding is, when appropriate, age bonding should always be used as a first line of defence if that doesn’t quite get to composite. If that doesn’t quite make it porcelain for this. That’s my view.
[00:51:16] So I’ve spoke to quite a few dentists to do a lot of composite veneers, and some of them who are on the main teaching circuit as well will tell me that it is a disaster waiting to happen. Right. That three years to five years from when all these composite veneers would be in place. And look, I’m not a dentist, so I can’t pass any judgement here or I’m just going off what have been conversations I’ve had that all of this work is going to come back somewhere. To be replaced either with the porcelain or go through the go through the pain that you’ve just described there of removing composite, which is sounds like it’s bloody hard work, right? And a lot of people say it’s a ticking time bomb waiting to happen. Maybe I’m over exaggerating the conversation that I’ve had, right? What’s your take on that that, you know, if we’re unnecessarily, as you’ve said, to mask their ability right or whatever, that whatever that thing is that do you think we’re going to be going to end up with this huge surge or wave of patients just coming into the clinic saying, What do I do with these now? They looked great the day they were put on. They look great for 12 months, but now I’ve got three teeth knackered. Yeah, against these other eight. Can you? Can you match these up? What? What’s your take on that?
[00:52:41] I mean, inherently, I think there’s the problem Prav. I think it’s I don’t think it’s going to be a disaster. I don’t think it’s going to be a disaster because we’ve always got something that we can do. But is it going to require more work? Yes. Is it going to invade more to structure? Yes. Is it going to mean the patient will always be on a cycle? Yes. And. You know, working with Kheri, for example. He’s got a guarantee process for all of the work that’s done. Now, if you’re compromising that actually you start having to pay for it yourself. Quite frankly, the practise and it’s not justifiable to say to a patient, I mean, personally, I don’t think it’s a person I wouldn’t feel right after three years being like, right, here’s another bill for another eight combativeness. Again, that’s just not right, because by that point, they could have paid for porcelain. They could have after one replacement sets. That’s it. You’re already opposing it anyway. I think it offers to those that would suit the needs. In general, it offers a fantastic, cost effective medium term measure to be able to provide the patient with something that will make them more confident, that will give them the ability to smile and be happy. I think there is a very, very good place for it. I think everyone needing commitment is eight to eight is not appropriate. I don’t think it’s appropriate and the replacement event is going to come to talks about that a lot. The replacement event is going to come and it’s going to be incredibly challenging. And the trouble is, no one will really know about it because we’ll just put composite over it again. The only point is when someone else will have to deal with it, and then you go back to the original to structure and you know how much has been evaded because it’s like putting a plaster, take the plaster, put another blast from the past, put another plaster on, and you’ve never really seen the skull underneath.
[00:54:47] Quick question about that plaster. If one composite veneer gets knackered, right? Two years later, how hard is it to match that composite veneer to the exact quite a straightforward process?
[00:55:01] Incredibly difficult. I mean, so there’s studies that prove that the same shade of composite in the same syringe from a different batch can have up to 12 to 15 percent variation in chroma value. And the same manufacturer are the same people the same batch. They’ve got quality control. Of course, yes, you can have variation, even in the same thing. So. I suppose what I think it’s going to be incredibly difficult. I suppose what it comes down to is how close you can match. It is sufficient enough for the social distance for it not to be, you know, visible. Yeah. But of course, it’s of course, it’s particularly Prav. If you’ve done a really delicate layering protocol where you’ve used a few shades, a few tints, you’ve used a few things to enhance the size of it. When it gets to that level, that that’s almost impossible to recreate. But yeah, yeah, we’ll find out if it’s probably next year.
[00:56:00] So talk to me about the replacement event. Do you have conversations with your patients about this? Do you do you talk to them about how long they’re going to last and when they should expect to replace them, for example? And then I’m interested to hear about your guarantee. How do you guarantee your work and how long do you guarantee it for? And do the patients have to play by certain rules in order to exercise that guarantee?
[00:56:25] Yeah, yeah. So so the replacement event is something that needs to be talked about from the get go. Despite using gold standard protocols and procedures, nothing’s going to last forever. Nothing’s going to last forever. And I think the most important thing from my perspective as a clinician is making it clear that I’m going to do the best that are in my hands and the technology we have now. But it’s going to be, you know, require replacement and regarding, and that falls into discussions with the guarantee in the service. So we’ve all got a car. We’ve had it a hundred times before. I’m sure you take that to get service right. You change the all, you change the filters, whatever it is that needs to be done on the car. And that’s to keep it going and performing highly. Well, actually, for us that seeing the hygienist to come and see us once a year or once every six months so we can see things if things are starting to look like, they might becoming a problem. Is there a way that we can do a chair side repair or a polishing of that restoration just to make sure it stays in perfect shape? Of course, that doesn’t always apply. People move. People have families. They’ll move to different countries. Life takes over. Not everyone can make it all the time. But our our guarantee process is placed on stipulations that we’ve done baseline records for you. We’ve done baseline end of treatment records for you. You’re seeing our hygienists every three to six months, according to your risk profile, and you’re coming in for your check-up and provided that’s followed. We will go into your restorations.
[00:57:53] Cool. Cool. Talk to me about your course, your anterior posterior composite, cos there’s so many composite courses out there. If I was a dentist, I would literally be confused as to which course I should take, right? And and I think some of it may be based on the individual right. So I may resonate or, you know, towards you more than one of the other speakers, stroke lecturers and so on and so forth. And sometimes, you know, you look at some of the stuff that some dentists are doing anything. How the hell am I going to take that back to my clinic and do that on Monday morning? Like it was great and inspiring watching how you flick that thing, that tool and that and that paintbrush and whatever it is you, do you expect me to do that on Monday morning? You’re having enough sunshine, right? And so a bit of ice cream, a bit of training, right is, do you know what trains a day practise tomorrow? You know, I’m a big believer in, you know, you need to be able to replicate what the guy is is teaching you. So tell me a little bit about your course, how you teach. Is it replicated all? Yeah.
[00:59:09] Firstly, I want to be very, very clear about this. I think there are some incredibly talented clinicians in this country. We have some world leading clinicians that are are sharing their expertise and knowledge, and a lot of them have already been on. Funnily enough, I’ve supported all of these individuals because I I think the point at which you think, you know, all is the point at which you’ll always decline, you know, and supporting your fellow peers and colleagues is important. So there are a number of choices that you can make, all of which will probably be fantastic. So that’s the first thing I want to say about our course. Fantastic thing is, I’ve been teaching A.P. Stories for at least about four or five years now, and I’ve done I’ve done tests. You know, dentists is course, reverse triangle technique and all this stuff. And you know, I think I guess for me, my course is made in a way of what I would want to know if I was because I’ve done probably Prav no exaggeration I’ve probably done about. Maybe 15 comes in courses, 15 after the first five. You’re probably not learning anything new, you’re just getting a chance to practise. Mm hmm. But here’s one thing that I’ll give everyone for free. Any course that you go on, you’ll probably be on a Friday or a weekend that Monday morning. That first patient you’re going to book in on that day is to do the thing you practise on the weekend.
[01:00:36] So you’ve got absolutely no choice but to put those habits into practise. Totally agree. So that’s the first thing I’ll say. Just do it. Plan the course and your patient. Move people around if you have to get that person in. You’re doing an to a composite course. Get that to your competition for the Monday. Do it. No questions. The fantastic thing I personally feel about. Yeah. Yeah. The fantastic thing I feel about my the thing that we’ve been able to do is I’ve taken lots of information, lots of knowledge from lots of companies, from lots of individuals and have been able to synthesise it into a relatively pragmatic and realistic pathway that most people will be able to apply on Monday. So having done style Italian and having done various things in the UK and having done stuff in the US and having done stuff in Japan, I basically what I’ve tried to do is left that altogether irrelevant or system irrelevant or material irrelevant or instruments and give a dogmatic type pathway for clinicians to be able to reproducibly predictably bond layer, restore, create anatomy polish without having to. You know, how many courses do you go on Prav that you see if that, oh, we can use this material and this is the result you’re going to get today? Everyone takes it, puts on the Instagram hashtag, blah blah blah. And it’s like, Yeah, to get that, you need to buy this kit and you need to buy this kit.
[01:02:02] You buy this and it’s like, Yeah, yeah, but I’ve spent, you know, one half thousand pounds on. Of course, I’ve got to spend another two to get all the stuff. Just to do it for Monday is what I want to try and show is, I mean, of course, we support it, of course, is supported by the company because I work quite closely with them anyway. And in fact, with drugs, I’ve been responsible and part of the design of the material, actually, some I believe in it quite a lot, but hopefully what I’m going to be showing you is principles irrelevant of the system, and I’m driven by principles as such as opposed to materials or companies. And I think that’s really, really key. I’m fortunate enough to have learnt from quite a few people. I’m fortunate to have been got a lot of feedback, positive and negative, and I’ve incorporated that over the years, so I hope it’s for everyone. Honestly, for me, the biggest honour was to be invited to do it alongside you guys is because I’ve looked up to it since I qualified. You know, I’ve looked up to TIFF Qureshi, particularly since I qualified, and to be able to share for him to open up that that opportunity for me to share on on. In essence, his and his team’s academy is a very big privilege. So I’m really honoured, really, really honoured.
[01:03:20] Really, really, it’s great to have you just talk to me about your checkered process and know we’ve been through it with Cary Wright and what he goes through and stuff. So if I am the patient, let’s let’s forget check-up consultation, whatever, right? What’s your style? So I come in as a patient and say, Hey, Shiraz, I want, I want. I want to improve my smile. Right? What is that process I come in? I have a consultation. Is that a paid assessment? Have I seen a treatment coordinator beforehand? Take me through your journey.
[01:03:55] So my journey is slowly become Khurais journey because I really believe in the process. I really believe in the process for a new patient. You’ll be sent a pre-medical questionnaire and you will come in for a 90 minute appointment. Okay. Well, that 90 minutes. We’re going to do a full assessment. We’re going to check your glands, your jaw, joints, your muscles. We’re going to tick the teeth, how they meet together, occlusion. We’re going to check the soft tissues. We’re going to do an aesthetic assessment which really forms part of everything as opposed to it being an individual thing. We’ll take four for four radiographs. We can take a full set of photographs. I’m going to get all of the information I need, and I’m going to say show probably a few things and say I’ll reserve to make any judgements on what we’re going to do after this data collection appointment. So that is a data collection point with all the information that I need to start creating an understanding of what the patient’s aspirations are and how we can parallel a plan to suit those aspirations. And we’ll spend two or three hours, maybe going through the photos, going through the X-rays, writing a letter, creating a presentation for the patient. As you know, from from Kuris, it’s basically exactly the same, and they will get a very detailed letter and set of their own photos and X-rays and explain to this needs to be done because of this what the options are, what the, you know, sometimes it’s a bit more complicated.
[01:05:19] So we have, you know, multiple options which ways we could go down. And the principal of the clinic is it is a comprehensive assessment. Nothing is left. No stone is left unturned. If we need to do a sectional CT scan or a CT scan to perform, part of our treatment planning will get that done before we make a plan for the next phase. So they’ll be given an interim treatment letter. But we’ll probably know where we’re going. Given that we’re asking for that scan so we can start creating a rough estimate and if, as all things, if treatment plan changes, we’ll send them an interim report or an updated report explaining that the following needs to be done because of X, Y, Z, et cetera, et cetera, et cetera. So there’s a lot to it. But the idea is that every possible outcome issue problem is assessed, sometimes run through by colleagues. Had a discussion about with colleagues, then an appropriate plan is given. And incidentally, I’ve stopped working at certain places because they didn’t allow for that process to exist because of time. It was just impossible. If you’ve got eight new patients in a day, you cannot spend twenty four hours writing letters and doing photos. It’s incredible. It’s difficult. It’s too difficult. So I’m in a situation where I’m trying to build that plan as being my base and then modify accordingly as and when it’s needed.
[01:06:45] How would you? You mentioned you send letters out to the patient, is there a point in time where you invite the patient in and actually present that plan to them and explain it to them? Or do they do they call and speak to a TKO about that? What’s what’s the process? Because I’ve come in and met you? You’ve done the full works, you know, a whole sort of assessment on me. And now I get this letter, which, you know, if it’s anything like some, you know, job advert, it’s there’s going to be quite a bit of information in there for me to absorb. Intense. Yeah. Yeah. How is how is that distilled back to me as a patient?
[01:07:25] So, so a part of the so treatment coordinate is key because the letter is talked through with the treatment coordinator. So the treatment coordinators on side with what’s going on, what are we proposing for this patient? They’ve got the treatment. Coordinating certainly always worked with us. At some point they’ll come in and watch procedures that are so they know what’s informed. They will then have in-depth discussions and we will invite them if they wish to, to have a Zoom chat, to cover certain things or come in to cover certain things, to have a discussion if something wasn’t made clear or or whatever. I had a patient coming in for a second opinion about something, and we had about a 30 minute phone call about all of the different aspects or nuances within the letter. So by and large, it goes to the treatment coordinator. They will discuss and see why and what and what is the options and so on. And then the next stage is either coming to meet us, doing Zoom or doing a phone call, whichever suits the patient. And by and large people that we treat the practise are really quite busy. So it’s almost like they’re trying to minimise the number of points they’re having anyway. But often we will we will exchange directly. But the treatment coordinator is key. It’s key in the smooth process.
[01:08:34] Yeah, I’ve got a couple of questions. I want to ask you around sort of a couple of topics that come up a lot when I when I speak to dentists currently now, anyway, very topical. And one of them is direct to consumer orthodontics. Your thoughts and opinions, which are which you can probably guess. But how do you handle that patient who comes in and says, Hey, I’ve been told I can go and get my teeth straightened in the supermarket or whatever, right? And then there’s a follow up question after that, but I just want to hear your thoughts. First of all,
[01:09:08] You know, I think it’s incredibly difficult, isn’t it, to not slap people down when they come with this? Yeah, with this outcome, you know, it’s like, Oh, what was that your your plumber can also be a plumber, can also do heart surgery a wicked go for it, you know, like that kind of principle. It’s like, Oh yeah, I don’t know. I’ve had patients who have come to me specifically because they’re like, I’ve heard, you know, how to do X, but relatively well. And those like, yeah, they’re like, Oh, I’m doing ortho with with X, a company that you can see on, on and out of it. All right, that’s fine. I’m just making it clear that any problems that have happened because of your orthodontics, I’m going to pick up and whether you do something about them or make an impact on whether we can continue treatment or not. Yeah, sure. Do you think like any type of 3D printing or scanning material is going to check for your constricted envelope function is going to check your excursions, make sure you’ve got balance protrusion, posterior dissolution on A. Gut, it’s not checking any of that.
[01:10:06] It’s not checking any of that. So anyone that tries to see to me that there’s a system that can do all of that great whatever. Moving on. When I write to them, I will say. No indication responsibility or long term maintenance is taking any responsibility for when it comes to this position. And if it turns out that your position movements that have happened are going to compromise my outcome if I’m not going to treat X. So I think when people come in, these guys have got an incredible marketing machine, you know, they’ve gone direct to consumer. A lot of people are trying to do that model anyway. Good on them for being able to crack the market, but unfortunately it needs to be regulated. And if it’s not being regulated, just like the, you know, the catastrophe event, that’s going to happen seven, eight years, 10 years down the line. Are you going to go to Ghostbusters? Probably that’s as realistic as it gets. There’s no one else is going to help. So, yeah, that’s my view on that. See a professional. You pay for what you get for, isn’t it?
[01:11:12] Sure. Do you think the AI technology will ever get to a point where they can just stick a scanner in your mouth and it can just handle everything? You’re in your protrusion, you’re constricted envelope of function, blah blah blah, the whole shebang?
[01:11:27] I don’t dispute at one point that we’ll be able to happen, you know, if you can create an artificial articulator. Yeah. If you get a reproducible CONDOLA guidance angle into the distance and and no scanning tiff knows about this very, very well. You can record video record protrusion excursions. If you can record those things, you can record how they change when the teeth change in space. So I don’t think it’s not something that you can’t do. I think at the end of the day, that’s health driven, not business model driven, and that’s why it won’t be invested in by a bunch of people who only see numbers. Do you know what I mean? So, yeah,
[01:12:06] Yeah, yeah, absolutely. And then the other thing that’s very topical at the moment, Shiraz is turkey teeth. Yeah, go into Turkey to get your teeth done. I can. I can get these done, you know, and get a holiday and some change and all the rest of it and a lot of my clients and dentists, I speak to come up against this all the time. Ok, the you know, what are your thoughts on me getting my teeth done abroad? And I spoke to Ian Buckle about this at length, and he gave me a really interesting, interesting and very direct answer to this question. I’d love to hear your thoughts on what you think about dentistry abroad and what would you advise a patient if they were considering to get their teeth done in Turkey, for example? I mean,
[01:12:58] I think it really, really simply. Ok, so let’s start with the first point, which is I’ve got some colleagues at work in Turkey as an example. They’re incredibly talented, gifted and skilled individuals that will lecture worldwide and probably wouldn’t do this sort of treatment, frankly. And so, you know, going abroad, there are still some incredible conditions abroad firstly. Secondly, it’s quite clear that if you’re going to have every tooth in your mouth drilled down right and you get it crowd stuck on them, they might look great. They might look fantastic if they’re going to fall off on the plane on the way back. Where are you going to go? You can go for another holiday just after you’ve had a holiday. I know for a fact I’m not going to touch anyone’s work unless it’s to replace all of it, which has significant financial impacts, right? And whilst some of these people may be incredibly skilled, I’ve seen I’ve seen immediate posts Prav have come in to me that, you know, the teeth arrived before they do kind of scenario, and there’s no such thing as prototyping. There’s no such time as provisional. There’s no such time as trial smiles, occlusion. And now they’re getting TMJ issues because the posterior occlusion has been managed properly.
[01:14:12] There’s no on working side interferences everywhere, postage chipping off just three weeks of being in there. You’re paying what you get, you’re paying for what you’re getting. So I very, very much disagree with it. But again, I think people have already met when people make a decision like this, they’ve already kind of made their mind up, haven’t they? And I’m not in the business of requiring to have to justify why I am going to do what I can do. I’m going to give you my options. It’s up to you if you’d like to find second opinion. I think that’s very healthy. But if you want to try to achieve X, this is what I think I can do. By all means, seek further opinions if you need. And you know, we’re really fortunate to not be in a situation where we need to treat people. We’re quite fortunate, extremely fortunate to be busy anyway. So if someone would like to continue on with us, we’re more than happy to treat them. If they want to go and find an alternative that probably is much more economical and cost efficient. Go for it. But as soon as you start skimping on things, you start skimping on quality. So, yeah, that’s my view. Very clear.
[01:15:15] Sure, sure. I’ve just got a couple of final question. I’ve got about so many questions loaded up Shiraz, but I know we’re I know we’re running short on time, and so we’ll probably have to invite you back.
[01:15:28] Maybe I’ll be more than happy to be more than happy to.
[01:15:31] So a couple of questions that we always end these podcasts. So one question is Shiraz. If it was your if it was your final day on the planet and you were surrounded by your loved ones, namely family, because you know you’ve already spoke about your close relationship with your family. And if they were with you on your final day, what three pieces of advice would you leave them with?
[01:16:02] So family is incredibly important to me, really had the chance to mention, but I’ve got a fantastic daughter who’s two years old, I’ve got a wonderful wife who’s supporting all of my aspirations within dentistry, and that’s incredibly difficult when your time is limited. Invariably, she’s been an incredible support. Three pieces of information that I’d say is always remain honest and humble. You never know what who you may be speaking to. You never know their story. You never know why they might be lashing out at someone who always try and remain honest, humble and considerate to others. Because we’re in a day and age where psychological complex has become incredibly, incredibly tender and uncomplicated. It’s not as as black and white. And if you think someone’s being an idiot and you say you’re an idiot, that’s almost frowned upon now. So just always be considerate to others. So having that as your core being. I think the other thing would be live every moment as if it’s your last and be grateful for any extra time that you get. You know, we’re incredibly fortunate to be part of this fantastic profession.
[01:17:12] To have family around the health can health can sort of evade us tomorrow. So if every moment like it’s your last and. I suppose the third thing would, and it probably sort of stays on the same theme is always spend time looking after your family and your loved ones, so you know and shout out goes to all of the mothers in the world because you know you carry this human being inside you for nine months. You get lethargic, you become sick, you lose. I mean, your organs are moving out the way for someone else to grow. You know, where else does that happen? And you know, mum’s really go through a lot through through the birthing experience, but also the years to follow. And also things like changing of careers and how you have to manage those sorts of things. So always, I mean, always be there for both parents because they’ll all but always provide. But mums, mums are the ones. Mums are the ones. So look after you, look after your parents and always give back.
[01:18:21] And how would you like to be remembered? Shiraz was finish the sentence.
[01:18:27] And. Himself. Shiraz was himself
[01:18:32] Short and sweet,
[01:18:32] Beautiful. Yeah, I do not try to appear as if I am someone or someone. I definitely don’t try to dress to impress anyone else. It’s some people’s taste, not to others. I am working hard to be the best version of himself and the time energy effort I give to those around me, those that are friends or colleagues, those at my family, all because it’s key to who I am as a human being. So I just want to be the best version of myself and not try and necessarily imitate and imitate anyone, but also be inspired by those around you. So, yeah, brilliant.
[01:19:11] And if you have 30 days left, Nate, what would you do with it?
[01:19:15] From 30 days left, I’ll probably fast to try and try and get into that leadership. I’ve always been. I’d I’d I’d go and help. This is really, really close to my heart. I try and do charity project. As you know, I lost my hair because I had such shaped cystic fibrosis trust. I’d probably dedicate a lot of that time to trying to help the refugees that are suffering in Afghanistan right now. If that was the next 30 days that I’d give a significant portion of my time, and on a self-indulgent note, I’d go and do motor racing and take my family around for the ride. So there are three things that I’d do.
[01:19:54] Beautiful, Shiraz, thank you so much for your time today. It’s been an absolute pleasure and we will have to get you back.
[01:20:01] Thanks again, Prav and keep up your great work and you’re doing you’re doing great stuff within the profession. So you know, we in the profession certainly appreciate your honesty, integrity and helping us grow as clinicians. So thank you as well. Very much.
[01:20:14] I appreciate that. Thank you.
[01:20:18] This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts Payman Langroudi and Prav Solanki.
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