[00:00:00] Why am I so optimistic? We have this discussion sometimes, you know, my son nowadays and we discuss and and I think if you look at the world as it is now, sometimes media likes to portray doom and gloom, you know, and says, Oh, look as a shortage where there won’t be any food in the stores and there won’t be any petrol because the shortage of this and this doom and gloom. But when you look at the civilisation as such, we have moved so far forward, look at the good things that have happened. You know, there’s so many good things happening all the time.

[00:00:43] 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.

[00:01:00] Too many people I speak to their careers have been sort of shaped intellectually by their first boss and, you know, I’m no different. My first boss is to that is today’s guest on the show, my first boss in practise. I mean, I had I did. I did the house show. But my first proper boss is our guest today, Nick Mahindra, who I’ve seen. I’ve watched his career from near and from afar go through NHS practise, mixed practise, high end private practise innovating, which will get to new ideas, new thoughts. And you know, if I if I had to think about it, I know I wouldn’t be where I am today if it wasn’t for Nick, that sort of free thinker. And I’m not only thinking about dentistry of a free thinker in general, there’s a massive pleasure to have you on the show, Nick. We start these things generally with the back story childhood.

[00:01:58] Well, I was. I saw it with my grandfather. My grandfather was born in India, and when he was in his twenties, Kenya was just being colonised and the British were building their railway down there, you know, just starting building the railway. And he was an engineer student and he went over to Kenya. He was employed by the British Railway people, and he went over to Kenya to. And he was the head of the building, the station master, as the railway was going into the mainland. And that really is the start of the innovative nature of our family. He wanted to explore things. He wanted to go forward. And I think that has carried on throughout our family’s history. He went back to India and then returned back to Kenya. My parents all lived in Kenya, but I was born in India. All my other brothers and sisters were born in Kenya. But for some reason my dad wanted to go back to India for a while and I was born there, and then it ate. At the age of five, I think I was six. He decided to come back to Kenya, and I always thought of myself as a Kenyan for when I first came to this country to study. Anyone would ask me, where are you from? And my answer was, I’m from Kenya. And over the years, that has changed. What am I now? It’s difficult to say. People say, Oh, of course you are British now. I’ve got British citizenship. But do I feel British? I don’t know. I don’t know.

[00:03:52] I mean, Nick, we’ve talked about this before about the influence of of one’s past. And I’ve always been impressed by African Indians in one sense and that they keep managed to keep their culture so intact. Throughout that move and then the same African Indians turn up here and again have to make it yet yet another sort of cultural move. And you know, we talked about this before you married a Scottish girl. That’s right back in the sixties, was it?

[00:04:27] That’s right. It was 1970, 71. I think it was married, you know, but we met in the 60s when I was at university at Edinburgh.

[00:04:37] Yeah, and quite a big step at that point. I’m sure. I’m sure it was. It was very rare and interesting thing is still quite rare. Not that common for Indians to marry out of Indian families,

[00:04:51] But that is true. That is true. You know, when I married your friend and we had our children, I said, this generation is going to see a very multicultural society. Yeah. And I think although we are going towards that path, but it takes a lot longer to eventually call the world as multicultural, still to stuck up and being British or Indian or American or Australian or whatever it is. But we have to, at some point of the other, realise we all belong together in the serve. Yeah, and the Earth is a very small part of the universe, you know?

[00:05:38] And what would you put you put it to, I mean, what’s your position on why more Indians don’t marry out of Indian culture?

[00:05:48] I think that’s a difficult one, that’s a difficult one.

[00:05:52] I mean, it’s not we’re not saying one is better than the other, right? But you’re right, in the amount of years the Indian subpoena, you’d expect more integration.

[00:06:00] Yeah, I think it probably is that. I don’t know. I think integration seems to be. You know, sometimes when you come to a new country, you tend to relate to people that you know from your past and therefore you get not segregated, but you get isolated into little bubbles. Yeah. And it’s very difficult to break out of these little bubbles, although you are living in a different country and you’re meeting lots of different people. But when you go home, you go back into that little bubble and it seems that, well, this Brexit thing just shows you that that bubble of being British is very difficult to sort of broaden yourself and say, No, we are Europeans. No. You know, so I think it just takes a lot longer than I thought. And this is why we are finding that it’s it’s not happening as fast as we think it should.

[00:07:10] What about when when you were a child in Kenya where you weren’t, you weren’t like the other Africans you were, you were an Indian. Did you feel part of that country or did you feel separate to it? Did you have any sort of barriers?

[00:07:23] I think we were there were barriers there as well, because although I thought of myself as a kid, Indian. But the way society was organised in Kenya in those days, there were schools for Asians, for Indians. There were schools for the white Europeans who had gone there and there were schools for the Africans. So you were segregated and you were in your own little bubble, you know? So when I came over here, I thought of myself as a Kenyan. But really, when I look back now, that was just a word because I didn’t feel like an African. Yeah, I really still felt like an Indian. You know,

[00:08:02] So tell me about the decision to leave Kenya and to come to Edinburgh to study. And you know, when was the first time you thought, I want to be a dentist and what was the influence that made you do that?

[00:08:16] Interesting, yes. It was my sister, actually. She went to London to study. She’s much older than me. She’s probably about eight years older than me, and she’d come to London to study optometry. And when she came back to Kenya, I was still at high school doing my A-levels. And she said to me, What do you want to do? And in those times, there were many choices given to you. You were either. Schools were divided into three main groups, so you went into the arts side or the science side. And then the science got divided into two biology and physics and chemistry, you know, so depending on which part you were in, so if you were in the arts, you had to become a lawyer. So if you were in the physics and chemistry side, you had to become an engineer. And if you’re in the biology side, you had to become a doctor and that’s how it was, you know? So my path was destined. I was going to become a doctor. And why Edinburgh? Well, my sister said to me, look, she knew a dentist in Edinburgh, in Scotland. And she said, Look, dead medicine is a very, you know, you really got to be devoted to medicine in those days to want to do medicine. She says, Have you ever thought about dentistry? I said, No, I haven’t. And she said, Well, why don’t you do dentistry? And after your first year, if you decide you don’t like it, you can change. And why Edinburgh? Well, in those days, the three top schools were guys Edinburgh, and I think there was a third one. Cardiff, obviously. Not quite, but I think it is God. There was a third one anyway, so I applied to all of those three colleges universities. I got rejected by guys, but Edinburgh was my next one that accepted me and I said, Yes, I go to Edinburgh. And that’s how I ended up studying it.

[00:10:33] Were you parents quite well-to-do to be able to afford to send both kids to the UK from Kenya to study?

[00:10:42] That’s right, that’s right, parents had to be quite wealthy to do to send children to in fact, what happened in our family was my sister, the eldest. She came to Britain to study, yeah, the second in the family. He came to study and did engineering and the two other. There are five of us in our family and the two others. My dad could afford to send them to university here, and they studied in Kenya. And then it came to my turn. And by that time, my sister had qualified. My other brother, who was an engineer, he was qualified, they were all working and they said to my dad, Look, our youngest, we’re going to send him to Britain to study, and if you can’t afford it, will chip in and pay the fees, you know, because all the fees had to be paid. And dentistry fees are quite high. And so the whole family then pulled in to let me study.

[00:11:43] How did it feel getting off that plane? Was it the first time you’d been to Britain? That’s right. How did that feel? That must have been a massive shock, right? Was it Nairobi to at home?

[00:11:56] I think the excitement of coming to a new country and whatnot really didn’t feel like a shock. I go back now and think back about the time when I was in Edinburgh, and I can remember going from the halls of residence to the university and the tears pouring out of my eyes because of the cold wind that used to be blowing, you know? But at that time, no, I didn’t think two hoots about it, you know, just got on with life. And once you start university life, you start to enjoy. So much are so many clubs to go through so many things to do the best

[00:12:30] Years of your life, best if you like. Did you manage in that? Was it. It was a four year course, wasn’t it? In that four years? Did you manage to get back to Kenya at all or did you just hear the whole time? No.

[00:12:40] My dad had eventually decided to leave Kenya, and he was living in London. I used to just go back to London, not to Kenya.

[00:12:49] I see how. How were you as a Dental student when you were? You like a good one or more like me?

[00:12:58] Well, the first two years I remember. No, the first year, actually.

[00:13:03] Which year did you meet Fran? Let’s start with that.

[00:13:06] I met her when I was in the dentist course was five years in Edinburgh. It was. It was, yeah. So I skipped first year because I’d got good grades in A-level. So they said, you can skip the first year and join in the second year. And I met Fran when I was in the fourth year. Oh God. But in the second year, because I’d come from a different country. Work ethic was you had to study a lot and I really worked very hard and I think I got a distinction in biochemistry or something like that. And my second year or the third year in the Dental school, by that time, I’d started enjoying life too much.

[00:13:54] Well, they say, they say, if you can remember it, you weren’t there right about the late sixties. That’s right. So that’s

[00:14:04] What happened. You know, that was the year of the psychedelic drugs and whatnot going on, you know, so.

[00:14:12] So then you I guess you qualified. And then did you? Was there a thought of staying on in Edinburgh?

[00:14:20] No, no, no, no. Because my parents had all supported my parents and family had supported me, so I knew I had to come back and sort of repay my debt to my family, you know? So when I came back, I bought my dad. We all bought a house in London and he lived there. Then while I worked in London for a couple of years, and then I went to South Wales to buy a practise there. Oh, and my parents then kept on living in their house. So in a way, I felt it was a debt that I owed my family and I felt relieved that I’d been able to do it.

[00:15:01] So that practise were the first one in South Wales that was like a proper full on NHS in the good old days of separate.

[00:15:11] That’s right. What happened was I wanted to really buy a practise in London because London was someplace I knew when I was looking for practises in London. They just weren’t many practises coming up. Most of the associates who were working in the practise would usually buy the practise if the owner was retiring. So the practise that came up were very rundown. So Fran and I decided, Look, we’re going to move out of London and let’s see what we can find. And the first practise we went to was this practise in South Wales, and the dentists there was very persuasive. And he just ended up buying this practise in Aberdare. Now you probably know everything. It’s one of the mining towns, you know? And but really, that practise is where I learnt a lot of things. One of the things that the alert down there was making dentures because dentures were never not taught. They were not that fashionable in the dental school. You know, if you wanted to do anything, you had to become an oral surgeon or something else, you know, dentures or something. But in South Wales, we used to make about, Oh, I don’t know, I forget now about 20 30 sets of dentures every week.

[00:16:34] Yeah, it was definitely high needs for dentures down there. They used to teach us a lot. Well, it’s difficult for me to to know whether they taught it more to us in carpets than than other studio other places. So, you know, you’re saying that practise taught you the beginnings of business. I remember you telling me, or maybe it was Fran telling me that, you know, even within the NHS system, you were really into doing your very best, giving the very best to that patient and making sure everything was right.

[00:17:05] Well, yes, because, you know, I mean, I started doing multi rooted route treatments on molars. Yeah. And I remember one of the chaps who used to work for me on a Saturday he used to teach in the hospital in Cardiff. I forget his name now anyway, and he was really quite impressed that I was even trying to do roux treatments on molars, you know? So I really wanted to, yes, keep up to whatever was the nearest. And in fact, that’s what happened. Well, what happened in South Wales was that our first son was born there in 1975, and after 18 months he got very ill. He developed a kidney problem, kidney disease, and he was treated at Great Ormond Street. And they said to me that, look, you have to move into the catchment area of Great Ormond Street for him to be able to have a transplant at the age of five because they wouldn’t do a transplant before the age of five in those days. So that’s why I moved from South Wales to Kent because Kent was in the catchment area of guys and Great Ormond Street. And even when I moved to well, one of the things that happened was when we did move, my son went into remission and then he didn’t need a transplant. So my aim in practise then became solely, What else can I do that I can, you know, they have pushed the boundaries to make my son better? He used to go to Great Ormond Street every five days to have a transfusion, a plasma transfusion because he was leaking so much protein. And so there really pushed the boundaries to keep him going. And now he’s gone into remission. What should I be doing? And my aim from that day onwards was whatever I’m going to do in my practise, let me try and do the best that I can, you know? And as you remember, I think I was, I’d already started increasing the vertical dimension.

[00:19:18] And yeah, the first time I met you, you were already doing that. But but this is to remind me, what year did you go to Kent?

[00:19:27] Right? Ok, so that must have been nineteen eighty nineteen eighty.

[00:19:32] Right? Yeah. So I met you. I happen to know in nineteen ninety six. So yeah, so you were in that practise for 16 years before I met you? Yes. Wow. And I remember on that first time I met you, you showed me a denture and you said you could. I think it was you were going to increase vertical by 20 millimetres on the right. And I just stood my finals right and the rule was two mm was the maximum. Yeah. And I thought, Oh my God, like, what’s he talking about? And but then you showed me this picture, this x. A photograph of this face pre and post, and just by looking at that picture, you could tell that it was, it was, it was a goer, you know, something something was up there and. And then of course, we found out years later. And today it’s a fully accepted that you can increase vertical by those amounts. That’s right. And that’s and often our discussion, mine and yours have been around this subject of, if you know, something to be true, do you need to prove it to the academic establishment and you’ve always thought of the academic establishment as your kind of target? And for me, it’s a similar story, but it’s kind of the commercial environment. You know, I know a certain gel to be better than another. You know, some some someone might come to me and say, Hey, prove it. Yeah. And I haven’t got a paper on it, but our discussion minded yours has always been around this subject. If you know something to be true, who should you prove that to?

[00:21:13] I wish I’d followed your advice

[00:21:15] Some years ago, because changing

[00:21:20] The profession is a much, much bigger task. And if you’ve got the money, they listen more. Yeah.

[00:21:28] To be fair, one of the things about you that really impressed the hell out of me and someone like TIFF Qureshi is a perfect example of this is someone from a single Dental practise making a change to the way we think about something you know and someone from a single Dental practise hasn’t got the same leverage as if, if, if your idea was thought of by the head of restorative dentistry at Eastman Buy. Now that it would be all over the world, it would be in conferences and so forth. Yeah, exactly. And so, you know, but if managed it somehow, yeah, he did manage to get his idea out of that practise.

[00:22:10] Well, that is the difficult bit, you know, when you’re in general practise and you’ve come out with a revolutionary idea. I remember when you came, you know, and you saw me increasing the vertical 20 mm and whatnot, and you said to me, Oh, I went back to my professor in prosthetics and told him, I’m going to work for this like man like Mahindra. And he said to you, Are you going to work for that mad

[00:22:33] Man, you know?

[00:22:35] And I still at times, unfortunately, I still feel like a mad man because I’m saying in these COVID days, you know, this relief could be helping people so much

[00:22:48] And we say, OK, let’s start from the beginning of this for someone. I mean, you’re talking about it like everyone knows what we’re talking about. But but it started with increasing vertical dimension on four full cases.

[00:23:01] Well, actually, if you really want to go back to the square one, it was, you know, the first thing I did in practise and Kant was looked at my peril cases, and that’s when I first developed the idea of zero bleeding index. Yeah. And because we were being taught to use floors and I used to get hygienists coming in and they’d start using floss. And I discovered that no flossing wasn’t the right answer. The incidental brushing is the one that will give you zero bleeding index, you know? Yeah, but having achieved that in my own mind, then I said, What’s the next thing? And the next thing was occlusion, because occlusion was a big thing in those days, it still is. And I remember my quiz was the one whose books we used to read, and I read all those books and I would practise occlusion, study occlusion on articulated and everything. And then came Brandon Stack with his ideas on the TMJ. And he said without dealing with a joint first, all this occlusion thing is rubbish. You know, you really got to treat the joint first. And I started treating the TMJ joint, and that’s when I started to use the pivot appliance. And the idea came to me that look, unless we increase the vertical dimension, we will not solve the TMJ problem cases. And that’s when I also started to think that perhaps in evolutionary term, we are losing lower facial height and by losing lower facial height. The only way we are going to get this TMJ joint in a stable position is restore that low facial height. So that’s where the low friction height ideas came. You know, it’s a progression of a period occlusion TMJ and then lower facial height. Yeah, yeah. And the lower fish, right? The easiest way to increase it was on adventurous patients.

[00:25:04] Yeah, yeah, that’s where that’s why it started with that. And I remember we had a we gave it a name and we added dimension. Ventures, I remember being the original, the original brand. Yeah, I remember Nick. In fact, it’s funny you say all of this because it all resonates with me. So I remember when I got there. Your son Kieran had medical problems and, you know, maybe they weren’t as acute as you first. You know, we’re worried that it would be, but it’s still there. And I remember maybe he was maybe 50 and ninety six, but that makes sense.

[00:25:42] Uh, yes. Yeah, that’s right. He’d be about that, yeah, yeah.

[00:25:48] And I remember this conversation about the dentures. And I remember you saying that, you know, if if the establishment won’t listen to me, I’m going to take it to the press and you’d hired a PR person and maybe, I don’t know, maybe six months or nine months into me being there or maybe whatever it is, something came out in the Daily Mail. That’s right. And you got flooded with patients. I’m completely flooded. And it was very instrumental in my thinking of, you know, wow, you know, it’s possible for a single man to make a difference. And then for that difference to go out into some area and it exploded. The number of people wanting to come and see you.

[00:26:40] That’s right. That’s when we then decided to move from Kent to London because I remember it was Sheila Scott who was working with us, converting us into Dental at that time. And she said, Nick, with this amount of publicity you have achieved, you don’t want to be staying here and can you ought to be in London and the centre of that so people can come and see you. And that’s when we decided to open the practise in Wimpole Street. But you’re right, when that article appeared in Daily Mail, and that’s the power of the press. I mean, the phone didn’t stop ringing for at least six months. The receptionist would put the phone down and it would ring again. Put the phone down, ring again, you know? Oh, it was just mad, but just mad. And that,

[00:27:29] You know, Nick, even when I got there, you were computerising. This NHS practise back in 96 and you know, you’ve got this sort of you’re putting it back down to your grandfather, right? Sort of the innovator who wanted to always improve things and all that. But it takes a certain amount of confidence to to do this, to say, Look, no one else has done this before, but I’m going to. And not to doubt yourself and say, Well, why has no one else done it before? And these sort of thing, I mean, this confidence that you’ve got? Were you always like that or are you confident as a kid, confident, you know, like.

[00:28:09] I think probably very focussed. And to make a decision like that, I had to keep rationalising in my mind why I wanted to do something. I didn’t think of it as being extraordinary or anything like that. It just in my own thinking, the curiosity that was right. So if that was right, I had to prove to myself that my thinking was right, and therefore it was more a question of proving to myself that my thinking was right rather than proving to anyone else or anything else. So it was just more me rather than anything else, you know, with computers and whatnot. And remember, we started having our first. My other passion was art and the art gallery. In the practise,

[00:29:03] I was going to mention how how did that come about?

[00:29:07] Well, I think it must have been a lull between my Dental technique or perhaps just before, and I was thinking, what else can I do, you know? And my passion for art was always there. You know, Fran and I would go into an exhibition. We’d walk around it, and both of us would pick up a three favourite paintings and they were always the same. The three of the two of us used to think so much alike as far as art is concerned. And then I heard that someone in Glasgow had started showing paintings in the surgery, and I said, Well, why not here? And Fran said to me, No, no, no, that was a private practise. This is a working class and it’s just practise. You can’t do that here. And I said, why not? And that’s sort of a challenge to me is something that, you know, I love challenges.

[00:30:03] Yeah, you’re the why not go in my world? You definitely. Yeah. Where did the art come from? I mean, okay, you were. You were. You were students in Edinburgh. Were you going to art things back then? Or when did that start?

[00:30:17] No, I don’t know. I think it is. When I was in primary school in India, I remember I used to I’m told I used to love our theatre, and I suppose that passion for art is sort of inbuilt in Fran and me and art architecture. We just love that. You know why? Difficult to say, but

[00:30:43] Because yeah, I, you know, I like a nice painting or whatever, but but but you had this converted barn or you saw, I guess you saw that this converted barn in Canterbury ish outside Canterbury, where it’s every single millimetre of the walls of this gigantic building had art on it. And I remember looking at it, just just besotted by the whole idea that that’s possible. A house like that size with those many paintings on it. And then I noticed the last place I came to yours. There wasn’t any art.

[00:31:20] No, because this place.

[00:31:23] What happened? Yeah. Well.

[00:31:26] This place we’re in, it’s it’s it’s like living in a glass house, you know, so all the outside walls are windows. Yeah. And therefore, to put our tenet, the art has to compete with what you’re seeing outside the windows. And that is very difficult combination to achieve in a room. You can put all that you like and you can combine things there to

[00:31:54] Complement each other so

[00:31:56] That true. But when you’re competing with nature and that nature is changing, the colours are changing. Winter colours, you get summer colours. Do you change your art to suit what’s happening outside? And that I’ve not been able to solve that. That’s a challenge for the future. How have you? How have you

[00:32:17] Managed to be so optimistic with the challenges you’ve been through? You know, with with Kiera and with all that’s happened to you in your life? You’re one of the more optimistic people that I know. You really believe in the human spirit. And you know, is it innate or did it come from experience? Are you not that person that’s got you wrong? No, you’re right.

[00:32:46] You’re right. You know, why am I so optimistic? We have this discussion sometimes. You know my my son nowadays and we discuss and and I think if you look at the world as it is now, sometimes there’s the media likes to portray doom and gloom, you know, and says, Oh, look, there’s a shortage. We are there won’t be any food in the stores and there won’t be any petrol because the shortage of this and this doom and gloom. But when you look at the civilisation as as such, we have moved so far forward, look at the good things that have happened. You know, there’s so many good things happening all the time. And although, OK, my latest challenge, I think I’ve still got another twenty five years to make. What I’m doing now is successful, you know? But it is getting tougher. But I think it will happen because as human beings, we can’t be held back. We have to move forward. That is the whole nature of civilisation as we move forward, you know, and as human beings, I think we’re at the top of our civilisation, at the top of the pyramid, and it’s sort of taking the downward slope. I think we’ll keep on moving forward and upwards that I’m happy, too optimistic to think that. And like every other civilisation, will eventually come down. I don’t think so. I think we are on the up.

[00:34:20] I feel like it’s in you, though it’s not. It’s not. It’s not like a logical thought out thing. It’s just a part of you. Maybe Fran is got her legs on the ground and you’ve got your head in the in the clouds and she keeps you grounded or whatever. But but then she’s also quite a quite an out there thinker, too. You know, it’s it’s it’s remarkable

[00:34:40] The combination of the two of us, you know, one of the things sometimes we ask is, you know, what are the important things in your life? And Mary Fran is probably being probably one of the most important things. And I think the combination of the two of us, you’re right, she does pull me down, not pull me down in the sense that she’s more grounded than me, but between the two of us, we are not afraid of taking challenges. Yeah, definitely. But it’s nice to have someone like Fran who can be more grounded. And just when you think you’re going too far ahead, you know you got pulled back a little and say, No, no, no, just a minute. Yeah, for instance, we might have to move again now, you know, we’ve moved so many times and we’ll probably have to move once again. Yeah, well, not once, but quite a few more times, I think in the next 20 years, but in the short term, we might have to move again now, you know? And Fran is the one who’s saying, Look, if that’s got to be done, you’ve got to be prepared for it, you know, and she’s well, grounded. She brings me down and I said, No, no, no, no, this is going to be huge and this is going to be bigger, you know? But no, you’ve got to be realistic as well. And Fran is the realist in our relationship.

[00:36:06] Yeah, I have. I have. I have Carla and in on the work side, Sanjeet, who does that job for me, for me. But Nick, talk me through the evolution of or lift from you said from the from the pivot appliance, we went to the full denture part. Then you went to London and then for a while, there you. You are picking a full mouth rehabs at new increased dementia, a vertical dimension. That’s right.

[00:36:32] That’s right.

[00:36:33] And then it went to this appliance. Yeah, yeah. Just talk me through that, that sort of evidence.

[00:36:39] So when we move to Whimpered Street and it was basically going to be a dental practise, you know? And eventually the denture patients fizzle down, it’s slowed down a bit. And the PR company I was working with, they said, Can’t you do this for people with their own teeth? And I said, Well, there’s no reason why we shouldn’t be able to do it. It just means it’ll be very invasive. And so I thought to myself, I said, if people have already got a lot of missing teeth, they could make partials at an increased vertical and crown the existing ones. So I said, Yeah, yeah, we can do it, you know? So he got an article published saying that Dr Nick Mahindra can do this Dental facelift technique now for people with their own teeth if if they’ve got more than, I think the press wanted a number, you know, and more than 10 missing teeth or something like that, you know? So that was my road onto full mouth reconstruction. And then I said, Look, if I’m doing this now for people who’ve got their own teeth, why can’t we do a full mouth reconstruction too? So the next stage was people. I had a patient who was a severe class to his class, too. And when you increase their vertical with the pivot of plants, the jaw tends to come forward. So it’s sort of being a class to you now they become class one.

[00:38:11] And then if you could crown those teeth and restore them, they’d remain in class one. So this young girl, she must have been in her 30s. She wanted me to do a full mouth reconstruction at that new vertical, so she wouldn’t have that to the chin anymore. And I said to her, Look, you can do orthodontics and whatnot, you know? And she said, No, I want you to do this. And I was very keen at that time to show that this could be done, you know? So I went ahead and did it. But one of the problems that occurs is that to restore the occlusion to the balance occlusion with canine guidance or something like that is not always possible because sometimes the teeth are half unit, so you can’t get accustomed to foster relationship. So I had to think very hard, should I be doing this? And I said, why not look at if you can teach the patient not to pair a function and look at the number of people that you see in daily life in dentistry who have not got the perfect occlusion and then manage life perfectly normally? And having restored a person to an attractive face from a class two to a class one, I said if I made sure that it didn’t pair a function, it didn’t really matter whether I’ve got the perfect conclusion or not for these people.

[00:39:40] But how did you come across the red lines? You know, because we know that the occlusion is an adaptive thing. We know after Ortho Invisalign, you take these two things out of the mouth and it all jiggles together, right? So we accept that. But there are red lines you can’t cross. How did you? Did you just cross some of those red lines and find out the hard way?

[00:40:01] Yep. Because in those days, you know, this is one of the things about innovation is you can’t go read in a book. No, what’s the next thing to do? So you have to play each moment as it comes and face the challenges. One of the biggest challenge was trying to get technicians to do what I wanted them to do. They were used to doing balance occlusion. And I remember I had a German technician. She was working on a full case for me. And halfway through the case, she says, Nick, your work is giving me so much headaches. I can’t go for it. And in the middle of the case, she stopped and said, I’m not doing anymore. So I had to find another technician who could carry on from there. It was hell. But eventually, what I started noticing was that why am I restoring these people, giving them full mouth reconstruction to improve their looks? And I found that using the pivot appliance alone before doing anything to the teeth was doing that as well. I had a girl come in again in her 30s.

[00:41:12] What do you put that down to? Do you put that down to the muscle fibres, changing direction and and reprogramming reprogramming?

[00:41:22] Now this particular girl, she was a. Suitcases, well, very refrigerated case, and when she came into the surgery, she says, I know what you’re doing, Dr. Mahendra. And I said, What is that? And she says, I always not let my teeth touch. I keep a very big freeway space so that my profile looks better. So I said, Well, if you know that, what do you want me to do? You know, you have achieved what I do. She says, No, no, no, I want you to go ahead. So I said, OK, what I’ll do is this was when I was doing or left. So I said, I’ll give you the little plants and we’ll see what it does for you. And it made her profile look even better. Her features started to look better as well. And then she said to me, No, now I want you to do me full mouth reconstruction of this vertical height. And I realised that this wasn’t quite the right thing to do because of even when you restore them to that height, they forget what they looked like. Then they start functioning and then you get all sorts of problems, you know? So I said to her, No. And for a year, we kept on arguing. I’d say no, and she’d say, no, I understand everything. Just please do it. And after a year, I said to her, OK, I’ll do this for you. But luckily for me, she was great and a mum got ill and she had to go back to Greece. I didn’t have to do that, you know? Yeah, and that was the last full mouth reconstruction that I ever did. After that, it was just a relief because.

[00:43:03] Describe describe for someone who’s never seen it before. What is your lift appliance look like? What’s the process for the patient or for the user now? We’re talking users more than patients. What’s the process? How long does it take or do they go through and what are the benefits?

[00:43:18] All right. The only appliance is really basically the pivot appliance. But remember the pivot appliance? You had to take impressions of the mouth. Send them to the technician. He’d give you a blank plate to fit on the bottom plate. And then you had to build up the pivot hard and then grind down, so you got just one contact.

[00:43:42] It’s quite what a pivot is, as all

[00:43:44] The pivots are two blocks on the side of the pliers added an increased vertical. And we used to use the swallowing technique to determine the vertical height. And so eventually, when the pivot appliance is in the mouth, the only contact that occurs is between the upper molar and the top of the pivot. So you just got one contact on each side. Yeah. There’s no other contact at all. And eventually, we replaced the technicians bit by making the fitting side in a thermoplastic material like, Oh my god.

[00:44:25] So you boil them bite kind of thing.

[00:44:27] Yeah, yeah. So at the moment.

[00:44:30] So how would they work for?

[00:44:32] Well, again, this was a remember for the Dental facelift technique. I used to establish the vertical height. I used to get the patients to wear the pivot applied for 16 hours, 17 hours, even twenty four hours on the densification, the patients because we built the pivot on the dentures and then restore them to that height. So initially I thought, Oh, they must have to wear it for a very long period to be able to get these improvements to the face. And then I had a husband and wife who were having the relief treatment, and the husband was getting a very good result, wearing it for 16 hours or something like that. And the wife wore the plans for one night and then wouldn’t wear it again, she said. It gave me the most severe headache I’ve ever had. You know, I’m not going to be this appliance at all, you know? Yeah. And at that time, my thinking was starting to change because as light with exercise, you know, you don’t have to do too much exercise to get the benefit. So I said to her, how much are you prepared to wear the plants? And she said at the most half an hour a day. And I said, OK, really it half an hour a day and let’s see what results you get. And she got even a better result than her husband. So then I said, if half an hour a day can do it, what is the minimum that a person has to wear it to get these rejuvenating effect? And the conclusion I came to that you only had to wear it every third day, and that is the regime now.

[00:46:11] And we were seeing Nic, we were seeing. I remember looking, I remember having dinner with you and you telling me I’m seeing more than just the facial lines and angles being corrected. I’m seeing just brighter patients, brighter eyes, better skin and all of this. And I remember being sceptical to tell you the truth when you when you first mentioned it. But then I remember running through with you some of your photos of patients, and one thing that you did very, very well was to document with, you know, that everything the same in the right position, the right lighting or everything standardised it was that you were definitely a pioneer in the photography part of it. But I remember I remember reviewing some of the photos with you, some of your longer term patients and literally seeing their skin improve. That’s right. And I remember you saying something about circulation or something, but in a way the way I the way I thought about it, even though I don’t understand this is, you know, in yoga, they talk about gee and energy cycles within a body and so forth. And how in that collapsing facial situation, how that can affect more than just a bone to bone contact and the way the way we’ve talked to think about it, that’s where are you? Where are you now with that? Wait, wait. Well, now we’ve had the third

[00:47:34] Leaders thinking we got I started working with Innovate UK and one of the guys down there put me in touch with the company, a multinational company, and they said they will do the research for me into this clients. And they were going to look at anti-ageing and anti-inflammatory biomarkers that circulate. And I think wearing this appliance for these very short periods will improve your immune system, your anti inflammatory biomarkers, anti ageing biomarkers. All these will improve. What’s the end result of it? Well, there’s more circulation. There’s more growth factors that are repairing the damage done by the ageing process. But not only that, but the posture is improving. The hat goes back on the shoulders, the shoulders go back, tummy gets flatter, so you get a much more vertical posture, which means increased circulation to the head and neck. But all this again needs to be put into to my own way of thinking in the scientific proof.

[00:48:47] Yeah, my my key question is, is it because you want to convince others or is it that you want to find out for yourself? Is it both?

[00:48:55] Well, when you open a new door, right, you go into this through, you find so many more new doors appearing. Yeah. You know, and that is my oh has been my ambition. But I realised that perhaps to achieve that, the commercial side of life has to come into effect as well. You can’t, as a single person, I can’t do the research. Well, what happened with the Innovate UK? Although they, this multinational, said they’ll do the research for me, but the research was going to cost so much that Innovate UK said, Oh no, no, no, we don’t fund research that is done outside the UK. Now this multinational has offices in the UK as well. So that was just an excuse, you know? So I realise now perhaps a little bit late that perhaps this opening up of new doors is too ideological and it’ll happen, but perhaps not in my lifetime. But what I can do in my lifetime is try to make it the if successful and hopefully by making it successful, those those can be opened faster.

[00:50:16] Yeah, yeah. Agreed. I mean, look, Nick, in my world, there’s there’s people selling teeth, whitening lights with non peroxide gels and selling loads of them selling loads and loads of them. Now those those guys I used to, I used to laugh at them and think, you know what, charlatans, but that those guys turned over $100 million last year. Yeah. So now if they if they turn their hundred million dollars in the right direction, yeah, they they might they might actually improve. Like, innovate, actually innovate something. I’m not telling you to do that. I know you would never do that right. But but the two do go hand-in-hand even in universities next year. Funding funding is a massive part of professors lives.

[00:51:06] This is what I’m finding, what I’m finding. This is true nowadays. Research costs so much. Yeah, I said this was the multinational. I mean, I eventually got Oxford University and there was someone in Birmingham University, and she said she’d support me with research grants. So we applied for another research grant. But again then the competition from people looking for research funding is so great that to give that funding to one individual is just a coup in Britain. We are not good at innovation or at least making a very good at innovating, but not making it into a commercial success. It’s the Americans who take the risks. Yeah, and move forward, you know, and wish I’d been in America and I think this would have.

[00:52:03] You’re right. You’re right. In America, there is that culture. In Israel, there is that culture of commercialising breakthroughs. If you like Nick, we ask everyone on this podcast this question, what would you say is your biggest clinical error?

[00:52:21] Biggest critical error, I don’t think. You know, there’s a question of in hindsight, you can go back and say, I wish I had done something differently. Yeah, but I don’t think at the time when I took those decisions, there’s anything that I regret.

[00:52:41] I don’t mean by regret. But you know, you know, you learn a lot by your mistakes in life. And and so, you know, where this question comes from is from a book called Black Box Thinking, which is about plane crashes when a plane crashes, that everyone opens up everything and says, what happened? Not not whose fault was it, but how do we stop this ever happening again? Whereas in medicine, if a mistake happens, everyone covers it up. In essence, because in medicine, we end up pointing the finger at one person or one one thing. And so you don’t learn by my mistakes and I don’t learn by your mistakes because we’re so busy hiding our mistakes. So, so what? The reason for the question is, can we share some errors? We’ve all make their errors.

[00:53:33] Yeah, I think, yeah, this is a difficult one, really. As I say, I hope dentistry is full of errors. You know, I was looking at a case on some forum and they had this 62 year old who had a lateral that was very crooked, you know, it was overcrowded and pushed out of the way. And at 62 years, she comes and looks to have this corrected. Oh, and the discussion was should be veneer. It should be granted. It should be

[00:54:11] Also

[00:54:12] On what should be do orthodontics and everyone saying that. And then so perhaps that is the regret that I do have that instead of just treating the tooth. Why is this 62 year rule at her age suddenly got concerned about this tooth

[00:54:31] Psychologically because he’s got a new boyfriend?

[00:54:34] Yeah. What’s happened to her is she suddenly divorced. Her husband died so she come into money. Oh, what is the reason behind it? And I think I wish I treated people as people rather than looking in their mouths.

[00:54:53] Oh, well, you were very good at that, I seem to remember.

[00:54:56] Well, I think Fran helped me to do that. Know I was a dentist looking in the mouth and was the

[00:55:03] One who was right. That’s right, because she worked with me because often you just by its very nature, you’d attract patients who, I mean, let’s say their problem was as much psychological as it was clinical sometimes. That’s right, the nature of TMJ work tends to be that the nature of West End tends to be that, doesn’t it? You tend to. It tends to funnel the difficult patients into that area. But I remember a huge part of your work was just a psychological part of managing these patients and friends.

[00:55:39] I wish I paid more attention to that, even in the days when I was first had my first practise in South Wales. You know, we must treat people, not the yeah, people as people and not as modes, you know, all over.

[00:55:57] What was your darkest moment?

[00:55:59] Darkest moment?

[00:56:01] No. Difficult to ask an optimist this question?

[00:56:04] Yeah, there’s quite a few that have been. And one was when Ken was about, Oh, he must have been about two and a half, and he was being treated in Great Ormond Street and they were going to get his blood potassium up and they were doing everything they could and they just the pedestrian level would not go up. And you knew by the morning if they had not managed to receive it, you know, then that was even live in the next day. And at about four o’clock in the morning, I remember walking down in the streets of London and saying, Oh, what shall we do now, you know? And I came back at about six and I was waiting in the waiting room. There used to be a little waiting room and suddenly a big. Her, I think, came out of here and surgery. And all the doctors had got his latest reading and finally, they’d managed to get the blood chemistry right. You know, that was probably my one of the darkest moments because I yeah, yeah, probably was.

[00:57:15] Was there more going on in your life that made it dark? You know, obviously sick child on that sort of level would be a dark moment for anyone. But what was happening outside of Kieren during that period where you running around practise and running then?

[00:57:32] Yeah, yeah, I think so. There were lots of things going on in my mind at that time, you know, but probably that was the darkest moment, but they’re always in life. There are times when you think, you know. Yeah, yeah, yeah.

[00:57:51] It’s difficult, difficult asking an optimist about his darkest moment, so. So going forwards, Nick? Yeah. If you had to make a bet. On how? People are going to think about the way they look and feel, because much of what you do is kind of opposite to injections and botox and, you know, obviously facelifts themselves actual surgical procedures. You’re more on this sort of, I would say, contemporary way of thinking about overall health and and balance as opposed to, you know, the way the facial aesthetics is at the moment is, you know, I feel like I would never stick a needle in my face with poison in it. I would never do it. I mean, but but your thing, I might do that. I might. If it’s realigning me, you know, realigning my face, I might do that.

[00:58:48] And I think what I’d like to be able to show is that this can happen so quickly. Yeah. You know, within minutes of wearing the plants, changes start to happen. The posture starts to improves. Growth factors are released. Blood circulation is

[00:59:13] Faces look younger, though, right?

[00:59:15] Yeah, well, we’ve got, you know, we’ve got the 16 year case histories now, Frances, that she’s been using it for, I think, 15 or 16 years. Well. And look at when you look at them now and you look at their age and you say, well, there’s something happening, you know, for that age, for them to be looking so good. Yeah. And I put it down to using this sort of lift, you know, and I think the more we have people using it on a long term basis, not only will they look better, but I think they will also feel better, you know? Did I tell you, perhaps this is something you may not want to include, but recently when I fell down and fractured my skull?

[01:00:06] Yeah, yeah, you did.

[01:00:07] I used the list for its anti-inflammatory effect. If in the end, the healing occurred so fast by me using lower left, but I had to use it for very, very short periods, you know, for about a minute or two at the most, because after that, the increased circulation would make the wound healing more difficult. But I use it, and I’m sure that helped me to recover from that fractured skull within about, I don’t know, a few weeks I was back at work working on the computer again. You know,

[01:00:45] You were so you. I remember when you guys were going to get a stand at the Dental show in Cologne. The ideas? Yeah, I remember the the cold mess people saying, No, this isn’t dentistry. So we can’t we can’t put this into the show. That’s right. And then on the other hand, you must have people in the skincare world and the and whatever Botox while saying, this is dentistry.

[01:01:12] Exactly, exactly.

[01:01:13] Tell me about that. Tell me about the, you know, that tension and and that and now I think, you know, the most interesting idea is you’re going to go direct to consumer with this, right? You don’t have to put it, pigeonhole it into whether it’s skincare, Dental or anything, you’re going for that, right?

[01:01:32] Yeah, I think that is the way. But what’s happened in going direct to the public is we are working on a subscription model, which will be that people have to pay a very minimal amount, but we’ll monitor them over the years. So if they subscribe to us, we will make sure that we look after them for the next year or two years or three years, or however long they want to keep the subscription because this is a long term result that they’re looking for, not just a very quick fix, mind you. Having said that, I’ve seen results after 10 minutes or even after two weeks, which are quite dramatic. So I think commercialising it with a subscription model may prove to be the better way forward. Recently, a lot of appliances have come on the scene, which are supposed to be like exercising appliances. You know, the

[01:02:34] Face angel or something?

[01:02:36] Yeah, yeah. But these can be so dangerous because if your practise and your muscles are already exhausted, the last thing you ought to be doing is making them even worse by chewing on gum or chewing on one of these jaw sizes or the other things. But they have in the public’s eye. They think of the oral gift as another one of these exercise

[01:03:04] Exercise machine

[01:03:05] Appliances, you know? And this is why by making this subscription model, we can educate them as we go along.

[01:03:14] You know, Nick, one thing I’ve noticed is that in the same way as a podcast, find its own audience. Yeah, like me, and you don’t have to sit here and worry about who’s going to listen to this. Yeah, the podcast will find its own audience. It’s just the way it works, you know, but in the same way, a product tends to find its own classification. So and sometimes that classification is different to the one that you put put on it. So, you know, as an example, I could bring out a toothpaste that’s nano hydroxy appetite sensitivity toothpaste. Yeah, that’s that’s what it is in my head. It’s it’s a sensitivity toothpaste. But when it goes into the market, depending on what the market’s, you know, the trends of the market, the people buying it, thinking of it as an enamel regenerator.

[01:04:08] And okay,

[01:04:09] Now I can hit my head on the wall and say, look, on the microscopic level, it doesn’t regenerate enamel. But because there’s this other toothpaste, you know, it’s called regenerate, right? This is not the same ingredient. Same everything. They’re actually saying the market’s now thinking that way. Yeah, right. So now what do I do? Do I do? I switch my marketing towards that because that’s the the current trend? Or do I carry on saying what I’m saying? My point is it doesn’t. I wouldn’t get yourself over bothered with whether or not someone calls this thing an exercise machine or an anti-aging machine or whatever, because the results will speak to the to the individual in their own way.

[01:04:54] That’s right.

[01:04:55] That’s right. For someone who’s never seen these results, you should have a look. Is it or live dot com or is it or Instagram? Where is it? Where can someone see results

[01:05:05] Or live dot com

[01:05:07] Or left? Because we’ve been talking about it because I’ve known Nick for 30. Years or something, 25 years. You know, it just goes without saying for me, but you have to look at some of the before and after the results of the faces and and it’s just very obvious that this is something that we need to look at further. Nick, we tend to end these things with the same question every time. And the question is, you’re on your deathbed. You’ve got your loved ones around you. You only give them three pieces of advice.

[01:05:44] I think the most important advice is follow your gut instinct, you know, follow what you believe in. Usually it is right. It may not be right in this commercial world that we live in, but I don’t think as a human being, you is very difficult to Payman, very difficult. My basic instinct would be to say to anyone is to follow your own instinct and believe in yourself. You know, you are the most important person to you. There’s no one more important than you to you, and therefore you have to believe in yourself and you’ve got to think it out. Be logical, but believe in yourself. That’s one. You don’t have to believe in yourself. Ok, let me put on France head on and be realistic as well. Don’t become too. You know,

[01:06:48] This doesn’t sound like you at Solanki. No, but I think

[01:06:52] You have to. You live in a real world, so you can’t ignore it, you know, and therefore you need to have a friend beside you if you haven’t got a friend besides you, you know.

[01:07:08] Ok? And the third one? The third one. The third one. Follow your heart. Get a Fran. Yeah.

[01:07:15] And the third one is enjoy life.

[01:07:19] Mm-hmm. You know,

[01:07:21] Don’t have regrets. Just enjoy life.

[01:07:24] You know, it’s surprising how few people say that one. I mean, a lot do, but a lot don’t. I think that one for granted. And then these are Prav final questions. He’s not with us, but I would just to just to give him the the bigger. You’ve got one month to go. You’ve got your health, but you know, you’ve got one month to go. What do you do in that month?

[01:07:46] I don’t think I’d do anything different.

[01:07:48] Come off it. I’ll do it. Go, go, go. You got an answer answer.

[01:07:58] I really do. I think if you followed your philosophy of believing in yourself, being a realist and whatnot, I don’t think enjoying your life in one month, you’re not going to change the world but enjoy what you’re doing in that month, you know?

[01:08:17] Yeah. And his final final question is, how would you like to be remembered? What would you like people to say about Nick Mahindra, what was he like? Well, he was what?

[01:08:30] What do I want my grandchildren to think of?

[01:08:34] Well, the well,

[01:08:35] Yeah, obviously it’s got to be on the left

[01:08:42] Side. It’s going to be on the left. I like that, nick that shows some commitment to the to the product. Yeah. Well, it’s been absolutely lovely having you. Yeah. And I’m I’m sure we’ll be seeing each other soon. Hopefully, this lockdown calms down. It’s been a real pleasure. Thank you so much. Bye, Payman.

[01:09:12] This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry.

[01:09:23] Your hosts Payman Langroudi and Prav Solanki.

[01:09:28] Thanks for listening, guys. If you got this far, you must have listened to the whole thing and just a huge thank you both from me and pay for actually sticking through and listening to what we had to say and what our guest has had to say, because I’m assuming you’ve got some value out of it. If you did get some value out of it, think about subscribing and if you would share this with a friend who you think might get some value out of it too. Thank you so, so, so much for listening. Thanks. And don’t forget our six star rating.